Therapy Agreement
Service: Psychological therapy is not easily described in general statements. It varies depending on the personalities of the psychologist and patient, and the particular problems you bring forward. There are many different methods we may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. For the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home.
Appointments and fees: We normally conduct therapy that will last from 4 to 5 sessions. the therapy is usually scheduled as one 50-minute session (one appointment of 50 minutes) per week at a time we agree on. You should notify in advance if you wish to cancel a session and postpone it.
You will be expected to pay for each session before the session. Our hourly fee is will be based on your therapist selection. In addition to weekly appointments, we charge the same amount for other professional services you may need.
Risks and benefits: Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have benefits for people who go through it.
Clinical records: The laws and standards of our profession require that we keep treatment records. You are entitled to receive a copy of your records, or we can prepare a summary for you instead. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. If you wish to see your records, we recommend that you review them in the respective therapist's presence so that we can discuss the contents.
Minor clients: If you are under eighteen years of age, please be aware that the law may provide your parents with the right to examine your treatment records. It is our policy to request an agreement from parents that they agree to give up access to your records. If they agree, we will provide them only with general information about our work together, unless we feel there is a high risk that you will seriously harm yourself or someone else. In this case, we will notify them of my concern. we will also provide them with a summary of your treatment when it is complete. Before giving them any information, we will discuss the matter with you. If possible, we will do our best to handle any objections you may have to what we have prepared to discuss.
Confidentiality: In general, the privacy of all communications between a client and a therapist is protected by law, and the therapist can only release information about work to others with your written permission.
There are some situations in which we are legally obligated to take action to protect others from harm. For example, if we believe that a child [elderly person, or disabled person] is being abused, we must [may be required to] file a report with the appropriate state agency.
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If we believe that a patient is threatening serious bodily harm to another, we are [may be] required to take protective actions. These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the patient. If the patient threatens to harm himself/herself, we may be obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection.
We may occasionally find it helpful to consult other professionals about a case. During a consultation, we make every effort to avoid revealing the identity of the patient. The consultant is also legally bound to keep the information confidential. If you don’t object, We will not tell you about these consultations unless we feel that it is important to our work together.
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My signature signifies my understanding of, and agreement with, the above statements and I hereby consent to participate in services as specified above. I understand that I may discuss any questions I have about this information with Koot Wellness PVT. LTD.