consent to online therapy

All clients who wish to receive online therapy services through New Roots Therapy are required to review the following consent form and agree to the terms and conditions outlined within.

Introduction

New Roots Therapy provides general counselling and psychotherapy services for individuals, couples, and families. We do not provide specialty services associated with assessments required for court proceedings in cases such as: child custody and access; parental competence; child abuse; pre-trial disposition reports; probation assessments; etc. If you require this type of assessment service, we may be able to refer you to other appropriate professionals.

We cannot adequately provide services to people when they are experiencing active and/or acute episodes of psychiatric illness, or clients in acute crisis situations. In such circumstances, we may be able to refer you to an appropriate resource.

Crisis: Should you be in crisis between sessions, you can call Crisis Services at Durham Mental Health Services at 905-666-0483 or 1-800-742-1890, or go to the emergency department of the nearest hospital.

About the Counselling Process

The process of counselling involves change. As such, it is important to know that there may be times when you experience some increase in distress and/or uncertainty. One of the goals of counselling and psychotherapy is to support and help you through this process.

During your first meeting, you and your therapist will discuss your concerns, relevant background information, initial goals, and what type of help we can offer. If it is determined that New Roots Therapy is not the best source of help for your situation, we will do our best to help you locate appropriate alternative resources.

Length & Frequency of Sessions

An initial session is typically 90 minutes in length, whereas ongoing counselling sessions typically last 60 minutes. The frequency of sessions will be based on your needs as well as the time commitments of your therapist.

Rates & Payment Processing

Rates vary according to the time and nature of the service provided.  Please ask us for more information.

We require a credit card number at the time of scheduling your first appointment in order to reserve your time slot. Your credit card information will be stored securely in our PHIPA-compliant practice management system. Payments for online therapy are processed on the day of your appointment using the credit card information you have provided.

Cancellation Policy

When you schedule an online therapy appointment at New Roots Therapy, we commit to reserving the time slot for you and only you, and you commit to paying for the reservation of time.  We understand that there may be times when you need to cancel your appointment. You will not be charged for the appointment if you are able to give New Roots Therapy 24 hours’ notice. If you do not provide 24 hours’ notice, or do not show up for your scheduled appointment, you will be charged the full rate of the session using the credit card information you have provided.  New Roots Therapy will notify you of any charges made to your card. Please note that insurance providers do not cover late cancellations or missed appointments.

In an effort to avoid late cancellations and missed sessions, New Roots Therapy provides appointment reminders via email and/or text message 48 hours before your scheduled appointment (provided with your consent). 

If you’re unable to attend your appointment at the last minute as the result of a crisis/emergency, please speak with us; we will assess your situation to determine if an exception to the cancellation policy applies. In the case of an exception, your credit card will still be charged at the time of the late cancellation/missed session and a credit will be applied to your account for your next appointment.

By respecting the cancellation policy as outlined here, it allows other clients who may be awaiting service to schedule an appointment during the available time slot, providing fair and equal access to services for all our clients. It also allows your therapist to be compensated for the time they have reserved for you. This cancellation policy is intended to respect the time of both our clients and our therapists, which we sincerely value.

Late Arrivals

If you are running behind for your online therapy appointment, we may not be able to overrun your scheduled appointment time, as there may be another client booked after you. In this case, the full amount of your initially scheduled appointment will be charged.

There may be times when your therapist is running behind. In this case, we will do our best to see you for the length of your initially scheduled appointment.  If this is not possible, you will only be charged for the actual length of your session.

Professional Ethics, Record Keeping, and Supervision

All of our therapists are members of the College of Registered Psychotherapists of Ontario (CRPO), or are supervised by a member of the CRPO.  As a client at New Roots Therapy, you have the right to ask any questions you wish about the process of counselling. You are free to discontinue services whenever it makes sense to do so. If you have a concern or dissatisfaction regarding your services, we encourage you to please discuss your concerns with us so that we can work with you to resolve the issues.

We keep records of all counselling sessions. Records are kept for 10 years after your last dated session. All personal information that is obtained, used, and disclosed at New Roots Therapy is done with your consent. You have the right to access personal information held by New Roots Therapy and to challenge its accuracy. If you wish to access your personal records, please inform your therapist.

The personal information that we have collected from you (e.g., name, age, comments, etc.) can only be used for the purposes for which it was collected (e.g., maintaining accurate records during counselling at New Roots Therapy).

As a part of the New Roots Therapy team, your therapist may consult about their clinical work within the context of clinical supervision or peer consultation from time to time. It is our hope to provide you with the best counselling service possible and we believe that clinical supervision and peer consultation are essential for providing such service. 

Confidentiality

Everything that is said in the context of the conversations between therapist and client is kept confidential. Here, the term “confidential” includes sharing information within New Roots Therapy and within supervisory/peer consultation settings. All supervisors and therapists that we consult with are ethically bound to maintain confidentiality.

Although New Roots Therapy takes measures to protect your confidentiality during online therapy (e.g., using an online platform which adheres to all Canadian privacy protection legislation, conducting therapy sessions from a private and distraction-free environment, etc.), it is important to know that there is no way to guarantee the same standard for confidentiality in online therapy as in the case of in-person therapy (e.g., someone could overhear your conversation; conversations could be recorded by a third party; etc.). You can learn more about the privacy policies of OnCall Health here, which is the platform we use for online therapy sessions.

There are a number of exceptions to confidentiality of which you should be aware, most often times when safety is a concern. Your therapist practices in the province of Ontario and is required to abide by Ontario safety standards, even if these standards are different in your location. Some of the exceptions to confidentiality include (but are not limited to):

1)    When a client is clearly at risk to hurt their self of others.

2)    When a client discloses that a child under the age of 16 has been or is currently at risk (as determined by the therapist) of being abused or neglected. This also includes situations when domestic violence or ongoing verbal abuse is reported where there is a child (or children) present.

3)    When a client discloses that they were abused in childhood and there is a possibility that the person who was abusive towards them may be a danger to other children in the present.

4)    When your therapist is mandated by a court order to disclose information, as can happen if there are legal proceedings, or if you involve your therapist in a lawsuit.

5)    When a client discloses that they have been abused by another helping professional.

6)    When a client gives written permission to have information from the counselling meetings communicated to another person(s) (e.g., family doctor).

By filling out and submitting the Consent to Online Therapy response form below, you indicate that you understand the terms of service as outlined above and that you voluntarily agree to receive counselling/psychotherapy under the above terms.

Client Contact Information - Person #1
please provide your personal information below. If some of this information was already collected during your intake call, this will help to ensure its accuracy.
Name *
Name
Birth Date *
Birth Date
Home Address *
Home Address
Phone *
Phone
Is this your home, work, or mobile number? *
Alternate Phone (Optional)
Alternate Phone (Optional)
Emergency Contact Information
Emergency Contact Name *
Emergency Contact Name
e.g., parent, spouse, friend, etc.
Emergency Contact Phone *
Emergency Contact Phone
Permissions
We will only contact you if you have provided permission below (we require at least one method of contact).
I give New Roots Therapy permission to send correspondence in an envelope marked "Confidential" to the address listed above. *
I give New Roots Therapy permission to call me at the number(s) listed above for the purposes of scheduling appointments or returning calls initiated by me/us. *
I give New Roots Therapy permission to leave messages on an answering machine at the phone number(s) listed above for the purposes of scheduling appointments or returning calls initiated by me/us. *
I give New Roots Therapy permission to leave messages with members of my household at the phone number(s) listed above for the purposes of scheduling appointments or returning calls initiated by me/us. *
I give New Roots Therapy permission to send information via email. I understand that email correspondence may not always be secure. *
All of the information provided here is accurate and no important information has been deliberately omitted. *
Consent to Service *
Client Contact Information - Person #2 (if applicable)
Scroll down to hit "submit" if you are receiving individual therapy and this section is not applicable to you.
Name
Name
Birth Date
Birth Date
Home Address
Home Address (if different than Person #1)
Home Address (if different than Person #1)
Is this your home, work, or mobile number?
Alternate Phone (Optional)
Alternate Phone (Optional)
Emergency Contact Information
Emergency Contact Name
Emergency Contact Name
e.g., parent, spouse, friend, etc.
Emergency Contact Phone
Emergency Contact Phone
Permissions
We will only contact you if you have provided permission below (we require at least one method of contact).
I give New Roots Therapy permission to send correspondence in an envelope marked "Confidential" to the address listed above.
I give New Roots Therapy permission to call me at the number(s) listed above for the purposes of scheduling appointments or returning calls initiated by me/us.
I give New Roots Therapy permission to leave messages on an answering machine at the phone number(s) listed above for the purposes of scheduling appointments or returning calls initiated by me/us.
I give New Roots Therapy permission to leave messages with members of my household at the phone number(s) listed above for the purposes of scheduling appointments or returning calls initiated by me/us.
I give New Roots Therapy permission to send information via email. I understand that email correspondence may not always be secure.
All of the information provided here is accurate and no important information has been deliberately omitted.
Consent to Service