Informed Consent for Psychological Services of Children
Consent for Service
Your consent is required for us to provide a psychological service to your child. 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
Note that all parents or guardians of child clients would usually have a right to access information that is contained in their file. If your child is assessed as a mature minor, this may impact what information you are able to access regarding their treatment if they do not consent to this information being shared with you. However, if there are issues of risk, harm or potential harm to your child, you will be informed. There may also 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 child’s file information, please discuss make a request in writing. When viewing your child’s 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 yours or your child’s 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
- Psychologists have a mandatory reporting requirement where there is evidence of abuse, neglect or when a child is at risk of such.
- Your consent cannot be gained due to a requirement to get your child 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 your child, or another person, at risk of harm
- Given your child’s prior approval (if they have capacity or consent), or consent of a parent or guardian who is legally authorised to act on your child’s behalf, to provide a written report to another professional or agency or discuss information with another person, e.g., parent
- You or your child has 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 this occurs, identifying details will remain confidential.
If, during your child’s 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 your child as a client. This is to protect client 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 child’s 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, your child 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 child’s 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 contact
How to make a complaint
If you have any concerns about your contact with the Childhood Cancer Association, please discuss these with your child’s 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 child’s psychologist or putting your request in writing. You cannot withdraw consent for a service that has already occurred. Your child’s psychologist can discuss with you any implications of withdrawing consent.
For Separated Parents
Where care is shared by two or more parents, each parent who can make decisions needs to provide consent for their child. Most of the time we rely on the attending parent to seek this consent and give feedback or information to the non-attending parent. If the other parent does not consent to the service, your psychologist will need to consider ceasing treatment until there is agreement from both parents. Unless a court order specifically states otherwise, information about a child's appointments or treatment (except confidential information) will not be withheld from either parent, unless the psychologist believes it is not in the best interests of the child for the parent/s to be provided with this information.
Where there are parenting agreements or court orders in place, these are to be provided to the Childhood Cancer Association prior to the first appointment. Documentation of the agreement or court order will be kept on file.
