SAMPLE Contract with Privacy Policy

Therapy contract and information sheet 

The therapy I offer is integrative, this means that I draw on a range of approaches including person centered, cognitive behavioural therapy and the psychodynamic approach, this allows me to use different approaches to help explore your thoughts, feelings and behaviours in a way that suits you best.

The content and pace of our work together is always driven by you and my approach can be tailored to your needs. As a British Association for Counselling and Psychotherapy (BACP) registered therapist I work within the BACP Ethical Framework, undertake regular supervision and have a commitment to continuous professional development (CPD). 

Duration of therapy 

I can offer a maximum of up to twelve months of therapy as I find that an agreed ending point helps to focus the work and can be more empowering than working open-endedly. Every client is different however, and shorter-term work may well be enough for you. We will explore your goals for therapy when we meet, and I will check in with you regularly on how we feel the work is progressing.

Face to face therapy will take place at The Studio, 6 Horn Lane, London SE10 0RT. Online sessions will be conducted via Microsoft teams.

As the counsellor I agree to:

• start and end our sessions on time 

• maintain safe professional boundaries and confidentiality.

• All information shared during the session will remain strictly confidential, except where there is a legal obligation to disclose, if there is risk of harm to yourself or others or with your explicit consent.

• I may contact your GP if I have serious concerns about your safety.

• As the counsellor I will endeavour to support your mental well-being and personal development, and the sessions do not constitute medical or psychiatric treatment. 

• I will keep brief notes of our sessions together, but these will not contain your name or the names of places or others that you may mention. I may also discuss aspects of our work with my supervisor, but you will not be personally identifiable.

• I may also discuss aspects of our work with my supervisor, but you will not be personally identifiable.

As the client I agree to: 

• To engage with the counselling process with honesty and respect.

• To attend sessions on time and pay the fee on the day of the session via bank transfer.

• To acknowledge that the therapeutic outcomes are dependent on my active participation and commitment to the process.

I am not able to offer an emergency service and contact is limited to the arrangement of meeting times or cancellations. In an emergency, please contact a dedicated 24hr crisis service such as the Samaritans: 

www.samaritans.org.

or

nhs 111

https://www.nhs.uk/nhs-services/mental-health-services/

Data privacy notice and storage,

• I will not share identifying information with any third parties. Contact details, notes from our sessions and attendance records are stored securely (personal details are stored separately from session notes). Email correspondence is password protected and deleted at regular intervals, and session notes will be deleted five years after our work together ends.

• Collection of personal information will include name, contact details, medical and psychological history, GP details, which are necessary to provide an effective counselling service.

• You have the right to request a copy of any data.

• You can request corrections to inaccurate or outdated information.

• In line with General Data Protection Regulations, I am required to inform you about the use and protection of your personal data. I only keep information that you might reasonably expect me to keep for the purposes of our work together:  

Cancellation policy: 

Outside of agreed holiday dates, any cancellations with less than 48hrs notice will be charged in order for me to be able to hold your weekly space open. I will, however, try to re-schedule the missed session for another time if possible.

Data privacy notice and storage,

• I will not share identifying information with any third parties. Contact details, notes from our sessions and attendance records are stored securely (personal details are stored separately from session notes). Email correspondence is password protected and deleted at regular intervals, and session notes will be deleted five years after our work together ends.

• Collection of personal information will include name, contact details, medical and psychological history, GP details, which are necessary to provide an effective counselling service.

• You have the right to request a copy of any data.

• You can request corrections to inaccurate or outdated information.

• In line with General Data Protection Regulations, I am required to inform you about the use and protection of your personal data. I only keep information that you might reasonably expect me to keep for the purposes of our work together: