Contract Information:

Counselling is a specific type of helping relationship that helps you to change what can be changed or accept the things that can’t be changed.

Counselling is confidential the only reason I would break confidentiality is If you are at risk to others or yourself or if there is a disclosure of abuse concerning a child or vulnerable adult.

I will talk about our work together in my supervision & your privacy will be always maintained.

For young people I may need to talk to your parent/s & if this is the case, I will discuss this with you first.

If you would like to add anything to this agreement I am happy to discuss this with you.

Each session will last for 40 minutes if video or telephone & 50 minutes for Face to Face sessions. I also offer 30 minute video or telephone sessions. There is no limit to the number of sessions, but I like to review every 6 weeks to make sure you are getting something from it.

If an appointment needs to be cancelled for any reason, I need at least 24 hours’ notice, or you will be charged for this appointment.

I would like some form of contact details from you in order for me to contact you in confidence.

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I understand that the service provided by affinitykcounselling.com is not intended for crisis situations or urgent needs.

In a crisis situation, please call local emergency services. Samaritans 116 123

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I am a member National Counselling & Psychotherapy Society & adhere to the NCPS ethical framework for good practise. Accredited Member MEMBERSHIP NO: NCPS21-02832

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Telephone & Video Counselling Contract

About Person Centred Counselling and how we will work together

The aim of counselling is to provide you the client with a confidential opportunity to explore personal issues in safety with support and guidance.

 

I am here to help you through this process without judgement in a non-directive way, not offering advice, but exploring with you, and facilitating an understanding your needs.

 

The Sessions are offered over a short or long period, dependent on your needs, issues and your progress. For therapy to be most successful, you need to work on things that we explore during our sessions and at home.

 

I may occasionally offer suggestions or offer information.  I may offer to refer you if I feel that I can no longer offer you the support you need based on your needs. 

 

Telephone/Video Counselling and how we will work.

You have requested Telephone/Video counselling which will take place during mutually agreed times and dates, over the telephone. You have agreed for me to hold your personal information and client confidential notes, compliant with the General Data Protection Regulations UK. 

 

I have agreed to offer you telephone counselling/ emotional support in the form of Person-Centred Counselling/.  You need to return the completed initial risk assessment & contract to me prior to our first session. 

 

Confidentiality

I will always maintain confidentiality in accordance with the National Counselling Society Ethical Framework for Good Practice in Counselling & Psychotherapy (Code of Ethics) – see. https://nationalcounsellingsociety.org/

 

I will agree not to share with any third party and social media the contents of our emails/communication. 

 

I may need to pass on any information to the relevant authorities in cases where the following may be present; If you threaten to harm yourself or to harm others, If the courts instruct me to

give information, or if you share information about a proposed act of terrorism or other illegal act.  For security reasons I will ensure that all data is stored on an external hard drive, which will be under lock and key, encrypted word documents, and the use of specific client codes/references to comply with the General Data Protection Regulations. 

 

 

Exceptions to Confidentiality

 

I may need to pass on any information to the relevant authorities in cases where the following may be present.

 

• If you threaten to harm yourself or to harm others

• If the courts instruct me to give information

• If you share information about a proposed act of terrorism or other illegal act

 

GDPR - General Data Protection Regulation

 

The work we cover together is confidential and I will abide with the GDPR guidelines.

 

Therapist Contact between Sessions

 

You can text or email me between sessions for any concerns or to rearrange the planned appointment. I am not always able to answer the phone, so please contact me by text. I will respond within 48 hours.

 

Telephone contact: 07306248844

Email: karinakam60@gmail.com

 

Emergency contacts  

 

In the case of an emergency or crisis where you feel that you need to speak to someone or considering self-harming, you are advised to contact either.

 

• G.P.

• A&E

• Samaritans Tel: 116 123 https://www.samaritans.org/

 

Session Fees and Payment

Fees:

£45.00 per 50-minute Face to Face session

£35.00 per 40-minute Video call session

£35.00 per 40-minute Telephone session

£30.00 per 30-minute video or telephone session

 

PLEASE NOTE: WE CANNOT BEGIN COUNSELLING UNTIL THIS AGREEMENT HAS BEEN READ AND COMPLETED BY THE CLIENT, AND ALSO SIGNED BY THE THERAPIST.

 

 THIS IS A CONFIRMATION THAT I HAVE READ AND UNDERSTOOD AND AGREE TO ALL TERMS AND CONDITIONS. 

 

I agree to receive Telephone/Video Person Centred Counselling provided by Karina Kaminski (AffinityKCounselling) and give consent for processing my data according to the GDPR UK and the NCS.

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Client Email address:

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Client GP & Phone No: 

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Client Emergency Contact No:

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Client Signature

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Therapist Signature: Karina Kaminski

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