INFORMED CONSENT FOR PSYCHOTHERAPY SERVICES

Understanding Psychotherapy

Psychotherapy, often referred to as 'talk therapy', is a method designed to assist individuals facing emotional challenges, personal concerns, relationship difficulties, and specific mental disorders such as depression or anxiety. It aims to facilitate a deeper understanding of oneself, and how thoughts and feelings influence behavior, reactions, and relationships, thus promoting a fulfilling life.

The initial session typically begins with an assessment to identify symptoms and behaviors that may be impacting your overall well-being. Psychotherapy is a collaborative effort between you and the therapist. The pace and progress of therapy can vary and largely depend on the nature of the concerns addressed and your active participation.

Potential Risks and Benefits of Psychotherapy

Psychotherapy can offer several benefits such as reduced emotional distress, improved self-esteem, enhanced interpersonal relationships, and increased comfort in various aspects of life.

However, therapy may also bring some discomfort or distressing feelings (like sadness, guilt, anxiety, anger, frustration, loneliness, or helplessness) when discussing certain experiences or situations. It's not uncommon for clients to initially feel worse before they start feeling better, which is generally a normal part of the process. If you have any concerns about your progress, we encourage you to discuss them with your therapist.

Confidentiality

Your privacy is of utmost importance to us. All information shared in therapy is confidential. However, under certain circumstances defined by law, therapists are required to break confidentiality, including:

1. If you pose a danger to yourself or others.
2. If you make a credible threat of violence towards a reasonably identifiable person.
3. If you provide written consent to release information.
4. If a court orders the release of your information. (Please note, our center does not provide services for court cases or police cases. Discuss with your therapist for further clarification).
5. For clients under 18 years of age, parents/guardians have the rights to therapeutic information. However, to ensure the child’s privacy, detailed information about the session will not be provided to the parent/caregiver unless the child gives their assent. Instead, general themes, ideas, recommendations, support, and encouragement will be provided to the parent/caregiver. We encourage parents/guardians to respect the confidentiality of the process.
6. If there's a suspicion of child or elder abuse or neglect.

Harassment (of any kind)

Planet Mind strongly prohibits harassment of any kind from all parties. Planet Mind will take appropriate and immediate action in response to complaints or knowledge of violations of this policy. For purposes of this policy, harassment is any verbal or physical conduct designed to threaten, intimidate or coerce a client of Planet Mind, an employee, co-worker, or any person working for or on behalf of Planet Mind.

In the event of any form of harassment was identified, it will be documented in the Incident Report (IR) as written evidence to facilitate potential police report, whenever deemed necessary. The IR and case will then be reviewed by Planet Mind's clinical director for appropriate and immediate action, in the account of the first violation. The client's services at Planet Mind will be immediately terminated upon second violation.

Fees and Sessions

At Planet Mind Care, we believe in transparency and mutual understanding when it comes to the fees for our services. This informed consent outlines our fee structure for the different therapy sessions offered. Please review the following information carefully:

Intake Session

The intake session is a crucial first step in your therapy journey. It involves a detailed discussion of your current situation, concerns, and therapeutic goals. This session typically lasts between 60 to 90 minutes.

• For our Therapists: The cost for the intake session is RM 250.
• For our Senior Consultants: The cost for the intake session is RM 550.

Standard Therapy Sessions

Following the intake session, standard therapy sessions usually last for 50 minutes.

• For our Therapists: The standard rate for each session is RM 200.
• For our Senior Consultants: The standard rate for each session is RM 500.

Please note that all fees must be paid in full at the time of each session. Payment can be made by cash and electronic transfer.

By continuing with the therapy process, you acknowledge and accept the fee structure outlined above. We understand that financial circumstances can change, and we are committed to providing support to all individuals, regardless of their financial situation. If you have any concerns or require financial accommodation, please discuss this with your therapist or our reception team.

Attendance and Cancellation Policies

Mutual commitment and trust form the foundation of the therapeutic relationship. Both you and the therapist are responsible for maintaining scheduled appointments.

Attendance: Please be punctual for your appointments. If you are late, the session will end at the originally scheduled time and will be billed for the full session.

Cancellation: ‍In the event that you must cancel your appointment, we again require at least 24 hours' notice. Please be aware that a 10% processing fee will be deducted from any refunds provided. Once your cancellation request is processed, typically within 72 hours, we will issue a refund for 90% of your original payment.

No Show/Cancellation less than 24 hours: In case of a no-show, where you fail to attend a session without prior notification, 50% of the total therapy fees will be forfeited. This policy allows us to manage our therapists' time effectively and accommodate other clients who may be waiting for an appointment.

For emergencies: Please notify us at least 2 hours in advance to avoid the cancellation fee. Emergency cancellations will be evaluated on a case-by-case basis. If the therapist needs to cancel a session, every effort will be made to reschedule it.

Please note that therapy sessions will not be conducted if you are under the influence of alcohol or substances.

Termination of Therapy

Client Initiated Termination: Participation in psychotherapy is voluntary, and you or your parent/guardian (if you're under 18) have the right to discontinue therapy at any time. However, we recommend discussing this decision with your therapist before ending therapy.

Therapist Initiated Termination: The therapist may also decide to terminate therapy for various reasons, such as untimely payment of fees, non-compliance with treatment recommendations, conflicts of interest, non-participation in therapy, your needs are beyond the therapist's competence or practice, or lack of adequate progress in therapy.

Upon termination, we recommend at least one or more termination sessions to reflect on the work done and to provide a positive conclusion to the therapeutic relationship. If needed, the therapist will provide referrals to another professional.

Therapist Availability

Please note that your therapist is unable to provide 24-hour crisis service. If you are in immediate danger or need urgent medical or psychiatric assistance, please call emergency services (e.g., 999) or visit the nearest emergency room.

Acknowledgment

By signing below, you acknowledge that you have read, fully understood, and agree to the terms and conditions outlined in this informed consent form for psychotherapy. You also agree to hold the therapist harmless from any claims, demands, or legal actions, save for cases of negligence, that may result from the treatment process.