**Membership Community Members must sign this form before participating in our membership**

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Danielle Aubin, MSW

 

INFORMED CONSENT FOR COACHING SERVICES

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Coaching services include: The Autistic Parent Support Group, The Late-Discovered Autistic Membership Community, and 1:1 Coaching services. 

INTRODUCTION

This agreement is intended to provide important information to you regarding Coaching Services. Please read the entire document carefully and be sure to ask your Coach any questions you might have regarding its contents.
 

GENERAL INFORMATION
 

The coaching relationship is unique in that it is a highly personal and at the same time, a contractual agreement. Given this, it is important for us to reach a clear understanding about how our relationship will work, and what each of us can expect. This consent will provide a clear framework for our work together. Feel free to discuss any of this with me. Please read and indicate that you have reviewed this information and agree to it by filling in the checkbox at the end of this document.
 

THE COACHING PROCESS

While there are some similarities between coaching and psychotherapy, they are very different activities and it is important that you understand the differences between them. Psychotherapy is a health care service and is usually reimbursable through health insurance policies. This is not true for coaching. Both coaching and psychotherapy utilize knowledge of human behavior, motivation and behavioral change, and interactive counseling techniques. The major differences are in the goals, focus, and level of professional responsibility.

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The focus of coaching is development and implementation of strategies to reach client-identified goals of enhanced performance and personal satisfaction. Coaching may address specific personal projects, life balance, job performance and satisfaction, or general conditions in the client's life, business, or profession. Coaching utilizes personal strategic planning, values clarification, brainstorming, motivational counseling, and other counseling techniques.

 

The primary foci of psychotherapy are identification, diagnosis, and treatment of mental and nervous disorders. The goals of psychotherapy include alleviating symptoms, understanding the underlying dynamics which create symptoms, changing dysfunctional behaviors which are the result of these disorders, and developing new strategies for successfully coping with the psychological challenges which we all face. Most research on psychotherapy outcomes indicates that the quality of the relationship is most closely correlated with therapeutic progress. Psychotherapy patients are often emotionally vulnerable. This vulnerability is increased by the expectation that they will discuss very intimate personal data and expose feelings about themselves about which they are understandably sensitive. The past life experiences of psychotherapy patients have often made trust difficult to achieve. These factors give psychotherapists greatly disproportionate power that creates a fiduciary responsibility to protect the safety of their clients and to above all else, do no harm.

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Because of these differences, the roles of coach and psychotherapist are often in potential conflict and I believe that, under most circumstances, it is ethically inappropriate for one to play both roles with a client, whether concurrently or sequentially. Positive change is difficult enough without having to worry about role confusion. This means that if either of us recognizes that you have a problem that would benefit from psychotherapeutic intervention, I will refer you to appropriate resources. 

PAYMENT FOR SERVICES (1:1 COACHING)

The charge for your initial 50-minute session is $275 and the charge for any subsequent 50-minute session is $275 unless another arrangement has been made prior to the appointment. 

FEE FOR SERVICES CHANGES

Fees for individual coaching services are reviewed annually and increased on January 1st of the new year. All coaching clients will receive at least 60 days' notice of any fee increases and a new coaching informed consent will be sent out to be reviewed and signed.

 

PAYMENT FOR SERVICES (Autistic Parent Support Group)

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The Autistic Parent Support Group is based on a pay-what-you-can model. Payment is due at the time of booking to confirm your spot. 

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CANCELLATION POLICY (1:1 Coaching and Autistic Parent Group ONLY)

 

You are required to give 24 hours' notice if you need to cancel or change the time of an appointment. Otherwise, you will be charged for the session in full.

 

PAYMENT FOR SERVICES (Late-Discovered Autistic Membership Community)

 

The Late-Discovered Autistic Membership Community is based on a recurring monthly subscription fee paid via PayPal.com. Your membership will remain active as long as your recurring payment subscription is active and/or you are invited to attend as a scholarship recipient. You may cancel at any point via informing me or canceling your subscription via PayPal.com.

LIABILITY

This agreement is for Coaching, not Psychotherapy. Danielle Aubin, MSW is working only within the capacities of a Life Coach and will not be held liable for discrepancies. While coaching can work with issues such as identifying and reaching life goals, and changing the behaviors that aren’t working well for you, coaching will not address psychological issues such as depression and anxiety. For issues such as these, seek the medical attention from a Physician or Licensed Mental Health Professional in your area. By signing this agreement, you are agreeing that you understand the difference in these two functions and you will get appropriate professional help for mental health issues, if necessary.

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CONFIDENTIALITY
 

 As a licensed clinical social worker, it is my duty to protect the confidentiality of the communications with my clients, including coaching clients. Confidentiality cannot be guaranteed if sessions are conducted via phone or online although zoom is HIPAA compliant. Clients should use their own discretion when utilizing these options. 

 

If you are attending the Autistic Parent Support Group and/or the Late-Discovered Autistic Membership Community, although I request that all participants maintain confidentiality, I cannot personally guarantee that members will protect your confidentiality. Please attend these group coaching services at your own discretion.  

 

By signing this agreement, you are agreeing to protect the privacy of all group members and agree to not share names or any personal information about anyone who participates in the group. 

 

I AM AGREEING THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.