Couples Contract

Counselling Contract for Couples Counselling

This contract sets out the working agreement between you (the clients) and me (the counsellor). Please read it carefully and ask any questions before signing.

1. Confidentiality

Everything shared within couples counselling is treated as confidential. Confidentiality supports a safe and respectful therapeutic space for all parties.

Counselling Records

Session notes are brief professional records made by the counsellor. These notes:

• Use      initials only and refer to you collectively as “the clients”
• Are      stored securely in accordance with data protection legislation
• Are      retained for 5 years after counselling ends, in line with professional and      insurance requirements
• Are      securely destroyed after this period

Personal Details

Your names, contact details, emergency contacts, and GP details are stored securely and separately from counselling notes. These details are retained for 5 years after counselling ends for legal, ethical, and insurance purposes, then securely destroyed.

If I become incapacitated or unable to practise, a therapeutic will arrangement is in place. In this situation, a nominated professional may access your contact details solely to inform you and, if appropriate, support you to arrange alternative therapy.

Supervision

I attend regular clinical supervision in line with professional requirements. Couples work is discussed anonymously, and no identifying information is shared.

2. Limits of Confidentiality

Confidentiality may be broken only where there is a legal or ethical obligation to do so. This includes situations where:

• There      is a serious and imminent risk of harm to either of you or to another      person
• There      is a safeguarding concern involving a child or vulnerable adult
• Disclosure      is required by law (for example, under terrorism or money laundering      legislation where there is reasonable suspicion)
• A      court orders disclosure of information

Where possible, I will discuss any need to break confidentiality with you beforehand. Any disclosure will be limited to the minimum necessary information.

Disclosure may involve:

• Contacting      your GP or local crisis team
• Contacting      emergency services or other relevant authorities

2a. No-Secrets Policy (Couples Counselling)

In couples counselling, the therapeutic relationship is with the relationship, rather than with either individual alone.

This means that I operate a no-secrets policy. I do not agree to keep information shared individually by one partner secret from the other where that information is relevant to the work of couples counselling.

If one of you shares something privately that significantly affects the relationship or the counselling process, I will encourage you to bring this into the joint sessions. I may support you in thinking about how and when to do this safely.

If a significant issue is disclosed privately and you are unwilling to share it, I may be unable to continue couples counselling and may recommend individual counselling instead.

This policy helps ensure transparency, fairness, and emotional safety for both partners.

3. Data Protection & GDPR

I am registered with the Information Commissioner’s Office (ICO) and comply with the UK General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018.

I am the data controller for your personal data. The lawful basis for processing your data is legitimate interest and contractual necessity, in order to provide counselling services safely and ethically.

You have the right to:

• Access      your personal data
• Request      correction of inaccurate data
• Request      erasure of data (where legally permissible)
• Restrict      or object to processing
• Lodge      a complaint with the Information Commissioner’s Office (ICO)

4. Online Counselling & Confidentiality

Online counselling sessions take place via Zoom. While I take reasonable steps to ensure confidentiality from my location, I cannot guarantee confidentiality from your location. You are responsible for ensuring:

• A      private and quiet space
• Freedom      from interruption
• Appropriate      use of headphones if needed

Online counselling is not suitable for emergency situations. You will be asked to provide emergency contact details before starting counselling. If you are in immediate danger, please contact emergency services.

5. Appointments & Timekeeping

• Couples      counselling sessions are 60 or 90 minutes, as agreed in advance
• Please      arrive on time
• If      you arrive late, the session will still end at the scheduled time

6. Cancellations & Missed Appointments

• At      least 24 hours’ notice is required to cancel or rearrange a session
• Cancellations      with less than 24 hours’ notice will be charged at the full session fee
• Missed      appointments without notice will be charged in full

7. Fees & Payment

Payment is required prior to the session or within 2 hours after the session ends.

Payment details:

• Bank:      Mettle
• Account      Name: Counsellor Midwife
• Sort      Code: 04-03-33
• Account      Number: 36194532
• Reference:      Your initials

8. Fees

Couples Counselling

• £60      per 60-minute session
• £90      per 90-minute session
• Concessions*:      £55 per 60-minute session / £85 per 90-minute session

*Concessions apply to students, clients claiming benefits, and OAPs.

Birth Debrief (Couples)

• £90      for a 90-minute session

9. Birth Debriefs

Birth debriefs for couples are one-off sessions offering a supportive space to reflect on and process your shared birth experience.

Further sessions may be discussed if additional support feels helpful, but there is no obligation to continue beyond the debrief session.

10. Face-to-Face Counselling Location

Face-to-face sessions are held at:

Ladybridge Connect
Off Meadway Road
Cheadle Hulme
Cheadle
SK8 5NZ

Please arrive on time. If I am with another client, please wait in the seating area near the entrance or café area. If the door is locked, please wait and I will greet you at your appointment time.

11. Safety and Violence

Couples counselling is not appropriate where there is current domestic violence or abuse within the relationship. If violence or abuse is disclosed or becomes apparent, the counselling relationship will be ended.

Where appropriate, I will provide information about specialist support services.

12. Engagement and Commitment

Couples counselling requires the engagement of both partners. This does not mean equal speaking time in every session, but it does require willingness from both of you to participate emotionally and psychologically in the process.

If, following discussion, I believe that one or both of you are not able to engage safely or constructively, I reserve the right to end counselling.

13. Voluntary Participation

Counselling is voluntary. Either of you may choose to end counselling at any time. If one partner withdraws, the couples counselling agreement will end. Either partner may seek individual counselling with another counsellor.

13. Concerns or Complaints

If you have any concerns about our work together, I encourage you to raise them with me so we can try to resolve them informally.

If you remain dissatisfied, you may make a formal complaint to the British Association for Counselling and Psychotherapy (BACP). Details of their complaints procedure are available on the BACP website.

14. Agreement

Please sign below to confirm that you have read, understood, and agree to the terms of this counselling contract.

Client 1 Name: ____________________________

Signed: ____________________________ Date: __________

Client 2 Name: ____________________________

Signed: ____________________________ Date: __________

Counsellor:
Samantha Phillis
MBACP (Registered Member), NMC
MSc | BSc | BMidwif | BA (Psychology) | Dip Couns
Certificate in CBT | Diploma in Hypnobirthing
Counselling Midwife

Email: counsellor@therapistmidwife.co.uk
Website: counsellormidwife.co.uk
Phone: 07736035033