Informed consent

1. Process

   1. Possible misunderstandings

      The client should be aware that misunderstandings are possible with text-based modalities such as email (since nonverbal cues are relatively lacking)

       

   2. Turnaround time

      The therapist will endeavour to respond to clients emails as soon as possible after receipt, and certainly within 24 hours.   If it is not able to respond within 12 hours, then the therapist will acknowledge the email and inform the client when they are likely to receive a more comprehensive response.

       

   3. Privacy of the therapist

      Privacy is more of an issue online than in person. The therapist has a right to his or her privacy and may wish to restrict the use of any copies or recordings the client makes of their communications. See also the below on theconfidentiality of the client.

       

2. Therapist

   When the client and the therapist do not meet in person (as is the case in online therapy), the client may be less able to assess the therapist and to decide whether or not to enter into a treatment relationship with him or her.

   1. Name

      Carol Vivyan

       

   2. Qualifications

      The client should be informed of the qualifications of the counselor. Examples of basic qualifications are degree, license, and certification. The counselor may also wish to provide supplemental information such as areas of special training or experience.

      Registered General Nurse (RGN)  Nursing & Midwifery Council

      Registered Mental Health Nurse (RMN)  Nursing & Midwifery Council

      CBT Psychotherapist  (University of Southampton, post-graduate diploma)   BABCP

      Clinical Hypnotherapist   GHR

      Meridian Energy Therapies Practitioner  Association of Meridian Energy Therapies

      Eye-Movement Desensitisation & Reprocessing (EMDR)  trained EMDR Workshops

      I have completed additional training in Solution Focused Therapy, Life Coaching, and Colour Therapy.   

       

   3. How to confirm the above

   I am registered with and/or accredited by, and abide by the professional codes of conduct of, the Nursing and Midwifery Council, the British Association of Behavioural and Cognitive Psychotherapies (Therapist Register), and the General Hypnotherapy Register.  

    

3. Potential benefits

   The potential benefits of email may include: (1) being able to send and receive messages at any time of day or night; (2) never having to leave messages with intermediaries; (3) avoiding intermediaries and voice mail; (4) being able to take as long as one wants to compose, and having the opportunity to reflect upon the content of email messages; (5) automatically having a record of communications to refer to later; and (6) feeling less inhibited than in person.

    

4. Potential risks

   The potential risks of email may include (1) messages not being received and (2) confidentiality being breached. Emails could fail to be received if they are sent to the wrong address (which might also breach of confidentiality), treated as spam by some email service or internet service providers, failure of email system, failure of internet provision or computer devices, or if they just are not noticed by the therapist (very unlikely but possible, especially in event of e.g. therapist or family illness).  Confidentiality could be breached in transit by hackers or Internet service providers or at either end by others with access to the email account or the computer. Extra safeguards should be considered when the computer is shared by others or used publicly.  This website uses a confidential web-based secure email facility at safe-mail.net

    

5. Safeguards

    This website uses a confidential web-based secure email facility at safe-mail.net

   The client is able to set up a free safe-mail account for their own secure email exchanges.  The client can take other measures to ensure themselves against potential risks such as using passwords for their computer account on a shared computer and logging off when leaving the computer.

    

6. Alternatives

   There are alternatives to receiving mental health services online. Other options might include (1) receiving mental health services in person (initially via your usual doctor or health professional), (2) talking to a friend or family member, (3) exercising or meditating, or (4) not doing anything at all.

    

7. Proxies

   In rare instances, a client may not be in a position to consent themselves to receive mental health services. In those cases, consent must be obtained from a parent, legal guardian, or other authorized party - and the identity of that party must be verified.

    

Standard operating procedure

In general, the therapist follows the same procedures when providing mental health services online as he or she would when providing them in person. In particular:

1. Boundaries of competence

   The therapist will remain within his or her boundaries of competence and not attempt to address a problem online if he or she would not attempt to address the same problem in person.

    

2. Requirements to practice

   The therapist meets the necessary requirements to provide therapy services where he or she is located. In fact, requirements where the client is located may also need to be met to make it legal to provide mental health services to that client. See also the above on qualifications.

    

3. Structure of the online services

   The therapist and the client will agree on the frequency and mode of communication, the method for determining the fee, the estimated cost to the client, the method of payment, etc. (as detailed on the Cost page)

    

4. Evaluation

   The therapist will adequately assess the client's problems before providing any mental health services online. The client should understand that that assessment could potentially be helped or hindered by communicating online.

    

5. Confidentiality of the client

   The confidentiality of the client will be protected. Information about the client will be released only with his or her permission. The client will be informed of any exceptions to this general rule.

    

6. Records

   The therapist will maintain records of the online therapy services.

    

7. Established guidelines

   The therapist will of course follow the laws and other established guidelines (such as those of professional organizations) that apply to him or her.

    

Emergencies

1. Procedures

   The procedures to follow in an emergency should be discussed. These procedures should address the possibility that the therapist might not immediately receive an online communication and might involve a local backup.

    

2. Local backup

   Another issue specific to online mental health services is that the therapist can be a great distance from the client. This may limit the therapist's ability to respond to an emergency. The therapist will therefore in these cases request the name and telephone number of a qualified local (mental) health care provider (who preferably already knows the client, such as his or her primary care physician).