Contractual Agreement

Agreement between (list all names)______________________________________ (referred to as “you”, “your” and “client”) and _________________ Counsellor, (referred to as “I”, “me”, “my”, “therapist” and “Emma Counselling”).

Aim of Counselling:

The aim of counselling is to provide you, the client, with a confidential opportunity to explore personal and relational issues in safety. The role of Emma Counselling is to help you through this process without judgement or moral bias. I may on occasions give information or offer suggestions. It is unethical, however, for me to make decisions on your behalf. Any decisions you make are wholly your responsibility. During counselling, we may set goals which will be agreed upon between the client and the therapist. The client will do their best to work towards the agreed goals. If at any time I feel I can no longer help you, I will offer to refer you to someone who can.

Description of therapy:

A description of different types of therapy I offer can be found at: emmacounselling.com

Confidentiality:

To ensure open exploration of the concerns that have brought you to therapy, Emma Counselling maintains confidentiality in accordance with the British Association of Counselling and Psychotherapy (BACP) Ethical Framework for Good Practice in Counselling & Psychotherapy (Code of Ethics) – see www.bacp.co.uk.

Exceptions to Confidentiality:

Emma Counselling must pass on any information to the relevant authorities in cases where human safety is concerned including the following cases:

If you threaten harm to yourself or to another person
If we believe a child or protected adult is at risk of harm or abuse
If the courts instruct us to give information
If you share information about a proposed act of terrorism or other illegal act

If Emma Counselling feels that either you or someone else is in danger or at risk of harm I would first endeavour to discuss with you my decision for breaking confidentiality. Depending on the circumstances this may be a doctor, the individual in danger, a Social Worker and/or the Police. However, I retain the right to break confidentiality without prior consultation with you should I consider that the urgency of the situation requires me to act immediately to safeguard the physical safety of yourself or others.

In certain cases, you, the client, may request that Emma Counselling share information concerning you. In these cases, I require written permission from you before I can carry out your request.

Confidentiality for Couples, Families and Groups:

When couples, families or groups meet for relationship counselling at Emma Counselling, sometimes the clients will meet all together for counselling and sometimes they may meet individually with the therapist. When individuals attend counselling sessions the therapist will not reveal any confidential information shared in an individual session with partners, other family or group members involved in relationship counselling without the prior permission of that individual.

Sessions:

Sessions last approximately 60 minutes and will be every week typically on the day and time suitable to you and within my hours of operation (refer to www.emmacounselling.com). It is expected that the session will begin at the agreed time. If you do not arrive or call within 15 minutes of the agreed appointment, this will be considered a cancellation and the therapist will not be available for the remainder of the session.

Contact between sessions:

In instances where you need to contact me between sessions, please leave a message via WhatsApp, Text Message or email. Messages will be responded to as time permits between sessions within normal operating hours.

Emma Counselling is not a crisis or emergency service

If you need to speak to someone immediately, please contact one of the following:

Emergency Services (Police/Ambulance/Fire): Call 112

Suicide hotlines:

SOS Voz Amiga: 0800 202 669
SOS Line Student: 808 200 204 969 554 545

If you or anyone you know is at risk of domestic violence, you can contact the following:

Portuguese Victim Support Association (APAV) for free legal advice and for support: 707 200 077
24/7 Domestic Abuse Hotline SOS Mulher (anonymous and free of charge): 800 202 148
Child abuse hotline (SOS Crianca): 800 202 651
Call 112 if you need emergency assistance

Cancellations:

Cancellations fees are charged for cancellations of in-person, in office sessions, made less than 48 hours prior to the session.

I will always offer a video call session as an alternative if a client cannot make a pre-booked in-person session, but if the session has to be cancelled the cancellation may be subject to fees according to the following:

- Cancellations of In-Person sessions made 48 hours or less before an appointment will be subject to a booking fee of €30.

- Cancellations of In-Person sessions made 24 hours or less will be subject to a fee equivalent to the In-Person session fee.

Cancellations made via text, via the website contact form or via email to emmaiacono@gmail.com sooner than 48 hours will be processed without penalty.

Number of Sessions:

Emma Counselling asks that you commit to 4 sessions before realistically evaluating the effectiveness of therapy.

I understand that your life circumstances may suddenly change. You may at any point desire or be obligated to discontinue therapy. Whatever the reason, I respect your decision but ask that you give one week’s notice before finishing so that we have the chance to discuss your decision.

Session Fees:

Fees are reviewed yearly and any changes take effect on 1st January and apply to new or renewed contracts.

Complaints:

Should you wish to make a complaint about the service you have been offered please contact: emmacounselling1755@gmail.com

I, Print Name............................................................... Name ..........................................................................., hereby agree to receive counselling provided by Emma Counselling

Signed.................................................................................... Signed................................................................................................... Date....................................................................................... Date.........................................................................................................

How did you hear about Emma Counselling (tick box)? □ Internet Search □ Friend □ Advert □Other ........................... Telephone........................................................................... Mobile...................................................................................................

Email......................................................................................................

Doctor's name(s).............................................................................................................................................................................................

Goals for therapy.................................................................................................................................................................................... ..................................................................................................................................................................................................................... .....................................................................................................................................................................................................................

Therapist Signature....................................................................................................................................