Counseling and Psychotherapy Consent and Services Agreement with Thrive Boston Counseling


This form is designed to provide information about psychotherapy (i.e., Boston counseling) with Thrive Boston Counseling. Please read carefully. If you have any questions, please do not hesitate to ask.

About Psychotherapy Services
Counselors at Thrive Boston Counseling take a person-centered approach to counseling and psychotherapy. An underlying philosophy of this approach is that the client is ultimately in control of his/her life. Thrive Boston Counseling is ‘growth-focused,’ meaning that sessions focus on improvement and client strengths. If at any time during counseling or psychotherapy you or your therapist feel the service is not, or will not, be helpful to you, your Thrive Boston therapist of life coach can assist you by making a referral to another Boston counseling service provider.

Benefits and Risks. Benefits of counseling or psychotherapy include better personal functioning, improved relationships with others, improved self-image and mood, and obtaining personal goals. However, in some cases persons have felt worse after participating in counseling or psychotherapy. Healing and growth is difficult, and some discomfort will likely be an aspect of the counseling therapy process.

Client Goal Review. Goals will be reviewed as a part of each session, and a more in-depth look at goals will occur once per quarter year, and when the counseling / psychotherapy relationship ends.

Scheduling and Cancellations
Scheduling an appointment is a commitment that counselors at Thrive Boston Counseling honor, and expect clients to honor. Appointments can be cancelled or rescheduled if 5 days notice is given before the appointment time. If sessions are cancelled or rescheduled with less than 5 days notice (120 hours), or if a client misses or is late for a session, the client agrees to pay for that full session. When rescheduling, payment is due at the time of the originally scheduled session. Thrive Boston Counseling holds strictly to this policy in order to provide care in a timely fashion to persons who want counseling.

Confidentiality
All communications or records with your Thrive Boston counselor / therapist will be held in strict confidence. Information may be released, in accordance with state law, when (1) the client signs a written release indicating informed consent to such release; (2) the client expresses serious intent to harm self or someone else; (3) there is reasonable suspicion of abuse against a minor child, elderly person, or dependent adult; or (4) a subpoena or other court order is received directing the disclosure of information. 

It is our policy to assert either (a) privileged communication in the event of #4 or (b) the right to consult with clients, if at all possible barring an emergency, before mandated disclosure in the event of #2 or #3.

Work Agreement
It is agreed that the client shall make a good-faith effort at personal growth and engage in the counseling or psychotherapy process as an important priority at this time in his or her life. This includes completing assigned homework activities, which are an important part of the growth process. Suspension, termination, or referral shall be discussed between provider and client for a pattern of behavior showing disinterest, lack of commitment, or for any unresolved conflict or impasse between provider and client.

Conflict Resolution. It is agreed that any disputes shall be negotiated directly between the parties. If these negotiations are not satisfactory, then the parties agree to mediate any differences with a mutually acceptable third-party mediator. If these are unsatisfactory, then the parties shall move to arbitration, and then binding arbitration, choosing an arbitrator mutually agreeable to both. Litigation shall be considered only if and after all of these methods of resolution are given a good faith effort and are unsatisfactory.

Emergency Contacts
Provider will establish several emergency contacts for you, the client, such as the phone numbers and location of a family member. The provider will also obtain alternative methods of contacting you, the client, such as a mobile phone number, home telephone number, and work telephone number. These emergency contacts may be reached if the provider perceives a client crisis. If you are in crisis and cannot reach your counselor, please contact emergency services of go to your nearest emergency room.

Service Fees
Payment shall be made before, or at the time of, each scheduled session. Clients agree to pay service fees out-of-pocket even if they have insurance. Unfortunately, we cannot extend credit or provide services until payment is made. Clients understand they are fully responsible for all fees if insurance or other vendor does not pay.

Contact a Thrive Boston Counselor
Call us at 617-395-5806. A Boston Counselor or Boston Psychotherapist wants to spend a few minutes talking with you today (if we are seeing clients, or unavailable when you call, please leave us your information and we will call you back today). 

We want you to find the help, care, motivation, encouragment, or information you need. Nervous about talking over the phone? You can also email us at ThriveBoston@gmail.com. Please leave your phone number and we will call you back within 24 hours. We look forward to meeting you!