COLLATERAL SERVICE AGREEMENT
Introduction: Thank you for accepting the invitation to assist in our client's psychotherapeutic treatment. Your participation is important and can sometimes be essential to the success of treatment. This document is to inform you about the risks, rights, and responsibilities as a collateral participant.
Who is a Collateral? A collateral is usually a spouse, family member, or friend who participates in therapy to assist the identified client. The collateral is not considered a client and is not the subject of treatment. Marriage and Family Therapists have certain legal and ethical responsibilities to clients, and the privacy of the relationship with the client is given legal protection. A therapist’s primary responsibility is to the client and he/she must place the client’s interests first.
The Role of the Collateral in Therapy: The role of a collateral will vary greatly. For example, a collateral might attend only one session, either alone or with the client, to provide information to the clinician and never attend another session. In another case, a collateral might attend all of the client’s therapy sessions and his/her relationship with the client may be the focus of treatment. You will discuss your specific role in the treatment during your first meeting and at other appropriate times.
Benefits and Risks: Psychotherapy often engenders intense emotional experiences and your participation may engender strong anxiety or emotional distress. It may also create tension in your relationship with the client. While your participation can result in better understanding of the client or an improved relationship, or may even help in your own growth and development, there is no guarantee that this will be the case. Psychotherapy is a positive experience for many, if not most, but there are risks, and it may not be helpful to all people.
Medical Records: No record or chart will be maintained on you in your role as a collateral. However, notes about you may be entered into the identified client’s chart and you should be aware that the client has a right to access the chart and the material contained therein. It is sometimes possible to maintain the privacy of your communications with the clinician. If that is your wish, you should discuss it before communicating any information. You have no right to access that chart without the written consent of the identified client. You will not carry a diagnosis, and there will be no individualized treatment plan for you.
Fees: As a collateral you are not responsible for paying for my professional services unless you are financially responsible for the client.
Confidentiality: Both federal and state laws protect the confidentiality of information in the client’s chart and the information that you provide. It can only be released if the identified client authorizes it. There are some exceptions to this general rule:
§ If you are suspected of abusing or neglecting a child, elder, or vulnerable adult, therapists are required to file a report with the appropriate agency. This is also true if you were the focus of abuse as a child and the perpetrator continues to have access to potential victims.
§ If you are a danger to yourself (suicidal), therapists are required to take actions to protect your life, even if protecting you discloses your identity and other information about you. If you threaten serious bodily harm to another, therapists must take those actions that are necessary to protect that person, even if the therapist must reveal your identity to do so. Recent legal proceedings may also compel a therapist to reveal your identity to protect another if a family member communicates that you intend to cause serious bodily harm to yourself or another.
§ If you, or the client, are involved in a lawsuit and the court requires a disclosure of information, a therapist must submit the information or testify as the court ordered.
Do Collaterals Ever Become a Formal Client? Collaterals may discuss their own problems in therapy, especially problems that intersect with the issues of the identified client. The clinician may recommend formal therapy for a collateral. Some examples of when this might occur are:
§ It becomes evident that a collateral is in need of mental health services because he/she is experiencing depression or other mental health challenges.
§ Parents being seen as collaterals in their children’s treatment need couples therapy to improve their relationship so they can function effectively as parents.
§ Most often, in these situations the identified client’s clinician will refer you to another clinician for treatment. There are two reasons a referral may be necessary:
§ Seeing two members of the same family, or close friends, may result in a dual role, and potentially cloud the clinician’s judgment. Making a referral helps to prevent this.
§ The clinician must keep focus on the original treatment goals associated with the identified client. The referral helps the clinician to maintain the proper focus of treatment.
§ One exception is when family therapy can be conducted effectively and ethically with subgroups within the family. Another exception is when the specific modality of treatment recommends that the clinician see both or all people individually in the interests of the overall treatment.
Release of Information: The client is not required to sign our Authorization to Release and Exchange Information Form to the collateral when a collateral participates in therapy. The presence of the collateral, with the consent of the client, is adequate; however, it is the practice of this office to require such an authorization. This provides some assurance that full consent for treatment has been given so that the client’s confidential information can be discussed with the collateral in therapy. The authorization form is also useful to the clinician on those occasions when he/she receives a telephone call from a collateral, or when the clinician calls a collateral for one reason or another. In most instances, the clinician cannot take a call from a collateral without an authorization form.
Parents as Collaterals: Clinicians specializing in the treatment of children have long recognized the need to treat children in the context of their families. Participation of parents, siblings, and sometimes extended family members, is common and often recommended. Parents, in particular, have more rights and responsibilities in their role as a collateral than in other treatment situations where the identified client is not a minor (15 years or older). In treatment involving children and their parents, access to information is an important and sometimes contentious topic. Particularly for older children, trust and privacy are crucial to treatment success. But parents also need to know certain information about the treatment. For this reason, we need to discuss and agree about what information will be shared and what information will remain private. We will always inform you if we think that your child is in danger or if he/she is endangering others. One of our first tasks is to discuss and agree on our shared definition of dangerousness so we are all clear about what will be disclosed.
§ If you are participating in therapy with your child, you should expect the clinician to request that you examine your own attitudes and behaviors to determine if you can make positive changes that will be of benefit to your child.
Summary: If you have questions about therapy, your clinician’s procedures, or your role in this process, please discuss them with your clinician. Remember that the best way to assure quality and ethical treatment is to keep communication open with your clinician.
Your signature below indicate that you have read the Services Agreement for Collateral Participation in Counseling and agree to abide by its terms during this professional relationship.