The Therapy Contract

Therapy or counseling is actually a contract - an agreement between two parties in which each has appropriate responsibilities and expectations.  Let me spell this out in greater detail.

I.   My Responsibilities 

As your therapist, I agree to provide the following three elements:

     1) I will provide safety. My location and work with you is designed to give a safe environment for you to open yourself to the inner work of psychological and personal change. My office will be free of physical, sexual, and other abuse, threats and acts of violence, weapons, or illicit drugs.

Another form of safety is the legal confidentiality that is afforded your work with me as set out by the laws of the State of Michigan. Further information about this can be found in my specific web page on Confidentiality.

An area of increasing concern for me is the securitiy of psychological and other private information released to third-party payors, especially in an era of frequent large-scale data breaches in the news. I also address this in other places on this website.

     2) It is my pledge to do my best to be more powerful than your problem or problems. If i need help in fulfilling that, it is my responsibility to get myself that help - which can involve reading and research, consultation with other clinicians (not revealing the identity of our client), or obtaining further professional training.

     3) It is also my responsibility to be clear with you about how I evaluate your presenting problems and your ongoing work with me, as well as to explain what my treatment plans and goals are. Treatment plans are by nature often ongoing works-in-progress. This means that I am constantly re-evaluating mywork and thinking about how best to serve and care for you.

You have the right to an explanation in language you can understand, of potential risks, consequences, and benefits of treatment and methods prior to their use, and are entitled to request and obtain information regarding treatment alternatives.

II.   Your Responsibilities 

As the Client, you also have responsibilities in your work with me.

     1) First, it is your responsibility to show up for client sessions. When possible, client sessions are set up on a regular schedule, which is not just for the convenience of my scheduling. The regularity of your sessions is an important part of your "inside" work. There are circumstances when clients don’t have the ability or luxury of such a regularity. And in those circumstances I will work with your schedule as best as I can.

     2) Your second responsibility is to take seriously the work we are doing – to cooperate with requests to do any "homework" given to you, and to spend time between sessions thinking, exploring and experimenting in the areas we are working on together. In short, it is your responsibility to pay attention to what is going on within and around you.

     3) Another part of taking the relationship seriously is upholding the financial agreement established with me. When or if circumstances make this impossible or a serious problem, I ask that you be straightforward with me about it, so we can explore additional options available.

     4) You are responsible for being as open and honest with me as is possible. At times this may be your greatest challenge in therapy. And it is my pledge to encourage and honor the specific trust involved in that openness.

     5) You are expected to be free of the influence of alcohol and drugs, except with my specific knowledge and approval.

     6) When it is time for treatment to discontinue, I ask that you participate in a final session designed for the specific purpose of terminating the treatment contract, evaluating its course, and projecting its benefits into your own future.

If I experience that you are not taking your work with me seriously, that you are not taking seriously the responsibilities listed above, in extreme cases I do claim the right to terminate treatment for lack of compliance. However, this would be considered as a measure of last resort for me, since I realize that once I have agreed to work with you, the stability of our my work is an important part of the therapeutic relationship.

© William K McDonald

Rev July 30, 2015