Informed Consent Contract - Mynurva

Informed Consent Contract 

 

Terms For Therapy

INTRODUCTION

A clear framework for our work together can avoid misunderstandings and greatly facilitate our working relationship. The following content, terms, and conditions of this informed consent contract will support this process.

Please feel free to discuss any of these with us at any time.

1. MENTAL HEALTH INTERVENTION

A range of mental health interventions and psychological interventions have been shown to have benefits for those clients who follow through with their engagement. They can lead to improved relationships, healthy solutions to specific problems, and significant increases in mental clarity and emotional balance.

We will be involved in a collaborative process with the intention of us building a relationship where you feel able to explore your thoughts, emotions, and behaviours, particularly those which may be causing you distress, impeding progress in achieving your life goals, and/or getting in the way of your ability to find fulfilment and meaning in your life.

In the exploration and processing of uncomfortable aspects of life, you may at times experience difficult emotions such as sadness, guilt, anger, depression, frustration, loneliness, and helplessness. Initially you may experience an increase in the symptoms for which you are seeking help. This is a normal response and will pass as our work together progresses.

2. APPOINTMENTS

The initial assessment with a Psychological Wellbeing Practitioner (PWP) may last up to 60 minutes in duration and sessions thereafter are up to 50 minutes duration.

Mynurva sends its clients a reminder booking email after each session. If on sending two reminders to book-in with a Mynurva therapist and the client does not book in a session, they will have chosen not to engage with Mynurva presently.

In the instance of no contact from the client, after the period of one month, Mynurva is unable to monitor risk and safeguarding concerns. Therefore, the client must adhere to the risk or safeguarding management plan initially agreed with the therapist and the responsibility of the client’s wellbeing reverting to the GP and the client themselves.

Rescheduling, cancellations and DNA’s

Appointments can be easily rescheduled with 24hrs notice. Unfortunately, if an appointment is cancelled with less than 24hrs notice, we class this as a DNA (Did Not Attend). We will report DNA rates to Partners periodically, and Partners may request a hold be placed on a client account based on a high number of DNAs. Any DNA’s count toward your number of sessions offered. If you are unable to keep your appointment, please contact us as soon as possible (see contact) This will mean that I am able to offer someone else an appointment rather than it be lost.

3. CONFIDENTIALITY

(See also Data and Information about what information is collected and Use of Data in Terms of
Service for how we use that data and GDPR)
We aim to create a safe environment and will maintain confidentiality for you to explore and
disclose any information which is helpful to your progress.

Our clinicians have a duty of care and they are legally required to disclose any information
which may indicate that you are at risk of harming either yourself or others, but would always
endeavor to discuss this with you prior to any disclosure of this nature to any third party, such as
other healthcare professionals or organisations.

Our clinicians keep notes of your sessions which help them remember important points,
assessments, plans, and interventions. They are required to do this in accordance with the
therapeutic governing bodies and guidelines of NICE (National Institute for Health and Care
Excellence).

Supervision

Our treating clinicians consult with clinical supervisors to ensure an appropriate standard of your
care and to enhance care. Supervisors will not know you personally nor professionally. You will usually be identified by your first name, or a code, and information relayed to them verbally when it’s helpful to the clinician’s professional processes or in line with our risk protocol. Any actions our clinicians take must be informed by the principles of choice, respect and dignity for the person concerned, with a clear focus at all times on helping them to achieve the outcomes they want.

Imminent Risk and Emergencies, specific agreement

If your health is in serious jeopardy, or our clinicians believe you are at serious risk of harm (even
if you have not told them) you agree that our clinicians may share your contact information with
an emergency healthcare service (e.g. Mental Health Crisis Team or 999 emergency services). This includes situations, for example, if a clinician is online and there is a loss of video or phone connection and the clinician is concerned that you cannot keep yourself safe from harm.

A general overview of your condition with the minimum details will be shared for the purpose of
keeping you safe, this will exclude specific details which are private and not deemed relevant to
that purpose. The Data Protection Act 1998 and the General Data Protection Regulations of 2018
permit information to be shared in a situation of ‘vital interest’, where it is critical to prevent serious
harm or distress or where someone’s life is threatened.

Criminal Acts & Whistle-Blowing

If the clinician becomes aware of your intent to cause harm to another person/organisation (e.g. terrorism, or taking class A drugs while driving or pregnant), the law may require that they inform an authority without seeking your permission. In such a situation, the law may require that they share your personal information without your knowledge (known as: whistleblowing). These also include serious historic criminal actions.

Self-harm

Please tell us immediately if you have ever, are currently, or will self-harm. We can then try to help you manage any difficult or distressing emotions and behaviours in new adaptive ways. By not letting us know, we may not be able to provide a ‘reasonable level of care for you. It may however be more beneficial to you, and clinically appropriate, for another service to help you. We can discuss this to see what is best for you.

Illegal Drug Taking & Substance Abuse

We respect your rights to choose how to live your life. We will only inform the police if we believe your actions will result in serious harm to yourself or others, such as driving under the influence.

4. SAFEGUARDING ADULTS

Safeguarding adults means protecting a person’s right to live in safety, free from abuse and neglect. They may find it difficult to protect themselves from abuse. Abuse can be: Physical; sexual; emotional/psychological; financial/material; neglect/acts of omission; slavery; discriminatory; or institutional.

We work to safeguard individuals in a way that supports them in making choices and having control in how they choose to live their lives and making safeguarding personal. Adults at risk are people who need care and support because of their mental health, physical disability, age or illness. Our clinicians will personalise any safeguarding to the needs and circumstances of the individual people they are designed to support and protect. All adults should be at the center of decision making about their lives, and should have the opportunity to make choices about, and have control, over how they live. Supporting people is essential, and if a safeguarding plan is needed to keep an adult safe, they – or a designated advocate or representative – should contribute to this and agree to it.

Effective safeguarding cannot be achieved without many organisations and individuals working closely together, and there being an explicit recognition that safeguarding is everyone’s concern; local services such as police, health services, housing organisations may become involved if necessary depending on the situation and circumstances.

Abuse and neglect

If an adult at risk of being abused or neglected cannot keep themselves safe or protect themselves from abuse or neglect, then safeguarding that person applies. If they are able to protect themselves, then a safeguarding response may not be appropriate.

Coercion

The clinician will seek to establish whether the person is driven purely by their own views and wishes, or whether they are potentially being unduly influenced or coerced by another person. If we believe that you are being coerced, the inherent jurisdiction of the High Court could apply.
If the clinician believes there is a risk to your own safety or wellbeing, they will act to intervene.

5. SAFEGUARDING CHILDREN

Where a child is suffering, or is likely to suffer significant harm; and the harm, or likelihood of
harm, is attributable to a lack of adequate parental care or control. This includes different types abuse: physical, mental, emotional, sexual, neglect, controlling and coercive behavior. Where we believe there is maltreatment; impairment of a child’s health or development, including schooling; they have to endure circumstances not consistent with the provision of safe and effective care; we will act to enable all children get the best outcomes.

Where impairment suffered from seeing or hearing the ill treatment of another for example, where there are concerns of domestic abuse, we will act. Our clinicians will enquire and ask questions. We will do this within the context of duty of care, not to be nosey or blame you or anyone else of anything. Our clinicians will be alert to potential indicators of abuse or neglect and may ask you questions regarding this. Our clinicians are aware of the risks which individual abusers or potential abusers may pose to children and therefore may ask you questions regarding this. Our clinicians are aware of the impact on the child of any concerns of abuse or maltreatment, and may ask questions in regards this. Our clinicians may analyse information as part of an assessment of the child’s needs. 

Unborn children or children up to the age of 1 – perinatal clients. Where there is potential harm or risk such as domestic abuse, parental substance misuse or mental ill health our duty of care is to both mother and child. Our clinicians will engage in an appropriate risk assessment and also make assessment of the child’s needs.

6. RISK Definition

Relates to a negative event/harm and (1) how likely it is that the event/harm will occur (2) how soon it is expected to occur and (3) how severe the outcome will be. Risk assessment involves working with the person to evaluate each of these aspects.

If on assessment you appear, or are deemed at risk in any way, a comprehensive risk assessment will be conducted by the treating clinician; this also includes others who appear, or are are at risk in any way. The treating clinician will do this so that we can keep you and others safe. In treatment, a general ongoing risk assessment which consists of checking-in with you or asking you to complete questionnaires is done.

Risk Assessments

Are specific to the type of presenting risk; they can include questions which may seem disturbing and may temporarily increase your distress or anxiety. They may increase thoughts of suicide/
self-harm or maladaptive coping later on in the day. The treating clinician will then get a better picture of how to help you or others the most. Knowing and understanding this, you give permission to undertake any necessary risk assessment.

Risk Management Plans

The purpose of risk management is to first assess the likelihood of risk events and then work with
the person to identify ways of reducing the likelihood of them occurring. It involves developing
flexible risk interventions or strategies, in a collaborative way, aimed at preventing negative events
from occurring, or reducing the harm caused. A risk management plan will be devised between
you and your therapist and you will agree to follow it. This is so that the treating clinician can
ensure you or others are kept safe or can reduce the risk of harm. Knowing and understanding
this, you give permission to devise a risk management plan.

Risk Interventions

Are designed to reduce any harm, but may temporarily cause some anxiety or distress. Generally, most people experience a sense of relief and a sense of hope at having shared the information with someone and having other methods to keep them safe. Knowing and understanding this, you give permission to attempt and carry out any interventions.

Choice

You have choice at all points not to engage in a risk assessment of self or others, risk intervention, or a risk management plan.

It is your right not to provide such information where you are at risk of harm if that is what you choose. In doing so, Mynurva and its treating clinicians will continue to have a duty of care but will unlikely be able to provide a ‘reasonable’ level of protection because they will not have all the information necessary to keep you safe. Therefore, in these instances Mynurva and its treating clinicians cannot be held responsible in the unfortunate events of harm taking place.

If we believe you may lack mental capacity to keep yourself safe we will likely refer you to secondary care, crisis teams, psychiatric services, or the emergency services.

7. CONTACT

24/7 Contact number: 0203 322 8176
Answered by our customer service team, who are able to advise on bookings, and liaise with the
bookings team to support providing appointments within 48hrs of contact.
Contact email: contact@mynurva.com
Our hours of work are: MonFri: 8am – 9pm / Sat – Sun: 9am-1pm BST

Responding to email messages
We cannot guarantee that we will be able to respond to you immediately.
Please note that this is not a crisis line. In case of a mental health emergency, you should contact your GP, local crisis service, or call 999.

8. CRISIS – What should you do in a crisis?

Risk tips
What can I do to soothe myself? What in the past has helped?
What would I say to a close friend who was feeling this way?
Take yourself out of the situation
A safe place I can go to is…

Talk to someone…
Calm yourself down by …
Discuss problem with …. when calm

Use out of hours GP if needed or NHS 111

If I still feel suicidal, can’t get to a safe place and feel out of control, I will go to the local A&E department, if I cannot get there safely I will call 999.
Samaritans UK
Telephone: 116 123

9. PROFESSIONAL RECORDS

As Cognitive Behaviour Therapists (CBT), and Psychological Wellbeing Practitioners (PWPs), we are governed by the standards laid down by the British Association for Behavioural & Cognitive Psychotherapies (BABCP). They state that we must keep appropriate and up to date records of all our assessments, plans, and interventions. Our counsellors are governed by the standards laid down by the British Association for Counselling and Psychotherapy (BACP). All such records are maintained as described in Confidentiality above.

10. YOUR RIGHTS

You have the right to end your sessions at any time, for any reason. If you feel that this is something you would like to do, it is always better to discuss your options with your clinician. Please do not just stop coming or end the video link.

Because of the nature of the PWP/CBT Practitioner/Counsellor – client relationship, our clinicians can have no social contact with you outside of the sessions and they cannot barter with you (exchange your professional services for theirs). Whilst working with Mynurva, you cannot become their private client and cannot become friends on social media or other platforms.

To protect your confidentiality, if you should happen to see each other in public, your clinician will not acknowledge you unless you acknowledge them first.

You have a right to question any aspect of your treatment, and to expect that, if your presenting problems and/or symptoms fall outside the areas of treatment expertise, that the clinician will suggest an alternative, appropriate intervention for your needs.

Please feel free to speak to us about any of the above if you have any questions or concerns.

If an appointment has to be changed because of the clinician, then you will be contacted with as much notice as possible. It is therefore very important that you have supplied an up-to-date contact number. Please note that it will be assumed that it is ok to leave a message on any number provided by you, unless you indicate otherwise.

11. YOUR RESPONSIBILITIES

You are choosing to engage in therapy. Your own motivation is important to the process throughout the work. The onus remains on you to attend.

You are also responsible for immediately telling us about any circumstances in which you are at risk of harming yourself or others being at risk. If this is difficult or too distressing to do, please let us know or ask us or someone else to help you. Perhaps writing it down for us may be easier. It is also within your rights not to tell us if this is what you choose.

Punctuality for sessions is important. If you are late, your session will still end at the appointed time. Any sessions which you cancel will be considered as part of the number you have been offered.

If you do not attend, the therapist will attempt to contact you twice via the phone number provided and will remain on the video link for 15 minutes. Mynurva will contact you after the appointment via email to understand the reason of nonattendance and to prompt booking the next appointment.

If you do not cancel an appointment and then fail to keep it, you may be discharged. If you cancel more than 2 sessions, then your therapy opportunity will be reviewed considering your ability to make a regular commitment. Attending a session under the influence of alcohol or drugs is not appropriate and the session will not take place (unless such use is agreed as part of the overall therapy plan).

Verbal aggression is not acceptable and will lead to termination of the session and a review of future intervention possibly even criminal prosecution.

Work set to be carried out between sessions is often a requirement. It is collaboratively agreed between you and the clinician and is an important part of the therapy. If this work is not completed, your session may be cancelled and if this happens on more than 2 occasions, your therapy may be ended.

Non-UK Residents

If you are accessing Mynurva services you accept that we provide online support to you as appropriate within our remit. You agree that we may signpost you to online resources if we cannot provide a ‘reasonable’ level of protection or care but that this may not always be possible.

You also agree that it may not be possible for us to signpost or refer you to other language services within your local area. However, your responsibility is to act on our best advice and to seek support locally in these circumstances.

12. OBJECTIONS

If you have any objections to agreement of this contract, you can engage with your clinician or and explore the below:

You can both explore reasons for your objections and find out what your concerns are. The clinician can explain why they are concerned about you and why they think it is important to share the information. Tell your clinician who you would like to share your information with and why.

The clinician can explain what the benefits may be to you in sharing information about you. You can both discuss the potential consequences of not sharing the information. Your clinician can reassure you that your information will not be shared with anyone who does not need to know.

13. COMPLAINTS & FEEDBACK

We welcome any feedback you have, both good and bad. We are growing as an organisation and want to make yours and others experience the very best it can be. Please feel free to share this with us if you cannot share it with your treating clinician. It is important to us that you feel heard and understood. If you have a specific complaint you would like to raise, we will deal with it professionally and try to get the best outcome for you.

14. AGREEMENT TO THE TERMS OF THIS CONTRACT

The number of sessions offered will differ based on customer group, unless you are a private client. This number is set by the customer group (company, charity, or university) and cannot be altered by Mynurva. Your number of credits will be visible in your account.

You acknowledge that you have read, understand, and agree to be bound by the content, terms, and conditions of this informed consent contract.