A psychotherapy contract is an agreement between therapist and client in which both of you have rights and responsibilities.
Professional Bodies such as UKCP do not make it a requirement to have a written contract because a verbal agreement can also act as a contract. However it is strongly recommended, particularly if you are going into private practice.
Becoming a psychotherapist is exciting but can also feel daunting, and setting boundaries within the therapy room can make all the difference in making you feel more secure within your practice.
One of the best and most effective ways of putting a boundary in place is with a written therapeutic contract.
A written contract is the foundation for informed consent. It gives a level of certainty as to what can be expected from both client and therapist. This means that a contract reduces the likelihood of complaints.
Each contract varies, but there are key things you should look to include:
1. Confidentiality - This should highlight that all sessions remain confidential except for special circumstances, these circumstances should be clearly laid out.
“I receive regular supervision with another qualified therapist. Should I take aspects of my work with you to this supervision I will refer to you by your first name only. My supervisor is bound by the code of ethics regarding confidentiality”
“If you become aware that there might be a risk of harm to you, or that you might be about to harm yourself or another, I will take appropriate action that might break our confidentiality.”
“If compelled by court or by law (e.g., under the legislation of terrorism or money laundering) to disclose information or any notes I may keep.”
"Clients were referred by other agencies such as a general practitioner meaning letters may be written at the start and end of our work to inform the referrer of progress, and at other times if changes occur or medical intervention is required.”
“In the event of my death my professional executor or my power of attorney would be given your details and will contact you to inform you of this."
2. Safety – This lets the client know what you expect when it comes to their behaviour in the therapy room
“You will not harm yourself or me, or cause damage to property during the course of your appointment. You will not attend any session while under the influence of alcohol or other non-prescribed drugs.”
3. Times and Payment - It is important to layout your cancellation fee policy, length, and cost of sessions to avoid any confusion.
“Sessions are fifty minutes long. I will be using a tool called Assistant for payments. Payment will be taken by card 24 hours after our session. I will charge for any sessions missed unless given a minimum of 24 hours notice. My fees are reviewed annually in March.”
**4. Data Protection - **This informs the client about the notes that are taken on them, what security you have surrounding these notes, and how the client can access these if needed. It should also highlight that you are working in accordance with data protection legislation.
5. Endings/ Termination - Most therapists state that a client can stop sessions at any time, however the counsellor might want to layout how they would like the sessions to end.
“Unless this arrangement is for the maximum number of appointments, should you decide to end our work together, I would recommend returning for one further appointment after announcing your decision to enable us to work together towards a constructive ending.”
6. Clients/ Doctors contact details - It is important to have this information in case your client is in need of medical attention whilst working with you, or has been referred by a medical professional.
7. A Complaint Procedure - Inform the client that if they did wish to make a complaint against you, they can do this to the professional membership that you abide by and their code of ethics.
The contract may change depending on how and where the therapist practises, for example:
Holidays and extended breaks - Psychodynamic psychotherapy is often long-term and some therapists feel extended breaks disrupt the relationship, so could have a section around this. Equally if the counsellor wants to go on holiday they should layout how they will inform the client about this.
Number of sessions - CBT (Cognitive behavioural therapy) normally offers time limited sessions, so the counsellor might want a section clearly laying out information about the number of sessions the client can expect to receive.
Arrivals - if you work from home or somewhere with no waiting room, some therapists might want to include something about not arriving too early (to preserve confidentiality of them and other clients), also let the client know what happens if they arrive late.
Assessment Review - If the assessment is done by yourself and not a colleague it could be an important part of the process to explain.
Address of practice - Where is it the sessions will take place.
Therapists’s qualifications - Some contracts have a small bit about the therapist and how they practise, as well as their qualifications.
Contact between sessions - If the client wants to contact you in-between sessions, what is the best way to do this? Each therapist has different guidelines on this.
If you see clients online you may have a section on Computer Privacy, or Technical Difficulties. An online contract should be well researched as there are many differences to a contract tailored to face-to-face therapy.
Explain to the client the purpose of the contract.
Do not make it look like a list of rules, it might put the client off.
Use clear simple language that means the client does not feel intimidated or confused, as this could cause unnecessary anxiety for the client.
The length of contract should be no more than 1-2 pages