Photo courtesy of John Mappley at Hamble Photography
Framework for Therapy
(Updated 10/04/18)
The psychotherapy relationship is different to any other relationship. For instance, whilst physical contact between therapist and client happens very rarely, if at all, many describe the relationship as more intimate and ‘real’ than any other relationship in their life. To make the process feel as safe and be as beneficial as possible it is important to have a sense of the frame of the work. This is what I hope to explain in the following document. Please feel free to discuss any aspect of it with me, at any stage of your treatment.
Assessment/initial meetings
I recommend meeting for two sessions, ideally one week apart, to enable us both to get a good sense of what it is like to work together, and also to give time to reflect between sessions. Sometimes the space between sessions enables important issues to come into awareness, including via thoughts, newly recalled memories, and dreams.
At the first session, I ask clients to provide their contact details, and to complete some basic questionnaires on how they have been feeling recently. This is a mark in the sand for how things are at the present time, and can help focus the work we do.
Length and frequency of Sessions
Therapy typically involves weekly sessions of 50 minutes, usually once but sometimes twice (or more) a week. Duration of the work and frequency of sessions varies depending on the nature of your issues and your individual treatment needs. Short term therapy focuses on a specific difficulty or issue. Longer term/on-going therapy can focus on many different areas of difficulty.
Payment of Fees
We agree the fee at the beginning of the therapy. In the initial phase of work, I require payment at or before each session. Later, you can move to invoicing at the end of each month, although I am happy to be paid each session as well. You can pay cash, by cheque or bank transfer (BACS). If you require a receipt for on-line transactions, please let me know as I don’t usually provide one.
I review my fees annually and will give you at least one month’s notice of any changes to your fee. If your financial situation changes, please feel free to discuss the issue of fees with me.
Cancellations
Therapy works best if sessions are regular and consistent - this enables the work to have an optimal momentum. However, there are times when life gets in the way, and sessions need to be cancelled.
I require at least one week's notice of cancellations (e.g. if you usual session is at 5pm on Wednesday, I need to know you are cancelling next week before the end of the preceding week's session), and reserve the right to charge for sessions missed if they are cancelled with less notice than this. In some circumstances, I may be able to offer you an alternative session, but this might be at a different venue to your usual venue, may be over the phone, or via a video call.
If you need to cancel a session, please leave a message on my private mobile telephone (07903 664020).
My Absenses
I usually take two weeks’ holiday at Christmas and Easter, and three-four weeks in the summer. You do not pay for holidays taken by me. I will give you at least three weeks’ notice of the dates of my holidays to give us enough time to think about what this means for you emotionally. Breaks in the work can bring up difficult and important feelings or practical issues, so discussion of their impact is a significant part of the therapy work.
If I need to cancel a session at short notice (e.g. due to ill health), you do not pay for this session. I may be able to offer an alternative later in the week (face to face, phone or video conferencing), but if we cannot find a mutually agreeable time, I will not charge you for this missed session.
Social media
I use both Twitter and Facebook for professional purposes. You are free to follow/like my pages, but I do not knowingly follow/like client’s social media accounts. I do not engage in clinical/personal communications with clients via Twitter or Facebook.
See my Digital Policy for further details about how I use technology in my practice.
Records held about you
As part of the initial meeting/s I will request your contact details, inluding your GP details.
All records that relate to you and your therapy will be held securely in accordance with the Data Protection Act and destroyed at a prescribed date after your therapy has ended.
As part of continuous professional development I often share aspects of my work with my professional peers (e.g. via teaching, conference presentations, in articles/books or via writing about my clinical practice). In keeping with the ethics and code of conduct of my training organisation (The Bowlby Centre) and the UKCP client confidentiality is paramount, and the way in which the material is presented will preserve this (i.e. through the alteration of key details, heavily anonymising and disguising information to protect all concerned). Please indicate on the separate sheet whether I can use aspects of our work together in this way. You have the right to change your mind about the use of material in this way at any point.
Confidentiality
Information you share with me will be kept strictly confidential and will not be disclosed without your consent. This extends to confirmation that you are in treatment with me – I do not share any information unless I have written confirmation from you, specifying whom I can disclose information to.
However, in line with my professional guidelines and to ensure the work we do together is optimal I am in regular supervision with a senior practitioner and share clinical material with this person. They are subject to the same code of ethics and conduct as I am.
Whilst the work you undertake with me is confidential it is important that you are aware there are a limited number of occasions where I may need to consider breaching that confidentiality in accordance with the law (see below). If for any reason this becomes an issue within our therapy where appropriate this would be something that we would talk through in detail.
Circumstances in which a therapist may be required to share information:
You disclose that you are at risk of carrying out serious harm to yourself or others.
·You make me aware of an identifiable minor being harmed and that there are issues that invoke the law as it relates to child protection.
You make me aware of matters relating to an act of terrorism.
You make me aware of activities covered by the drug trafficking act (1994)
A request is made by the authorities in the context of legal proceedings.
This issue of confidentiality is why I require your GP details at the start of your treatment.
Complaints
I endeavour to provide a service to my clients that is respectful, helpful, and in accordance to their needs. However, there may be times when a client feels the service I provide does not meeting these standards.
As a first line of action, I encourage clients to discuss any concerns with me in the session. This may feel challenging, but it is very important (and I would also say potentially very healing) to talk about any dissatisfaction or disappointment about their therapy.
If this does not address the issues, please do consult the UKCP (my governing body) about how to make a complaint.
Freedom to withdraw/endings
Endings can be a hugely important part of the therapeutic work. Where possible, I prefer to set a date for the therapy to finish and for us to work towards this, exploring what comes up for you as we do so. At our final session, I ask you to repeat the questionnaires completed at the start of therapy, so that we can use them as part of our review.
You have the right to end treatment at any time, however this is something that is important to discuss together rather than for there to be an abrupt ending to the work. If after discussion you are intent on leaving therapy I would ask that we have at least one ending session to review our work together and say goodbye.
