INFORMED CONSENT
What is Psychotherapy?
Psychotherapy or talk therapy is a way to help Client(s) in the face of emotional difficulties and personal concerns including, but are not limited to: difficulties to cope with daily life; relationship problems; and specific mental disorders, such as depression or anxiety disorders. Psychotherapy is a process to help Clients of all ages better understand one’s self, and how their thoughts and feelings influence the way they behave, react, and relate to others, leading an enjoyable and satisfying life.
The first psychotherapy session usually starts with an intake assessment of problematic symptoms and maladaptive behaviors that have affected the Client’s functioning in various aspects of life. Psychotherapy is a joint effort between Client and Therapist; the progress may vary based on the particular concerns or issues being addressed as well as the Client’s willingness to participate in the therapeutic process.
Risks & Benefits of Psychotherapy
Therapy sessions carry both benefits and risks. These benefits may include, but are not limited to, reduced distress in feelings and thoughts, increased self-confidence, improved interpersonal relationships, increased comfort in work, academic, and/or daily activities.
In therapy sessions, Client may experience personal discomfort or unpleasant feelings (such as sadness, guilt, anxiety, anger, frustration, loneliness, or helplessness) when recalling or discussing uncomfortable experiences / situations with the Therapist. This is one of the considered risks of psychotherapy.
During the therapeutic process, many clients may feel worse before they feel better, which is generally the normal course for psychotherapy. Personal growth and change can be easy and smooth at times, but may also be slow and frustrating. The Client should address any concerns he/she has regarding his/her progress in therapy with the Therapist.
Confidentiality
The information disclosed by Client is secure and strictly confidential. However, under certain circumstances (as described below), all Therapists are mandated (by law) to break confidentiality, if/when:
1. Client poses a danger to him / herself.
2. Client makes a serious threat of violence towards a reasonably identifiable victim.
3. Client provides written authorization to request the release of information.
4. The Court orders a release of information (*Our centre does not provide psychological services for court cases or police cases. Kindly discuss with your Therapist if you have any queries regarding this matter).
5. Client is below 18 years of age, parents/guardians have the rights to therapeutic information (*However, we hope parents/guardians acknowledge the importance of confidentiality. The therapist will brief parents/ guardians of the summary of the session).
6. A child / an elderly person is abused or neglected.
| Services | Time | Price |
1st Intake Session
(i) Assessment, ~70 minutes
(ii) Feedback & Recommendations, ~20 minutes | 90 Minutes | RM330 |
| Subsequent Session | 60 Minutes
| RM220 |
| Extended session | Every 30 Minutes | RM110 |
| 2-Session Bundle | 2 Sessions
= 60 Minutes / Session | Total: RM 420
= RM 210/session |
| 4-Session Bundle | 4 Sessions
= 60 Minutes / Session | Total: RM 800
= RM 200/session |
Attendance/Cancellation
Psychotherapy requires the joint effort of both Client and Therapist. This therapeutic relationship between both parties is based upon trust and commitment, with both parties accepting responsibilities for keeping their appointments.
a) Attendance Policy
Please arrive on time for appointments. In the event that the Client arrives late for an appointment, only the remaining time of the session will be available (eg: Client arrives at 415pm for 4pm session, only 45 minutes will be available), but the full scheduled session will be billed. Please contact our centre at
+6011-3344 5270 if you will be late for the session.
b) Cancellation Policy
Cancellation of sessions with less than a day’s notice will incur a cancellation charge of 50% of the session fee. In the event of an emergency situation (i.e. sudden illness, accident, etc.), Client must immediately notify Therapist of the cancellation at least 2-hours in advance of the session. Failure to do so will also incur a cancellation charge of 50% of the session rate. Emergencies will be reviewed on a case by case basis. In the event that Therapist must cancel a session, every effort will be made to reschedule a make-up session for the Client.
The session will not take place if the Client is under the influence of alcohol or substances.
Termination of Therapy
a) Client
Psychotherapy is a voluntary process. Client or client’s parent / guardian has the right to terminate therapy at his/her discretion. It is highly recommended for Client to discuss with Therapist before discontinuing the therapy.
b) Therapist
Therapist reserves the right to terminate therapy at his/her discretion. Reasons for termination include, but are not limited to, untimely payment of fees, failure to comply with treatment recommendations, conflicts of interest, failure to participate in therapy, Client’s needs are outside of Therapist’s scope of competence or practice, or Client is not making adequate progress in therapy.
Upon either party’s decision to terminate therapy, Therapist will generally recommend that Client participate in at least one, or possibly more, termination sessions. These sessions are intended to facilitate a pleasant termination experience and give both parties an opportunity to reflect on the work that has been done. Therapist will also attempt to ensure a smooth transition to another Therapist by offering referrals to Client.
Therapist Availability
Therapist is unable to provide 24-hour crisis service. If Client is feeling unsafe or requires immediate medical or psychiatric assistance, he/she should call emergency hotlines (eg: 999), or go to the nearest emergency room of public hospitals.
Acknowledgment
By signing this document, Client acknowledges that he/she has reviewed, fully understands and agrees with the terms and conditions in this informed consent form. Client agrees to hold the Therapist free and harmless from any claims, demands, or suits for damages from any injury or complications whatsoever, save negligence, that may result from such treatment.
