Agreement and Contract
Professional Services Agreement: Counselling, Psychotherapeutic
Counselling and Coaching
Welcome
Our professional relationship aims to provide non-judgmental, empathic,
and confidential co-created space in which you can explore the concerns
that matter to you. I will adhere to ethical standards and work within the
limit of my competence. I will listen to you, intend to understand your
experience and use interventions; questions, curiosity, reflections, and
challenges wherever it is appropriate.
Please read this agreement/Contract Sheet and email me if you have any
concerns or questions on this.
You may confirm your agreement by signing below, by email, or verbally
during a session.
Sessions
Our professional relationship aims to provide non-judgmental, empathic,
and confidential co-created space in which you can explore the concerns
that matter to you. I will adhere to ethical standards and work within the
limit of my competence. I will listen to you, intend to understand your
experience and use interventions; questions, curiosity, reflections, and
challenges wherever it is appropriate.
Please read this agreement/Contract Sheet and email me if you have any
concerns or questions on this.
You may confirm your agreement by signing below, by email, or verbally
during a session.
Payment
Each session is £xx.xx Payment is made before the session via banktransfer. Advance notice of any increase in fees is given through email andopportunity to discuss if any concerns or struggle.
Cancellations
If the Client has to cancel a session, then 48 hours’ notice must be givenby email or text message. Cancellations with less than 48 hours’ notice willbe classified as a ‘no show’ and the £xx.xx fee for the session is stillcharged. This fee is paid before the next session via bank transfer.If the Client is not available within 20 minutes of the session startingwithout prior notice (either does not arrive at the office or is not online)then I may terminate the session. In this instance, the session is classifiedas a “no show” and the session fee is still charged. The Client is responsiblefor paying for this missed session.I will give the Client as much notice as possible of any personalcircumstances that prevent them from being available for the scheduledsession.
Confidentiality
What is discussed during the session is confidential to create a safe place
for the Client.
The only exception of breaking confidentiality is in situations where
disclosure is required by law. This includes risk of harm to self or others or
legal requirement (e.g. protection of children or prevention of terrorism).
If necessary, other services/agencies may also be contacted. In most
cases, the Client will also be aware of this break in confidentiality in
advance. This breach of confidentiality is always in the best interest of the
Client’s safety.
For safeguarding purposes, please fill out your GP contact details below:
GP surgery and name of GP (if known):
Address:
Phone number:
As a Registered Member of the BACP (British Association for Counselling
and Psychotherapy), I adhere to its Code of Ethics and Good Practice of
Counselling and Psychotherapy. I undertake Clinical Supervision on a
monthly basis as it’s my responsibility to work under regular supervision
which provides emotional and practical support. As a consequence, I
discuss content from sessions with my supervisor to ensure the best
possible service for the Client/s. The discussion between Supervisor and I
is professional and confidential.
The General Data Protection Regulation (GDPR)
The Counsellor has a legal obligation to write notes after each session,
which cover the main themes of the session and any actions taken. Session
notes are kept in secure locked cabinet which only I have access to. Adult
counselling and psychotherapy notes are normally held securely for seven
years after the professional relationship ends. The Client can ask to have
a copy of these session notes at any time. More information about the
collection and storage of personal information can be found in the Privacy
Policy.
Social Media:
To protect confidentiality and professional boundaries, there won’t be any
communication through social media. Please use email, text or what’s app
messaging for communicating about work.
Nature of the service:
Nature of the service be described as counselling, psychotherapeutic
counselling or coaching depending on what we contract or agree on, your
location as well as any relevant legal, regulatory professional or insurance
consideration.
Online sessions
Sessions online will be via the Zoom video platform or agreed platform.
Please be ready for the online session at the time agreed. If the Client is
not online (in the Zoom waiting room) at the session time, I will send an
email or text message reminder. The Counsellor intends to be online at the
agreed session time.
To ensure confidentiality, the Client should try to log in from a quiet and
private environment. I will be running the session from a safe, private
space where no-one else can overhear the conversation. The Client may
like to have a glass of water and some tissues nearby. After the session
has ended, the Client should ensure all internet pages that relate to the
session are closed to maintain their privacy.
Although Zoom has the facility to record sessions, this feature will not be
used by either the Client or me unless they have discussed this previously.
Interruptions may happen during online sessions and both the Client and I
will be active in trying to minimise this. If a session is affected by
technology problems that make it difficult to communicate, the Client and
I should both try to trouble shoot this together. If this does not work, the
I will call the Client and continue the session by phone. If the Client feels
there has been significant disruption to the session, please discuss this with
the Counsellor and the session will be re-scheduled.
In Person session
There is visitor parking available near premises please allow enough time
to park. Please attend on time as I might be in the session with my client
online or in person, I might be not able to answer the door if it is earlier.
Agreement:
I have read the above and hereby agree to abide by the terms and
conditions of this agreement.
This contract is between xxxxxxx (“the Client”) and xxxxxxxxx
(“Psychotherapeutic Counsellor or Coach”).
This is a mutual agreement negotiated between the Counsellor/Coach and
Client prior to the start of counselling or coaching. It states the
responsibilities of the Counsellor/Coach and Client in the context of the
therapeutic/coaching relationship
Client Name:
Client Signature: (a typed signature is acceptable):
Date:
Counsellor/Coach Signature: xxxxxxxxxxxxxx Date: xx/xx/xx
Where agreement is given by email or verbally, Wajda Tabassum will
retain a dated record of that agreement.
Payments:
Payment can be made via bank transfer, or payment method agreed. If
you need invoice/s please request by emailing me.
Bank details:
Bank Name: xxxxx
Account name: xxxxxxx
Sort code: xx-xx-xx
Account no: xxxxxxxx
Reference: xxxxxxx
Concerns and complaints:
If there is any concern please contact me directly so that we can discuss
it and if possible, resolve it together.
(BACP Privacy and data protection)
BACP ethical framework link
Governing Law:
If there is any concern please contact me directly so that we can discuss
it and if possible, resolve it together.
(BACP Privacy and data protection)
BACP ethical framework link
Contact Details:
Wajda Tabassum, Wajda Tabassum Counselling
Email: wajdacounsellingandcoaching@gmail.com
Tel: 0044-7506 166508