My name’s Kathleen Daymond and, together with my colleague Sarah Millward, I've been running the Get help with counselling concerns service for around 10 years. The Get help with counselling concerns service is a confidential phone and email information and guidance service for any clients or members of the public who've got questions or concerns about their experience of therapy or a therapy-related service.

It’s our experience that concerns about contracting are recurring issues. Concerns can often develop during therapy because things haven’t been made clear by a contract or agreement of some kind at the beginning of therapy and we’d like members of the public (potential and existing clients) to be aware of what that should address.

Before therapy begins, perhaps in an assessment or first session and whether therapy is long-term, short-term, or open-ended, a therapist should explain how they work and how they plan to work with you. As part of the initial discussions, it’s also helpful for a therapist to mention that they have supervision, and we would hope that therapists may (depending on their modality) remind you both when the end of a session is approaching to ensure no big subjects are started and existing discussions can come to a safe and calm end.

Most types of therapy will include a plan to review the work with you on a regular basis, so they know how you feel about the way therapy is working for you. These terms of working with a client, whether written or verbal, should be discussed before sessions begin as this gives the client the information to decide whether they may wish to start working with the therapist.

The therapist should be professional at all times and, whilst remaining receptive, create an environment which feels comfortable enough for a client to trust them and be able to talk about whatever they feel they need to. Part of that is maintaining professional boundaries at all times.

We'd suggest the following would usually be included when contracting and preferably be provided in a written format, either in a formal agreement which you might sign or a leaflet which you can keep or be sent to you by email. Things included are:

  • the suggested length of therapy - how long a session will be, for example, 50 minutes or an hour
  • the cost and frequency of the sessions, for example, weekly, same day, same time or another arrangement
  • the therapist should explain if there are cancellation fees if sessions are missed or what the terms of notice are if a client wants to end therapy
  • what happens about when the client or therapist has holidays
  • the contact time outside of sessions - is it OK for the therapist to be contacted and under what circumstances, for example, just to rearrange a session or more?
  • confidentiality and when they might breach that confidentiality, for instance, in relation to certain laws or if they have concerns about any harm to yourself or harm to others in some way
  • what do they do about notes? Do they make them (BACP members are recommended to do so), what happens to them, where are they are kept and how long for? Who might see the notes? If a practitioner works privately it should be straightforward regarding how and where they’re kept, however, if the therapist works for an organisation, it may be more complicated. Either way, they should still explain where and how they are kept and who can read them

The confidential Get help with counselling concerns service is available Monday to Thursday, 9.30am to 4pm, by phone and email.

Call us on 01455 883300 option 2, 07811 762114, 07811 762256 or email us at gethelp@bacp.co.uk

Anything you say will be confidential and you can speak with us anonymously if you prefer. Due to the number of enquiries we receive, we do try to limit the calls to a maximum of 30 minutes, where possible.

Kathleen and Sarah 

Views expressed in this article are the views of the writer and not necessarily the views of BACP. Publication does not imply endorsement of the writer’s views. Reasonable care has been taken to avoid errors but no liability will be accepted for any errors that may occur. Please be aware that we collect and process personal data. For more details, see section 2n of our privacy notice.