Kristen Berube, MA, RCC

Registered Clinical Counsellor

(250) 619-0901


Memorandum of Understanding

 

About Me:

I received my Masters of Arts in Counselling Psychology through the Adler School of Professional Psychology in Vancouver, British Columbia, with a concentration in Mindfulness-Based approaches to overall health and well-being. I utilize a number of brief therapies including mindfulness-based cognitive therapy (MBCT), cognitive behaviour therapy (CBT), Applied Behaviour Analysis (ABA), Dialectic Behaviour Therapy (DBT) and Motivational Interviewing in order to create individualized planning to meet your unique needs.

 

My approach to clients is always strength-based, as I believe that every individual has unique strengths and resiliencies that can serve as a foundation for their personal growth. One of my key professional interests the cultivation of resilience (the ability to bounce back from adversity), and self-efficacy (one's own belief in their capacity to change and achieve goals). I believe that both of these internal resources can be cultivated in any individual through personal exploration and self-reflection. I assist clients in tapping into existing strengths.

 

What is clinical counselling?

Clinical counselling helps people improve their mental, emotional and physical health while encouraging positive relationships with self, others and the larger community. The building of a trusting and comfortable relationship between client(s) and counsellor is important as counselling may cover topics of distress, therefore questions or comments on the counselling process are invited at any time.

 

Benefits of therapy:

Therapy can help a person to gain a new understanding about his or her problems and to acquire new ways of coping with and solving those problems. Therapy can help a person to develop new skills and to change behaviour patterns. Therapy can contribute to an increased understanding of self and others.

 

Risks of therapy:

While there are potential benefits to therapy, success is not guaranteed and there are potential risks. Therapy may stimulate memories, evoke strong feelings, and changes in awareness may alter oneÕs self-perceptions and ways of relating to others.   Sometimes clients will feel worse before they feel better.  This is especially a concern for trauma clients.  A person needs to understand that therapy is a process and you can continually discuss any concerns you are having with your therapist.

 

Contact and Communication:

You can contact Kristen by phone at (250) 619-0901 or via email at restorativecounselling@outlook.com Most communications will be responded to within 24-48 hours.

 

Collection and Storage of Personal information:

Storage and collection of client information is in accordance with the personal information protection act (PIPA) and in accordance with the BCACC and CCC guidelines.  If you have any questions regarding this, please talk to Kristen directly.

 

Complaints or questions:

If you have a complaint or question, please feel welcome to talk to Kristen first.  If you would like to talk to someone else, you can contact the BC Association of Clinical Counsellors at (250) 595-4448 or you can contact the Canadian Counselling Association at 1-(877)-765-5565.

 

Fees:

The fee for counselling at the Wentworth Street office location is $105 for individuals and $120 for couples (includes tax).  Individual sessions are 50 minutes in length, and couples sessions are 1.5 hours for the first session, and 60 minutes for each subsequent session.  ÒWalk TherapyÓ sessions can be arranged after the initial session, with options of meeting at a beach, or walking a trail. Outdoor sessions are $105 for 50 minute sessions and $120 for 90 minute sessions. A sliding fee may be available for students and individuals with financial hardship. Longer sessions are also available, charged at the above rate, when they are required. Telephone consultations and distance counselling are charged by the ¼ hour. Payment is accepted by cash or can also be made through PayPal (using credit card or debit card) on www.restorativecounselling.com and this payment is requested in advance of sessions.  In the case of payment not being made before the appointment or at the appointment time, clients will be charged a $10 fee per unpaid session for each full or partial month that they have not paid. Clients have 30 days before this fee will begin to accumulate.

 

Cancelled and/or missed appointments:

24 hours notice must be given for the cancellation of appointments otherwise, the full session fee will be charged.  As there is a high demand for services, your time is reserved exclusively for you and therefore is not available to others.

 

Extended health benefits and income tax:

Clinical counsellor fees are not covered by MSP but may be completely or partially covered by your extended medical plan or possibly deductible as a medical expense on income taxes. Some insurance companies will cover expenses of a counsellor if they are supervised by a Registered Social Worker or Psychologist. 

 

Child and Youth Therapy Guidelines:

á       Kristen typically uses the age of 12 years old to determine whether a youth can provide consent.

á       It is recommended that a parent stays in the waiting room while their child is in session, especially for the first session.  Outdoor sessions may be suggested for later sessions, if your child would benefit from engaging in an activity outdoors while talking. This is often less intimidating for children.

á       Regularity and consistency of attendance is extremely important so the therapist and your child can develop a trusting therapeutic relationship.

á       Do not question your child about their counselling session.  Your child will share what they feel comfortable with.

á       Do not press a child to attend counselling or to talk about a particular issue in counselling.  The child will address issues as they feel safe and ready to do so, or they may be addressing them in other ways, i.e. through play or art. Pressure from a parent/caregiver may place undue stress on a child and may in fact be detrimental to the counselling process.

á       Do support your child as they courageously face their issues in counselling.

á       Do be open to participating in counselling yourself.

 

These are general guidelines only. Your counsellor and you can discuss these in depth and develop a plan about how you can best be of support to your child in counselling.

 

Limits of Confidentiality:

Information about counselling sessions will not be released to anyone without your informed, voluntary, and written consent.

 

Exceptions are:

á       When you may be a danger to yourself or others

á       When there is suspicion or disclosure of abuse of vulnerable persons, such as a child or elderly person

á       When records are subpoenaed by court order

Every reasonable effort will be made to discuss these circumstances with you prior to the involvement of other professionals.

An additional exception may be made if the counselling is being paid for by a third party (such as an EAP). This will be discussed with you at the onset of counselling.

 

Consent to Release Information

In the event of an emergency, or should your counsellor determine you are at risk, please provide the name of an emergency contact person that can be contact and collaborated with to ensure your safety. All information shared with this person will be discussed with you in advance, or with you present. Initial here to consent ________

 

Emergency Contact Name________________________________ Phone_______________________________

Contacting other Health professionals:

 

It may be helpful or necessary for Kristen to speak to other professionals who may be involved in aspects of your physical and emotional health.  Wherever possible, this will be done with your understanding the intent of such contact.  You have the right to know what transpired in any conversations between your counsellor and other professionals.

 

*Please confirm by initialling here that you give your permission for me to give updates, receive information and/or discuss your case with these professionals ________

 

Other professionals involved in my health care are (ex. DrÕs, SWÕs, other therapistÕs):

Name:

Contact:

 

 

 

 

 

 

 

Were you referred by your Dr. or an agency?  YES/ NO  

Initial, _____if you give permission for us to acknowledge this referral with the referring Dr. or agency, etc.  YES/NO

 

Couples and family Counselling:

For these types of counselling, please understand that KristenÕs policy is to Òhave no secretsÓ between her and the parties in the therapy.  If you have concerns about this, please speak to Kristen directly.

 

Consultation:

In order to provide the best possible service, I may consult with another professional(s) about our work together; your name and other identifying information would not be used. ______

 

Kristen does presentations about her work and about teaching principles of caring for ourselves and others.  If you would like Kristen to be able to use your story (Kristen will change identifying characteristics such as your name, age, sex and some details about your story), please initial here indicating that you agree and give consent______

 

Kristen regularly presents and facilitates stress-reduction groups and art workshops.  If you would like to be included on her contact list, please initial here______. You can join a waitlist for these services by accessing the group page at www.restorativecounselling.com

 

Additional client rights:

á       Clients have the right to withdraw this consent at any time.  Please provide this in writing wherever possible.

á       Clients have the right to refuse particular counselling interventions.

 

Clients with Addictions concerns:

Clients must not be affected by substances at the time of the counselling appointment. This typically requires that a client is sober for the 24 hours before the time of the appointment.

 

My Private Practice Social Media Policy

This Social Media Policy was copied and slightly modified for my own use from the Social Media Policy from the website for Holloway Counselling which credited the information to Keely Kolmes, Psy.D., who licensed it under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License,  making it available to other mental health professionals.

 

The BCACC requires Registered Clinical Counsellors (RCC) who use Social Media to have a Social Media Policy. This document outlines my office policies related to use of Social Media. Please read it to understand how I conduct myself on the Internet as a mental health professional and how you can expect me to respond to various interactions that may occur between us on the Internet.

 

If you have any questions about anything within this document, I encourage you to bring them up when we meet. As new technology develops and the Internet changes, there may be times when I need to update this policy. If I do so, I will notify you in writing of any policy changes and make sure you have a copy of the updated policy. I will also change information on my website accordingly.

 

Friending

 

I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. I also do not interact with clients on social networking sites such as Twitter, Facebook, or LinkedIn. If you need to contact me between sessions, the best way to do so is by phone, or by email. If you have questions about this, please bring them up when we meet and we can talk more about it.

 

Following

 

I occasionally post articles related to wellness and psychology on my website, on the Restorative Counselling Facebook page and I post psychology news on Twitter. I have no expectation that you as a client will want to follow my blog or Twitter stream. Comments have been not been disabled on my website, because it is an open space for members of the public to post. Please be aware of your own confidentiality and whether you may be recognized as a client if you have an easily recognizable username. If I happen to notice that youÕve followed me on LinkedIn, Twitter or have ÒlikedÓ the Restortive Counselling Facebook page and I am concerned about your confidentiality, we may briefly discuss it and its potential impact on our working relationship. My primary concern is your privacy. You are welcome to use your own discretion in choosing whether to follow me.

 

I only follow other health professionals on Twitter and I do not follow current or former clients on blogs or Twitter. My reasoning is that I believe casual viewing of clientsÕ online content outside of the therapy hour can create confusion in regard to whether itÕs being done as a part of your treatment or to satisfy my personal curiosity. In addition, viewing your online activities without your consent and without our explicit arrangement towards a specific purpose could potentially have a negative influence on our working relationship. If there are things from your online life that you wish to share with me, please bring them into our sessions where we can view and explore them together, during the therapy hour.

 

Use of Search Engines

 

It is not a regular part of my practice to search for clients on Google or Facebook or other search engines. Extremely rare exceptions may be made during times of crisis. If I have a reason to suspect that you are in danger and you have not been in touch with me via our usual means (coming to appointments, or phone contact) there might be an instance in which using a search engine (to find you, find someone close to you, or to check on your recent status updates) becomes necessary as part of ensuring your welfare. These are unusual situations and if I ever resort to such means, I will fully document it and discuss it with you when we next meet.

 

Business Review Sites

 

You may find my psychology practice on sites such as Yelp, Google, Yahoo Local, Bing, or other places which list businesses. Some of these sites include forums in which users rate their providers and add reviews. Many of these sites comb search engines for business listings and automatically add listings regardless of whether the business has added itself to the site. If you should find my listing on any of these sites, please know that my listing is NOT a request for a testimonial, rating, or endorsement from you as my client.

 

The British Columbia Association of Clinical Counsellors (BCACC) Standard for Promoting and Advertising Services states, Òan RCC should never solicit testimonials, expressly or by implication, from clients or other persons who, because of their particular circumstances, may be vulnerable to undue influenceÓ (BCACC Code of Ethical Conduct and Standards of Clinical Practice and Guidelines for Registered Clinical Counsellors, 2011).

 

You have a right to express yourself on any site you wish. But due to confidentiality, I cannot respond to any review on any of these sites whether it is positive or negative. I urge you to take your own privacy as seriously as I take my commitment of confidentiality to you. You should also be aware that if you are using these sites to communicate indirectly with me about your feelings about our work, there is a good possibility that I may never see it.

 

If we are working together, I hope that you will bring your feelings and reactions to our work directly into the therapy process. This can be an important part of therapy, even if you decide we are not a good fit. None of this is meant to keep you from sharing that you are in therapy with me wherever and with whomever you like.

 

Confidentiality means that I cannot tell people that you are my client and my Ethics Code prohibits me from requesting testimonials. But you are more than welcome to tell anyone you wish that IÕm your therapist or how you feel about the treatment I provided to you, in any forum of your choosing.

 

If you do choose to write something on a business review site, I hope you will keep in mind that you may be sharing personally revealing information in a public forum. I urge you to create a pseudonym that is not linked to your regular email address or friend networks for your own privacy and protection.

 

Location-Based Services

 

If you used location-based services on your mobile phone, you may wish to be aware of the privacy issues related to using these services. I do not place my practice as a check-in location on various sites such as Foursquare, Facebook, etc. However, if you have GPS tracking enabled on your device, it is possible that others may surmise that you are a therapy client due to your location.

 

Thank you for taking the time to review my Social Media Policy. If you have questions or concerns about any of these policies and procedures or regarding our potential interactions on the Internet, do bring them to my attention so that we can discuss them.

 

Email and Electronic Communication Policy (ECP)

It has been determined by the BCACC (BC Association of Clinical Counsellors) that Registered Clinical Counsellors (RCCs) who use any form of electronic communication in their practices should develop an Electronic Communication Policy (ECP). Given the widespread use of electronic communication, it is anticipated that nearly all RCCs need an ECP.

To ensure informed consent, RCCs should share the ECP with their clients as part of the intake process. An important function of an ECP is to provide the client with a general reminder of limitations in the security of information shared via each electronic medium available to the client.

 

Email

 

Email is used as a point of primary contact for a number of my clients. I may also use email for confirming appointment times and for forwarding links to articles, meditations, books and other resources to enhance your therapy. There is always a chance that your privacy can be compromised when appointment times and resources are sent electronically. Please read below for more information:

1.          No form of encryption is used by the practice for outgoing emails.

2.          Kristen Berube, MA, RCC is the only employee at Restorative Counselling entitled to read and respond

            to emails from clients. The specific email address to be used for general scheduling or inquiries as well as

information addressed directly to Kristen is restorativecounselling@outlook.com

3.          When you receive a message from the Restorative Counselling, it is clear who has written the message based on

            the use of my personalized signature line.

4.          Emails will generally be responded to within 48 hours (unless your counsellor is on vacation), and if a response

has not been received within that time, you can call 250-619-0901.

5.          When sending emails to your counsellor, please identify the purpose of any email you send, and its urgency, in

the subject line (ex: ÒArticle- Non-urgentÓ, or ÒAppointment Cancellation, would like to Reschedule- UrgentÓ)

6.          All communications from the practice will also include a subject line that makes clear the purpose and urgency of

the communication.

7.          Email messages become part of your counselling records and as such may be subject to being shared along with

your record should the documents be subpoenaed by the courts, RCMP or other governing agencies.

8.          If you have any concerns about this mode of communication, you may revoke your consent at any time. You are also welcome to discuss any questions or concerns with your counsellor further in your next session.

 

9.          Emergencies- Should you find yourself in crisis, email is not an appropriate means of communication. You may try to contact Kristen directly at 250-619-0901 or the 24-Hour Vancouver Island crisis line at 1.888.494.3888. You can also access walk-in single session crisis counselling Monday through Friday from 10am to 6:15pm through Island Health. No appointment is necessary. Services are offered to all ages free of charge. This service is located at Brooks Landing Mall, #203-2000 Island Highway, Nanaimo, BC.

 

Please Initial Here Indicating if you agree to engage in email communication and understand the risks to privacy: ­­­­______

 

Text Messaging

Some clients request appointment changes or resources to be sent to them via text message. While this is an easy and convenient way to send communication, it is also the least secure and it is requested that you fully consider the risks to your confidentiality surrounding your access to counselling services if you request this option. Below is a list of potential risks associated with the use of text messaging such as SMS (Short Message Service):

1.          Communication issues can arise when communicating in text due to the lack of access to visual or voice cues, as well as limits on the number of characters that exists in most text messaging environments, and the common use of ÒshorthandÓ words or characters to represent meaning.

2.          Text messaging is not particularly secure. Further, a lost or misplaced cell phone, or a phone simply left in an insecure location, can inadvertently communicate to others that you are in counselling.

3.          Your First Name and Last Initial will be stored in the cell phone for Restorative Counselling. Although the phone does have a secure password for access, should you text or call the phone there is a chance that your first name and last initial will be displayed.

4.          Text messages are meant to be used for booking appointments, rescheduling appointments, cancelling appointments and for links to resources to be made accessible to you for enhancing your therapeutic process. Should they be used inappropriately (such as to ÒchatÓ or to Òaccess counselling supportÓ), the messages will not be responded to and this may be discussed for clarification in the next session.

5.          Text messages will be responded to within 48 hours unless your counsellor is on vacation. If you are in a crisis, you may try to send a text message requesting a phone call, but if this is not responded to in a timely manner, please call the 24-Hour Vancouver Island crisis line at 1.888.494.3888. You can also access walk-in single session crisis counselling Monday through Friday from 10am to 6:15pm through Island Health. No appointment is necessary. Services are offered to all ages free of charge. This service is located at Brooks Landing Mall, #203-2000 Island Highway, Nanaimo, BC.

6.          All text messages become part of your counselling records and as such may be subject to being shared along with your record should the documents be subpoenaed by the courts, RCMP or other governing agencies.

7.          If you have any concerns about this mode of communication, you may revoke your consent at any time. You are also welcome to discuss any questions or concerns with your counsellor further in your next session.

 

Please provide your cell phone number and initial here indicating if you are requesting to engage in text message communication and confirming that you understand the risks to privacy: ­­­

Initial _________

Cell Phone Number for text messages ___________________________________

 

I have read, understand, and agree with the above.

 

__________________________________________________Date:________________

Client (1)

 

__________________________________________________Date:________________

Client (2)

 

__________________________________________________Date:________________

Kristen Berube MA, RCC