CONSENT AGREEMENT FOR COUPLES COACHING
The Coach and the Client(s) enter into this contract voluntarily.
1. THE COACHING PROCESS
A. Role of the Coach: The Client(s) understand the Coach’s role is to facilitate conversations which promote relationship growth in five primary areas: conflict repair, accepting differences, interpersonal communication skill building, shared visioning, and self-care. The Coach will listen carefully, ask key questions, facilitate learning and give insightful feedback that promotes successful creation and implementation of vision strategies and relationship goals. The Coach is not serving in the role of a therapist. The Counselor, Social Work, and Marriage and Family Therapist Board does not oversee the services provided. If the Coach determines that psycho-therapeutic interventions would be helpful for the Client(s), the Coach will make a referral to an appropriate therapist.
The Coach holds no liability for any outcomes or consequences resulting from the coaching process or terms of any coaching agreement.
B. Role of the Client: The Client(s) understand that the Client’s role is to answer the Coach’s questions as completely and honestly as possible, to engage to the fullest extent possible in the coaching process, to follow through with the positive strategies to the best of the Client(s)’ ability, to give feedback to the Coach as completely and honestly as possible regarding the coaching process and the implementation of the selected strategies.
C. Collaboration between Coach and Client(s): The Client(s) understand that Coaching is a collaborative process in which the Coach and the Client(s) work together to co-create the Client(s)’ visioning and implementation of goals.
2. POLICIES
A. Appointments: Appointments with the Coach shall be scheduled at the request of the Client(s) by phone or electronic calendar. Standard appointments are 60 minutes in length, and the Client(s) may request additional coaching over the telephone or by email.
B. Communication: The Client(s) may contact the Coach by telephone, email or text message. The Coach will make every effort to respond within 2 business days. Recording is not allowed without the written consent of the coach.
C. Confidentiality: All communication between the Coach and Client(s) is confidential. Any sharing of information between the Coach and any other party requires an authorization form signed by the Client(s) giving written permission for a release of information. Your coach may require a release of information as authorization to speak with other service providers such as your attorney or therapist.
D. Cancelled or missed appointments: Client(s) shall pay in full for any cancelled or missed appointments unless 24-hour cancellation notice is given. Clients are not charged for appointments missed due to a weather emergency.
E. Termination: The Client(s) may terminate services at any time. The Coach may terminate services at any time including but not limited to the following reasons; lack of progress, inappropriate behavior, or lack of payment for services.
3. FEES
Client(s) shall pay for appointments at the time of service. Alternative arrangements may be made at the request of the Client(s). Fees for appointments are $175 per hour for individual sessions and $125 per person for couples’ joint sessions. Fees for additional time spent in telephone or email conversations are billable at $175.00 per hour, calculated at 10-minute intervals. Additional fees may be charged for time spent communicating with other professionals including your attorney or therapist. CFR may increase rates with 30 days or more notice.
4. DISCLOSURE
Confidentiality is a high priority; however, there are specific situations where legal or ethical requirements indicate that information may be reported to proper authorities without consent to ensure your safety and the safety of others. These situations include disclosures of child abuse or neglect; the abuse, neglect, or exploitation of a disabled or elderly adult; a clear intention to harm yourself or others, or animal abuse.
