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Young Person (Child) Therapeutic Contract Form

Agreement Between:

Name: Valerie Barr (The Therapist)
Name: (The Parent/Guardian)

Name of Client

(The Client/Child)

The term “Client” refers to the Child who is receiving therapy. The term “Child” is used generically to cover all young people 16 years and younger. This term is not used in a derogatory or demeaning way, but as a term to describe a young Clients.

The term Parent is used to cover both Parents and Guardians.

To ensure the highest degree of professional service, it is a requirement to enter a therapeutic contract which sets out the expectations of therapy between the Therapist, Parents and the Client (Child). To ensure the existence of a professional service, a focus is placed on the therapeutic relationship between the Therapist and Client. This involves the creation of trust, openness and exploration of emotions and thoughts. To assist this relationship in developing in an appropriate and caring manner, the following terms provide the Parents with a contract that explains what the Parents and your Child can expect from the Therapist. The contract will also contain information about boundaries and confidentiality within the therapeutic relationship which are important in protecting the confidentiality and safety the Therapist and Client alike.

Terms and Conditions of Therapy

1. The Therapist is bound by the code of ethics and practice of the British Association of Behavioural and Cognitive Psychotherapists (BABCP). A copy of the code of practice and ethics are available on request, or may be viewed on the BABCPs web site:


2. Prior to the commencement of treatment, it is important for you to understand your Therapist’s approach to Child Therapy. In order to obtain informed consent from the Parents, it is necessary that the Parents understands the type of treatment offered by the Therapist and the potential outcomes. Following an initial introduction and assessment, and subject to the Therapist being satisfied that the Client problem is one that can be alleviated, the Therapist will provide therapeutic sessions. This is the Therapist’s commitment to the Client. With the exception of section 10 below, the Client is not contracted to any specific number of sessions. The Client may terminate therapy without further cost at any time, by providing more than 48 hours’ notice.

Following the assessment, the Therapist will provide information on the intended treatment plan, treatment protocols and potential outcomes. The Therapist will answer any questions or concern you have about treatment but will not be able to offer any guarantees on treatment outcomes. Following the discussion on treatment, the Therapist will then seek consent to treat the Child.

3. The treatment offered will be predominately led by the Cognitive Behavioural Therapy model (CBT). This is an evidence-based psychotherapy which is recommended by NICE and a leading treatment for mental health conditions. your Therapist will be trained in all the above and covered by the relevant bodies which govern their use.

For information on NICE Guidelines, or to understand the efficacy of CBT, please consult the NICE website:


4. One risk of Child therapy involves disagreement among Parents and/or disagreement between Parents and Therapist regarding the best interests of the Child. If such disagreements occur, the Therapist will strive to listen carefully so that they can understand the Parent’s perspectives and fully explain their own perspective.

Such incidents of disagreements are rare and are typically resolve easily, but in certain circumstances, the Therapist and Parents can agree to disagree, so long as this enables the Child’s therapeutic progress. Ultimately, the Parents will decide whether therapy will continue. If either Parent decides that therapy should end, the Therapist will honour that decision, however it is recommended that the Therapist be allowed to have a closing session to appropriately end the therapeutic relationship with the Client.

5. Therapy is most effective when a trusting relationship exists between the Therapist and the Client. Privacy is especially important in securing and maintaining that trust. One goal of treatment is to promote a stronger and better relationship between the Child and their Parents. However, it is often necessary for the Child to develop a “zone of privacy” whereby they feel free to discuss personal matters with greater freedom. This is particularly true for adolescents who are naturally developing a greater sense of independence and autonomy. By signing this contract, you will be waiving your right of access to your Child’s therapeutic records.

6. It is policy to provide Parents with general information about treatment status. The Therapist will raise issues that may impact your Child either inside or outside the home. If it is necessary to refer your Child to another mental health professional with more specialised skills, the Therapist will share that information with you. The Therapist will not share with you what your Child has disclosed in confidence without your Child’s consent. The Therapist will tell you if your Child does not attend sessions. At the end of the Child’s treatment, The Therapist will provide you with a treatment summary that will describe what issues were discussed, what progress was made, and what areas are likely to require intervention in the future.

7. If the Child is an adolescent, it is possible that he/she will reveal sensitive information regarding sexual contact, alcohol and drug use, or other potentially problematic behaviours. Sometimes these behaviours are within the range of normal adolescent experimentation, but at other times they may require Parental intervention. It is important that the Parents carefully and directly discusses their feelings and opinions regarding acceptable behaviour at the outset of therapy. If the Therapist ever believes that your Child is at serious risk of harming themselves or another, they will inform you.

8. The Therapist’s responsibility to your Child may require their involvement in conflicts between the two of you, but the Therapist requires your agreement that their involvement will be strictly limited to that which will benefit your child. This means, among other things, that you will treat anything that is said in session with the Therapist as confidential. If the Child lives with Parents who are separated or divorced the

9. Therapist requests that neither Parent attempts to gain advantage in any legal proceeding between the two of you from the Therapist’s involvement with your Child. In particular; you agree that in any such legal proceedings, neither of you will ask the Therapist to testify in court, whether in person, or by affidavit. You also agree to instruct your lawyers not to cite the Therapist or to refer in any court filing to anything the Therapist has said or done.

Note that such agreement may not prevent a judge from requiring evidence from the Therapist, even though the Therapist will work to prevent such an event. If the Therapist is required to provide evidence, they are ethically bound not to give an opinion about either Parent’s custody or visitation suitability. If the court appoints a custody evaluator guardian or legal representative, the Therapist will provide information as needed (if appropriate releases are signed or a court order is provided), but the Therapist will not make any recommendation about the final decision. Furthermore, if the Therapist is required to appear as a witness, the party responsible for the Therapist’s participation agrees to reimburse the Therapist at the rate of £85.00 per hour for time spent traveling, preparing reports, testifying, being in attendance, and any other case-related costs.

10. The normal duration of each therapeutic session is approximately 60 minutes, although the Therapist reserves the right to amend the length of each session for therapeutic reasons if necessary. If for any reason the Client is late for a session, The Therapist will see the Client for the duration of the remainder but will be unable to work beyond the allotted time as this will disrupt the clinic for other Clients who may be waiting. Sessions will usually be conducted on a weekly basis, unless otherwise jointly agreed between the Therapist and Parents. The initial session will be an assessment of needs where the Therapist will conduct a thorough assessment detailing elements of the Client’s past, medical history, presenting problems, issues of risk and general symptoms. The Client will be required to fully participate in the assessment process and disclose the required information. This is necessary to ensure that the Therapist’s Treatment plan meets the needs of the Client. After the assessment, the Client, Parents and Therapist will decide if counselling is required and appropriate.

11. It is understood that sometimes sudden events, such as emergencies happen, that may make it necessary for the Client to cancel their appointment last minute or fail to attend and are unable to provide notification. On these occasions it is at the Therapist’s discretion if a fee will be charged. In general, if the Client fails to give less than 48 hours’ notice of their intention to cancel or postpone an agreed therapy session or if there is a repeat pattern of cancellations/DNA’s the Therapist reserves the right to charge in full for that session.

12. If the Client has self-referred the cost for each session will be £50.00. Payment can be paid at the end of each the session by BACS or Cash.

Bank Details: Account: Dynamic Diamond Consultancy
Sort Code: 82-60-30
Account No: 80046177

13. The cost of therapy includes any written materials the Therapist may supply but excludes the cost of any books which might be suggested to the Client/Parents for reading.

14. In the event that a private health care plan or employer is being used to fund the Client’s treatment, therapy will not commence until approval in writing has been received from the private health care organisation or the Client is able to provide the relevant authorisation code.

15. As part of the Therapist’s code(s) of practice, they are required to carry out continuing professional development, and to engage in regular on-going clinical supervision. This is to ensure an ethical and professional service to Clients. As such, the Therapist may discuss your Child’s case in supervision but would endeavour to not use any identifying details which would disclose who the Child is. If there was an element of RISK in your Child’s case which required disclosure of their personal details, your Therapist’s supervisor is contracted under a confidentiality agreement which prohibits the supervisor from disclosing any information to third parties. It’s important to note that supervision is an integral part of therapy and offers a level of protection for Clients and Therapists alike.

16. Confidentiality is the backbone of the helping profession and the Therapist takes Client confidentiality seriously. The Therapist will always be respectful, understanding, non-judgmental and empathic towards Clients and will maintain confidentiality within the code of ethics and legal requirements of UK Law (English and Scottish).

Confidentiality does not apply where it would mean that the Therapist might break the law or where withholding information means that the Therapist would breach their code of ethics. Confidentiality may be breached if the Therapist considers that there is a risk that the Client may harm themselves self or others. In such exceptional circumstances, where there is concern for the Client’s well-being or that of others, it may be necessary to seek help outside the therapeutic relationship. If it was necessary to breach confidentiality, the Therapist will always endeavour to consult the Client and Parents first and discuss the rational for breaching confidentiality. If, however the risk is of such a nature, that there is no time to consult the Client/Parents, or where such consultation could be considered dangerous for the Therapist or others, then the Therapist would take the required action without consultation ASAP.

If the Therapist believes that Child is at RISK and fears for the Child’s safety, the Therapist will communicate this to you ASAP, and refer the concern to social services. If the RISK is due to or caused by the Parent’s then this would be reported directly to social services as a child protection concern, in which case it is unlikely that the Therapist would raise this concern directly with the Parents. (Please not that this is extremely rare and unlikely, however it is necessary to protect children and a requirement of the vulnerable children’s act.)

17. In the case of the Client/Parents disclosing information pertaining to acts of terrorism, drug trafficking, murder, vulnerable adult or child protection issues; confidentiality will be breached, and such disclosures will be passed onto the relevant authority without delay. Clients and Parents should offer due consideration before disclosing anything of a previously unreported criminal nature, as the Therapist will be obligated to contact the relevant authorities to report the disclosure.
18. The therapeutic relationship between the Therapist and Client will always remain a professional one. The boundaries of which (such as contact outside of sessions) will be agreed between all parties during the initial therapy session. The Therapist is precluded from accepting social media requests, services in lieu of therapy and invites to special occasions and events. It is inappropriate for the Therapist to enter any form of sexual or intimate relationship with a Client and would therefore reject any advances of this nature.

Children often like to provide small gifts to their Therapist especially at the end of therapy, whilst there is no need for such gestures, the Therapist will not offend the Child by refusing to accept, so long as the gesture is reasonable.

19. Notes may be taken by the Therapist during and after each therapy session. These will be kept in accordance with the Data Protection Act (2018) and General Data Protection Regulations (GDPR 2018). Such notes will be securely stored in accordance with the Information Commissioners Office (ICO) best practice and the Therapist’s code of conduct. Your Therapist will discuss the disposal, retention or otherwise of any such notes at the end of the therapeutic engagement, but clinical notes are usually retained for a period of 6 years. All clinical notes and documents will remain in the possession of the Therapist and will not be disclosed to anyone except the Therapist’s clinical supervisor, unless required under a court of law subpoena or citation. Clients have the right to inspect their records should they wish, and this request will be fulfilled during a therapy session. As per section 5, by signing this contract, you will be waiving your right of access to your Child’s therapeutic records.

In the age of social media, it can be easy to post subject matter about therapy online. Whilst the Client or Parents can post/share information about their therapeutic journey, the Therapist hereby states that they give no permission for images or information containing their person to be shared online or via any other media.

20. If agreed payments for therapy are not being paid, then the Therapist reserves the right to terminate therapy immediately.

21. Therapy can at times be demanding, frustrating, and emotional. Clients may at times find this process very difficult and feel the need to end therapy. Clients are encouraged to provide feedback on their experience at the end of each session and this is a good opportunity to discuss any aspects of the treatment being offered. As the Parents, you are encouraged to discuss therapy with your Child. If you discover any difficulties or issues, please do try and communicate this verbally with Therapist or encourage your Child to discuss their concerns in session. This gives both parties the chance to address and resolve engagement issues and find solutions.

In the normal course of therapy, Client’s usually know when they’re ready to finish treatment. The Client or Parents can raise their desire to end therapy at any time, and thereafter the Therapist will work to conclude treatment. In Child Therapy it is always recommended that the Child and Therapist have the opportunity to end therapy and say good bye, sudden endings can be harmful for the Child.

22. The Therapist will not suddenly or without warning terminate the therapeutic contract, except in exceptional circumstances, which would become clear in the course of the therapeutic work together. This would be fully discussed at the point of concern with the Client and Parents but is highly unlikely. Please note that any threats or acts of violence from the Child or Parents will invalidate this agreement and therapy will cease. It’s important to note, especially with adolescents, that sessions will not take place if the Client arrives under the influence of alcohol or non-prescribed medication. Such sessions would still be charged at the agreed rate and a new session date would be agreed. If the Child arrives for their session impaired and unaccompanied, the Therapist will contact the Parents to make safe arrangements for the Child getting home.

Therapy would end if the Client missed 3 consecutive sessions regardless of payment.

23. The Therapist will notify the Client in advance of any holidays they plan on taking which may occur during treatment. However, there may also be occasions when sessions may be cancelled because of illness or because of attending training sessions or meetings. The Therapist will try to give the Client/Parents as much notice as possible of any cancellation and will offer an alternative time. Therefore, please notify the Therapist of any change to your personal contact details.

In order to provide the Client with therapy the following permissions are required so that the Therapist can provide treatment. Please note: Client confidentiality rights are protected in each case.

I agree to Dynamic Diamond Consultancy:

Retaining manual and electronic Client records by recording my Childs treatment and progress and storing them for a period of 6 years, (or more if required for legal reasons).

As discussed in Sections 5 and 19, we acknowledge that we are waiving our right of access our Child’s therapeutic records to help maintain confidentiality.

To get the best opportunities from therapy it’s important that we’re able to contact you, send you reading, home learning tasks and sessional information. Please let us know which modes we can use to do achieve this:

Phone Text Email Mail

Therapy works best when you agree to apply what you’ve learnt in-between sessions. As such home learning tasks are usually agreed between each session to help you explore and develop new skills. Do you agree to participate in agreed home learning?

Young Person (Child) Therapeutic Contract