Counseling Therapy Informed Consent Form - Assignment Example

Counseling Therapy Informed Consent Form Presented Counseling Therapy Informed Consent Form Please read the form carefully before signing. You are encouraged to ask any question where necessary. 1. Protocol title: Guidelines for a private counseling session 2. Purpose of the Research Study The purpose of this study is to inform and prepare a client for a private counseling session, regarding the possible expectations of such a counseling session on particular issue. You will be required to be psychologically prepared and willing to be fully involved in the session for any degree of effectiveness to be achieved. 3. Duration of the Subject’s participation A counseling session will take between 45 minutes to one hour, but may vary from client to client depending on the gravity of the issue, cooperation of the client and the respective response of a client in such a session. You will in addition be booked for several respective counseling sessions over a period of three months for the therapist to make respective follow up regarding the effectiveness of a therapy session, and whether more intervention would be required to solve a particular issue. You will be required to fully participate in all the arranged follow up sessions to ensure the therapy’s effectiveness. 4. Procedures to be followed You have to consent to each step of the counseling procedure for the success of a session. First, you have to arrive well in time in the counseling room to avoid any lateness that may interfere with succeeding sessions. You have to read this consent form slowly and in detail, and have to indicate if they have understood the consent form before a session begins, and whether they agree to all the procedures as set out in this form. After you agree to the terms as set out in this form, the therapist will ask you to identify yourself and ask a few questions regarding your family, work, and any background that the therapist considers appropriate in a particular case. You will be required to carry out simple exercises in the therapy room as instructed by the therapist where necessary. These may involve simple breathing exercises, or any other exercise that the therapist will consider appropriate in relieving tension before a therapy begins (International Organization for Migration, 2009). After a therapist is satisfied that you are prepared to go ahead with the therapy, you will be required to narrate your case comprehensively and in details as much as possible with the therapist making minimal interventions to ask for clarifications on important aspects. You will be required to put forward any concerns for the therapist to clarify. The therapist will provide support depending on any specific case, and will advise on the possible ways to alleviate the problem. After this, a therapist will facilitate a coping process in solving the problem (IOM, 2009). In the entire counseling session, you will be required to cooperate with any suggestion provided by the therapist, and voice any concerns for any specific area you feel uncomfortable to ensure you are comfortable in the coping process as instructed by the therapist. 5. Experimental procedures You will be expected to undergo mild physical exercises that the therapist finds necessary in helping you undergo the therapy session appropriately. Such may include simple breathing exercises, walking, or any simple physical activity that would help you in relaxing, or cooling emotions where necessary. Such exercises will however be mild and easy with no straining effects. 6. Risks and discomforts The therapy session is not prone to any foreseeable risk or physical harm on the part of a subject. However, you will experience some emotional discomforts and mental disturbances particularly when sharing private or personal issues with the therapist. However, such emotional problems will fade away with increased confidence as you share your predicament in offloading your emotional burdens, which has an emotional healing aspect to the subject. The mild exercises that you will be required to perform do not pose any risk to the subject. 7. Benefits The subject stands to benefit greatly from a counseling session through offloading any emotional or mental burden that they may be experiencing. Moreover, a counseling therapy session provides a subject with various possible ways to approach or solve a particular problem or issue, which makes them more confident in approaching such issues. A counseling session in addition opens up the issue to the subject to reveal other dimensions whose challenge may not be evident imparting more skills to a subject. After undergoing a counseling session, you stand a better chance to coach and help others to withstand or undergo similar or different situations through their experience in a counseling session. Undergoing a counseling session is therefore an asset not only to you, but also to the community in solving diverse range of problems amicably. 8. Possible alternate procedures You are encouraged incorporate or try other alternate procedures that may help in solving their predicament. These would involve sharing information with close friends, relatives, religious leaders, or any other party whom you trust to offer a formidable solution to their challenges. Moreover, you are encouraged to search for information from reliable websites that offer real time narratives of people with similar predicaments, or even books addressing similar issues. 9. Statement of Confidentiality The information shared with a therapist shall be treated with utmost confidentiality; it cannot be shared with a third party, or be used in any way detrimental to the subject, or any of their interests. Contrary usage of such information is an offence chargeable under the law. 10. Contact For more information related to counseling therapy, you are encouraged to contact our offices near you around the country. In case of any claim or complain, you are encouraged to register such a complaint with the American Counseling Association offices, 5999 Stevenson Ave. Alexandria, VA 22304, or visit their website http://www.counseling.org. All registered complaints have to indicate the specific issue challenged and the specific counselor that the complaint is rouged against. 11. Statement of Volition A counseling therapy session is a voluntary session and no any form of coercion, intimidation, or rewarding can be used to make a subject undergo a counseling therapy session. You are free to refuse divulging any information that you are not comfortable with, or terminate an ongoing therapy session at any time without giving any details regarding such a decision. Moreover, you have the right to choose and prefer a specific counselor to undertake the session over others without giving any details regarding your decision; you are however encouraged to undertake such termination of a session through writing, and the letter submitted to any of our offices. 12. Termination of a session by a therapist A therapist reserves the right to terminate any session with you without giving any further notice in case of the following reasons: i. they consider you are not cooperating as would be required in the sessions, ii. They discover you have provided false or information that may not be substantiated regarding a particular case, iii. You fail to turn up for sessions as agreed with the therapist. 13. Consequences of termination Termination of a therapy session after starting the sessions implies you have forfeited any payment with respect to the therapy sessions. However, payment may be reimbursed when such a session is terminated before you start such sessions. In case a therapist terminates a session due to the reasons listed above, the reimbursed payment will be considered based on the number of sessions attended and the reasons for termination. You reserve the right to contest any decision made on the same to our offices, or through ACA. 14. Additional payment Additional payment besides the agreed amount may be required if you insist on prolonging the sessions over the agreed period, in case where a therapist considers a subject’s situation as serious to warrant medical attention or other specialized services, or in case of any unforeseeable occurrence besides the terms agreed before the therapy session. However, such decision has to be discussed between you, a therapist, and a guardian where necessary for subsequent approval. 15. New findings You will be notified of any finding in the therapy session, or any necessary information that emerges in the therapy session. 16. Number of people involved A therapy session shall at any time involve the therapist and the subject. However, in cases where a therapist considers appropriate to have guardian, such a person shall be involved at the appropriate time, which has to be consented by the subject. 17. Commitment I…………………………………. have read and understood the private counseling therapy consent and would hereby commit myself to attend a therapy session from (day)…….. of (month)….. in the year….. I hereby append my signature for commitment and cooperation in a therapy session. Name………………. Sing………………….. Date…………. For official use only; Therapist assigned Name:…………. Sing………………….. Date……………… Reference International Organization for Migration (2009) Introduction to Basic Counseling and Communication Skills, IOM: Geneva Switzerland. Read More