Consent and Disclosure for Therapy

Please read carefully and complete the form at the bottom of the page.

Philosophy of Practice and the Therapeutic Relationship

It is my passion to support people in living harmoniously with their authentic selves and with others.  I believe that the relationship between a therapist and client is an important vehicle of transformation and I value each person's unique expertise and perspective.  I am a sex positive therapist, meaning that I believe that the informed and caring fulfillment of our unique sexuality is one of the keys to wellness in life.  

Education and Professional Memberships

I hold a Master’s degree in Counselling from City University and am a Professional Member and Certified Canadian Counsellor with the Canadian Counselling and Psychotherapy Association (CCPA #10001584). I am currently also a doctoral student in Psychology at Cal Southern University.

I hold a Bachelor of Education from UBC, a graduate certificate in Language and Literacy from UVIC, and a certification in Level B Assessments from Queen's University.  I am a professional educator licensed by the BC Teacher Regulation Branch (#L174080).  

Confidentiality and Limits of Confidentiality

In order to establish trust and for counselling to be effective, anything that is shared with me during our sessions will remain strictly confidential, and information you share will be received without judgment.  

 

There are important exceptions to confidentiality:

  • I am legally required to tell the Ministry of Children and Families if I learn of a child being abused.

  • I am legally required to warn anyone whose life is in danger.

  • I am legally required to warn the authorities if a client has a plan to kill him/herself and is at serious risk to carry out this plan.

  • I am legally required to comply with a subpoena to appear in court or to provide my personal notes to a court.

Electronic Communications

It may become useful during the course of treatment to communicate by email, text message (e.g. “SMS”) or other electronic methods of communication. Receiving receipts for services by email or text message fall into this category as well.

Be informed that these methods, in their typical form, are not confidential means of communication. If you use these methods to communicate with me, there is a chance that a third party may be able to intercept these messages.

Some of the potential risks you might encounter using these methods of communication include:

 People in your home or other environments who access your phone, computer, or other devices that you use might read your email or text messages.

 Loss of cellular phone, computer, or other devices.

 Email accounts can be hacked.

 Text messages and emails are stored on servers.

 Misdelivery of email to an incorrectly typed address.

 Third parties on the Internet such as server administrators who monitor Internet traffic might intercept your communication.

Telehealth Counselling

Telehealth counselling refers to providing counselling and/or therapy services remotely using telecommunications technologies, such as telephone or video conferencing. Although there are benefits of telehealth service, there are some differences between in-person therapy and online counselling, as well as some risks (such as those outlined above) and responsibilities.

 

Confidentiality and Telehealth
Although online appointments are only held via platforms with end-to-end encryption, there is always a risk that our electronic communications may be compromised, unsecured, or accessed by others. You should also take reasonable steps to ensure the security of our communications (for example, only using secure networks for online counselling sessions and having passwords to protect the device you use for online counselling). 


The limits to confidentiality that are outlined for in-person counselling still apply in online counselling. 

Small Town Life

As you may be aware, since we live in a small community, our paths will cross in many ways.  We will likely see each other around town.  Please know that I will always be discreet during such encounters, and the level of our interaction will be strictly up to you.  Most clients are comfortable with friendly small-talk, but I always have a discussion about your preferences at our first session.  

There are some instances when an existing relationship would prevent me from being able to appropriately support you in therapy.  If any past or present social relationship exists between us, I will be very happy to refer you to a trusted colleague but I may not ethically become your therapist.  Every situation is unique, however, so there will be other times when we need to carefully assess the viability of a therapeutic relationship.  Sometimes this will entail enlisting the support and consultation of a supervisor who is bound to the same ethical standards as I am.  Your confidentiality, comfort, and safety is of utmost priority.

Remember, you have the right to participate in therapy as little or as much as you feel comfortable with, and you always have the right to terminate counselling at any time.

Services Offered

I approach my work from a client-centred, existential perspective, which means that I am interested in YOU and helping you make choices that are in line with your unique values and desires.  I am well-trained in a diverse array of therapeutic techniques to help people work through issues, but mostly I focus on creating a safe space for you to explore and express yourself. 

In addition to psychotherapy practice, I offer support to students and families who are experiencing challenges related to school and learning.  I specialize in reading and literacy issues and can offer detailed assessment and specialized recommendations for future growth.  I also offer group and individual knitting classes and support for project completion.

I will encourage you to exercise your right to ask questions about, change, or stop any therapeutic techniques introduced in therapy if you wish.

If you are unhappy about anything that happens during therapy with me, please bring it to my attention so that I may address your concerns.

 

Fees and Terms of Service

Rates for private services start at $125/session for individual counselling.  Payment is due before the start of each session and can be paid with cash, credit, email money transfer, or PayPal.  I also offer a range of services at no cost to clients, including counselling by donation, a free clinic, and First Nations Health Benefits program delivery.

To avoid being charged for a missed appointment, twenty-four hours notice is required for appointment cancellation or rescheduling.

Counselling Records

Your file is maintained under the provisions of the Personal Information Protection Act (BC January 1, 2004).

Your file is owned by the counselling agency and kept in a secure place. It is kept for seven years after the end of contact.

You own the contents of your file and are welcome to see your file at any time. You can ask for a copy of your file for yourself or to be given to another professional.


Contact between Appointments

You can contact me between appointments at this number: 250-266-1476, or email info@equanimitywellbeing.org. I will respond to your call within 48 hours.

If you are experiencing a crisis or emergency, please visit the Tonquin Medical Clinic, the Emergency Room at Tofino General Hospital, or phone one of these numbers:

Crisis Line 604 872-3311 or 1-866-661-3311

BC Crisis Line for Suicide 1-800-SUICIDE

Victimlink 1-800-563-0808

Kids Help 1-800-668-6868

BC NurseLine 811

911

Your Signature (optional)

©2018 by equanimity.