Welcome to Private Therapy Clinic. This document details crucial information about our professional services and the business policies of Private Therapy Clinic. Upon your signature (or by attending the sessions), the document will constitute a binding agreement between you and your practitioner. Private Therapy Clinic is an organisation that manages self-employed practitioners only and is not the provider of services to the client. The service provider shall at all times be the practitioner.

Please read the following document with care and make a note of any questions you may have. Your practitioner will be happy to discuss anything you are unsure of at your next meeting.

If you wish to revoke the contract at any time, you can do so simply by writing to us.

PSYCHOLOGICAL THERAPY AND PSYCHIATRY CONSULTATIONS

In the initial consultation, we will aim to discuss the issues you are concerned about and will consider the feasibility of a diagnosis if any. It usually takes a couple of sessions to be able to discuss all the issues and expectations and to establish a treatment plan (which may or may not include medication if you attend our Psychiatry service). Both our Psychologists and Psychiatrists will advice on potential psychological interventions that may be appropriate. After the initial assessment, we will advise on whether one or more follow-up appointments might be appropriate. You will be given full information about what the investigation and treatment involves the benefits and risks, whether there are any other reasonable alternative treatments, and what will happen if treatment does not go ahead. At any time do not hesitate to ask questions if you are not clear about any information you are provided with.

CONFIDENTIALITY

Your treatment will entail discussing some very intimate things with your practitioner, such as your thoughts, feelings, and actions. To some extent, your practitioners ability to help you will really depend on how open you are about yourself during your meetings. Anything that you do disclose will, remain confidential. It is important that during your discussions, you feel you can talk openly with your practitioner and that your right to privacy is protected. This generally means that your practitioner cannot discuss you or your case with any third parties without your consent.

Records: It is useful that your practitioner take notes during your sessions. These tend to be brief and include information such as the dates you met, the topics covered and any problems or goals you have. These are really just to document your meetings and are subsequently kept locked in a filing cabinet and protected under the strictest of privacy rules. Records of charges, payments, diagnoses, and any other sensitive information are kept on your practitioners computer and is password protected.

Audio-recording: It is also useful for Psychological Therapy sessions to be Audio-recorded as it can also be helpful for both Clients and practitioners to listen back over sessions. Audio recording are reviewed by your practitioner for the purpose of treatment planning and clinical supervision and remain confidential. All Audio-recordings are kept securely on a recording devise which is password protected and are completely erased when your treatment is complete.

Exceptions to confidentiality: There are some situations that may arise where confidentiality-codes can be broken. Although these situations are rare, you should be made aware of what they are:

  1. If you threaten to harm another person, your practitioner is required by law to protect anyone they feel may be in danger. This could include making contact with the person or people who have been threatened and, in some cases, notifying the police. In the case of clients under the age of 16 parental consent will be acquired first. Where parental consent is not obtained however, and the clinician believes it is in the child’s best interest, child safeguarding procedures will be put in place.
  2. Likewise, if you threaten to cause severe harm to yourself, and your practitioner believes your threat to be serious, then he/she is ethically required to protect you in any way they see fit. In situations such as these, their intervention may involve talking to you about going to a hospital, or having you placed in a hospital without your permission. They may also need to call a crisis team or, in some cases, the police.
  3. If your practitioner suspects that any child, elderly person, or incompetent person is at risk from abuse or neglect, the law requires me to report this to the appropriate body. Laws such as these are in force to protect any dependable persons from being physically hurt.
  4. If you have been ordered or referred to Private Therapy Clinic by a court for psychotherapy or an evaluation of your mental state, the court will require some form of report from your practitioner. Therefore, it is in your best interests to provide me them with any court letters or orders so they can determine exactly what the court wants to know. Of course, you have the right to only disclose information you feel necessary; however, in some cases, they will be required to reveal treatment plans or progress and results’ reports to the court.
  5. If you are involved in a lawsuit or administrative procedure, E.g. an Employment Tribunal, you may wish to tell the court about your psychological issues, especially if they could help your case. However, if you do this, please be aware that we may not be able to keep your records or information about your therapy private in court.
  6. If Private Therapy Clinic receives a subpoena or a court order requesting your records, we will be required to provide any relevant information.
  7. If you are planning for your health insurance to cover the costs of your psychotherapy expenses, you will be asked to sign a consent form enabling Private Therapy Clinic the right to disclose certain information to the insurance company. Generally, insurers require us to submit a diagnosis, treatment plan and treatment summary. On some occasions, they may even request progress reports. Please take into consideration that once an insurance company requests this information, it is no longer in your practitioners control who sees it. Insurance companies state that they will keep the information confidential, but you Therapist cannot assure you that they will. However, prior to sending any information to any third parties, they will discuss with you what has been detailed. It is completely up to you what information they release, but please note if you do not release the information required most companies won’t fund your treatment.
  8. In order for your practitioner to provide you with the best treatments, they may need to seek advice from other mental health professionals. For example, this could be your practitioners Clinical Supervisor as all psychologists, psychotherapists and psychiatrists consult with a Clinical Supervisor on a regular basis for the duration of their career to ensure best practice is maintained. If they do need to talk with their clinical supervisor or colleagues about your case in order to help you, this will be done with your best interests in mind. Your identity will always be kept confidential. Furthermore, the content of what we discuss will also be treated with the same level of confidentiality and the same exceptions to confidentiality will apply to other professionals as well.
  9. If your therapy sessions involve family members or couples then your practitioner will ask each person involved in the therapy to keep the content of the sessions confidential. This means that no-one in the therapy should discuss what has been said or done with anyone who is not involved in the therapy, except of course their own individual therapist. Despite requesting this discretion, I cannot guarantee that everyone will honor this agreement.
  10. If you book an appointment with more than one practitioner at our clinic your information will be shared within the new practitioner/s in order to provide you with the best care. If you do not want this information sharing to occur please let your practitioners know.

FEES

Psychological therapy and Psychiatry

Our fee for an initial 50 minute initial assessment is as stated in your appointment offer email. After this first session, treatment sessions are 50 minutes or unless otherwise agreed with your practitioner. Treatment sessions are also the same fee. If your sessions are longer than this, the basic fee could change on a pro-rata basis. Please bear this in mind that family and couple sessions are at a higher rate.

It is up to Private Therapy Clinics’ discretion regarding any changes to our charges. We always aim to see you at a fee you can afford; however, if this is not the case, we can provide lower-fee referrals for you.

Our prices usually increase every couple of years due to inflation and increased living costs. Where this does occur, your practitioner will notify you well in advance and only change the fees at the beginning of the new calendar year.

If you want to keep a regular slot with your therapist we will hold this same time for you each week and you can take two weeks off without losing your regular time. Alternatively, you can pay to reserve your slot for anything more than two weeks so that you do not lose the usual time.

If you wish to take more than 2 weeks off from therapy and don’t want to pay then we can let you know your therapists availability 7 days before you next want to attend.

Please note that if you are away for more than two weeks there is a chance your therapists diary may be full when you get back in touch.

OTHER SERVICES

We will charge the same hourly rate on a prorated basis for other professional services you may require. Other services may include reading or writing reports, telephone conversations exceeding 15 minutes, attendance at meetings, consultations with other professionals upon your request, and preparation of records or treatments.

LITIGATION

If you become involved in litigation that requires your practitioners participation, you will be expected to pay for their professional services, even if they are required to testify by another party.

(We charge £150 per hour for preparation and attendance at any legal proceedings for Psychologists and Psychotherapists. Our Psychiatrists fees are for this are quoted on a case by case basis.

PAYMENT

Payment for your first appointment must be made at the time services are booked, unless we have made alternative arrangements in advance. Your debit/credit card details will be stored securely and will be charged on the morning of any future appointments booked.

Payment must be made on time, in full, and without any deduction, set off or counterclaim. In the event that an account is outstanding, we will refer the matter to our debt collection agents, which will incur a surcharge of 15% of the debt, plus VAT at the prevailing rate. You agree that you will be legally liable to pay us that surcharge, and that payment of the same can be enforced against you in court. You also agree to pay interest at the relevant reference rate provided for under the Late Payment of Commercial Debts (Interest) Act 1998, which interest is payable both after and before any judgment of the court and continues to accrue.

INSURANCE

If you are planning to file a claim for your psychotherapy sessions with your insurance company, you must check your coverage terms with your provider prior to entering into a contract with Private Therapy Clinic. Please do not assume that all mental health services are covered. Please monitor how many sessions your insurance company will cover throughout your treatment. Private Therapy Clinic is not responsible for monitoring whether your sessions are covered by your insurance company. If you attend sessions which are not covered by your insurance company you will be responsible for paying for these session.

You should also note that some insurers will require pre-authorisation from us before they help to cover the costs of any services required. Many insurance policies look towards short-term therapy approaches and may require us to provide continual approvals after a small number of sessions.

In the instance that your insurance coverage runs out before the treatment is complete, we can discuss ways of trying to complete our work together regardless. However, if you cannot afford our fees, and we cannot find any reduced slots available, we will look to source you another practitioner, who can continue the course of treatment from where we stopped.

MISSED APPOINTMENTS

Please note that an appointment is considered confirmed once verbally agreed with the practitioner. If you cannot attend a planned appointment, please call or email our office (02081507563 / info@privatetherapyclinic.com) to notify us as soon as possible. If you simply fail to show up for a scheduled appointment, or do not cancel 48 hours in advance, the full fee will still apply. Please take into consideration that insurers will not cover you for any missed appointments and you will be responsible for the full fee if you were unable to notify us 48 hours prior.

CONTACTING YOU

If we need to contact you, your practitioner or our admin team will try to speak to you personally over the phone. If this is not possible, we will leave a message by phone or email you. We will not speak to anyone else about your treatment without your permission*.

SHARING INFORMATION WITH YOUR GP

Your patient records are confidential within the practice and will not be shared with other parties without your prior permission. For some clients, it is helpful to keep your GP informed of your treatment and for us to be able to contact you if we need to. However this is a private service and you have the right to decline information sharing with your GP*. When medication is prescribed it’s best we update your GP about this unless you can come up with an alternative plan with your Psychiatrist. To do this we will require your consent as set out below.

If you agree, a letter may be sent by email/fax to your GP or another referring specialist with an outline of your condition, diagnosis and treatment recommended. During your treatment it may be helpful for your GP to be informed about factors relating to your mental health or treatment. It may also be necessary for the consultant to get details of your medical history from your GP. In these cases, the consultant will ask for your permission again before doing so.

COMPLAINTS

If you have a complaint about your practitioner please contact their professional body which will be one of the following:

  • British Psychological Society (BPS)
  • Health & Care Professions council (HCPC)
  • British Association for Behavioural & Cognitive Psychotherapies (BABCP)
  • Royal College of Psychiatrists (RC Psych)

 

ACKNOWLEDGMENT AND CONSENT

By signing this form or by attending your sessions you are acknowledging that:

  • You understand and agree to abide by the policies detailed in Private Therapy Clinic’s Patient contract;
  • We have discussed and clarified any questions you may have about this document.
  • You have the option of whether details are shared with your GP or not (please indicate yes or no in the relevant field below)
  • By attending the appointments you are accepting the client contract terms.

 

Who is your appointment with:

Do you have any thoughts about your condition and treatment?

What are your worries regarding your current symptoms?

What were you hoping from treatment?

How do you think we could manage your condition?

Current medications:

Known mental health diagnosis if any:

Previous medications for mental health problems if any:

Have you ever being admitted into hospital for mental health problems?

Are you registered with a GP surgery? If yes, can you give us the GP surgery

Do you require a letter from you or your GP summarising (diagnosis, treatment plan etc.) your appointment? (It's an additional £120 if a letter is required).”

Name:

Phone No:

E-mail address:

(We will send any communication here unless otherwise stated)

Permanent address: (UK/Overseas):

Temporary UK address: (if applicable):

Date of Birth:

Occupation:

Name of your Private Therapy Clinic practitioner:

Are you happy for us to write to your GP /Referring Consultant as outlined above:

GP Details: (optional)
(PLEASE DO NOT FILL THIS IN IF YOU DO NOT WISH FOR ANY COMMUNICATION TO GO TO YOUR GP). Any reports will be sent to your GP unless otherwise instructed.

GP’s Name:

GP’s Address:

GP’s Post Code:

GP’s Tel:

GP’s Fax:

GP”s Email:

How will you be paying for your sessions?

What company is your Health Insurance with?

Your address (which is registered with your insurance company)

Company (if different from above):

Country that your health insurance is registered in:

Insurance policy membership number:

Authorisation code:

Amount your insurance will pay session:

Amount you must pay per session:

Number of sessions authorised:

Signature:
(Use your mouse to sign in the box below)

  • SPEAK TO ONE OF OUR THERAPISTS FOR FREE
    We now offer a free telephone chat with a Therapist or Psychiatrist of your choice. This practitioner will be able to answer any questions you have and recommend the right treatment and approach for you. The chat will be about 15 minutes. .

    TO BOOK YOUR FREE INITIAL TELEPHONE CHAT CLICK BELOW BOOK ONLINE NOW
  • £20 OFF EVERY SKYPE/FACETIME SESSION
    Skype and FaceTime sessions are now seen as being as effective as Face to Face treatment. £20 off all video call sessions (Skype or FaceTime) per session, when you book online below.

    TO GET £20 OFF PER SESSION CLICK BELOW BOOK ONLINE NOW