© of A Yates 2011

Cognizance Therapeutic Principle

Normal ethics

I advocate the idea that as a therapist I am expected to maintain good ethical practise in the best interests of my clients to help promote the clients well being. Ethically the therapist-client relationship, needs to be restricted by boundaries, these important boundaries keep therapy focused on a working relationship and helps protect both therapist and client. No therapist should ever enter into any kind of relationship outside of the normal therapeutic relationship. Any kind of friendship, sexual relationships, financial partnerships and any social and social media interaction. No contact should be initiated outside of the regular therapy sessions, unless necessary for rearranging or communicating changes to times and dates, or to inform the client of cancellations or other important information.

Online therapy ethics & ethos

As a professional full-time online therapist, I have for many years worked with clients in a way that I believe is founded on empathy, equality and respect, and I now call this the cognizance therapeutic principle. When I am working as a therapist, I do my best to create a harmonious and equal relationship between therapist and client. Although there is always going to be a natural inequality between therapist and client, I found a way of working that partly redresses the balance in a few essential areas. cognizance as a principle is the foundation that this online therapy service is based upon. It is the structure that binds together the ethical values and ethos as a way of working with clients.

No testimonials requested from clients

I will not ask you to help me advertise my business by asking you to provide me with a testimonial; I work for you I do not expect you to work for me, neither do I expect you to interact with prospective clients who want to check if your testimonial is real or fake, that would not be ethical and very unprofessional and breaches the clients confidentiality.

Not charging for the first session,

All therapists need to do risk assessments and check to see if the client is suitable before taking them on as prospective clients (especially working on-line) and as successful therapy is often dependant on the strength of the therapeutic relationship the client needs the time to see if they feel happy to continue, not every therapist is suitable for every client. Why does the client have to pay for the privilege of find out for themselves?

Promoting independence.

In all interactions I believe that the therapist should always try to build and promote the clients autonomy by helping them take responsibility for their own thoughts and actions. I do not ask for payment until after the session has ended, this gives the client time to reflect on the therapy session and they have the freedom to pay only if they are happy to continue with therapy, this helps promote personal choice and responsibility.

No broken promises

There can never be any promise of success given to the client to persuade them to pay for therapy, that just builds up false hope and can even damage a client’s self-esteem when therapy cannot deliver what has been promised. The truth is that all any therapist can do, is try their best to help you discover what is possible for you, I will do my very best to help and support you, to make the changes you want in your life, but I cannot promise you success only the possibility of progress.

This service tells the truth about your confidentiality.

I think it is important to inform my clients about the truth so they can make an informative choice based on facts and not misleading information especially about confidentiality. Some therapists promise total confidentiality, but forget to inform the client that in truth there is no total confidentiality as it is not possible to provide it. The truth is no security can be totally secure, all any one can do is reduce the risks involved as much as it is practical and possible to do so. One way to do that is to reduce risk is by reducing the amount of information stored or kept on file, one of the reasons why I do not keep detailed information about a client’s personal experiences or record sessions, this is to remove the possibility of a breach of confidentiality as much as is possible to do so. Allowing the client to remain totally anonymous if they wish is one way to further reduce the risk even lower, but it does complicate working with people in crisis. All software can be hacked and documents stolen, all cabinets and offices can be broken into and people can breach trust inadvertently or accidentally. Whether you are promised hippa compliance or secure encrypted communications, that still does not guarantee total confidentiality, any statement promising any such guarantee is bad information at best and being untruthful at worst, just to get the clients custom. There is nothing wrong in saying total confidentiality as most people know what the limits are, but it still needs to be clarified for ethical disclosure helping people to make an informed choice on the facts provided not opinions.

The Cognizance way of working

The Cognizance Therapeutic principle is about helping the therapist to be mindful of the importance and value of the client. It expects that the therapist will treat the client as a person of equal value and equal importance, to recognise the importance of respecting upholding and protecting the client’s autonomy and self- determination. As a therapist, I believe in working in a mindful way that aims to enhance the importance of the client within the therapeutic alliance, in a way that I think is founded on equality and respect that I call the cognizance therapeutic principle. The principle is founded on the belief that all humans are equal and treated on an equal standing, whatever their race religion sex or sexual orientation. This way of working attempts to prioritise the focus of the relationship between therapist and client in a way that prioritises enhances the client's experience, helps build trust and rapport, while confirming the client’s importance, self-determination and independence.

The application of cognizance.

The principle covers five areas of focus for the therapist. Appreciation. To acknowledge the importance of the client’s morals, opinions, personal qualities, values and personal experiences and hold them in high regard. Awareness. To be conscious of the client’s life choices, internal and external emotional influences and situational life pressures. Knowledge. To gain a working knowledge of the client’s world and help the client gain self-knowledge and behavioural and emotional insights. Perception. To see hear and become aware of the importance of the client’s thoughts emotions life experiences and life choices. Recognition. To except that a client is a person of equal value who has the right to be treated as a human being with compassion and understanding.

Actualising cognizance

The therapeutic alliance between therapist and client is inherently unequal, as the client is always being seen as needing support, the therapist is seen as inheriting the supporting role. As there will always be an imbalance of influence between therapist and client in the therapeutic relationship, the relationship can still be directed by the therapist to show, that both therapist and client are both recognised as being equally important, by introducing the principle at the start of therapy. I achieve that by informing the client of four working practices, I use that is based on the principle.

Working practices

There is no charge for the first session The first contact is a time for evaluation for both therapist and client, not charging equalises the relationship. A free consultation gives both the client and therapist time to discover if continuing to the next paid session is in their best interests. The client needs to be able to find out if they think the therapist is one they can continue working with, or if it is in their best interests to discontinue, before becoming financially obligated. The therapist needs time to check if the client is suitable for the service they provide, or if there are any reasons why the offer of therapy needs to be discontinued, perhaps for ethical or safety concerns.

No charges for missed appointments.

Automatically charging for a missed session in some cases both disrespects and punishes the client, the therapist because of the natural imbalance between therapist and client, the therapist is able to impose the rules with impunity, doing so not only risks disempowering the client but suggesting that the therapist is superior. No payments required until after the therapy session The invoice is sent after the therapy session has ended to allow the client time to evaluate the session, and their commitment to therapy without any pressure to continue from the therapist, this gives the responsibility to the client to make a choice on their terms and in so doing enhances their independence.

No advanced payments required

No payments are requested in advance, or booking deposits, a therapist demanding payment in advance of the therapy session is both disrespecting the client and also bringing the clients trust into question, not a good start to a therapeutic relationship supposedly built on mutual trust and respect.

The exceptions

As therapy is complex, there needs to be a set of limitations to protect the therapist and client from unusual conditions. 1/ Client insists on paying If the client has requested or insists on making a payment for missing an appointment, the therapist can send the invoice and request payment. Insisting on not charging could disrespect the client's wishes and personal ethics, so graciously excepting the reimbursement would be beneficial by recognising the importance of the client's wishes, this may also confirm the client’s ability to make personal choices and further establish their independence. 2/ Client responsibility Regularly missing sessions can be seen as the client creating an advantage over the therapist and being disrespectful, there could be mitigating circumstances that a therapist can judge as reasonable, such as the client is terminally ill and suffering from unpredictable consequences of the illness. Under such conditions therapist may modify their arrangements. The client and therapist, each have an equal responsibility to attend any therapy sessions, if the client has missed a number of sessions, the therapist may renegotiate the relationship. This could include a condition that the client will pay for any further missed appointments, without 48 hours prior notice, or even insisting on payment in advance before any more dates can be booked. This is allowing the therapist to protect themselves from being abused.
Cognizance Therapeutic Principle
Online Therapy Service
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© of A Yates

Cognizance Therapeutic

Principle

Normal ethics

I advocate the idea that as a therapist I am expected to maintain good ethical practise in the best interests of my clients to help promote the clients well being. Ethically the therapist-client relationship, needs to be restricted by boundaries, these important boundaries keep therapy focused on a working relationship and helps protect both therapist and client. No therapist should ever enter into any kind of relationship outside of the normal therapeutic relationship. Any kind of friendship, sexual relationships, financial partnerships and any social and social media interaction. No contact should be initiated outside of the regular therapy sessions, unless necessary for rearranging or communicating changes to times and dates, or to inform the client of cancellations or other important information.

Online therapy ethics & ethos

As a professional full-time online therapist, I have for many years worked with clients in a way that I believe is founded on empathy, equality and respect, and I now call this the cognizance therapeutic principle. When I am working as a therapist, I do my best to create a harmonious and equal relationship between therapist and client. Although there is always going to be a natural inequality between therapist and client, I found a way of working that partly redresses the balance in a few essential areas. cognizance as a principle is the foundation that this online therapy service is based upon. It is the structure that binds together the ethical values and ethos as a way of working with clients.

No testimonials requested from

clients

I will not ask you to help me advertise my business by asking you to provide me with a testimonial; I work for you I do not expect you to work for me, neither do I expect you to interact with prospective clients who want to check if your testimonial is real or fake, that would not be ethical and very unprofessional and breaches the clients confidentiality.

Not charging for the first session,

All therapists need to do risk assessments and check to see if the client is suitable before taking them on as prospective clients (especially working on-line) and as successful therapy is often dependant on the strength of the therapeutic relationship the client needs the time to see if they feel happy to continue, not every therapist is suitable for every client. Why does the client have to pay for the privilege of find out for themselves?

Promoting independence.

In all interactions I believe that the therapist should always try to build and promote the clients autonomy by helping them take responsibility for their own thoughts and actions. I do not ask for payment until after the session has ended, this gives the client time to reflect on the therapy session and they have the freedom to pay only if they are happy to continue with therapy, this helps promote personal choice and responsibility.

No broken promises

There can never be any promise of success given to the client to persuade them to pay for therapy, that just builds up false hope and can even damage a client’s self-esteem when therapy cannot deliver what has been promised. The truth is that all any therapist can do, is try their best to help you discover what is possible for you, I will do my very best to help and support you, to make the changes you want in your life, but I cannot promise you success only the possibility of progress.

This service tells the truth about your

confidentiality.

I think it is important to inform my clients about the truth so they can make an informative choice based on facts and not misleading information especially about confidentiality. Some therapists promise total confidentiality, but forget to inform the client that in truth there is no total confidentiality as it is not possible to provide it. The truth is no security can be totally secure, all any one can do is reduce the risks involved as much as it is practical and possible to do so. One way to do that is to reduce risk is by reducing the amount of information stored or kept on file, one of the reasons why I do not keep detailed information about a client’s personal experiences or record sessions, this is to remove the possibility of a breach of confidentiality as much as is possible to do so. Allowing the client to remain totally anonymous if they wish is one way to further reduce the risk even lower, but it does complicate working with people in crisis. All software can be hacked and documents stolen, all cabinets and offices can be broken into and people can breach trust inadvertently or accidentally. Whether you are promised hippa compliance or secure encrypted communications, that still does not guarantee total confidentiality, any statement promising any such guarantee is bad information at best and being untruthful at worst, just to get the clients custom. There is nothing wrong in saying total confidentiality as most people know what the limits are, but it still needs to be clarified for ethical disclosure helping people to make an informed choice on the facts provided not opinions.

The Cognizance way of working

The Cognizance Therapeutic principle is about helping the therapist to be mindful of the importance and value of the client. It expects that the therapist will treat the client as a person of equal value and equal importance, to recognise the importance of respecting upholding and protecting the client’s autonomy and self- determination. As a therapist, I believe in working in a mindful way that aims to enhance the importance of the client within the therapeutic alliance, in a way that I think is founded on equality and respect that I call the cognizance therapeutic principle. The principle is founded on the belief that all humans are equal and treated on an equal standing, whatever their race religion sex or sexual orientation. This way of working attempts to prioritise the focus of the relationship between therapist and client in a way that prioritises enhances the client's experience, helps build trust and rapport, while confirming the client’s importance, self-determination and independence.

The application of cognizance.

The principle covers five areas of focus for the therapist. Appreciation. To acknowledge the importance of the client’s morals, opinions, personal qualities, values and personal experiences and hold them in high regard. Awareness. To be conscious of the client’s life choices, internal and external emotional influences and situational life pressures. Knowledge. To gain a working knowledge of the client’s world and help the client gain self-knowledge and behavioural and emotional insights. Perception. To see hear and become aware of the importance of the client’s thoughts emotions life experiences and life choices. Recognition. To except that a client is a person of equal value who has the right to be treated as a human being with compassion and understanding.

Actualising cognizance

The therapeutic alliance between therapist and client is inherently unequal, as the client is always being seen as needing support, the therapist is seen as inheriting the supporting role. As there will always be an imbalance of influence between therapist and client in the therapeutic relationship, the relationship can still be directed by the therapist to show, that both therapist and client are both recognised as being equally important, by introducing the principle at the start of therapy. I achieve that by informing the client of four working practices, I use that is based on the principle.

Working practices

There is no charge for the first session The first contact is a time for evaluation for both therapist and client, not charging equalises the relationship. A free consultation gives both the client and therapist time to discover if continuing to the next paid session is in their best interests. The client needs to be able to find out if they think the therapist is one they can continue working with, or if it is in their best interests to discontinue, before becoming financially obligated. The therapist needs time to check if the client is suitable for the service they provide, or if there are any reasons why the offer of therapy needs to be discontinued, perhaps for ethical or safety concerns.

No charges for missed appointments.

Automatically charging for a missed session in some cases both disrespects and punishes the client, the therapist because of the natural imbalance between therapist and client, the therapist is able to impose the rules with impunity, doing so not only risks disempowering the client but suggesting that the therapist is superior. No payments required until after the therapy session The invoice is sent after the therapy session has ended to allow the client time to evaluate the session, and their commitment to therapy without any pressure to continue from the therapist, this gives the responsibility to the client to make a choice on their terms and in so doing enhances their independence.

No advanced payments required

No payments are requested in advance, or booking deposits, a therapist demanding payment in advance of the therapy session is both disrespecting the client and also bringing the clients trust into question, not a good start to a therapeutic relationship supposedly built on mutual trust and respect.

The exceptions

As therapy is complex, there needs to be a set of limitations to protect the therapist and client from unusual conditions. 1/ Client insists on paying If the client has requested or insists on making a payment for missing an appointment, the therapist can send the invoice and request payment. Insisting on not charging could disrespect the client's wishes and personal ethics, so graciously excepting the reimbursement would be beneficial by recognising the importance of the client's wishes, this may also confirm the client’s ability to make personal choices and further establish their independence. 2/ Client responsibility Regularly missing sessions can be seen as the client creating an advantage over the therapist and being disrespectful, there could be mitigating circumstances that a therapist can judge as reasonable, such as the client is terminally ill and suffering from unpredictable consequences of the illness. Under such conditions therapist may modify their arrangements. The client and therapist, each have an equal responsibility to attend any therapy sessions, if the client has missed a number of sessions, the therapist may renegotiate the relationship. This could include a condition that the client will pay for any further missed appointments, without 48 hours prior notice, or even insisting on payment in advance before any more dates can be booked. This is allowing the therapist to protect themselves from being abused.
Cognizance Therapeutic Principle