Terms & Conditions, Privacy, Confidentiality Agreement & Consent
This consent form explains the nature of the psychological services that you are about to receive. As consent is an ongoing
process, any changes that may influence your consent will be discussed with you.
Nature of treatment: (i) Assessment Sessions for Parent(s)/Young Person(s)/Child(ren); (ii) Clinical Recommendations Meeting; and (iii) Treatment Sessions for Individual/Joint Family Members.
Treatment effectiveness varies from person to person. Discussing, working with, and changing thoughts, feelings and behaviours may be painful and challenging at times.
Approach: Your psychologist will complete an intake assessment to understand how the current difficulties may have
developed and may be maintained within the various contexts of family life. The results of this assessment will be shared with you,
and a treatment plan outlined in the Recommendations Meeting will be developed including some potential strategies that may be used to help you reach your goals. Throughout the process, you are invited to share any concerns or questions that you may have
about the therapy process. This helps the therapist to personalise the treatment strategies to better match your unique needs.
Services are by appointment only; in an emergency please call 999 or go to your nearest A&E.
Fees and payment: Fees are £150/session. All sessions are 50 minutes in length. Every attempt is made to see clients on time. Payments can be made via insurance if applicable or via the psychologist. Invoices are payable on the day of issue. FORTY EIGHT (48) hours notice is required to CANCEL OR RESCHEDULE an appointment to avoid being billed for the full fee of the missed session. PLEASE NOTE THAT MOST INSURERS DO NOT COVER MISSED SESSIONS SO PLEASE CONSULT YOUR INSURER AND NOTE YOU WILL BE CHARGED FOR MISSED SESSIONS.
CONFIDENTIALITY: Psychological records are kept in line with regulatory requirements as outlined here: https://explore.bps.org.uk/content/report-guideline/bpsrep.2017.inf115/chapter/bpsrep.2017.inf115.9
No information about you, excluding the below exceptions, can be released to a third party without your prior written consent or verbal consent. Exceptions include: (1) you are under 18 years of age and your parents/legal guardians want access to your file, (2) risk of imminent danger, such as suicide, death, risk of running away, or serious bodily harm to an identifiable person or group, (2) suspected or known abuse or neglect of a child or vulnerable person, (3) unsafe operation of a motor vehicle, (4) requests ordered by legal bodies, or (5) access is required by other personnel (e.g., administrative staff) to carry out their professional duties. In these events, psychologists must, as soon as the interest of their client so requires, receive supervision, consult another psychologist, a member of another professional order, or another competent person. Disclosure of identifying information will be minimised.
Mutual rights and responsibilities: The relationship must remain limited to a respectful therapeutic framework. You may
refuse any therapeutic suggestions offered to you, or to suspend or cease treatment at any time without penalty. If you
decide to stop treatment for any reason, please notify your psychologist so that your file can be closed and/or you can be
referred to another resource. If you stop treatment without an explanation, you will be discharged and your file will automatically be closed after 14 days.
GDPR: Dr Samantha Farag is the data controller responsible for your personal data. I collect data for the purposes of assessment, consultation and providing appropriate support and recommendations. Data may include parent/guardian details, child details, written notes, assessment and treatment information, and video recordings provided by the parents. The data is securely stored using password protection and access is limited to the psychologist and is not shared without your consent unless required by law. Records are kept only for as long as necessary for professional and legal purposes and are securely deleted thereafter. You have the right to access, correct, or request deletion of your data, and to withdraw consent at any time. You also have the right to lodge a complaint with the Information Commissioner’s Office.
CONSENT & CONFIDENTIAL AGREEMENT FOR VIDEOS:
VIDEO CONTENT GUIDELINES: Parents may provide videos of their own children to demonstrate a particular behaviour(s) where parental description is not sufficient. Videos should show the child in natural, everyday situations such as play, interaction with a parent/guardian, routine activities, or any behaviours of concern. Recordings should be brief (typically 1-3 minutes) and captured in a way that allows the child to be seen and heard clearly, without directing or prompting behaviour. Only the child and relevant family members should be included where possible; other children, members of the public, or identifiable individuals outside the immediate family should not appear in the recording. No sensitive personal information (e.g. full names, addresses, school uniforms with logos, or documents) should be visible. Recordings should take place in a setting where consent has been given by all individuals present and where privacy can be reasonably maintained.
VIDEO COLLECTION, STORAGE & CONFIDENTIALITY: Videos must be uploaded using a secure link provided via Google Drive or a secure Google Forms upload form. Access to all files is strictly restricted to the parent(s)/guardian(s) and the psychologist. Public or “anyone with the link” sharing is not used. All videos are treated as confidential clinical information and are used solely for the purpose of understanding the child’s behaviour and informing assessment and recommendations. Videos will not be shared with third parties unless required by law (e.g. safeguarding). Files are stored securely within password-protected, access-restricted systems, and appropriate measures are taken to protect data from unauthorised access, loss, or misuse. Videos are retained only for as long as necessary for assessment and record-keeping purposes and are then securely deleted usually within 3 working days. Parents/Guardians are required to upload videos only via a secure link , not to share files via email or public links, and to ensure that only relevant consenting individuals are visible in recordings.