1. Introduction
It is a mutual agreement between APF Wellness represented by the Therapist and the Client before the commencement of therapy. It outlines the Therapist’s responsibilities towards the Client and the Client’s obligations in the Therapy relationship.
The APF Wellness is a trading name of APF Business Ltd, Companies House number: 8832114. Registered address: 72 Hopwood Road, Middleton, M24 6HY
The Therapist
Full name: ………………………………………………………………………………………………………………………
Phone number: ………………………………………………………………………………………………………………………
Email address: ………………………………………………………………………………………………………………………
Website: ………………………………………………………………………………………………………………………
Address: ………………………………………………………………………………………………………………………
The Client
Full name: ………………………………………………………………………………………………………………………
Date of birth: ………………………………… Phone number: ……………………………………..……
Email address: ………………………………………………………………………………………………………………………
Address: ………………………………………………………………………………………………………………………
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The Client’s emergency contact details:
Full name: ………………………………………………………………………………………………………………………
Phone number: ………………………………………………………………………………………………………………………
The Client’s GP contact details:
Name of GP practice: ………………………………………………………………………………………………………………………
Address of GP practice: ………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
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Name of GP: ………………………………………………………………………………………………………………………
2. Duration of therapy
The total number of therapy sessions will depend on the nature of the problem and the agreed therapy plan but will usually involve between four and twenty individual appointments.
3. Sessions
Sessions last for 60 minutes. The Client would usually meet with the Therapist once a week, at the agreed time and day. The whole session time belongs to the Client, whether he/she chooses to attend or not, and the Therapist will be present for the entire session. If the Client arrives partway through your allotted time, the Therapist will see the Client for the remainder of the time. If the Client’s circumstances change and the session time is no longer suitable, the Therapist will do their best to accommodate this and offer an alternative time. Therapies are for individuals only; no other person will be permitted in the therapy room at any time or for any reason. The only exceptions to this are family therapy, mediation, and relationship/couples’ therapy.
Sessions online
Online therapy is delivered either by video, voice, and instant messaging. Video, voice, and chat are delivered via Zoom online platform. Video and voice sessions are never recorded, and the content of instant messaging sessions, deleted.
- It is recommended for the online session to use a safe device and where confidentiality can be ensured. Ensure to exit all online therapy sessions fully. It is advisable to delete browsing history after communication if the device is shared with somebody else.
- The environment chosen for the online session must allow for the physical and emotional safety and privacy of the Client. These steps help to ensure the therapy session remains confidential.
- In case of technical difficulties during the session, the Therapist will endeavour to contact you on your phone number straight away and try to reconnect online within 10 minutes. If after 10 minutes it is still not possible to connect back, the remaining time of the session will be rescheduled free of charge. Please note, the Therapist will never intentionally end a session prematurely.
- Online therapy is not appropriate if the Client is experiencing a crisis or having suicidal or homicidal thoughts. If a life-threatening situation should occur, the Client agrees to contact a crisis helpline, call 999, go to a hospital A&E department, or go to appropriate services if you are overseas.
4. Commitment
A course of therapy requires a commitment from both the Therapist and the Client, so it is essential there is a clear policy on cancellation of appointments.
Therapy can sometimes be very demanding, frustrating, emotional, and there can be a natural reluctance to attend. A firm commitment is needed to attend regularly and keep absences to a minimum. Too many gaps will slow down the progress of therapy work.
The Therapist commits to:
- Provide the Client with a dedicated time slot each week
- Give at least two weeks’ notice of any scheduled cancellations, for example, if the Therapist will be away, and as much notice as possible in the event of an unscheduled cancellation, for example, if the Therapist is unwell. All such cancellations will not be charged.
The Client is asked to commit to:
- At least four sessions to allow realistic effectiveness evaluation of therapy.
- Attend booked sessions on-time
5. Confidentiality, supervision and note-keeping
It is a very important aspect of the therapeutic relationship. Everything that is discussed with the Therapist in the therapy session is kept in the strictest confidence.
As a member of their respective professional organisations, the Therapist must have regular supervision and discuss their work from time to time with their supervisor. However, the Therapist will not disclose the Client’s name or anything to identify the Client. Any information that a supervisor receives is confidential and subject to the same ethical criteria as therapy. If a local GP is treating the Client for emotional difficulties, the Client should inform the GP about the Therapist and vice versa. The Therapist will not confer with the GP without the Client’s knowledge and permission.
The Therapist may keep brief notes after a session that will be securely stored. Occasionally they might want to make an audio recording of the therapy session to monitor their work, but this would only occur with the Client prior knowledge and permission. Again, these data are securely stored and destroyed after use.
6. Exceptions to Confidentiality
There are situations in which the Therapist can break confidentiality without your consent:
- Where the Client permits for information to be shared.
- Where a court of law compels the Therapist.
- Where the information is of such gravity that confidentiality cannot be maintained. It includes instances in which the Therapist considers the Client or others to be in imminent danger.
The Therapist will always attempt to speak to the Client before breaking confidentiality.
7. End of therapy
Endings are an essential part of the therapy process. For most people, the decision to end therapy will arise naturally during the course of work. In the normal course of events, the Client will probably know when it’s ready, and the Therapist will agree with the Client on the work they need to do to prepare for this.
At times, therapy may feel challenging. If the Client wishes to end suddenly due to feeling distressed or because of a change in life circumstances, the Therapist would ask the Client to discuss these difficulties rather than abruptly ending therapy. Whatever the Clients reason, the Therapist will respect the decision, but it will give a chance to:
- resolve any critical issues around the work that have been done, and
- to process the ending of a powerful and unique relationship.
8. Contact outside sessions (including social media)
The contact details provided in this Agreement are for use in the case of cancellations, alterations or in case of emergency.
The Therapist understands there are times when contact may be required outside booked session times. The Therapist strongly advises that the contact details provided are not always manned, and messages will only be picked up on an irregular basis throughout the day. Therefore, in extremis, the Client is advised to call for medical help/advice. However, the Therapist will reply to all messages as soon as possible within office working hours.
The Client and the Therapist shall not meet and/or have contact outside of the therapy relationship. The Therapist shall not otherwise or in other public places make contact with Client or recognise Client in a public place to protect Client’s privacy.
APF Wellness does not provide crisis intervention services. Should the Client need emergency support between the sessions, it is recommended to contact a local GP or one of the following organisations https://www.mind.org.uk, https://www.mentalhealth.org.uk, https://www.samaritans.org, https://www.depressionalliance.org, https://www.depressionanon.co.uk.
The Client may also want to contact the Therapist to bring the appointment forward.
9. Fees and payments
Fees for the specific therapy are published at APF Wellness website https://www.apf-wellness.co.uk.
Payments are due at the session in cash or by card or payable online during the session booking process. If the fee for the previous session is outstanding, the Client must settle this before any further appointments take place. It includes fees for missed sessions. Should the Client experience any difficulties with payment, the Client is asked to discuss this with the Therapist.
Charges for therapy are reviewed each year, and the Client will receive at least one month’s notice of any increase.
Payment must be made on time, in full, and without any deduction, set-off or counterclaim. If an account is outstanding, APF Wellness will refer the matter to debt collection agents, which will incur a surcharge of 15% of the debt. The Client agrees that it will be legally liable to pay that surcharge and that payment of the same can be enforced against the Client in court. The Client also agrees to pay interest at the relevant reference rate provided under the Late Payment of Commercial Debts (Interest) Act 1998. Interest is payable before and after any court judgment and continues to accrue.
10. Cancellation and Holidays
If the Client is unable to attend a session, provided the Client give the Therapist not less than 24 hours of notice, the Therapist will do their best to accommodate this and offer Client an alternative time or date. However, if this is not possible, the full fee will be charged for the missed session. Cancellation of an appointment or failure to show for an appointment will also incur the full fee. The Therapist will be available for the Client except for their holidays and occasional times when they might attend a training workshop or a conference.
11. Data Protection
The Therapist keeps confidential records about all clients. These records are kept securely, are only seen by authorised APF Wellness personnel, and may be used anonymously to produce practice statistics. The records held by APF Wellness are subject to the UK GDPR and Data Protection Act 2018, which gives clients the right to access personal data held about them. To provide therapy, the Therapist needs to collect personal data safely and appropriately from the Client, and by signing this Agreement, the Client gives consent to collect this data. Therapy is a confidential process, and the Therapist does not reveal the Client personal data or the content of therapy sessions to a third party without the Client express permission. The only exceptions to this would be in the circumstances described in the “Exceptions to Confidentiality” section.
12. Ethics and code of conduct
The Therapist is a BPS member and works within the BPS Code of Ethics and Conduct (2018) ethical framework for good practice. A copy of the framework can be found on the BPS’s website https://www.bps.org.uk/news-and-policy/bps-code-ethics-and-conduct.
13. Right to refuse
The Client is asked not to turn up under the influence of drugs or drink as the Therapist may not see the Client and have the right to refuse admission. The therapy premises operate a non-smoking policy.
14. Complains
If the Client has complaints about the Therapist, please contact APF Wellness in writing via email: [email protected] or BPS professional body.
| The Therapist | The Client |
| Full name: | Full name: |
| Signature: | Signature: |
| Date: | Date: |