Privacy, Confidentiality, and Informed Consent Form
Informed Consent & Confidentiality Agreement for the Provision of Online Counselling Services
Purpose and Nature of Counselling
Clinical Counselling has been referred to as “a process by which a person is assisted or seeking consultation to learn to think, feel, and behave in a more rewarding manner.” As a process, it takes place over a period of time and promotes healing, comfort, clarification, and reconciliation. People who seek counselling have usually attempted to change some behavior that is not, in the final analysis, rewarding to them. However, their attempts have been unsuccessful and so they come to counselling with aspirations and anxieties, hoping for a helper or consultant who will relieve their distress and help them replace it with something more rewarding.
The three basic elements in counselling are the counselee (the person in pain desiring to be healed), the registered clinical counsellor or registered social worker (the helper who listens), and the negative experience, or that which causes pain and distress. The counselee identifies the negative experience and is helped to choose a path that is more satisfactory. Those seeking help are the experts on their problem(s); they have been living with it for weeks, months, and often years. Now they want release. The counsellor must, therefore, carefully listen and help the counselees spell out their needs. Counsellors assist individuals to identify and achieve goals that they have selected in response to the difficulties they are experiencing. The counsellor provides an atmosphere of acceptance and genuine caring to facilitate the process.
When people engage in counselling, they may be ready for change in some aspect of their life. Counselling can lead to improved mental health by helping you better understand your thoughts, emotions and behaviours. It can also improve your relationships, how you relate to others, and the world. The number of counselling sessions you have depends on the goals you set and how long it takes to reach these goals. Your counsellor will work collaboratively with you to help you set and achieve your goals while facilitating personal growth through the counselling process.
Risks
Counselling presents both benefits and risks. The benefits include, but are not limited to, better relationships, solutions to specific problems, an increased sense of well-being, and a reduction of distressing symptoms. However, because counselling tends to bring up uncomfortable feelings and difficult memories, people sometimes feel worse before they begin to feel better. Some find that, as they experiment with new ways of thinking and behaving, relationships with others are altered or disrupted. You are encouraged to share any feelings of fear, concern or doubt about the counselling process with us at any time during your sessions.
Collection and Storage of Personal Information
We maintain records on the content of our sessions, which are locked in a secure location, and can only be accessed by Orchard Valley Counselling Services Inc. This is done in accordance with BCACC guidelines and the Personal Information Protection Act (PIPA).
Fees
We offer a free 20-minute initial consultation, via email or phone, to identify your concerns and/or reasons for seeking our services. You also have an opportunity to ask any questions you have about the counselling process and to see if you feel we are a “suitable fit”. Our standard 50-minute counselling session costs $120(plus 5% GST for RCC’s, and CCC’s services), according to BCACC fee guidelines. RSW or RCSW counselling services are tax exempt (aren’t required to charge GST).
Costs may differ depending on the type of counselling chosen. For instance, a video session with your counsellor will cost more than email counselling. We also have some sliding fee options available for eligible clients in financial need. If finances are a concern for you, please discuss this with your specific counsellor.
Payment is due prior to each session and can be made through any major credit cards such as American Express, Visa, or MasterCard, PayPal or e-transfer at christina@ovcs.ca to provide payment.
If you wish to change or cancel an appointment, please provide 24 hours notice via text to your counsellor, email or telephone. Should you miss your appointment or do not provide 24-hours notice, you will be charged the 75% of the total fee of the session.
Please Note: Technical Issues or a Poor Internet Connection May Be A Problem
There is the possibility with technology of any kind that your counselling session may be disrupted due to internet connections or other technical issues. When you decide to undertake this type of counselling through online, it’s essential that you are aware and in agreement that there is the potential for technical issues to occur. If a technical issue due occur, which is rare, we will contact you as soon as we can. This will be to either resume the session or reschedule the remaining portion of the session. Although this doesn’t often happen, there may be times that an internet connection may be poor or there may be a client emergency. If we are not online within 15-minutes of our scheduled time, you may be provided a credit for your session and we will contact you at our earliest moment to reschedule.
Contact Us
Please contact us by email at admin@ovcs.ca or by phone at 236.361.0043. We also have a toll-free number at 1.877.215.7759 for those out-of-town. Our regular business hours are Monday to Friday from 10AM-4:30PM. Evening and Weekend appointments are available. We will return your call as soon as possible, however, if there are times while we are in session that we may not be able to call back till the following business day. Should you need to get a hold of us between sessions, is to email us. If you have a specific counsellor, you may ask to have their email provided to you by emailing our office at admin@ovcs.ca or you may go on our website under our ‘Counsellors’ to locate your specific counsellor to contact them directly by email.
If you have an emergency, please call 911, or your local crisis line contact. In BC, this number is 1-800-784-2433. For youth aged 5-20 years old, contact Kids Help Phone at 1-800-668-6868.
The Client’s Rights
As a client, you have the right to the following:
- To decline a particular technique in counselling or to stop counselling at any time
- To be referred to another counsellor or health care professional
- Withdraw or decline consent for the collection, use, or disclosure of your personal information, except where precluded by law, and access or obtain a copy of the information in your counselling records, subject to legal requirements
- Ask questions about our therapeutic approach, background and experience or any other concerns that will impact your ability or choice to engage in counselling sessions
- To pass on any questions, or say no to anything we suggest or any approach we use
The Counsellor’s Rights
Online counselling can occur anywhere in the world, OVCS counsellors are able to treat clients vacationing or residing outside of Canada or the USA. However, should a legal claims be brought forth by a client as a result of online counselling with an OVCS counsellor, the client agrees to file the demand or proceeding inside Canada or the United States of America. The client understands and agrees that any legal suite needs to be filed in Canada and the USA in the result of a concern from their counselling services.
Confidentiality
All information you share with us is strictly private and confidential. It will not be released without your voluntary and written consent. As part of regular 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
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. Common videoconferencing services, such as Skype, are not secure and data is stored in web servers and thus subject to electronic monitoring. We use software that has increased security, however it is important that you secure your privacy as much as possible. All of our counsellors’ information is secured according to PIPEDA policy regulation. 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 remaining information and notify all parties involved immediately. If these risks are of concern to you, in person or telephone counselling are alternative ways to connect with one of our counsellors.
If you are at imminent harm to yourself or someone else, we are ethically and legally bound to let the proper authorities know. These ethical and legal obligations are our concern for your health and safety, and that of those with whom you interact.
Disclaimer:
You must be at least 18 years of age to legally consent for online counselling with all Orchard Valley Counselling Services Inc. counsellors. If you are under 18 years of age, your parent or guardian must provide consent for you. There are no exceptions.
Terms and Conditions
I have read, understood and agree with the information in this document, and would like to proceed with counselling.*
Yes, I agree to the Terms and Conditions in this document. Informed consent is agreeing to receive treatment for the issues you bring into the sessions. Do you consent to being an active participant in this process?
Please sign and complete all required fields.
