Informed Consent

Welcome. Thank you for choosing to work with me. Please take a moment to read through this form which will provide you with some basic information about who I am, how I work, and what you can expect therapy to look like with me. Please feel free to ask me questions about the
counselling process at any time. Yu have the right to withraw your consent to counselling at any time.  

If you agree to begin counselling as described, please electronically sign this consent form on your Jane profile. If you prefer, you can come to your appointment and discuss any questions you may have, and decide then if you would like to go ahead.

My Philosophy

I received my education at the Adler University. I believe that our experiences in life, starting in our childhood, create a web of interconnected thoughts, feelings and logic that guide us through our decision making. In understanding these patterns of thoughts, where they originated, and our underlying beliefs and assumptions, we can evaluate our current ways of being and decide how we want to move forward. Often the very things we think hold us back are also the things that can help us succeed. You are the expert on your life and you will guide where we focus our work together.

I will work with you to establish your goals for therapy and will support you to reach those goals. My practice involves techniques aimed at helping you gain insight into your current behaviour. Building on this insight, we will explore ideas and strategies you can choose from to help you navigate more effectively in your relationships, and in facing challenges in your life, and nurture your emotional wellbeing. During our sessions, I will listen to your stories and will ask you questions so that I can try to understand both your history, and your current challenges.

If you prefer to tackle the things that are not working for you now, we can work out some immediate relief and move towards developing a long-term sustainable approach that works for you.

Potential Risks

Some of our conversations may require you to talk about things that make you sad, angry or uncomfortable. I may ask you questions that bring up painful feelings, or memories, and you may feel vulnerable. You are free to choose what you want to talk about, and can end conversations whenever you wish to do so.  I encourage you to take these risks and share openly. This is where you may find the greatest discoveries about yourself and reap the greatest benefits in therapy. You have the right, at any time, to withdraw your consent to treatment, terminate therapy, or decline to participate in any form or part of the therapy that doesn’t feel right to you. If our work together isn’t what you feel you need right now, I am also happy to refer you to another counsellor with a different approach. The important thing is that you feel like you are in the right place.

Potential Benefits

Therapy often results in changes in your awareness about yourself and others in your life. You may find yourself surprised by some of the insight you gain, and you may see yourself or others differently. Some clients find that what they learn in therapy is empowering, and allows them to
identify and move away from unhealthy patterns of thinking and acting. My goal is to support you and empower you on the path you choose towards emotional wellbeing.

Appointments

Appointments are 50 minutes long unless we agree otherwise in advance. Your appointment is reserved for you alone. If you are late to your appointment, we will still need to end the session as scheduled to accommodate clients scheduled after you. Appointments should be arranged
online, in person, by phone, or through email.

Fees

My standard fee for individual counselling is $120 for a 50 minute session. My standard fee for extended individual, or couples is $150 for a 75 minute session. Fees are collected at the beginning of each session.

Payment can be made via interact e-transfer, credit card, or by personal cheque. Receipts will be issued at the time of payment. If you do not attend your scheduled session, or if you cancel with less than 48 hours notice, it is my policy to charge you the full amount for the missed appointment. Exceptions may be made where we both agree your absence was unavoidable. Please note that
insurance providers will not reimburse you if you did not attend the session.

Confidentiality

You will be sharing your personal story with me, and I understand the importance of knowing that your information will be kept confidential. I will honour your trust with a commitment to confidentiality. I will not share your personal information, or any information about our conversations, except in the following instances:

1) If I believe you are at risk of suicide, and we are unable to reach an agreement on how we ensure your continued safety;

2) If I believe that you are planning to kill or cause significant physical harm to a specified person or group of people;

3) If you share information with me that makes me aware of the risk of harm to a child or vulnerable person; and

4) In the event that a court orders me to release information about you.

Please note that in order to maintain your confidentiality, if I see you outside of the counselling setting (i.e. in a coffee shop or at the theatre), I will not acknowledge you. You are free to acknowledge me, though in order to ensure confidentiality and maintain our professional relationship, I prefer to keep interactions outside of the office to a courteous minimum.

Personal Information and Privacy

Online video and phone counselling are not as secure as private, in-person meetings, and are subject to potential breaches of security.  I use ZoomPro for online counselling sessions.  ZoomPro is approved by my Professional Liability Insurance provider, and my Professional Association (The BC Association of Clinical Counsellors) to meet the legal standards for the protection of privacy and information.  I will do my best to ensure the continued safety and privacy of our sessions online.  If you agree to online video counselling, you acknowledge and accept this risk.

 

I am required to keep records of our time together. This includes information about you, and a record of the dates and times of our meetings, your reasons for seeking therapy, your goals in therapy, and a summary of what we discuss. These files are kept in a secured location at all
times, and will only be used or disclosed as noted above, or with your permission, and in accordance with the Personal Information and Privacy Act. If you have any questions or concerns about your privacy, please ask!

If at any time you wish to discuss what is in your file, you can request that we do so in our sessions. You may also request a copy of your records, or have your records forwarded to another counsellor. There is a $50 fee to cover administrative costs. If you request a copy of your file and I determine that access to your record will be detrimental to your wellbeing, I will inform you in writing of my reasons for refusal, along with procedures for appealing. You then have the right to appeal to the Privacy Commissioner.

Email and Social Media

Email and text messages should only be used for scheduling or changing appointments with me. Please do not share information relevant to your therapy with me through text message or email.

These modes of communication are not secure, and I cannot guarantee the confidentiality of content shared in this way. Keep in mind that the content of emails and text messages sent using
devices issued by your employer are the property of your employer, and may be monitored.

Due to the professional nature of our relationship, please note that I do not accept requests from clients to connect on my personal social media.

Complaints

If at any time you are unhappy with how things are going in our sessions together, I invite you to talk to me about your concerns so that we can address them. Should you feel that your concern
is not adequately addressed, or you do not feel safe to discuss them with me, you have the right to file a written complaint against me with the BC Association of Clinical Counsellors.  You can initiate that process by contacting them at 1-250-595-4448.

778-828-9971

Vancouver, BC, Canada

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