Therapy Contract of Agreement
This contract of agreement states the terms and conditions set out between the therapist and client when a treatment plan is devised and goes ahead. It allows for a clear and mutual understanding about the dynamics of the therapy session logistics, the expectations from both parties, in addition to other information that demonstrates to the client how their data is protected and stored.
This contract will be given to clients on their first appointment to sign.
Therapist: | Enlighten Your Mind Therapy (Clare Cavalli) and… |
Client name: | |
Contact number(s): | |
Email address: | |
Date: | Signed by client: ................................................................... |
| Signed by therapist: .............................................................. |
I Clare Cavalli agree to the following when working with you, my client:
I will abide by the regulations stipulated under the ICO guidelines when storing and protecting your data for GDPR purposes.
No information will be shared with other parties, unless it is deemed necessary in relation to safeguarding you or other people around you, or if I need to talk to my supervisor. I will ask your permission to share your case notes, but your identity will be kept confidential at all times.
My client has the right to request seeing their records at any point in the future and all the information I record about their treatment. (In line with GDPR regulations, your details will be kept for 7 years. They will be stored away safely under ‘lock and key’ during this time.)
All of your data is stored safely and securely and no consultation notes or treatment plans are ever kept together to ensure the strict confidentiality is adhered to.
I will work to the highest standards and code of ethics under the APHP and NRPC guidelines in relation to Professionalism and Integrity including:
Comprehensive training in order to provide a high level of service to my clients, inclusive of having regular supervision
Maintaining strict confidentiality within the therapeutic relationship consistent with the good care of the client and the laws of the land and ensure that any client notes and records be kept secure and confidential.
Never promise a cure for any condition or problem, nor give advice or otherwise pass comment on any medical, psychiatric, or psychological problem or condition unless they have training and qualifications in these fields
The APHP (The Association for Professional Hypnosis and Psychotherapy) Code of Ethics list can be found here (click on image):
6. I will conduct therapy sessions at the agreed time and location, either face-to-face or on Zoom.
A reminder message will be sent to my client using their chosen method of communication e.g.,
email or text 24 hours before their appointment.
7. Once you have a clear understanding about how hypnotherapy works and how sessions will be
conducted, I will ask you to sign this agreement which forms part of your consent in order for me
to provide you with a tailored treatment plan.
8. If I feel that you require a specialist to help you with your treatment during our sessions, I will
make you aware of this explaining the reason for this fully. The specialist maybe another
hypnotherapist, healthcare professional or medical care for example.
I ………………………………………………. (client) agree to the following when working with you, my therapist (Clare Cavalli):
1. I agree to do any work that is required in between sessions in order for me to gain the most out of
my treatment.
2. I will inform you if I am currently seeing another therapist for treatment. (This is important as
you will need to ask their permission to have hypnotherapy, to ensure it does not conflict with
your results.)
3. I will give you at least 24 hours’ notice if I need to cancel or reschedule my appointment and I
understand that if I do not turn up for my appointment, I will lose my deposit and am responsible
for contacting you to book another one.
4. I understand that if I am running late for my appointment, I may have to wait for an alternative
date and time and I am responsible for contacting you to book another one.
5. I will commit to my healing journey with you my therapist and abide by the guidance you give me
in between sessions in order to achieve my goal(s).
6. I will seek medical advice if asked in order to proceed with any treatment.
7. I am aware that my own success is not guaranteed and is down to me following Clare’s guidance.
ADDITIONAL INFORMATION
Therapy fees are charged at £70 per hour.
Full payment of the session will be required on the day of your appointment. I accept bank transfer or cash.
Therapy sessions conducted face to face will require a deposit of £20 48 hours before your appointment and the remainder paid on the day.
Therapy sessions conducted on Zoom will require a deposit of £20 24 hours before your appointment and the remainder paid on the day.
I adhere to a time schedule in order to provide the best service for my client’s, so please ensure you turn up to your appointment on time.
When listening to any MP3 recordings in between or after sessions, please ensure you are not driving, operating machinery or doing anything that requires your full focus and attention. Recordings must never be distributed or sold to other parties under any circumstances.
The terms and conditions have been provided in order to establish clear boundaries, expectations and a mutual agreement between the therapist and client.
DISCLAIMER:
Hypnotherapy is a complementary form of therapy and is not in any way provided as a solution to resolve medical based issues. Hypnotherapy is not a ‘cure’ for any illnesses and cannot be used as a form of substitution with medical treatment. Where necessary permission from the client’s GP will be sought before hypnotherapy can commence.
Its effectiveness includes the commitment of the client following the advice given by Clare Cavalli at Enlighten Your Mind Therapy, including (but not exclusively) to listening to recordings for example in between sessions. The number of sessions required will vary from client to client, so an estimation will be given according to the information provided during their treatment by the client. On occasions clients bring up information they had forgotten about, a number of sessions in their treatment, so this may require additional sessions, but Clare will bring this up where necessary.
Clients are individuals with their own unique challenges and Clare is committed to providing the best and most professional service during their treatment; she is a professionally trained and qualified practitioner. Hypnotherapy is by no means ‘magic’ and results will vary from person to person. Therefore, a willingness and openness to change should be present.
Should a client present symptom of psychosis or any other psychiatric conditions, then Clare will have the right to refuse treatment, as hypnosis is not recommended for those experiencing such mental disorders. If this situation arises Clare will advise her client to seek medical advice from their GP. This forms part of Clare upholding the integrity and responsibility of ensuring her clients have the right help and that their wellbeing is of the upmost importance.