Informed Consent

The purpose of this informed consent is to make you aware of your rights and responsibilities as a client, the rights and responsibilities of a counsellor, to make you aware of the limits of confidentiality, and to give you some insight into the approach that I generally take with clients and what you can expect from participating in a counselling relationship. I hold a Master’s level degree in Counselling Psychology from Rutherford University. I am a Master Practitioner in Clinical Counselling registered with the Canadian Professional Counsellors Association and bound by their Ethical Practice Standards. I work with a combination of perspectives that include Family Systems Theory, NLP, Cognitive, Gestalt and Psycho/spiritual orientations. This means that we will likely be exploring your family history and looking at how it may relate to your current situation. We will examine in detail patterns in your life that you feel are not working and look at the beliefs that drive them, inviting new options. I can also support you in exploring your personal spiritual base as it relates to how you operate in life. While much of the work is experiential and can bring up strong feelings it is important to be aware that ultimately, you are responsible for both the content and the pace of the work we do together. All of the information that we share together is strictly confidential unless one of the following should occur:

The courts subpoena our files.
Either one or both of us are subpoenaed as witnesses in court.
If we suspect cases of child abuse that have not been previously reported. This includes physical harm, sexual abuse, sexual exploitation, and emotional harm. In this case we are required by law to report to the Ministry for Children and Families.
If you threaten to harm yourself or another. In this case we are also required to report this to the proper authorities

Note: These duties override all other claims of confidentiality. It is important for you to understand that you are the primary decision-maker in the direction your therapy takes, and therefore you have the right to full and active participation in the decisions that affect you. In addition, you have certain rights, which include:

the right to receive an appropriate referral to other resources as needed.
the right to accept or reject any task, exercise or procedure that I may suggest.
the right to be made aware of the rationale, risks, and benefits of any and all counselling interventions.
and the right to know your options in cases where you are in disagreement with any aspect of the counselling relationship.

My counselling fee is $140.00 for each 1 hour session or $180.00 for 1 ½ hour session, payable at each visit. For 120 minutes the cost is $260.00. I accept cash or cheque or e-Transfer. You will be charged the full session fee for missed, cancelled or changed appointments unless you have given at least 24 hours notice by telephone to 604.331-4642. Please do not email appointment changes or cancellations. I can be reached by phone during business hours Monday through Friday, 9am to 5pm at the number listed at the top of this consent. I will return your call within 24 hours unless I am out of town. If you do not understand fully any portion of this statement, or have questions about it, please do not sign below. I can go over this disclosure and clarify any questions you may have. In the event of a counselling crisis and if you are unable to reach me, please call the Vancouver Crisis Centre @ 604-872-3311. By signing below, I indicate that I have fully read, understand, and agree with the above.