Therapy Contract

(Francesca Nuttall CBT)

Therapist’s name: Francesca Nuttall

Client’s name:

AGREED DATE OF FIRST CONSULTATION:

Terms and Conditions of Therapy – please read these before you come to our first meeting).  I will ask you sign them, and I will sign them as well so that we both understand how we will work together.

1.     I am bound by the British Association of Behavioural and Cognitive Psychotherapies (BABCP) Standards of Conduct, Performance and Ethics as well as by the Code of Conduct of Social Work England. A copy of the BABCP Standards can be seen here.

2.     At our initial meeting(s) we will work together to identify the problem or issue that you would like help with. I will ask you about the problem(s), how they trouble you, and when and how they started, as well as any other treatment or support you have had or are having now. This may take one or two meetings. At the end of this period (the assessment) we will agree on your goals for therapy, decide if I am likely to be able to help you, and if you would like to continue working with me. You will be under no obligation to continue working with me. 

3.     If we agree that we will work together to address your goals, I will initially offer you a specific number of sessions. This is usually 6-20. We can revise this to have more or fewer sessions and will routinely review your progress every 4 sessions. You can end therapy at any point without further cost.

4.     Sessions usually last for an hour (50-60 minutes).Sometimes it is clinically useful to have longer, or shorter sessions and we can discuss that if relevant. If you are late for one of our sessions, we will be able to meet for the scheduled time but will not be able to continue beyond the time we had scheduled to meet.

5.     Most sessions will be held online or at _________. Sometimes we may continue our online treatment outside, or leave the office, as part of treatment.

6.     I will let you know 4 weeks in advance when I am going on holiday. However, there may be times when sessions are cancelled because of illness or because of other work/family commitments. I will always give you as much notice as possible if I need to change our sessions and will offer you an alternative time to meet.  

7.     The cost of a one-hour (50 minute) individual therapy session with me is £70 (online)/£75 (in-person). This may be adjusted if we agree to have a longer or shorter session for a clinical reason. 

8.     Payment should be made prior to each session by bank transfer or cash. Payment details are:

Francesca Nuttall CBT

04 00 06

41500823

9.     I understand circumstances can change and I offer flexibility to rearrange sessions where possible, however I ask for 24 hours notice if you need to cancel or rearrange a session. Cancellations without appropriate notice (less than 24 hours) will be charged at half the cost of the session.

10.  The cost of therapy includes any written materials I supply, but not the cost of books I recommend.

11.  If you are using a private health care plan to pay for your treatment, therapy will not begin until I receive authorisation from the private health care organisation.

12.  If payments are not made on time and as agreed, I reserve the right to end our treatment sessions. 

13.  If you make a payment by bank transfer, your name may appear on my bank statement. This is considered personal data. I retain these records and may need to share them for accounting and tax purposes only, in line with legal obligations.

Confidentiality, supervision, and note keeping

14.  The BABCP Standards of Conduct, Performance and Ethics require that I maintain your confidentiality and keep information about you safe and secure. 

15.  To protect you, as my client, to ensure safe and ethical practice, and to maintain my accreditation I am required to have continued training and to engage in regular supervision. Therefore I may discuss your case in supervision. I would not use any identifying details. My supervisor will also be bound by the BABCP / HCPC / etc Code of Practice and confidentiality.

16.  Sometimes I will audio / video record our treatment sessions together. I will ask for your agreement before I make a recording.  Recordings are used in clinical supervision and form part of your clinical notes. I will destroy recordings of our treatment sessions after we finish our work together. You are also welcome to record the session, please let me know if you want to do this. Please keep any recordings that you make secure so that other people cannot access them.

17.  I will take notes during and/or after our sessions and will keep these securely, in accordance with the Data Protection Act (2018). I may also ask you to complete questionnaires about your experiences and / or symptoms and this will form part of your clinical notes. You can inspect these if you wish; just ask during one of our sessions.

18.  Your clinical notes are also kept confidentially. I will discuss them only with my clinical supervisor. In limited circumstances I can be required to share your clinical records in court, by a judge. If this happened, I would let you know.

19.  I am required by my professional body to hold a clinical will. This provides instructions for a professional executor to carry out in the event that I die or am permanently incapacitated. If this were to happen during our therapy or within seven years of it ending, the executor would be responsible for arranging the confidential storage of your therapy notes until seven years has elapsed since our last session.  At this point the notes will be destroyed.  The executor will be another psychological therapist and will abide by the same standards of confidentiality as I do.

20.  If we agree to work together, I will normally contact your referrer to confirm that we have started our work, and to outline the goals of our therapy. At the end of therapy, I will contact them again to tell them that we have completed our work together. 

21.  There are some limits to confidentiality. I may be required to break confidentiality if I consider that there is a risk you may harm yourself or others. I am required to break confidentiality if I become aware of acts of terrorism, safeguarding issues, illegal activity, or misuse of vulnerable adults. You should therefore be cautious about sharing any information with me that may mean I have to break confidentiality. If I am considering breaking your confidence for the reasons outlined, I will normally discuss this with you first. 

22.  If you have been referred by an outside agency, for example a solicitor or insurance company and there is a civil court case pending, for example if you have been injured in a road accident, under the Data Protection Act (2018) I may be obliged to supply copies of our therapy records to an appropriate party providing you consent.

The therapeutic relationship, working together and ending therapy

 23.  Psychological therapy can often be demanding, frustrating, and emotional. Sometimes you may find treatment difficult or even want to end therapy. You may find that some ‘tasks’ you are given are very challenging and you should feel able to tell me this and to ask me for support. I want to hear about how you think treatment is going and how you are experiencing it and will ask you to review your treatment with me regularly.

24.  It is important that you understand the reasons behind our treatment. If you feel unhappy or unsure about any aspects of the treatment, please try to tell me during our sessions. This gives both of us the chance to try to address the issue(s) and to resolve it/them. If you have serious concerns about my conduct or your treatment and cannot resolve this with me, you can complain to my professional body (see note 31 below).

25.  We will meet regularly at our timetabled sessions, usually once a week. You can contact me between sessions by emailing francescanuttallcbt@outlook.com I may not be able to answer immediately so please leave me a message. I do not offer you an emergency service. If, during a session, I become concerned about you harming yourself we will discuss what to do and how to seek help in an emergency.  

26.  Please do not contact me on social media – our relationship is professional and it is not appropriate or ethical for me to have a non-professional relationship with you.  This would be a breach of my professional ethical code. However, I have a professional social media account which you can follow and interact with. 

27.  Due to working hours I cannot offer crisis or emergency support, and clients should make use of local NHS mental health, emergency or voluntary services for such provision. If you are experiencing significant, life threatening difficulties please contact NHS 111, 999 or the Samaritans 116 123. Clients agree to take responsibility for their own safety and wellbeing, or that of their child (if client is under 18). All clients must be registered with a UK based GP practice unless otherwise discussed and agreed.

28.  We will discuss your progress regularly and you should be aware when we approach the end of treatment. Before we end, we will discuss how to prevent relapse and any other professional help or support that might be useful.  

29.  I will not end our treatment suddenly or without discussing this with you, unless there are exceptional circumstances. If I am taken ill or am not able to work with you for any other reason I have made arrangements to make sure that your care can be continued with another therapist.

30.  Please note any threats or acts of violence will invalidate this agreement and CBT will cease. Sessions will not take place if you arrive under the influence of alcohol or non-prescribed medication.

Complaints

 31.  If you are unhappy with the service I provide please discuss this with me. If you feel unable to do so or you are not satisfied by my response you have the right to complain to my professional body, the BABCP. They can be contacted here: complaints@babcp.com