Mend Counselling Welcomes You
You will be sent this consent after booking to fill out electronically.
Finding a therapist can be challenging. Judging profiles and picking from a sea of specialities and jargon can be tiring. But here you are! You are already making a move forward.
Beyond all the logistics, I am already looking forward to meeting and creating change together. This shared intention will guide all our sessions.
I am going to go over policy, consent and service information in this document. It’s important we both have a shared understanding of this information. Please read and carefully review the following statements and sign that you are in agreement at the end.
The Counselling Relationship
Multiple studies over the years have shown that the most important predictor of success in counselling is the relationship you have with your counsellor. If at any time you feel I am not the right fit for you, for any reason, I will absolutely help you find another therapist. My ultimate goal is healing for you.
During our work together I will maintain necessary boundaries to avoid dual relationships and maintain a high degree of professionalism as outlined clearly by my regulatory college; the British Columbia College Of Social Workers.
I will:
Engage and collaborate on all parts of treatment
Educate fully about any treatment offered
Make a plans along side you and revisit goals in sessions
Engage in feedback and track change.
Engage in professional consults to ensure the highest degree of care
Be flexible, open and deeply engaged in our work at all stages of therapy.
I will not:
Engage in any other business with you other than therapy
Dismiss any concerns you have about a modality I offer
Engage in any relationship outside our sessions with you
Push you to talk about experiences you aren’t ready to share
Give medical, legal or financial advice
Be connected on my personal social media accounts(e.g.- I will not knowingly accept “friend requests” on any platform for my personal accounts or on yours)
Receive gifts (other than small token, like a thank you card)
Informed Consent
Consent is an ongoing, process we work on together. If we decide on a new treatment modality, we will explore consent again. Informed consent means you have all needed information you need to make decisions about any treatment plan.
Confidentiality
Confidentiality is a necessary condition of counselling and endures during and continues after the end of the counselling relationship. This means, I will not speak with anyone about your story and situation.
I do engage with other therapists and case consultation, but the limits of confidentially extend to these therapists as well. I may request to audio record a session and this is for my continued professional development only. This information is kept secure and destroyed within 2 months.
Limitations to Confidentiality
There are three (3) important limits to maintaining confidentiality all counsellors must follow.
These primarily concern risks of harm:
1. If there is risk of harm or neglect to a child or vulnerable/dependent adult
2. If a counsellor believes you are at risk of harming another person or yourself;
3. For the purposes of complying with a legal order
Your Personal Information & Record keeping
Your personal information is only collected to be used by me in the delivery of counselling services to you.
Your personal information will not be disclosed to any third party without expressed, written consent by you or in the case of the above limits to confidentiality.
Any notes made include the minimal amount of information that is important for me to remember when providing ethical and effective care. I only write what is necessary to decrease possible harm that may occur on the very low chance your file is legally requested by outside parties.
Third parties like ICBC, require a written assessment. It is required under the Vehicles Act to provide this assessment as requested
If you’d like more detailed information about the privacy in the Jane system, please visit;
https://janeapp.com/guide/basics/security-faq
At any time you may simply request a copy of your file, and one will be made available within 30 days with an administration fee of $50.00. This is a standard way for health information to be shared legally.
Communication
I use Jane app for notes, payment and video conferencing. They are a consistent leader the industry in encryption and security. All consents & notes are held within their secure servers which reside within Canada as per Canadian legislation.
Any pertinent e-mail correspondence you send will be copied into your account file.
Direct e-mails are not secure, so be mindful of the information you send via regular e-mail.
I regularly check my e-mails but I will not respond while on a planned leave/vacation or out of office hours of 8-5 Monday to Friday.
I do not text with clients as it is not secure
On-line sessions
Using video conferencing for therapy has been shown to be just as effective as in-person sessions. As you can imagine, it has its benefits and drawbacks.
By engaging in video conferencing, you understand there are some risks to confidentiality, either by those in your home or via the connection itself.
I use Jane-app, a leader in the area of encryption and privacy matters. However, a breach can still occur.
As you can imagine addressing emergency or crisis situations is not ideal in video conferencing. However, we take precautions such as knowing your address, and emergency contact person to help mitigate these issues.
You are not charged for down times in our sessions. If we are unable to re-connect. I will call the provided phone number to make other arrangements.
Some situations are not conducive to on-line service. This is assessed on a case-by-case basis.
Mend trauma does not provide emergency services. If you are in crisis while out of sessions, please call the
Vancouver crisis centre 1-800-784-2433
or
Emergency services at 9-1-1
Feedback Process
You may be sent questionnaires so I can learn how to improve in the care I provide.
I am very open to feedback and see it as an essential part of our work together.
I will regularly check in about your experiences in the sessions.
Coverage
CVAP- After you apply they will send you a letter of approval and claim number. I will use this number to bill CVAP and they will partially cover my service. You may be entitled to up to 48 sessions through this program.
FNHA- Up to 20 hours of coverage may be approved. After we have spoken, I will take some information and submit approval on your behalf. It may take a few days to weeks for approval. Your sessions are fully covered.
Fees
160 /50 min session
Payment & receipts
Session fees may be paid by credit card which I keep on Jane app’s secure servers
Receipts will be issued for each paid session and will include my name and professional association ID number for insurance claims.
Most coverage does not cover the full amount of service (except FNHA, full cost is covered). I can direct bill to all these insurers, but not your extended health plan as of yet.
Receipts can only be provided for sessions that you have attended.
Receipts can only be issued to the individual receiving the services.
Please confirm with your health care provider to ensure that Registered Social Workers are covered in your plan.
Health care spending accounts can often cover the cost of counselling as well.
Cancellation Policy
Clients will be charged their full appointment fee for all missed sessions or sessions cancelled with less than 24 hours notice.
The full charge is due for missed appointments.
If you are cancelling an appointment due to a fever, cough or known exposure to a person with COVID-19. You will not be charged and will be unable to have in-person sessions for a period of 14 days and can only return to in person session if you are symptom free.
If you cancel 3 sessions in a row with no medical explanation, your remaining sessions will be set to pre-paid, and your cancellation period set to 5 days.
Please refer to your 3rd party coverage for their cancellation policies. Some will cover misses sessions, most will not. The fee will then be your responsibility.
COVID Response & Policy
Do not attend any in-person session if you have a fever or a cough or if exposure to someone with known COVID-19 infection.
If you are cancelling an appointment due to a fever, cough or known exposure to a person with COVID-19, you will not be charged. We will move to on-line sessions, if appropriate, for 14 days. You must be symptom free to resume in office sessions.
During in-person sessions we will not have any physical contact including hand shakes or hugs and will maintain space of 6 ft while in the office.
The office and any tactile objects cleaned between visits daily with approved cleaning products.
There is available hand washing station and hand sanitizer to use when arriving and leaving.
Acknowledgement of Informed Consent & Agreement to Consent to service and mend counselling policy
My signature below confirms;
I have fully read, understand and accept the statements in this document.
I am a B.C resident, currently residing in B.C.
I have had the opportunity to ask any relevant questions in advance of signing this form.
I understand and agree to comply with above policies outlined
I understand the limits to confidentiality as outlined.
I am fully prepared to enter into a counselling agreement with
Laura Vander Steen, MSW RSW 08524
This document was adapted from a variety of sources including;