Informed Consent & Confidentiality Agreement for the Provision of Online Counselling Services
Why do Children attend Social and Emotional Counselling?
When parents decide to engage their children in counseling, it is often because they have either seen, experienced, or heard or the child has disclosed information that would merit the need for professional intervention. Social and emotional skills training can lead to improved mental, and emotional health and consequently behaviors by helping the child to gain a level of self-awareness. The number of counseling sessions the child will have depends on various factors including goals, age, the severity of issues, the need for ongoing support, and others. Your counselor will work collaboratively with you to help you and your child to set and achieve your goals while facilitating growth through social and emotional learning.
Collection and Storage of Personal Information
We maintain records on the content of our sessions, which are stored and kept safe and secure. This is done in accordance with privacy guidelines and the Personal Information Protection Act (PIPA).
IMPORTANT: Procedural Concerns for Phone and Video Counselling
Due to the nature of these modalities and the possibility sessions may be interrupted using our secure online software or with internet connections, it is important to note that you agree to the potential of technical issues. If a technical issue occurs, we will contact you as soon as we can, to either resume the session or reschedule the remaining portion of the session. Although rare, there are times we may not have an internet connection or there may be a client emergency. If we are not online within ten minutes of our scheduled time, you will be given a credit for a session and we will contact you at our earliest opportunity to reschedule.
You can contact us by email at firstname.lastname@example.org or by phone at 866-503-7454. You can reach us by phone during regular business hours, Monday to Saturday, 9 am-5 pm. We make every attempt to return phone calls as soon as possible, however, if we are in session all day, we may have to return your call the following business day. If you need to contact us between sessions, the best way to do so is by email. If you have an emergency after hours, please call 911, or your local crisis line contact. You may also contact Kids Help Phone at 1-800-668-6868.
All information you share with us is strictly confidential and will not be released without your voluntary and written consent. As part of routine practice, we may, on occasion, consult a clinical supervisor on your case in order to provide you with the best care. Your confidentiality will be strictly maintained and your name will not be used. There are limitations to the confidentiality described above and these include:
– Reporting of suspected child abuse or neglect
– Complying with the requirements of a child protection investigation
– Complying with a subpoena
– Responding to a threat of harm to self or others
Positive Kids is a counseling and training practice; for best practice, all our therapists engage in weekly supervision from an accredited clinical supervisor, who may on occasion join sessions to observe and assist. For training purposes some sessions may be recorded with your consent, such recordings will only capture your voice and/or the therapist’s face. Clinical supervisors share the commitment to confidentiality.
Client confidentiality is of utmost importance, however, online communication is not 100% secure. There are risks involved and it is important that you are aware we cannot guarantee your protection. We use software that has increased security, however, it is important that you secure your privacy as much as possible. All of our counselors’ information is secured according to HIPAA policy regulations. If a breach occurs, we will remedy it as soon as it is discovered by taking the necessary steps to recover your personal information, secure the remaining information, and notify all parties involved immediately. If these risks are of concern to you, in-person or telephone counseling are alternative ways to connect with one of our counselors.
If it appears that your child is imminently about to harm him/herself or someone else, we are ethically and legally obligated to let someone know. More important than the legal obligations, though, are our concerns for your health and safety, and that of those with whom you interact.
All fields are required.