Therapist & Client Contract
Name of practice: PSRT
Name of Therapist/Counsellor: Matthew Chou
- To be available at the agreed time.
- To start and end on time.
- To offer a quiet, appropriate and undisturbed space for face to face or online sessions.
- To maintain safe, professional boundaries.
- To regard all contact and information as confidential unless the therapist has reasonable doubt concerning actual safety of the client or other.
- To encourage client autonomy.
- To work within the College Of Sexual & Relationship Therapist Ethical Framework (available upon request) including regular supervision. To review therapeutic work and relationship regularly.
- In the unlikely event of the therapist cancelling, an alternative appointment offered ASAP
- To attend punctually whether it is online or face to face.
- To give a minimum of 48-hour notice when cancelling/changing an appointment (or the full fee becomes payable)
- The online session is considered in the same way as a face-to-face session.
- To pay £50.00 for the initial session in advance then £50.00 (single) or £60 (couple) per session. Payment in full prior to each appointment.
- Recording of the session is not permitted.
- No eating or drinking during the session other than a beverage that is normally offered such as tea. coffee or water.
- To agree to give permission to contact GP if the therapist has concerns about risk to self (client) or others.
- To discuss with the therapist when the client decides to end therapy.
- To let the therapist know if the client is considering entering another therapeutic relationship.
- Both the therapist and the client must be in a private space alone to ensure maximum confidentiality.
Face to face session
- To pay £50.00 for the initial session in advance then £50.00 (single) or £60 (couple) per session payment in full prior to each appointment.
- Communicating with the therapist outside agreed counselling sessions to be limited to making, changing, or cancelling an appointment unless by prior arrangement.
- To be respectful to the counsellor and his property
- To agree to give permission to contact GP if the therapist has serious concerns about risk to self (client) or others.
- To discuss with the therapist when you feel you are ready to end therapy.
- To let the therapist know if you are in or are considering entering another therapeutic relationship.
We currently collect and process the following information:
Date of Birth
General Practitioner’s name and address
How we get the personal information and why we have it
All information we process is provided to us directly by you is solely for the purpose:
Psychosexual Relationship Therapy
We use the information that you have given us is to help provide the appropriate level of psychosexual and relationship therapy and safeguarding concerns where indicated.
We may share this information with General Practitioners/social services only after discussion with the client concern.
Under the General Data Protection Regulation (GDPR), the lawful bases we rely on for processing this information are:
(a) Client consent. Client remove his/her consent at any time. You can do this by contacting Matthew Chou.
(b) We have a contractual obligation.
(c) We have a legal obligation.
(d) We have a vital interest.
How we store your personal information
Your information is securely stored electronically and paper format.
We keep name, address, Dob, GP details, phone numbers, emails, and clinical notes for 7 years. We will then dispose your information by propriety File Erasers and paper shredder.
Your data protection rights
Under data protection law, you have rights including:
- Your right of access - You have the right to ask us for copies of your personal information.
- Your right to rectification - You have the right to ask us to rectify personal information you think is inaccurate. You also have the right to ask us to complete information you think is incomplete.
- Your right to data portability - You have the right to ask that we transfer the personal information you gave us to another organisation, or to you, in certain circumstances.
You are not required to pay any charge for exercising your rights. If you make a request, we have one month to respond to you.
Please contact us at the above correspondence address if you wish to make a request.
How to complain
If you have any concerns about our use of your personal information, you can make a complaint to us at by contacting Matthew.firstname.lastname@example.org
You can also complain to the ICO if you are unhappy with how we have used your data.
The ICO’s address:
Information Commissioner’s Office
SK9 5AF Helpline number: 0303 123 1113 ICO website: https://www.ico.org.uk
Client signature………………………………………….. Date……………………………
Therapist signature ………………………………….. Date……………………………
Contract is subject to regular review by the therapist or the client
Information Commissioners Office registered ref: ZB079558