Coaching Agreement and Informed Consent
Full terms and conditions (for individual clients)
Thank you for your interest in working with Krystyna Kidson, psychologist, coach and supervisor.
This Agreement and Informed Consent form, while lengthy, outlines exactly what you can expect from working with me: my services, policies, confidentiality standards and your rights to privacy. It constitutes a contract between myself, Krystyna Kidson, and yourself (the “Client”). As the Client, you should read it carefully and raise any questions and concerns that you may have before you sign it or the summary. It must be signed prior to the beginning of our first session.
Coaching is a process that promotes personal and/or professional development, as we collaborate to develop and implement strategies to help you reach your goals. Professional supervision is about creating a safe space of trust and transparency, where we reflect on, learn, explore and deepen your work and calling. I am happy to offer you either or both of these services as required, depending on what your goals are for this engagement. My service also involves stress and resilience training and support as requested or required.
I will be honest and direct, kind and supportive, asking questions and using challenging techniques to help you move forward. You will need to consider your own progress; and, if the arrangement is not working as you wish, you should immediately inform me so that we can both take steps to correct the problem. Do note that, as with any human endeavour, coaching/supervision can (indeed, should, occasionally) involve feelings of discomfort and frustration which may accompany the process of change.
Because progress and change happen at rates that are unique to each individual, it is best that we commit to working together for an initial three‐month period. This allows the relationship necessary time to develop and progress through the objectives, obstacles, and successes that occur.
The coaching/supervision relationship may be terminated at your request; when you have achieved the changes for which you engaged my services; and/or when the action plans we agree upon in session are continually incomplete, indicating that the arrangement is not adequate for your current situation.
Coaching is scheduled at our mutual convenience. The day and time for the next session will be scheduled at the close of each session. Please allow for at least 24 hours notice for changes to appointments.
All sessions are conducted face to face or online as arranged between us. At or prior to the scheduled appointment time, we will arrive at a predetermined meeting place or online meeting space and begin the session. If you opt to attend appointments by phone, you will call me at the pre-arranged time and telephone number as scheduled, and you cover the telephone charges for the call. We commit to start and finish each session on time. If you are more than 15 minutes late for a session, I will assume the session is cancelled and you will forfeit the session fee if pre-paid, or be charged a cancellation fee.
Once Upon a Time $120.00 (1 session)
Vitality Check $250.00 (2 sessions)
Getting Unstuck $450.00 (4 sessions)
Ongoing sessions/EAP (community rate) $120.00 per session
Ongoing sessions (corporate/ multiple stakeholder rate) $250.00 per session
Ongoing pastoral supervision $100.00 per session (or $400 per 5-session block) - conditions apply.
Each session is charged at the above rates. Ongoing sessions include unlimited email support and phone support between sessions. A call-out fee may apply to face-to-face sessions held outside my local area, proportional to the time spent in travel. Please contact me should you need to discuss this further.
All clients must agree to the fee amount before services are provided. I will provide invoices prior to each session, which must be paid before services commence. Fees can be paid via direct deposit online in the days prior to the session; or by cash, EFTPOS or credit card (Visa, MasterCard or American Express) at the beginning of face-to-face sessions. (Please note that all card payments attract a 2% surcharge and I must be advised prior so that I can bring my card reader to session.)
Any changes to this procedure must be mutually agreed upon in writing and signed by both of us.
Some few health funds do give rebates for coaching – please contact your provider and advise me as specific conditions and application forms often apply. Some sessions may also attract GST if your coaching is specifically related to your work or the sessions are paid for by a third party (e.g. your employer). Check with your accountant for further information.
Please note that it is your responsibility to manage your appointment times. I will attempt to send you a courtesy email or text reminder prior to your appointment so please keep your contact details updated.
If you need to cancel or postpone your appointment, please give me at least 24 hours notice. I will endeavour to do the same for you. I will make reasonable efforts to reschedule sessions which are cancelled in a timely manner.
If you provide me with less than 24 hours notice and I cannot fill your appointment time with another client, you may be charged 50% of the consultation fee (or equivalent thereof if you have chosen a programme). You will be charged 100% of the consultation if you do not attend (or forfeit the equivalent thereof if you have chosen a programme). As you can understand it is nearly impossible for me to book a new client at very short notice, and if several clients cancel in one day then I lose a large amount of my income. (Imagine a salaried employee arriving at work and being told they will only be receiving half their salary that day!) If you consider the situation in these terms, then you can understand why I must charge a cancellation fee for missed appointments. Please note that insurance rebates are not applicable to cancellation fees.
If a third party person or organisation pays for your sessions up front, and you decide to cease working with me while some session fees remain unused, I will retain the payment until you advise me of the refund pathway the third party requires me to follow, at which point I will refund the unused session fees.
IN CASE OF CONFLICT
Should you have any concerns arising from this agreement or my practice as our working relationship proceeds, please advise me so that we can discuss it fully and come to a good understanding. Should you have concerns regarding my ethical practice which cannot be resolved by discussion or mediation, I encourage you to contact the Psychology Board of Australia or the International Association of Coaching. We agree that, between us and your assignees, family or estate, that any difficulties relating to this agreement that we cannot otherwise settle, shall be settled by arbitration by an accredited individual or organization with an arbitrator whom we both agree upon. The arbitration may occur by telephone.
RECORDS AND INFORMATION MANAGEMENT
It is important for the success of the coaching/supervision relationship that you have confidence in my ability to manage your records responsibly. As part of providing a service to you, I collect and record relevant personal information, in order to facilitate provision of services later either by myself or by other professionals (should you so choose), to ensure accountability, and to meet Australian legal requirements. This information will inform my practice and thus will be a necessary part of the coaching process. You do not have to give all personal information requested, but if you don’t, this may mean that my approach will not fit your needs.
All communications between us become part of your records, which are stored in your client file. Client files are held in a secure filing cabinet that is accessible only by me. You have a general right of access to all information in your file, unless one of the exceptions to National Privacy Principle 6 applies (where giving access would pose a serious threat to the physical or mental health of any individual, jeopardise the privacy of others, or hinder any law enforcement activities). If you wish to view and / or have a copy of the material recorded in your file, make the request in writing and send it to me. Upon receiving your request I will discuss your access options. As a psychologist, I am required to keep records for a minimum of seven years since last client contact unless legal or other requirements specify otherwise.
The coaching/supervision relationship is built on trust. I agree to keep all conversations and information with you private and confidential. No personal ideas, information or thoughts expressed will be shared with anyone except with your permission. All the information I gather during the provision of the service will remain confidential and secure except where:
1. It is subpoenaed by a court, or
2. Failure to disclose the information would place you or another person at serious and imminent risk; or
3. Your prior approval has been obtained to a) provide a written report to another professional or agency or b) discuss the material with another person, eg. a parent or employer; or
4. If disclosure is otherwise required or authorised by law.
In all circumstances, I am judicious in the amount of information that is disclosed. When possible, I inform clients about the disclosure of confidential information and possible ramifications before the disclosure is made.
In my dealings with the public and media (including social media, professional presentations and writing) I will be careful to guard your confidentiality. Moreover, I will disguise confidential information so that my clients are not individually identifiable. I will only disclose confidential information if you or your legally authorized individual has given express written consent.
In a consultative capacity (e.g. meetings with my own supervisor for the purposes of quality control), I share information only to the extent necessary to achieve the purposes of the consultation (e.g. to improve my service delivery). I would not share confidential information that could lead to your identification. I also take logical precautions to protect client confidentiality in the event of my cessation of practice, incapacitation, or death.
Likewise, you, the Client, agree to maintain the confidentiality of all information communicated to you by other coaching/supervision clients (e.g. in group work) and by me. Please feel free to discuss your experience with trusted colleagues and friends, but do not share any information which would allow other clients to be identified. In order to honour and protect my intellectual properties, you also expressly agree not to disclose or communicate any proprietary information about my practice, materials, or methods to any third parties. We agree to be bound by this mutual nondisclosure agreement during and after the termination of the coaching relationship.
You should also be aware that, though I will give it my best effort, it is impossible to guarantee the confidentiality of Client information which may be transmitted electronically, i.e., electronic mail and other information stored on computers connected to the internet, by cordless or mobile devices and similar telecommunication and computer equipment. Therefore, it is agreed between us that unless you utilise encryption and other forms of security protection, you waive any action legal or otherwise against me and hold me harmless for any interception of your information resulting from the use of the above-mentioned equipment.
REGARDING PSYCHOTHERAPY, MEDICARE & TELEHEALTH
As you are aware, I am a registered psychologist in Australia, with training and experience in diagnosing and treating emotional and psychological problems. Although there are some similarities between coaching, supervision, and psychotherapy, I will not conduct psychotherapy per se under most circumstances with my clients.
Coaching, supervision, and psychotherapy, operate under different assumptions, need different levels of privacy, and work towards different goals (e.g. goal-oriented, future focus; professional formation focus; vs healing and recovery from past hurts). As such, Medicare rebates do not apply to these services.
Coaching is an ongoing professional relationship that helps people produce extraordinary results in their lives, careers, businesses or organizations, through a thoughtful process of questioning, listening and observation which helps the Client find clarity and direction for the future. The training I offer provides added insight, awareness, understanding and skills for my clients to utilise in this future-focussed process.
Supervision is an ongoing professional relationship that helps the helping professional form themselves in the context of their work. It has restorative (coping with the stresses and strains of the work), formative (growing and forming as a professional in your context) and normative (day-to-day managerial, boundaries, ethics, conflict or team management) functions. It also operates through a thoughtful process of questioning, listening and observation which helps the Client find clarity and direction for their ongoing professional development.
Psychotherapy relies on a therapeutic alliance and a higher level of therapist-driven direction and influence to identify disorders, manage symptoms and treat psychological dysfunction. Given these distinctions, Medicare does not subsidise this coaching service.
We must agree that if either of us recognizes that you, the Client, have a problem that would benefit from psychotherapy as opposed to the coaching and mind-skill training that I provide, I may refer you to appropriate resources in addition to or in lieu of coaching. In some situations as a condition of my continuance as your Coach/Supervisor, I may insist that you enter psychotherapy and that I have your consent to discuss matters which concern you with your therapist. It is further understood that I am not obligated to provide you, the Client, with psychotherapy services.
Where sessions are conducted online, we agree that the email and information exchange occurs in NSW, Australia, as if you were using the technology to travel to me. These interactions are subsequently governed by the laws of that state.
Your signature to this agreement, as the Client, acknowledges that you have read all this information contained in the Agreement and Informed Consent; indicates your assent to the terms of the Agreement; and signifies your assurance that you will abide by its terms during our professional coaching relationship.