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CONSENT FOR GROUP TREATMENT
PAYMENT POLICY
- The fee for this group is$75/week.
- The first month’s fees (which will cover the first three groups) will serve as a non-refundable registration fee to hold your space. This fee will be applied to the first month’s group meetings, but will not be refunded if you decide not to participate in the group.
- Full payment (automated credit/debit card or check) for each month is due by the first group of the month.You are responsible for keeping your financial account current. If you are unable to make a payment, it is your responsibility to contact me to make alternative payment arrangements.
- Make checks payable to Sonya Brewer. If a check is returned, there will be a $25 fee.
-If a second check is returned, you are expected to pay for continuing sessions in cash or a credit card on file.
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CONFIDENTIALITY
- I am committed to assuring your confidentiality.
- California state law mandates the reporting of child and elder abuse.
- Safety concerns sometimes require an exception to confidentiality when a client intends to physically endanger herself or another person.
- Although group members are not mandated by law to maintain confidentiality; it is expected that group members will maintain confidentiality and anonymity for one another.
AUDIO TAPING
Audio taping is sometimes utilized in order to facilitate therapy. Recordings are used for me to review my therapeutic work. They are regularly erased and discarded, and are not kept as part of your client file. Issues of confidentiality will be observed.
APPOINTMENTS AND CANCELLATIONS
Because your contribution to the group is valuable and unique, your consistent participation in the group is very important. By registering for this ongoing therapy group, you are committing to attending the group for of twelve (12) weeksbeginning January 17, 2018 and ending April 11, 2018. We do understand that, sometimes, things come up, and you absolutely must miss a group. Please remember, you are responsible for the tuition for the full 12-week cycleregardless of whether or not you attend each individual group.
January17, 24, 31= $225Please make sure to attend the first group. Beginnings can set the tone for the entire group, and it is an essential trust-building time.
February7, 14, 21, 28= $300We meet all four weeks this month
March7, 14, 28= $225There will be no group on March 21, 2018.
April 4, 11 = $150Please try to attend the last group. It is important to honor our goodbyes. How we end is as important as how we begin.
In the event that you absolutely must miss a scheduled group, please provide at leastone week advance noticeto the group. In the event of illness or emergency that requires your immediate absence, please notify your group leader, by text at (510) 239-6864, as soon as you can so that I can inform the other group members that you will not make the meeting. This is really important. Both your group facilitator and members of the group will be distracted by your absence if we don’t if you’re coming or not or if you’re safe. Please honor the group by letting us know if you can’t attend.
Group begins on time. All members are expected to be on time for the group. If you are late, please enter quietly and allow yourself time to orient to what is happening in group. We will not recap what you have missed, but you’ll be able to catch up if you spend some time listening and observing.
THERAPIST’S USE OF TOUCH
During the course of the group, your group leader will sometimes offer to use touch as a way to guide you in learning some of the somatic practices we will be using. I may also sometimes offer hands-on work as a direct way to work with places in the body that are holding traumatic experiences or that reinforce ways of being that you would like to change. When this gentle, non-invasive approach to hands-on work is offered, it is always optional, and does not involve massage or the removal of clothing. You are encouraged to think about or modify it, change your mind, ask questions, or stop at any time.
I have reviewed and understand the above policies:
Print Name______
Signature______
Date______
Sonya Brewer, Licensed Marriage & Family Therapist # 89901
1505 Solano Avenue Albany, CA 94707 Phone: (510) 496-6010 Email: