The purpose of this form is to share some important principles, which guide my therapeutic practice so that your decision to place your child/adolescent into therapy with me can be based on accurate, informed expectations. Please read this carefully and feel free to ask any questions about what you have read if you need further clarification.

Therapy is a process which relies heavily on building a trusting relationship between the therapist and the client. This takes time for a person to open up and for the therapist to understand what they are struggling with. To do justice to your child or adolescent, they need time to undergo a process that will bring about long-term change and help them regain their footing on the developmental path they may have lost. their offer a minimum of TEN sessions.

In general, one of the most important rights the person seeking therapy has involves confidentiality, even if it is a young child. Information revealed by a client during the sessions will be kept strictly confidential and will not be revealed to any other person or agency without written permission, with the following exceptions:

To maintain professionalism, therapists are required to be supervised by another therapist during these interactions, and client anonymity is of paramount importance.

Confidentiality also has some legal limitations. There are situations where the therapist can be required to reveal information obtained during therapy to another person without the parent’s or child’s permission. These situations involve harm to self, harm to others and any safeguarding concerns. Whenever possible, the child/adolescent will be informed before these concerns are shared.

Therapists who work with children/adolescents have the difficult task of protecting the child/adolescent’s right to privacy while at the same time respecting the parent’s or guardian’s right to information.

Therapy is most effective when a trusting relationship exists between the therapist and the client. Privacy is paramount in securing and maintaining that trust. One goal of

treatment is to promote a stronger and better relationship between children/adolescents and their parents. However, it is often necessary for the child/adolescent to develop a “zone of privacy” whereby they feel free to discuss personal matters with greater freedom. This is particularly true for adolescents who are naturally developing a greater sense of independence and autonomy.

It is helpful if you refrain from asking your child/adolescent what they discussed after each session. However, if they wish to share anything with you, that is their choice, but they should not feel pressured to do so.

If it is necessary to refer your child/adolescent to another mental health professional with more specialised skills, I will share that information with you and recommend an appropriate referral.

I will not share with you what your child/adolescent has disclosed to me without your child’s/adolescent’s consent. (However, this is not applicable if it is a safeguarding concern.) At the end of your child’s/adolescent’s treatment, it may be helpful to review the sessions in general.

It is helpful to remember that our relationship is professional and not social. Our professional relationship is of utmost importance as we work together towards achieving your goals and bringing resolution and healing to your child/adolescents life. If you have any concerns regarding your child/adolescent during the therapeutic process or wish to update me, please email me at info@yourmindmatters.com. I am available Monday to Friday from 9am to 5pm and will respond to you as soon as I can. Please understand that my therapeutic relationship is with your child/adolescent and therefore it is helpful if you let your child/adolescent know what information you have shared with me.

Both you and your child/adolescent are in compete control and may end the therapeutic relationship at any time. Endings are an important part of the therapeutic process, in order to manage an ending appropriately with your child/adolescent I require at least two weeks’ notice prior to an ending.

Sessions last 50 minutes, sessions are delivered through video / audio calls on the virtual platform. Please note if you are late, sessions will still end at the agreed time.

I require 24 24-hour cancellation notice prior to the session. If appointments are not cancelled within this time frame, then fees will still be due. Please note I work in conjunction with the school term and break during school holidays.

Therapy sessions must be paid for before or directly after each session. I will send you an invoice for your records.

Please understand that I am not a crisis service. In the event of an emergency, please take your child/ adolescent to your local Accident and Emergency (A&E) department or call 100.

The only data I collect is the name, address, email, and telephone number of the parent/carer of the child or young person with whom I am working. I am obliged to keep notes of the key issues discussed during the sessions, and these will be kept for six months before being deleted.

By your signature below, you are indicating that you give your permission for your child/adolescent to be in therapy with Dr. Lakshmi Chinnappan, and that you have read, understood and agreed to the information provided by this consent form. Please return this form to me as soon as possible.