INDIVIDUAL LETTER OF AGREEMENT
Welcome. We are pleased that you have selected your therapist from “Turning Points” Counselling Center. We hope your time here is worthwhile. We are giving you this document to disclose important information about 1) the background(s) of the therapist(s) associated with “Turning Points”; 2) the nature of our professional relationship; such as, what to expect from out meetings and how we should work together; and 3) some of the procedures and financial policies of “Turning Points” Counselling Centre. Please go over this carefully. This disclosure statement should answer many questions you may have, but feel free to ask about anything whenever you have questions.
At the end of this letter is a place for us to sign our names. Signing means we agree with all the points in this letter. However, before signing, we think it’s important to share some of our ideas about therapy and the counselling process; and to explain what we feel generally is the way we can best work together.
We believe successful counselling and/or therapy depends on your active involvement and effort to make changes in the areas you want to change. Therefore, we believe it is extremely important to identify goals for our work together, and that we monitor your progress towards these goals. We can review these goals as we go along, and we can change them anytime we want if, together, it seems like a good idea. Change is often difficult, slow, and painstaking, and while part of our job is to support you in that process, we cannot “fix” your problems or offer you instant solutions. Instead we offer support through what changes you wish to make, and suggestions about ways to do this. Frequently we also include suggestions for activities outside of our sessions, such as journaling, reading books, attending support groups, or various other therapeutic tasks. Finally, we share a strong belief that people have inner resources for healing, and our philosophy of therapy focuses on creating a safe and honest relationship in which you can discover your own inner resources, abilities, and direction.
The professionals associated with “Turning Points” are influenced by diverse philosophical backgrounds and treatment strategies. Generally, the treatment approaches offered are closely related to the ideas of Milton H. Erickson, MD and the professionals he influenced. Our practice has focused on working with particular areas in which we have done a great deal of research and training.
Whenever you decide to make changes in your life, there are benefits and costs. Oftentimes, people who enter counselling in a serious way experience strong feelings, which may be uncomfortable or even frightening, because people are often unused to experiencing intense feelings. We will nonetheless be actively engaged in helping you find safe and appropriate ways to express, release, and cope with these feelings. It is possible you may also experience difficulties in your relationships. Often when you change, this necessitates changes in your relationships which others in your life may or may not appreciate or have difficulty with. At times things may seem to get worse initially, and it is important for you to know that we will not decide for you how to handle these issues, but again, we will actively support you in sorting through them and clarifying your own values and goals as we go along. Before we proceed with therapy, we will discuss probable length of treatment, costs, as well as, risks and benefits so that we can develop a realistic set of goals which we can continue to re-evaluate and/or revise as needed. Now, let’s review what we both need to understand to make our meetings worthwhile.
SEEING YOUR DOCTOR
Ideally, we recommend that you get a medical examination from your personal/family physician, especially if you have not had one recently. This is important to make sure that none of the problems to be discussed are the result of physical health difficulties. Because we are not physicians, we cannot know if you have medical conditions that might be related to our work. If you wish for us to be in contact with your physician about our work, we can establish contact with your physician to exchange appropriate information or we can write to them from time to time to describe your progress. Since these letters might be included in your medical records, you may be given the opportunity to review any material before it is sent. That way, any possible corrections, additions, or deletions that you wish can be made before being sent.
APPOINTMENTS: TIME & LENGTH OF SESSIONS
We believe our counselling sessions work best when scheduled regularly. Generally, appointments for individual counselling or therapy are scheduled to last 45-50 minutes. Occasionally, if we both agree, we can work in shorter or extended time periods. Whatever is agreed upon, we will strive to make the best use of our time together, and that often means planning and preparing ahead, so we emphasise the importance of the time we have reserved to work together.
Usually we begin promptly at the scheduled time. If we are late we’ll try to let you know in advance, even if the delay is just a few minutes. If we cause a late start, we will still be together for our scheduled time. Also, be aware that if you arrive late for a session, we will continue only until the end of the scheduled session, and the charge for these meetings will be for the full amount. You will not be charged for a session if you cannot keep it and contact our office at least 24 hours in advance. However, if you fail to keep a scheduled appointment or do not notify us 24 hours ahead of time of any cancellations, you will be charged for the time and service reserved.
STOPPING OUR SESSIONS
We believe closure to therapy, or termination of counselling works best when we agree together that it is time for our counselling to end and our therapy to stop. We suggest two basic ways to do this. We can specify as we get started the length or general time frame of our work together, so that we know in advance when the last session will be. Then, when the time comes, we will stop, unless we make a new agreement with a new set of goals. Another way we might stop is decide as we go along. From time to time, where appropriate we can make adjustments, develop different goals, or stop. We might decide together to stop because we have reached our goals. Or we might decide we are not going to reach them. This is a possibility, because we cannot guarantee that we will reach all of the goals we establish together. You may discontinue counselling or therapy at any time, for any reason. We’d prefer, especially if we do not agree, that you attend to one final session so we can review our work together and also discuss your future plans. If you stop coming without letting us know in advance, we cannot make recommendations or offer you other alternatives; nor can we assume responsibility for your care and well-being after that.
FEES: COST & METHODS OF PAYMENT
Our fees vary according to the type of service (individual therapy, marital therapy, family therapy, group therapy, etc.) and the length of each session. The fees for distance therapy or tele consultations is the same as face-to-face sessions. The initial consultation or diagnostic assessment fee for new clients seeking any direct counselling or therapy service offered by “Turning Points” is $175.00 (usually 60-75 minutes). The rate for subsequent individual sessions lasting 50 minutes is $150.00. If we agree in advance to have sessions shorter or longer than the standard 50 minute hour, the charge will be based on the amount of time we are together. For example, if you have a 20-50 minute consultation, the charge will be $120.00. Concession rates for each of these individual services is also available with proper documentation. Our family therapy rates are $200 per hour. Couples/Marital therapy rates are $175.00. (Please note that Medicare does not reimburse for this service). Group Therapy rates for a 75-80 minute group session is $75.00.
You may pay by cash; EFPOS; or most credit cards. Payment for consultations are requested 24hrs prior to your session and also serves as a confirmation of your scheduled appointment. Medicare rebates will be process at the conclusion of each session; and consultations funded by EAP/insurance funders will be invoiced on the date of service. Any balance older than 30 days may be subject to a 1.5% monthly finance charge (18% APR).
Medicare or your EAP provider may help to pay for this treatment. As a service, we are willing to coordinate with your EAP provider for reimbursement guidelines for these services. Ultimately however, it is primarily your responsibility to resolve any differences that may arise with your health fund EAP provider or Medicare.
“Turning Points” uses an automated answering system to manage both normal business and emergencies. Our contact number is 0488 969 687. Your call may not answered directly due to our being in session or other reasons. Please leave a message or we will be unable to return your call and assist you. We ask that you only call us after hours for emergency or crisis which cannot wait to be dealt with until our next planned session. In most emergency situations we will be able to respond to your call promptly. If we are away from town or otherwise unavailable during vacations or professional meetings, other arrangements will be made to ensure access to us or another qualified professional in the area. In the unfortunate event of a true psychiatric emergency or crisis when you feel the need for help and cannot reach us or the designated professional, please contact your personal/family doctor, or proceed to the nearest Emergency Room.
Our profession(s) and our professional ethics require us to keep everything you discuss with us in the strictest of confidence. We have no intention of giving information about you to anyone unless you ask us to and sign a “Release of Information“ specifying the nature of the information to be given to the specific person or agency. We have no objection however, for you to reveal anything you want to anyone you want about our meetings.
We are required to keep written record of our contacts. These notes are primarily for our use, and are used to help us in sticking to our goals. These notes are confidential, but as they are about you and our work together, you may request to have a copy made at a nominal fee.
There are a few exceptions to the principle of confidentiality which we would like to bring to your attention. These apply to all mental health professionals in this state. If you indicate to us convincingly that you seriously intend to harm yourself or someone else, we are required to take action to prevent that harm from occurring, including alerting the authorities and/or the person(s) being threatened. We are also required to report any suspected child or elder abuse. In some rare circumstances, we could be called upon (subpoenaed) to testify about you in court. This could happen if there was reason to believe we know of certain types of criminal wrongdoing. If the law ever required us to do this, we would try to discuss with you beforehand any testimony we might be compelled to present. Again, the likelihood of any of this happening is very rare, but we believe you deserve to be informed of the possibility.
CLARIFICATION OF RELATIONSHIPS
Because of the importance of the counselling or therapeutic relationship, it is important to understand there will be limitations on the other types of relationship we may have. All professions agree that under no circumstances will we ever engage with you in a romantic or sexual way. However, not all professional disciplines agree on the nature of dual relationships, especially in rural areas. Generally, we believe both parties are better served when dual relationships can be avoided. While we may come to care a great deal about each other, socialising will be discouraged in favour of staying focused on your concerns and goals. We would be glad to discuss your feelings about this at any time, but want you to be clear from the start, that entering into this professional relationship together may limit the possibilities for other types of relationships.
The intention behind this document is to convey the idea that you are the boss, and we are working in your interests. You can determine what your goals are, and our role is to help you reach them. We may help you to define your goals or discuss with you what the consequences of reaching these goals might be, but you have the last word on this. At the end of this letter, there is a place where you can list the goals we hope to achieve in our work together. We both agree they can be amended or changed at any time, however, if we change goals, we also agree to restate them and clearly document these changes accordingly.
We the undersigned have read this statement, understand it, and agree with its terms. We agree to comply with all the points in this letter on our personal and professional honour. It is understood that our relationship may be discontinued whenever these terms are not fulfilled by either of us. Upon signing and dating of this agreement, a copy will be provided for you and the original copy will be retained for your record.
Client Signature: Date:
Counsellor/Therapist Signature: Date: