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Therapy Agreement

Please do not attend if you have a bad cold or flu – even if it’s not Covid.


I am committed to providing a safe, therapeutic environment for my clients.

All sessions will be conducted in strictest confidence and this confidence will be maintained and applied to all records, except in the following circumstances:

  • Where you give consent for the confidence to be broken – i.e. sharing information with GP/Insurer.

  • Where the therapist is compelled to do so by an order of a court.

  • Where the therapist reasonably considers that the information is of such gravity that confidentiality cannot be maintained (for example, aspects of terrorism, trafficking, treason or money laundering).

  • Where the therapist reasonably considers that there is a risk of serious harm to yourself or others. 

  • On occasions when there is another person in the room, I cannot guarantee that they will maintain confidentiality.

  • In couples work I cannot offer secrecy between the individual members of the couple.


I am a member of the National Counselling and Psychotherapy Society and abide by their ethical framework. One aspect of working ethically is that I am required to undertake supervision (all therapists should do this); although client issues are discussed within supervision, confidentiality is maintained and your identity will not be revealed. A brief record of the contents of each session may be kept. Notes are kept in secure electronic format, encrypted and password protected.

Therapy Model

I use an integrative therapy model which means that I have a variety of psychological and therapeutic theories and 'tools' available to help clients if appropriate. 

Fees & Payment:

Fees are £80.00 per hour. If you have health insurance then you will need to obtain pre-authorisation for the first meeting beforehand - I am recognised by most insurance companies; I will ask for payment and can provide a receipt if you have not been able to obtain preauthorisation. Please understand that you will be liable for fees if your insurer declines to cover you. The hourly rate applies to therapy sessions and to any report writing or other time where my services are requested. If someone is paying the session fees on your behalf then I will inform them only of the date of the meeting and whether or not you attended.

Cancellation Policy:

Fees for cancelled or missed sessions are still payable unless 48 hours prior notice is given or if there are particularly extenuating circumstances. Please note that I will not see you if you are under the influence of alcohol and/or drugs. 

In couples therapy if one person does not attend then I will offer to work with the one that does attend. It will be your choice to accept or cancel the session, however the fee will still be payable.

Parent / Guardian Consent:

Prior to beginning therapy, it is important for you to understand my approach to young people’s therapy and agree to some rules about your child’s confidentiality during the course of their therapy.  


Therapy is most effective when a trusting relationship exists between the therapist and the client. Privacy is especially important in securing and maintaining that trust. One goal of therapy is to promote a stronger and better relationship between children and their parents/guardians. However, it is often necessary for children to develop a ‘zone of privacy’ whereby they feel able to discuss personal matters with greater freedom. This is particularly true for adolescents who are naturally developing a greater sense of independence and autonomy. By signing this you will be agreeing not to access to your child’s treatment notes. You will not attempt to gain advantage in any legal proceeding from my involvement with your child.

If I ever believe that your child is at serious risk of harm – either to themselves or risk to someone else, then I will inform you, or an appropriate agency. I may break confidentiality in exceptional circumstances - where I am compelled to do so by an order of a court, or where I reasonably consider that the information is of such gravity that confidentiality cannot be maintained (for example, aspects of terrorism, trafficking, treason or money laundering, or where a safeguarding issue is considered to be present). 


It is my policy to provide you with general information about the treatment status. If it is necessary to refer your child to another mental health professional with more specialised skills, I will share that information with you; I will not share with you what your child has disclosed to me without your child’s consent. 


I will tell you if your child does not attend sessions.

If any parent/guardian decides that therapy should end, I will honour that decision, however I ask that you allow me the option of having a closing session to appropriately end the therapeutic relationship. At the end of your child’s therapy, we will review the sessions in general, non-specific terms, such as areas where progress was made and what areas are might require further intervention in the future.


Any complaints about my work can be made through the National Counselling and Psychotherapy Society.

Privacy Policy:

I am registered with the Office of the Data Protection Commissioner, I hold the following data:

  • Name and age – this is basic information that helps me get to know you

  • Address, email address, phone number – I use this as a way of contacting you regarding your sessions. I will mainly use the method we agree on but if I can’t reach you I may try a different method.

  • Doctors details & medication – If I was worried that you were at risk then I may need to contact your doctor, if I could I would tell you I was going to do this. Knowledge of your medication helps me to understand what medical interventions might be in place which might affect our work together.

  • Insurance information if necessary to claim fees from your insurer.

Data storage: 

Any data on paper (such as this agreement) will be scanned and kept electronically; the original will be destroyed. Any notes from our sessions are kept electronically with encryption and password protection. Data is held for 5 years, which is the time frame my insurance company requires.


The Data Protection (Bailiwick of Guernsey) Law, 2021

I understand that by signing this section it has been explained to me that:

  • I am giving my consent for John Bate to process my personal data for all purposes in connection with the provision of therapy services.

  • I give my consent freely, and I have been informed that I have the right to withdraw my consent at any time. I have been advised that I have the option of refusing my consent.

  • I understand that the processing of my personal data is necessary for the proper performance by John Bate of his responsibilities in providing therapy services to me.

  • I understand that a brief record of the initial consultation and the contents of each therapy session may be kept. 

  • I am advised that John Bate takes appropriate measures to protect the security of my data in his possession.

  • My personal data will, except as follows, be accessed only by John Bate and his supervisor (in an anonymised form). 

  • I understand and consent to my personal data being disclosed to appropriate third-party agencies in any one of the circumstances set out in the terms and conditions section of this Therapy Agreement.

  • I have a right to know what personal data John Bate holds regarding myself. I may ask for a copy of the information held.


If I have any concerns about the handling of my data, which cannot be resolved between us, I have the right to complain to the Office of the Data Protection Commissioner.

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