CYP Contract for therapy

Please complete the form below to agree to the terms in this information page and to provide emergency information.

 

Psychotherapy Agreement for Children and Young People

UKCP-accredited Psychotherapist with children and adolescents

As an integrative practitioner, I draw on a range of theories including Relational Transactional Analysis, Gestalt, Somatic Trauma Therapy, Polyvagal Theory, Jungian perspectives, and body psychotherapy. I utilise my experience, certifications, and understanding of a range of interventions including Jungian sandplay, sensorimotor art, play, EMDR, image work, movement and gesture, relationship, mindfulness, and much more, to offer a diverse and individualised approach to nourish and meet the diverse parts of your child or young person.

Usually, our first 3–6 sessions are understood as building our therapeutic relationship and getting to know each other. In the assessment and initial sessions, we will also develop a plan so that we both know what we are working on, what goals you/the young person would like to meet, and how I might best be able to support you. Sometimes, a referral to an outside support group or another professional may be suggested or required. For example, a referral to a substance abuse recovery group, or an eating disorder specialist may be a necessary part of the plan.

At times your child or young person may be asked to complete tasks outside of the therapy session. These might include journalling or drawing, thought and behaviour tracking logs, practising stress reduction techniques, and practising assertive communication skills. These outside tasks can be useful aspects of our work.

As our sessions are usually 45 or 50 minutes out of 168 hours in a week, I very much recommend some strategies to use at home that we can discuss in initial sessions. I also share some of these resources for parents here (password: sunflowers). I also recommend watching this webinar for parents and carers, which is split into small videos, total time about an hour:
https://wildandwellbeing.com/parents-coping-with-overwhelm (Password: sunflowers).

Contract for Therapy

The therapist agrees to:

  • Work safely and ethically in accordance with UKCP and BACP codes of ethics and practice.

  • Provide weekly sessions lasting 45 minutes for children under 12 years or 50 minutes for those aged 12 and over, or as otherwise agreed.

  • Review our work together approximately every 6 sessions, or as otherwise agreed.

  • Hold the session time for up to 15 minutes after the start of the session. If you (parent/carer) do not get in touch to let me know that your child is late or not coming, I will assume the session is cancelled. The full session fee remains payable. If your child arrives late, the session will still end at the scheduled time and the full fee is payable.

  • Keep the content of the session confidential unless there is a risk of harm to your child or to others, or for another reason covered in the confidentiality section below.

  • If I am ill, I believe that it is important that I do not return to work until I am able to be fully present. I will let you know with as much notice as possible and will aim to rearrange sessions where we can.

  • Hold appropriate professional indemnity insurance and engage in regular clinical supervision.

The child / young person agrees to (in age-appropriate language):

  • Attend appointments as arranged, as far as possible.

  • Let me know in sessions if something does not feel helpful or if you want to change how we are working.

  • Talk with me in sessions when you feel ready to end therapy. When you decide to end your work with me, I ask for at least two sessions’ notice so we can have a thoughtful ending together.

(These expectations will be explained in a child-friendly way and adapted to developmental level.)

The parent / carer agrees to:

  • Ensure that the child/young person attends appointments, and to contact me as soon as possible if they are unable to attend.

  • Be available nearby during the session time (for example in the waiting room), unless we have explicitly agreed something different in early sessions.

  • Respect the child/young person’s choice about the confidentiality of session content, within the limits of safety and safeguarding described later in this agreement.

  • Attend review or feedback meetings with the young person and therapist, as discussed at assessment, where appropriate.

  • Not attend in-person appointments if you or your child/young person are unwell, or if you are not yet showing symptoms but someone in your household is ill. This includes any of the following:

    • a high temperature or shivering (chills)

    • a continuous cough

    • a sore throat

    • a loss or change to your sense of smell or taste

    • shortness of breath

    • feeling tired or exhausted (along with another of these symptoms or for no clear “reason”, or if you/your child would be too tired to focus in the session)

    • an aching body

    • brain fog

    • headaches (along with another of these symptoms or for no clear “reason”, or if it would affect the ability to focus and be present in the session)

    • diarrhoea

    • feeling sick or being sick

If your child is well enough, and I have availability, we can arrange an online session, or postpone until they are well. This is because my own health is important, and essential for me to be present and effective with all my clients. I also work with some clients who are immuno-compromised and endeavour to be as careful as possible not to pass on viruses etc. I also feel that when someone is unwell, therapy is often not helpful. Please let me know with as much notice as possible if you wish to rearrange or move online.

·       As I work with some vulnerable clients, if you or your child have COVID-19 or flu symptoms, bearing in mind that tests produced in 2020 may not show a positive result for more recent covid strains, please do not attend an in-person session for ten days from the first symptoms. If your child is well enough, I may be able to offer an online session during this time, although this will depend on internet availability at my practice locations.

·       If your child attends a session when unwell, I reserve the right not to continue the session.

  • Give 48 hours’ notice (two working days) if you need to cancel an appointment, otherwise the cancellation fees described in Fees, Cancellations and Missed Sessions will apply.

Therapy as a Collaborative Process

  • The child/young person has the right, at all times, to refuse any suggested ways of working.

  • They have the right to stop any therapeutic process for any reason.

  • Parents and young people have the right to ask questions about and discuss any techniques or procedures.

  • Please let me know of any problems, concerns or other issues that emerge during this, or any other kind of therapy work so that we can think about them together.

Cautions

Care must be taken in the use of any physical or movement-based exercises. If your child has any health problems you are aware of, please consult your GP or relevant health professional before they try new physical exercises, and let me know about any relevant medical conditions.

As with any psychotherapy, this work can sometimes lead to times where a child or young person feels more upset in the short term as difficult emotions, sensations and situations are brought into their awareness. Although the intent is to work these through towards some kind of resolution, this is not always possible within a particular session, so these feelings may continue beyond session time.

Please let me know in the next session if this occurs. If needed and available, I may be able to offer additional support, but this is subject to availability.

For physical or medical concerns, please consult your doctor or other professional healthcare provider.

Our Relationship and Contact Between Sessions

To be clear about our therapeutic relationship, there can be no other contact between us other than client/therapist. I cannot be your or your child’s friend outside of the relationship or be involved with you in any other relationship.

If we accidentally meet outside of the therapy room I will acknowledge you in a brief and friendly manner, unless you or your child express a wish not to be acknowledged – we will discuss your preferences about this.

Contact between sessions should be only for the purpose of arranging or rearranging appointments. If a parent would like a discussion or to let me know an update about a child, please do not send detailed information by email. If it is helpful to have this discussion without the child present, please email to arrange a separate parent session, or arrange for someone to look after the child during a portion of the usual session so we can talk.

I do not engage with clients or parents via social media (for example by following, commenting or direct messaging), and I do not accept friend or contact requests from current or former clients or their family members. This is to protect your privacy and the therapeutic relationship.

Appropriate Therapeutic Environment

The therapeutic environment provided will consider what is developmentally and age-appropriate for the child. Children and young people will be made aware of what is permissible in this environment, and I will maintain these therapeutic boundaries.

If a child cannot maintain these boundaries and is putting themselves, me, or others at risk, I will consider ending the session in a way that is respectful and provide an explanation to the child and, if appropriate, the person holding parental responsibility for the child. We can then think together about whether and how to continue safely.

Touch Policy

I am aware that the use of touch with children and young people is complex. It is acknowledged that there can be benefits of therapeutic touch and that there may be situations when complete abstinence could feel unkind or confusing, particularly with younger children (for example, a hand to help up from the floor if asked for and initiated by the child, or a brief high-five when agreed, or agreed tapping of feet, hands or shoulders in EMDR).

However, touch can also be experienced as intrusive and unwanted, particularly for those who have been sexually or physically abused or for those for whom touch is overwhelming. I therefore:

  • Use clinical supervision to think carefully about any use of touch in the work.

  • Aim to use the minimum touch necessary in the therapeutic context.

  • Do not touch children or young people in intimate or private areas, and do not use touch as a substitute for verbal or relational work.

  • Always seek to negotiate and gain consent with children and young people around any intentional use of touch, in ways that are age-appropriate and understandable.

  • Wherever possible, also think about and negotiate this with those holding parental responsibility when working with a dependent child.

  • Let children and young people know that they can say “no” to touch at any time, or change their mind later, and that this will be respected and not seen as “rude” or “unkind”.

Physical restraint is not used as part of therapy. In the extremely rare event that immediate physical intervention is needed to prevent serious harm (for example, to stop a child running into a road), this would be for safety only and we would aim to talk about this afterwards in a supportive way.

Ending

There may be times in the counselling when a child or young person feels very distressed and feels that counselling is not helping them. It is wise, where possible, to come and discuss these difficulties rather than suddenly ending the counselling. This gives an opportunity to understand and perhaps resolve the distress, or to think together about whether another form of support might be more appropriate.

I usually require two sessions’ notice to end therapy. Ideally, this will include at least one dedicated ending session. If you do not are unable to attend these last two session, you will still be charged for the two sessions notice.

When appropriate, I may invite parents/carers to be part of an ending conversation, with the child/young person’s consent.

Confidentiality, Safeguarding and Gillick Competency

All sessions are confidential. For children and young people, confidentiality is often a crucial part of building trust and safety. However, there are important exceptions, which include:

  • If the client (child/young person) requests confidentiality to be broken or asks for specific information to be shared.

  • If the child/young person discloses the possibility of harm to themselves or to others.

  • If the child/young person discloses something about themselves that is considered to be a safeguarding issue. In such cases, I will follow UKCP and BACP safeguarding guidance and local safeguarding procedures.

  • If the child/young person discloses something about someone else that is considered to be a child protection or vulnerable adult issue. In such cases I will follow UKCP and BACP guidance.

  • If I am compelled by a court of law.

  • Work may be discussed in supervision. My supervisor is also bound by confidentiality; in supervision clients will only be referred to by initial or first name.

  • If I am unable to practise due to accident or sudden incapacity, a qualified colleague will contact you and enquire about your wish for further therapy.

  • Non-payment of fees resulting in legal action being taken.

  • If I need to share verbal or written information with other professionals/agencies, which will wherever possible be agreed with the child/young person and/or parent/carer, unless there is a safeguarding reason not to.

  • Where disclosure to an appropriate authority, like the police, social care or another safeguarding agency, is in the public interest and in line with ethical guidelines. For example, where there is evidence of serious crime, or a risk of death or serious harm to the child/young person or someone else.

Examples of serious crime include (not an exhaustive list):
Acts of terrorism; drug trafficking; slavery; people trafficking; firearms offences; offences related to prostitution and child sexual abuse, including the use of child sexual abuse material; armed robbery; money laundering; certain offences in relation to public revenue; bribery; counterfeiting; blackmail; computer misuse including the use of child sexual abuse material; certain serious environmental offences; and organised crime.

Examples of what may constitute serious harm include: ill-treatment, including sexual abuse, neglect, emotional abuse and psychological abuse; impairment of physical or mental health; impairment of physical, intellectual, emotional, social or behavioural development.

In short, disclosure must be considered essential to protect the child or young person, protect third parties from the risk of death or serious harm, or prevent a serious crime or civil wrong. The most important considerations are how real and imminent the risk of harm is and whether there is an appropriate person or authority to whom disclosure can be made who could, in turn, help avert the harm.

Wherever possible, if one of these exceptions becomes necessary, I will discuss this with the child/young person and with parents/carers, taking into account the child’s age, understanding and safety.

Parents and Confidentiality

The right to confidentiality is extremely important, even if the client is a child or young person. Keeping the content of sessions confidential typically enables a trusting therapeutic relationship to form between therapist and client. This relationship is the cornerstone of any successful therapeutic intervention and is therefore important to protect wherever possible and safe to do so.

Therapy should be a supportive space for the child or young person, and knowing that they can speak freely helps them to be open and honest about their thoughts, feelings and concerns.

The principles of Gillick Competency will apply. This means that if a young person is considered to have sufficient understanding and intelligence to fully understand what is involved in their treatment, they may have a stronger right to confidentiality, including in relation to what is shared with parents/carers. If a parent requests information about the content of a therapy session and the child/young person does not want to share this information, I will consider:

  • the child/young person’s age and understanding,

  • their safety and wellbeing, and

  • my safeguarding responsibilities.

There will be times when parents may need to be aware of the themes discussed in sessions. For example, so that parents can support the child/young person with therapeutic tasks between sessions, or to help keep them safe. It may also be helpful for the parent to be involved in some therapy sessions. If it is felt that sharing information from sessions would be helpful, this will be discussed with the child/young person beforehand wherever possible.

Consent to share information with parents and other professionals/services is not needed in the event of safeguarding concerns where there is risk of serious harm.

Outdoor Sessions and Confidentiality

Outdoor sessions have some additional considerations regarding confidentiality, such as being seen when walking together in a public setting. Prior to any outdoor work in public places, we will discuss how we will manage this in a way that best suits us and protects the child/young person’s privacy as far as possible.

Between-session reflection
It can sometimes help children and young people to draw, write, or talk to a trusted adult between sessions about anything that feels important (only if they want to). For some, keeping a small “feelings journal” or sketchbook is useful. We can agree together what, if anything, might be helpful for your child to do between sessions, and how you as a parent/carer can support this. 

Record Keeping, Data Protection and Your Rights

I keep very brief clinical notes for each child/young person which I hold confidentially.

I am registered with the Information Commissioner's Office, and all information is stored in line with the Data Protection Act 2018 and UK GDPR.

I generally process personal data on the lawful bases of contract (in order to provide therapy and manage our agreement) and legitimate interests (for example to maintain records, manage my practice, and receive supervision).

Your child’s records will not be released to any other person without appropriate consent, unless in those situations outlined in the Confidentiality section above or where required by law.

I never use or share your information for marketing purposes. I will only share such information as necessary, and where I am satisfied that the other individual or organisation is entitled to receive it.

I usually retain records for a minimum of seven years after their 18th birthday, or longer where required by my professional body or insurers. After this time, they are securely destroyed.

As the data subject, your child/young person has rights in relation to the information held about them, including:

  • the right to access a copy of their information;

  • the right to ask me to correct any inaccurate information;

  • the right to request erasure of their information in some circumstances;

  • the right to request that I restrict how their information is used in some circumstances;

  • the right to object to certain kinds of processing.

For younger children, those with parental responsibility may exercise some of these rights on their behalf where appropriate and in the child’s best interests. I will balance any requests for access with my safeguarding responsibilities and the child or young person’s right to confidentiality in therapy.

If you believe the information I hold is incorrect, or if you have concerns about how I am handling this information, please contact me in the first instance. You also have the right to complain to the Information Commissioner’s Office (ICO) if you are unhappy with how data is handled.

Research

I may use anonymised information from time to time in my own research, writing or teaching. Any information I do use would be sufficiently altered so as to make your child unidentifiable and not compromise their therapy.

Participation in any such use of material is entirely optional. You can tell me at any time that you and your child do not want anonymised material or creative work to be used in this way, and this will not affect their therapy.

There is a separate space on the consent form to indicate whether you and your child consent to anonymised creative work being used in publications (such as books and research papers).

Code of Ethics and Practice

I am a member of UKCP and BACP and endeavour to abide by their codes of ethics.

You and your child have a right to have your complaints heard and resolved in a timely manner. If you have a complaint about your child’s treatment, please inform me as soon as possible so that we can discuss the situation together.

If we are not able to resolve your complaint together, you have the right to raise it with my professional bodies. Details of how to do this can be found on the UKCP and BACP websites.

Online Sessions

For online sessions with children and young people, ideally you need a quiet and private room, free of intrusions, with a good signal. Depending on age and need, we may agree whether a parent is in the room, nearby, or in another part of the home.

If the signal on your device or online platform breaks up, I will email or telephone you. If you have a technical problem or cannot attend the session, please email nes@wildandwellbeing.com.

Other screens should not be in use during the session. It is helpful to turn off notifications so that messages are not popping up on the screen and disturbing you during the session.

For online work, I may ask you to provide:

  • the full address from which your child is joining the session, and

  • an emergency contact (for example a parent/carer or other trusted person, and GP details),

so that if I am seriously concerned about their immediate safety during an online session and cannot contact you, I can consider contacting emergency services or your emergency contact in order to support their safety.

Fees, Cancellations and Missed Sessions

My fee is based on a sliding scale per 45-minute session for children aged under 12, and 50 minutes for those 12 and over. My fee is based on the sliding scale per session, found here: https://wildandwellbeing.com/faq-practical-info  Fees vary based on where you are on the sliding scale and the time of your appointment. 

There is usually an increase of fees in January each year proportionate to the annual increase in business expenses. Increases will reflect my commitment to keeping fees as low as possible while maintaining a sustainable living wage with the various expenses of insurance, supervision, professional body membership, CPD etc. I will give at least six weeks’ notice of any increase.

Payment

Payment is due within 48 hours of the session, by bank transfer:

  • Account name: V Bear

  • Bank: Triodos Bank

  • Account: 22126597

  • Sort code: 16-58-10

Cancellations and missed sessions

  • Please give at least 48 hours’ notice (two working days) if you need to cancel an appointment. Otherwise, the full fee will be charged for the missed session.

  • If you choose to move the session to another day/time or to an online session within that same week, where available, the full fee will still be due, but the room hire portion (£12) may be waived if we do not use the room.

  • For less than seven days’ notice of cancelling an in-person session (but more than 48 hours), there is a cancellation charge of £12 to cover the room hire costs. This is still payable if the session is moved to another day/time that week.

  • If you do not attend a session and do not contact me, the full fee is payable.

Annual and Professional Development Leave

Due to the nature of the profession, to maintain professional levels of self-care I tend to take regular breaks, usually 1–2 weeks every 6–8 weeks. This is to ensure that I am able to be as effective as possible.

Due to the nature of my work, regular CPD (required by my professional body) is imperative and therefore some working weeks I will also be unavailable due to training. I will give as much notice as possible for this.

I update the dates currently in my diary as annual leave and professional development here:
https://wildandwellbeing.com/client-information

Session Booking

I strongly recommend having a regular time and day for therapy. This avoids confusion and offers predictability and routine, which are generally supportive for children and young people.

To set up a recurring weekly or fortnightly day and time for your child’s session, email me using the days and times available in my calendar (as shown on my website) as a guide to my availability.

However, I am aware that for some people it is difficult to arrange a regular session. For sessions that are less regular, it is usually useful to book the next session at the end of a session.

My timetable is subject to change. I will endeavour to give two weeks’ notice of any change in time, day or venue where possible.

Contact Information

Email: nes@wildandwellbeing.com

If you send me an email: I usually respond to emails within a week. I am not able to respond straight away as I work part-time as a therapist, and much of my work is away from a computer. If I am away on professional development or holiday, you will receive an automatic email response informing you when I will return to work.

If you do not want me to respond to your email, please tell me explicitly in your message.

I am the only person who has access to my emails. However, emails are generally not guaranteed to be secure. Therefore, please do not include personal or highly sensitive information about you or your child in emails.

Crisis and Additional Support

I do not offer a crisis service.

If you or a child you care for are experiencing suicidal thoughts and are making plans to end your life, please go to your nearest A&E.

If you or a child you care for are severely depressed, please go to your GP.

If you or a child you care for are experiencing emotional difficulties and need to speak to someone without delay, please call The Samaritans on 116 123.

If you are worried about a child, call the NSPCC Helpline: 0808 800 5000.

If you think you or a child is at immediate risk of harm, please call the Police on 999.

If you have concerns that you may commit sexual abuse or sexual violence yourself or are concerned about another person’s behaviour, or a child’s behaviour, you can contact the Stop It Now helpline. Telephone: 0808 1000 900 More information including opening hours can be found online at Stop It Now: https://www.stopitnow.org.uk/

If you are worried about domestic abuse and hurting the ones you love while staying at home, call the Respect Phoneline for support and help to manage your behaviour. Telephone: 0808 8024040. More information including opening hours can be found online at Respect Phoneline: https://respectphoneline.org.uk/

Additional support helplines and links can be found here:

https://wildandwellbeing.com/links

Agreement and Consent

Please read this agreement carefully. You are welcome to ask any questions about any part of it, either by email or in our sessions.

By signing below (or by indicating consent in writing for online forms), you confirm that:

  • You have parental responsibility for the child or young person named below, or have the authority of those with parental responsibility to agree to therapy.

  • You have read and understood this agreement.

  • You have had the opportunity to ask questions.

  • You agree for your child/young person to enter into psychotherapy with me on this basis.

Where a young person is considered Gillick competent, I will also seek their own consent to therapy and to this agreement.