THERAPIST & CLIENT AGREEMENT
Dr Gordon F Gatiss is a registered member and adheres to the Codes of Conduct of the following organisations:
The National Register of Hypnotherapists & Psychotherapists, 86 Wateringpool Lane, Lostock Hall, Preston, PR5 5UA
Much of what you share with me as we work together may be personal and confidential. I work under a code of professional ethics which means that everything you tell me remains between the two of us. However, there are limits to that confidentiality which I need to tell you about:
Supervision: As a professional requirement, I have regular Supervision sessions, where I discuss my case-load with another therapist in a Supervisory role. During the time you are in therapy, this will include your case. The purpose of these Supervisory sessions is to ensure that you, my client, are getting the highest quality of work from me. Like me, my Supervisor also works according to a strict ethical Code of Conduct. No details are disclosed which could reveal your identity, so for example only a client's first name is ever used.
The Children Act: I am bound by an act of Parliament called The Children Act, this deems that if anything a client shares with me leads me to believe that there are any children (under 18) at risk of abuse now, or were abused in the past, which has gone unreported, I cannot hold that confidential.
The Terrorism Act: I am bound by an Act of Parliament called The Terrorism Act which requires me to disclose any information told to me by a client which leads me to seriously believe that National Security is at risk.
Legal Testimony: Should I ever be asked to give testimony in a Court of Law about information a client has told me, I am bound by Law to disclose that information.
Harm to self or others: If anything you tell me leads me to seriously believe that you intend to harm yourself or another, I cannot hold that confidential.
MY PROMISE TO YOU AS MY CLIENT:
1) I will treat you with respect, consideration, and to the best of my professional abilities.
2) I will endeavour to see clients at the appointed time and to maintain appropriate time and professional boundaries.
3) Periodically, we will review your progress to ensure we are on track and you are happy with your treatment.
4) When any form of publication is being considered, I will safeguard the welfare and anonymity of clients. As appropriate, written consent will be sought whenever possible.
ENDING THIS AGREEMENT:
In therapy, all endings are considered significant events. How something ends is important for your emotional well-being. Therefore the following possibilities are presented.
1. Ideally the therapy will come to a natural end when you have reached your stated therapeutic goal, and by mutual consent.
2. You the client may end this agreement at any time, should your circumstances or goal change, simply by informing your therapist you wish to do so. Even if you have had a gap in your treatment, it is still advised to formally complete your agreement in this way, so that it doesn’t live on for you as a loose-end, or unfinished business.
3. Should you miss a session without notification or advance payment, or late cancel three times, Gordon reserves the right to end this agreement and will do so in writing (email).
CLIENT CONTACT INFORMATION:
Name of Client:
Home phone: Work phone: Mobile:
I hereby give Dr Gordon F Gatiss permission to contact me for the purpose of facilitating my therapy via post ❑ , mobile phone/text ❑ , email ❑, home phone ❑, work phone ❑
• I have read and understood the Confidentiality limits ❑
(Please note that if sessions are late cancelled three times, Gordon reserves the right to end this agreement and terminate your therapy.)
I have read this contract and agree to the terms stated.
Signed by client: Date:
I will regard all contact and information as confidential within the parameters stated above.
Any notes that I take are for my records only and are available to be viewed by the client.
I will not prolong treatment unnecessarily.
I abide by the Codes of Conduct laid down by The National Register of Hypnotherapists
I have regular Psychotherapeutic Supervision in accordance with good practise.
Signed by Therapist: Date: