CLIENT INFORMED CONSENT AND SERVICE AGREEMENT
By completing your online registration (whether in part or in whole) or by clicking “I agree,” you indicate your agreement with these terms.
This agreement is between you and Lorraine Irlam, M.A. (Registered Clinical Counsellor with the British Columbia Association of Clinical Counsellors, registration #1828), operating as “My Therapy Online”, also known as “My Therapy” and/or MyTherapyOnline.ca, hereinafter referred to as My Therapy.
In all communications with My Therapy, you must agree to honestly represent your identity and Personal Information.
You must not claim to be anyone other than yourself or provide any false information about yourself.
You must not register for online counselling on behalf of someone else, even if the information you provide is accurate information about that person.
Role play is acceptable only if and when your counsellor suggests it as a part of your online counselling process.
You must not allow any third-party to login to your account. Your login username and password are the means used by My Therapy to authenticate that you, and only you, are accessing your account.
If you are under 19 years old, you must be willing, upon request, to obtain signed parental/guardian consent before your counselling services can proceed.
THE NATURE OF COUNSELLING AND PSYCHOTHERAPY
Psychotherapy is not easily described in general statements. It varies depending on the personalities of the counsellor and client, and the particular problems you bring forward. There are many different methods that your counsellor may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the counselling to be most successful, you will have to work on things you discuss with your counsellor both during and between sessions.
Counselling can have benefits and risks. It can lead to changes in self-awareness, and different ways of relating to others. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable or strong feelings like sadness, guilt, anger, frustration, loneliness, and helplessness, or difficult memories. On the other hand, counselling has also been shown to have benefits for many people who go through it. Counselling often leads to increased self-awareness, gaining personal insights, learning new ways to cope with or solve problems, developing new skills, better relationships, changing unwanted behaviours, and significant reductions in feelings of distress. But there are no guarantees of what you will experience and not engaging in counselling is also an option.
The first part of counselling involves a collaborative assessment/clarification of your needs. Goal setting, bringing focus and developing plans for action are the next phase of counselling. The final phase involves your counsellor supporting you in the changes you have made and saying goodbye to your counsellor. You should always take note of whether you feel comfortable working with your counsellor. If you have questions about your counsellor’s procedures, please discuss them with your her whenever they arise.
LIMITATIONS OF THE SCOPE AND NATURE OF ONLINE COUNSELLING
In face-to-face psychotherapy, counsellors are responsible for the treatment of their clients and exercise significant control over the therapeutic process. Important differences between online and face-to-face psychotherapy limit the responsibilities assumed by My Therapy’s counsellor. Online counselling is delivered from a distance. Therefore, you must agree to assume significant responsibility for, and control of your treatment
You, as a prospective client, must take responsibility for making treatment decisions, including:
(A) whether on-line counselling is the best option for your needs (to learn more about benefits and drawbacks of online counselling, see http://insomnia-help.net/benefits/ and http://insomnia-help.net/possible-drawbacks/)
(B) whether on-line counselling is appropriate for your particular situation,
(C) whether you possesses the necessary computer literacy and language literacy
Asynchronous “Private Conversations”
With the asynchronous (i.e. not “live”) Private Conversations messaging system used for counselling, there are no visual or auditory cues to interpret communication. You must base your interpretation of your counsellor solely on your counsellor’s written statements. Likewise, your counsellor must base her interpretation of your needs solely on what you type and transmit to them.
Counsellors exercise control over the content of their contribution to the transcript only. Because Private Conversations are asynchronous, your counsellor loses “therapeutic control” as soon as the transcript is sent. Your counsellor will try to anticipate your needs. However, there is no way for your counsellor to control either the context of your interpretations or your reactions to your transcripts.
Your counsellor will create Private Conversations transcripts based on her clients’ statements but cannot provide her clients with emotional support beyond what she writes to her clients.
For these reasons, counselling through the Private Conversations messaging system cannot be considered the same kind of service as traditional psychotherapy. It is psychotherapy delivered from a distance, and includes the passage of time between exchanges of messages.
In addition to your responsibilities as a prospective client listed in (A) to (C) above, if you choose to use Private Conversations for counselling, you must take responsibility for additional treatment decisions, including:
- whether you possesses the necessary reading and writing skills; whether, when, and where to read the transcripts sent by your counsellor or your counsellor’s supervisor,
- whether, when, and where to write messages to your counsellor,
- how much of each transcript to read, what information to accept and what to reject,
- planning in advance what you will do if you become in need of emotional support upon reading or writing a message.
In accordance with Canadian laws and ethical codes of the counselling profession, we assure you that the counsellors of My Therapy will not communicate your Personal Information to anyone without your consent. However, there are several important exceptions to our assurance of confidentiality:
- In order to give you the best possible service, and as required by accepted ethical counselling practice, My Therapy’s counsellors are regularly supervised by other qualified counsellors. Supervision may involve the supervisor viewing/monitoring your personal information and counselling records.
- The law requires all Canadian citizens, including counsellors, to report any suspicion of risk of child abuse or neglect, or risk of abuse to vulnerable individuals. If we believe that a child or vulnerable person is at risk of being abused, has already been abused, or that someone who previously abused children or vulnerable individuals is still a threat, we must report the information to appropriate authorities. This report may be given without your knowledge.
- If we believe that a person may be at risk of serious harm to self or other, we will report the situation to appropriate authorities and/or your emergency contact person and/or the endangered person. This applies to cases of potential suicide and homicide.
- Courts of law have the power to demand that we release your records if you are involved in a court case in which your relationship to My Therapy is somehow relevant.
- If a counsellor of My Therapy receives an email from you that is not secure, you waive your right to confidentiality, for both the email you sent and the reply that our staff may send you using similar insecure means.
- If you have an unpaid debt to your counsellor and/or My Therapy, and should the counsellor decide to take legal or other action to collect the debt, including engaging the services of a third-party collection agency, you waive your right to confidentiality, to the extent permitted by the Personal Information Protection Act of British Columbia.
LIMITATION OF MY THERAPY ONLINE’S DUTY TO REPORT LIFE THREATENING SITUATIONS
My Therapy’s counsellors’ ability to fulfill their obligations as described in 1, 2 and 3 above are limited by the information that you provide them.
You must agree to provide My Therapy, and maintain correct information in your PrivacEmail Profile: your address, telephone number, and e-mail address. Failure to do so releases My Therapy from our ethical and/or legal obligations as described in 1, 2 and 3 above.
The purpose of the collection, use and disclosure of your personal information is for the provision of professional online counselling, including supervision for the purposes of improving provision of such counselling services.
Only your counsellor and your counsellor’s supervisor have complete access to your records while they are in the custody of My Therapy. Administrative staff engaged by My Therapy cannot access your counselling records, but may have access to general account information.
YOUR RESPONSIBILITY TO PROTECT YOUR OWN PRIVACY
My Therapy cannot protect your confidential information when that information is not in My Therapy’s control at the location of your computer or stored on your computer. You are responsible to prevent any and all third parties at your location from detecting your involvement in online counselling. You are responsible to select and control the environment in which you engage in online counselling.
We strongly discourage you from disseminating, distributing or copying your counselling records — for example posting to social networking sites or on a website. However, if you believe it may be beneficial to take any such action, we urge you first to consult with your counsellor.
At My Therapy, we do our utmost to protect and safeguard your personal information. The servers we use are firewall protected. My Therapy’s systems ensure that only encrypted transmissions are allowed to communicate within the Internet systems owned and/or operated by My Therapy. As well, all stored data is encrypted.
However, My Therapy does not warrant that its Internet systems will be error free, that you will be able to operate them without experiencing problems or interruptions, or that they are not susceptible to intrusion, attack or computer virus infection.
My Therapy does not warrant the security of confidential material that becomes insecure because of actions you may take or that is a result of software that My Therapy did not supply. Examples of security breaches that we do not warrant include, but are not limited to:
- leaving confidential material on a computer screen for others to see
- storing confidential material on the computer you are using
- use of monitoring software (this could be spyware or legitimate monitoring by an employer, or other monitoring systems not listed here)
You must agree to use My Therapy’s PrivacEmail Professional system for all therapeutic communications to and from My Therapy or associated staff, or otherwise waive your privilege to confidentiality. In addition, you must assume full responsibility for the risks inherent in insecure Internet transmissions, including any losses or damages.
STORAGE OF CLIENT RECORDS AND PERSONAL INFORMATION
My Therapy creates verbatim recordings of all counselling communications except those that take place through Videocounselling (when and if this service becomes available). Verbatim recordings of written counselling sessions are called “transcripts.” My Therapy will securely store all records containing personal information, including transcripts, for a period of seven years from the last entry in your counselling record.
RIGHT TO ACCESS YOUR RECORDS
You have the right to access the information in your clinical records or to obtain a copy of those records, upon payment of any reasonable fees for such services.
RESPONSE TIME AND TECHNOLOGICAL FAILURE
Your counsellor at My Therapy will endeavour to reply to you using Private Conversations after your completed registration and payment, within three business days. Thereafter, your counsellor will inform you of his or her anticipated availability to answer each Private Conversation message (or to schedule time with you to conduct Chat Counselling or Video Counselling sessions, if/when available).
Counsellors normally space their replies and real-time sessions approximately one week apart. However, there are several reasons that your scheduled session could be disrupted. It is possible that My Therapy’s technological equipment or your equipment could fail unexpectedly and at any time. It is also possible that your counsellor has suffered incapacitation. If you suspect that any of these possible conditions have happened, or if you think there has been an unwarranted delay in My Therapy’s response, please contact your counsellor by telephone at 604-771-4444.
If your counselling is taking place only online, My Therapy cannot be held responsible for helping you manage a crisis. Because of the delays associated with the use of asynchronous communication, My Therapy cannot act as a crisis centre. If you experience an emotional crisis (intense feelings of distress, emergency or life threatening situation, or any other crisis) during the course of your treatment, merely sending an asynchronous Private Conversations message to your counsellor at My Therapy is not appropriate.
Rather than turning to My Therapy’s online counsellor to help you manage intense feelings of distress, emergencies or life threatening situations, or an emotional crisis, you must agree to take the actions described on the “In Crisis?” web page.
If a crisis occurs, you must manage the crisis by using resources other than those offered by My Therapy.
FEES AND PAYMENT
Unless otherwise agreed, fees, including all applicable taxes, are $85.00 Canadian per 60 minute session, and pro-rated to $1.45 per minute for shorter sessions if applicable, and must be pre-paid through PayPal. This rate applies to all counselling sessions, regardless of modality. In the case of Private Conversations, sessions involve your counsellor carefully reading your message(s) and writing a therapeutic reply. The hour also includes a 10 minute allowance for counsellors to deal with administrative tasks related to the services you receive. Counsellors very strictly track the amount of uninterrupted time they spend on their Private Conversations sessions.
Although services currently offered are asynchronous text communications, if, in the future, you are scheduled for real-time counselling sessions (whether by chat, video, or telephone), you are expected to provide 24 hours’ notice if you need to cancel an appointment. Otherwise, you will be charged the regular fee if you miss a scheduled appointment.
Should you have coverage by another organization or individual (such as extended health benefits or Employee Assistance Plan), you are responsible for confirming the scope of coverage with the paying organization, including that they cover the online counselling services of a Registered Clinical Counsellor, as you are required to pay the fees at the beginning of each counselling session and then request reimbursement from the paying organization, if applicable.
All fees are subject to change with 60 days notice.
If you have a concern about these billing or collection practices and do not feel that your counsellor has addressed that concern, you may contact the Registrar of the BC Association of Clinical Counsellors at 1-800-909-6303.
Your counsellor at My Therapy, as well as any associated support staff, are committed to providing you with caring, ethical, and professional services. If, at any time, you feel that your counsellor or anyone working on behalf of My Therapy has not served you to your complete satisfaction, please let your counsellor know as soon as possible. She will take immediate corrective action to resolve your concern.
If, after bringing your concern to the attention of your counsellor, you are not satisfied that your counsellor has addressed that concern, you have a right to file a written complaint against the counsellor with the BC Association of Clinical Counsellors (BCACC). BCACC may be contacted at 1-800-909-6303 or #14 – 2544 Dunlevy Street, Victoria, BC, V8R 5Z2.
LOCATION OF SERVICES
You agree that the counselling services provided by Lorraine Irlam and My Therapy, for all legal purposes, take place in Canada only, and specifically, in the province of British Columbia.
Any claims against My Therapy, its directors, officers and employees as well as your counsellor and your counsellor’s supervisor, which give rise to suits or judicial proceedings must be filed and tried only within Canada, and specifically in the province of British Columbia.
By agreeing to this Client Consent and Service Agreement, you irrevocably submit to the exclusive jurisdiction of the courts of the province of British Columbia, Canada. In the event you initiate against My Therapy any claim, demand, action or proceeding relating to your counselling services or this document (collectively, “Claims”), you agree that the resolution of all Claims will be governed by and construed in accordance with the laws of the province of British Columbia, Canada, and the substantive law of Canada, not including My Therapy’s choice of law provisions.
My Therapy makes no representation that its counselling services are appropriate or available for use in locations outside of Canada. If you are a citizen or resident of the United States or any country other than Canada, the laws in your place of residence may require counselling practitioners to register and/or be licensed to practice in your location. Since you agree that My Therapy’s online counselling services take place in Canada only, and specifically, in the province of British Columbia, laws and regulations pertaining to the United States or any country other than Canada do not apply to your relationship with My Therapy.
Without limiting any other term herein, you expressly waive any right you may have to initiate any Claims against any of My Therapy’s directors, officers and employees as well as your counsellor and your counsellor’s supervisor in the United States or any other foreign jurisdiction in respect of the Services you receive or of this document.
– If you construe the location of My Therapy’s online counselling services to be any location other than Canada, you are prohibited from accessing My Therapy’s services for any reason.
– If you construe the jurisdictional laws under which My Therapy is governed to be any jurisdiction other than Canada, you are prohibited from accessing My Therapy’s services for any reason.
LIMITATIONS ON DAMAGES
In any lawsuit arising out of these services, consequential damages, emotional distress damages, and punitive damages awarded shall not exceed the fees paid for these services.
You must agree to indemnify and hold My Therapy and its staff harmless from any and all liability, costs, attorney fees, and other legal expenses arising out of negligence or the provision of services offered by My Therapy, to the maximum extent allowed by law.
REFUSAL AND WITHDRAWAL
You may refuse to accept the advice or opinions expressed to you by your My Therapy counsellor. You may withdraw from online counselling at any time with no obligation to My Therapy or your counsellor.
DURATION OF THIS AGREEMENT
This Agreement will remain in effect for seven years from the date of your last counselling session. My Therapy reserves the right to change the terms of this Agreement at any time, as long as My Therapy allows you the ability to agree to the new terms.
SCOPE OF THIS AGREEMENT
If any part of this Agreement is deemed by a Canadian court of appropriate jurisdiction to be illegal, invalid, or unenforceable, that part of the Agreement shall be limited or eliminated to the minimum extent necessary so that this Agreement shall otherwise remain in full force and effect and enforceable.
This agreement constitutes the entire, final, complete and exclusive agreement between the parties and supersedes all previous agreements, proposals or representations, oral or written, relating to this agreement. You are not permitted to modify or amend this agreement.