EAMONN MCVEIGH

UKCP Reg, PG Dip OP, DHP MCS (Acc) MIHS MBRCP

Cognitive Behavioural Therapist, HypnoPsychotherapist, Mnemodynamic Therapist. Schema Therapist, EFT/EMDR Practitioner, Supervisor

I abide by UKCP Code of Ethics

I have Professional Indemnity Insurance

I am in regular Psychotherapy supervision

This is a Therapy Contract with

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Confidentiality

Psychotherapy is highly confidential and is carried out within strict professional boundaries. I will however break confidentiality when I have good grounds for believing that a person may cause serious harm to themselves or others

• Disclosure of criminal activity or knowledge of criminal activity

• Other statutory obligations

• Terrorism Act 2000:

• Drug Trafficking Act 1994:

• When necessary to uphold Child Protection Law

We agree to meet at the same venue for professional therapy  every             for                  hour/s

Procedures

We agree that the following arrangements will take place in the following situations

BEFORE THE FIRST AGREED ASSESSMENT SESSION HAS BEEN CONFIRMED A PAYMENT OF £60.00 MUST BE PAID (NON-REFUNDABLE)

This can be paid by PAYPAL on my website or by cheque/cash (receipt will be given)

Cancellation

For a routine cancellation, a one week notice is required

For an emergency cancellation then as much notice as possible is required (fee payable)

Non attendance less than 24 hours (or cancellation less than 24 hours)

Contact me to re –arrange (this will incur the full fee) as soon as possible

Complaints

If you have any concerns about your Therapy, and feel that you are unable to address it accordingly with your therapist, then please contact relevant organization or

UKCP 2nd Floor, Edward House, 2 Wakley Street, London.

Availability

I can be contacted by the personal mobile number that I will give you on our first appointment after signing agreement.

I will be available only between 9 -5 pm, Monday to Friday. I may have my phone switched off as I may be with a client. Leave a message and I will get back to you.

Contact may also be made by email.

If I am not available, an alternative arrangement will be made in advance.

Roles and Responsibilities

We have agreed that as therapist I will take responsibility for:

Time Keeping: Managing agenda: Giving feedback: Monitoring the therapeutic relationship: Creating a safe place: Ethical issues: Keeping notes:

Expectations for Client

I expect client to attend on time: agree in advance of next session: have notes prepared. If working under or for another organizations, provide copies of their workplace procedures if needed. I expect clients to do homework/tasks when requested.

FEES

• All fees are to be paid at the start of session/or before next agreed appointment

• All sessions are 50 minutes in length and the fee is 60.00 Pounds

• A receipt can be given at the end of session. By email as an attachment or given on a monthly basis or when all sessions are complete.

• Cheque/cash in sterling only or by PAYPAL

• All first sessions have to be paid in advance to minimize DNA or late cancellations. The first fee is £60.00. 

As from 10/12/2010, I am unable to complete or assist in written support or testimony for clients requirement for Social Welfare benefits (DLA or ESA) or any other Agency requirements.(Housing) It is the full responsibility of the client to obtain the required information from their GP or other Agency. In completing and signing this contract the client fully understands and adheres to this understanding.

Signed (Therapist)…………………………………………...............................Date……………………………….

Signed (Client)……………………………………………………………………………Date…………………………………

PLEASE COMPLETE THE FOLLOWING INFORMATION AND BRING THE FORM AT FIRST SESSION

PRELIMINARY CLIENT INFORMATION

Client Name:

Address:

Post Code

Date of Birth:

Telephone No:

Employment Status

Contact details of next of kin

Telephone No:

- - - - - - - - - - - - - - - - - - - - - - -

Medical Conditions:

Medications (inc. dosage & length of time taken):

Other Agencies Involved:

Previous Counselling or Psychiatric Contact:

Outcome:

Summary of Presenting Difficulties: