Counselling in Gosport

The Lodge

19 Ham Lane


02392 355607/07884 432174

Agreement for the provision of therapeutic services

Psychotherapy and counselling involve the provision of a non-judgemental and confidential space in which you can explore the psychological and emotional difficulties which are adversely affecting you.  The aim is that through the time we spend together, you are enabled to live your life in a way that is more acceptable to you. 

At our first session, copies of this agreement will need to be signed by all involved in the therapy to acknowledge agreement to these terms.  All parties will then receive a copy of the signed agreement.  Additional terms and conditions apply to third party commissioners of Counselling in Gosport which will be provided upon enquiry.

If following our first assessment session you decide to continue, future sessions will be of one hour’s duration beginning at the agreed appointment time.  In as far as is practicable, we will seek to arrange those sessions on the same day and time each week.  Our commitments will require some flexibility in this, and an opportunity will always be provided at the end of each session to discuss and confirm the next appointment.

Should it be necessary for you to cancel an appointment I would ask that you give a minimum of twenty four hours notice.  It is usual practice to require payment for missed sessions except in the case of unavoidable emergencies.

Confidentiality means that I will not discuss our work together with any other person or agency without your explicit permission.  Sessions will not be electronically recorded by any party.  Attendees may take notes if they wish.

There are some exceptions to this statement as follows:

If you disclose information about a serious criminal offence

If you make me aware that either you or another person is at risk of harm

If you are in contact with any statutory service that need to know about our contact

Should any such disclosure be necessary, I will always seek to make you aware before doing so.

Should you require the sharing of information with a nominated third party, explicit written permission from you will be required.  No reports will be provided, nor opinion offered regarding risk issues, but confirmation will be provided regarding duration of contact, and other matters as agreed between us following discussion.

In order to maintain the quality of my work, I am required to engage in regular clinical supervision.  This single person/my supervisor will be aware of the content of the work we are doing together, but will only know you by your first name.  My supervisor will also be given your contact telephone number to ensure that should I be unable to continue our work together for any unexpected reason, you will be made aware.

Certificates of qualification and insurance will be shown on request when you attend appointments.

I keep brief notes regarding our sessions to enable progress to be monitored.  Notes are handwritten and kept in a secure cabinet. They will be destroyed in due course ie when our work is completed plus a period of time afterward commensurate with the possibility of your returning for any reason.  Third party access to any notes will only occur should the judicial process require this (ie subpoena/court order). All information that Counselling in Gosport holds regarding you is done solely with the purpose of expediting our work together, and will not be shared with any third party for any reason other than those already outlined. You are invited to enquire at any time should you have any outstanding questions about GDPR compliance that have not been addressed in this statement.

I am registered as a psychotherapist with United Kingdom Council for Psychotherapy (UKCP).  Should you be unhappy about any aspect of my work, and following discussion with me have been unable to address those issues to your satisfaction, you may contact UKCP at

America House

2 America Square

London EC3N 2LU

Telephone: 020 7014 9955

UKCP have a robust complaints procedure in place and will advise you regarding how to progress this.

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