Consent for Use of Al and Audio-Visual Tools as an Accessibilityand Disability Accommodation
Consent to Record and Summarise Therapy Sessions using Al
I, the undersigned, hereby grant permission to Ayna Hennessy of Safe & Sound Counselling to utilise
tools that may record therapy sessions, generate transcripts, or create automated text summaries during
sessions (e.g., Zoom meeting summaries, Otter.ai, Fathom, or similar applications).
The primary purpose of these recordings, transcripts and summaries is to assist with note-taking due to
memory challenges, ensuring accurate and detailed session records, supporting therapeutic continuity,
and helping to notice therapeutic themes and patterns over time. They are essentially an accessibility
and disability accommodation. These notes are often shared with the client to support reflection and
therapeutic progress.
The recordings, transcripts and summaries will be used for the following purposes:
Note-Taking and Memory Support:
To ensure accurate records of therapy sessions and
accommodate memory challenges for either the therapist or the client.
Treatment Planning:
To review and refine therapeutic interventions.
Supervision:
For professional supervision, if required, to ensure high-quality care. Identifying
information, including the client's name, will not be shared in supervision without the client's explicit
consent.
Review and Reflection:
To enhance therapeutic continuity by providing clear session records.
Case Notes, Pattern Recognition and Progress Tracking:
To track therapeutic progress, identify
recurring themes, and notice patterns over time.
Conditions
Limited Access:
Audio/visual recordings, transcripts and automated summaries are for use within the therapeutic
relationship, the therapist's clinical record-keeping processes, and professional supervision where
required.
No other party may access these recordings, transcripts or summaries without the client's explicit
written consent, unless disclosure is required by law, professional or ethical obligations, or serious
risk considerations.
Automated Summaries:
Tools such as Zoom meeting summaries, Otter.ai, Fathom, or similar applications may generate
audio recordings, text-based summaries, transcripts, or notes from the session. These recordings,
summaries, transcripts, or notes are used to assist with therapeutic documentation, memory support,
accessibility, therapeutic continuity, and review of therapeutic themes over time. They are securely
stored and accessible only to the therapist unless explicitly shared with the client or otherwise agreed
in writing.
Client Copies:
Notes or summaries from sessions are often shared with the client to support self-reflection and a deeper
understanding of the therapy process.
Storage and Security:
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All recordings, transcripts and automated summaries will be securely stored to ensure confidentiality.
Audio/visual recordings will be deleted after review by the therapist unless explicitly agreed otherwise for therapeutic continuity or required for clinical record-keeping.
Revocation:
I can revoke this consent at any time by providing written notice.
This release must be signed by the client and the therapist.
My Consent Preferences:
Please tick one or more options based on your preferences:
I consent to both recordings (audio and/or visual) and automated summaries.
I consent to audio-only recordings for note-taking and review purposes.
I consent to automated summarisation (e.g., transcripts or summaries) but do not consent to recordings.
I do not consent to any form of recording or summarisation.
I would like to decide on a case-by-case basis.
Other
Client Name:
Client Signature:
Date:
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Client Name:
Therapist Name:
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Therapist Signature:
Date:
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