Pre-Counselling Form and Information

If you have booked a counselling appointment with me please

complete this form before our first session together.

(If you are completing this on a mobile device and you press send and your entries disappear

the form has sent. I will email you to confirm I have received it).

Thank you

Counselling Information

Location​

Dovetail Counselling Service is at 6 Stafford Road, NP26 5DE. There is street parking. Entry is via the door on the garage (there is a sign saying 'Dovetail Counselling Service' and a bell for you to ring). 

The counselling room is located on the ground floor, with a ramp going from the garage into the house.

It is all on the flat with no steps.

There is no waiting area so please arrive at your appointment time.

 

Counselling Sessions

Our first meeting together is a trial session. This is to see if counselling is for you, and if you wish to continue with further sessions. There is no obligation to book anymore.  After the first session if you decide you would like to continue with counselling then I ask you make a commitment to attend regularly, in order for you to get the most from your therapy. This might be weekly, or fortnightly. The average number of sessions needed is six, although it could be shorter or longer, depending on your needs and issues.

 

Counselling Contract

At the beginning of the first session we will both sign a counselling contract with the following on it-

I aim to give the best possible service to my clients.  The contract below sets out my commitment to you, and in return what I would consider to be your responsibility. 

I will:

  • Work to the BACP Ethical Framework for Counsellors. 

  • Be clinically supervised to ensure safe practice at all times.

  • Treat you with respect and without judgement.

  • Treat the work with confidentiality. Confidentiality will only be broken, with or without your permission, in the event of disclosure of abuse of children, other vulnerable people, serious criminal offences, or harm to self or others. There is also a duty to disclose acts of terrorism, under the terrorism act.

  • Make a commitment to you to attend every session, and to advise you in good time if this is not possible, for unforeseen reasons.

  • Meet with you at a time, day and venue agreed. 

  • Ensure the venue will be a safe place for us to discuss your issues.

 

You will:

  • After the first session if you decide you would like to continue with counselling then I ask you make a commitment to attend regularly, in order for you to get the most from your therapy. This might be weekly, or fortnightly.

  • Inform me if you are unable to attend (less than 48 hours notice full fees apply).

  • Agree to engage in the process, being open and honest.

  • Agree a planned ending to the work with myself.  If you take the decision to end counselling prematurely I will respect your wishes, but would appreciate the opportunity to discuss this with you.

  • Agree not to be under the influence of substances.

 

Fees

Each session is booked for 50 minutes and at present costs £45. Once you have booked an appointment with me I ask that payment is made within 24 hours to secure that booking for you. Payment can be made by direct bank transfer (I will send you my bank details). By card via my online booking system when an appointment is booked here - https://10to8.com/book/gholjz-free/#/.

If you cancel or rearrange with more than 48 hours' notice of the appointment time I will refund your money for a cancelled appointment or transfer the payment to the rearranged appointment. 

My fees are reviewed annually and I will give you four weeks’ notice in advance if I am increasing them. 

Severe Weather Conditions

If you are unable to attend my premises due to severe weather conditions like snow I am able to offer the alternative of telephone or counselling via WhatsApp. If you feel this is not suitable for you, and cancel with less than 48 hours' notice, then half of the usual fee will be refunded to you.

 

Privacy Notice

You will have been given a privacy notice with this contract at our first session. This sets out how I manage and safeguard your data and the notes I take.

 

Please contact me beforehand if you have any questions or ask me when we meet up for our first session.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

Counselling Information – Referral from an Organisation

 

Location

Dovetail Counselling Service is at 6 Stafford Road, NP26 5DE. There is street parking. Entry is via the door on the garage (there is a sign saying 'Dovetail Counselling Service' and a bell for you to ring). The counselling room is located on the ground floor, with a ramp going from the garage into the house. It is all on the flat with no steps.

There is no waiting area so please arrive at your appointment time.

 

Counselling Sessions

Our first meeting together is a trial session. This is to see if counselling is for you, and if you wish to continue with further sessions. There is no obligation to book anymore.  After the first session if you decide you would like to continue with counselling then I ask you make a commitment to attend regularly, in order for you to get the most from your therapy. This might be weekly, or fortnightly.

 

Counselling Contract

At the beginning of the first session we will both sign a counselling contract with the following on it-

 

I aim to give the best possible service to my clients.  The contract below sets out my commitment to you, and in return what I would consider to be your responsibility. 

I will:

  • Work to the BACP Ethical Framework for Counsellors. 

  • Be clinically supervised to ensure safe practice at all times.

  • Treat you with respect and without judgement.

  • Treat the work with confidentiality. Confidentiality will only be broken, with or without your permission, in the event of disclosure of abuse of children, other vulnerable people, serious criminal offences, or harm to self or others. There is also a duty to disclose acts of terrorism, under the terrorism act.

  • Make a commitment to you to attend every session, and to advise you in good time if this is not possible, for unforeseen reasons.

  • Meet with you at a time, day and venue agreed. 

  • Ensure the venue will be a safe place for us to discuss your issues

 

You will:

  • After the first session if you decide you would like to continue with counselling then I ask you make a commitment to attend regularly, in order for you to get the most from your therapy. This might be weekly, or fortnightly.

  • Inform me if you are unable to attend (less than 48 hours’ notice full fees apply).

  • Agree to engage in the process, being open and honest.

  • Agree a planned ending to the work with myself.  If you take the decision to end counselling prematurely I will respect your wishes, but would appreciate the opportunity to discuss this with you.

  • Agree not to be under the influence of substances.

 

Referral from an Organisation

There will be a set number of sessions that your referrer has agreed to pay for and I will invoice them for payment. They will be informed of sessions you attended or didn’t attend. If you need to cancel or rearrange if 48 hours’ notice is given then that session will not be counted in your allocated number of sessions.

 

After each session I will give the organisation a brief summary of a sentence or two of what was covered in the session and/or how I am working with you. I may also be required to do a report at the end of our counselling sessions. Please ask me if you would like us to discuss what will be written. I will not disclose any other information to you referrer unless if it is agreed with you beforehand or it breaks the confidentiality listed above.

Severe Weather Conditions

If you are unable to attend my premises due to severe weather conditions like snow I am able to offer the alternative of telephone or counselling via WhatsApp. If you feel this is not suitable for you, and cancel with less than 48 hours' notice, then this will be used as one of your allocated sessions

 

Privacy Notice

You will have been given a privacy notice with this contract at our first session. This sets out how I manage and safeguard your data and the notes I take.

 

Please contact me beforehand if you have any questions  or ask me when we meet up for our first session.

 

Dovetail Counselling Service

07401 331521

6 Stafford Road, Caldicot, Monmouthshire, NP26 5DE,

©2018 BY DOVETAIL COUNSELLING SERVICE.