Informed Consent for Psychological services
Nature and Purpose of the Psychological Service
Psychology services vary depending on the personalities of the psychologist and client and the particular reasons you are seeing a psychologist. Your psychologist may use many different methods to address the problems that you hope to address. Your psychologist is registered with the Psychology Board of Australia and will utilise evidence-based approaches when working with you. Psychology and psychotherapy require a very active effort on your part. For the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home.
If you have questions about the service, you and your psychologist should discuss them when they arise. You can cease therapy with your psychologist at any time. If you feel uncomfortable with what is happening in a session, please inform your psychologist so that this can be addressed and/or you may request that the session cease at any time.
Consent for Service
Your consent is required for us to provide a psychological service. Your psychologist will explain to you the benefits and any potential risks of accessing psychological services. Please ensure that you fully understand the service information provided and ask for further information if you are unclear as to the information outlined in this consent form.
Personal Information
As part of providing a psychological service, we will need to collect and record personal information that is relevant to your current situation. This information is a necessary part of the services provided and guides treatment. You do not have to give all of your personal information, but choosing not to share your relevant information may mean that the psychological service may be affected and a service may not be offered. Your information will be confidentially retained to document what happens during sessions and enable the psychologist to provide a relevant and informed psychological service to you.
At times, with your consent we may also gather information from others to help inform the psychological service. That information is treated in the same way as your personal information.
Information Storage
Your information is stored securely. It is only accessed by your psychologist and as required, by authorised staff and personnel engaged by the Childhood Cancer Association. Your information is stored in a physical filing cabinet at the Childhood Cancer Association office, and all archived files are held in a secure cloud-based storage system.
Psychologists are required to keep your file for a minimum of 7 years or, if clients are under the age of 18 at the time of treatment, until they are 25 years of age. If you have concerns that the information recorded is not correct, please discuss your concerns with your psychologist.
Access to your information
At any stage you are entitled to access your personal information kept on file. There may be some exceptions to this as outlined in relevant legislation or policies such as in the Privacy Act 1988. If you would like to make an application to access your information, please discuss make a request in writing. When viewing your record for the first time, it is preferable to have your psychologist present to offer support, clarify any areas of concerns and answer any questions.
Consequences of not providing personal information
Psychologists are required to keep clear and accurate client records as part of their professional obligations. If you do not wish for your personal information to be collected, we may not be able to provide the psychological service to you. Please discuss any concerns with have with your psychologist.
Confidentiality and Privacy
Personal information gathered by your psychologist will remain confidential expect for certain circumstances. In most cases, any sharing of information will only occur with your consent.
All personal information gathered by the psychologist during the provision of psychological service will remain confidential and secure except when:
- A court subpoena or other disclosure is required or authorised by law
- Your consent cannot be gained due to a requirement to get you emergency services during a medical crisis
- If there is unauthorised access to data held by the Association, some limited information may need to be shared with the Office of the Information Ombudsman.
- Failure to disclose the information would place you or another person at risk of harm
- Given your prior approval, or consent of a parent or guardian who is legally authorised to act on your behalf, to provide a written report to another professional or agency or discuss information with another person, e.g., parent or employer
- You have provided your consent to share your information for a specific reason and purpose.
- You would reasonably expect your personal information to be disclosed to another professional or agency, and disclosure is directly related to the primary purpose for which it was collected, such as to the referring practitioner of treatment and progress
- Clinical consultation with another professional is required to provide better services. If your information is shared in this context, all care is taken to deidentify your information in such a way that you remain anonymous.
If, during your treatment, the psychologist becomes aware of a risk to someone’s life, health, or well-being, the psychologist is required to report the matter to the appropriate agencies.
Please note that we will not engage with you in public or online in a way that will identify you as a client. This is to protect your privacy and due to the requirements to uphold professional boundaries. Please only contact your psychologist through the Childhood Cancer Association contact details rather than approach them on social media or in public forums.
Telehealth
Throughout your service provision at the Childhood Cancer Association, you may utilise counselling provided over phone or video. We ask that you read and agree to the below information in relation to the provision of telehealth services.
To access telehealth consultations, you will need access to a quiet, private space; and the appropriate device, i.e. smartphone, laptop, iPad, computer, with a camera, microphone and speakers; and a reliable broadband internet connection.
I also understand that there are potential risks and downsides of telehealth/video conferencing therapy sessions and that these can include:
- Telehealth/video conferencing may not feel the same as face-to-face sessions.
- Technical problems could affect the video/sound quality or connection, which may disrupt the session in some ways.
- Although my psychologist chooses video conferencing software, which has end-to-end encryption and high-security standards, there is still a small risk of hacking or others tapping into the video connection.
I understand that my psychologist is taking the necessary precautions to ensure confidentiality on their end of the call, including:
- Ensuring the privacy of the telehealth session is upheld in the same way an in-person session would be,
- Not allowing any voice or video recording of the session.
I understand that I can ask questions about the telehealth session anytime. If I do not wish to continue or if technical difficulties interfere with the session to the point where we cannot continue, a phone consultation will be offered as an alternative.
Session Fees & Cancellation Policy
There are no fees associated with receiving counselling services at the Childhood Cancer Association. If you are required to cancel or reschedule your appointment, we ask that at least 24 hours notice is provided.
Emergency
In an emergency, please go to the nearest hospital's emergency department or call 000. You may also call the Mental Health Triage Service on 13 14 65 or Lifeline on 13 11 14 for out-of-hours phone support.
How to make a complaint
If you have any concerns about your contact with the Childhood Cancer Association, please discuss these with your psychologist, if you are able. If you would like to make a complaint, you are able to do so by contacting us either by phone or in writing to:
Manager Family Service
PO Box 1094
North Adelaide SA 5006
Period of Consent
This consent is valid for a period of twelve (12) months. Consent will also be reviewed as required should the terms of service change.
You have the right to withdraw this consent at any time by telling your psychologist or putting your request in writing. You cannot withdraw consent for a service that has already occurred. Your psychologist can discuss with you any implications of withdrawing consent.
