Prosperity Organisational Policies

Prosperity will only utilise evidence-based treatment plans and those in line with professional and ethical standards of bodies such as BACP. This means that some treatments that do not meet these conditions will not be utilised. The widest range of treatment options that meet this condition that we offer is CBT.

Prosperity should be accessible to as many people as possible. This takes 2 forms, financial access and practical access. Financial access means keeping the service affordable, at less than typical market rate. The aim should be for the service to be self sustaining while offering a reasonable wage for a therapist but no more. Where possible , fees should be controlled. Fees are defined in the contract but are typically £45 per session. Discounts can only be made for those on very low incomes as the service is priced below the average as standard. For current clients fees can only be reviewed at the start of the new financial year in April. Clients who do not pay will have their referral cancelled. Practical accessibility includes offering a range of therapy types, in-person or online where possible. Therapy rooms should be as accessible as possible. Clients should not be denied treatment based on complexity, except where the therapist is not qualified to work with the issues. There will be no discrimination based on ethnicity, sex, gender, sexuality, nationality, religion or other personal factors.

Prosperity will maintain professional standards and memberships of professional bodies such as counselling bodies, ICO and Disclosure (PVG). It will adhere to all guidance around ethics, supervision, CPD, professional conduct, confidentiality, data protection and safeguarding. Some clients may be on different payment plans relating to different incomes but Prosperity should avoid favouring higher income clients in referral for financial reasons.

All session content, notes, recordings and other paperwork will be confidential or anonymous. They will comply with data protection regulations. Confidence will only be broken in the following scenarios:

1) Where the client consents to confidence being broken.

2) When compelled by a court of law

3) Where there is a possibility of harm to the client or another person.

4) Where there are concerns around child protection. If confidentiality must be broken, the client will be notified.

People can self-refer online and must complete the form including the emergency contact and GP details. Failure to do so will result in the referral not being taken forward. Thereafter a contract will be issued. This can be negotiated if some aspects are not right for the person but some clauses such as those relating to ethical or professional guidelines cannot be altered. A signed contract must be agreed for service to begin (digital signatures can be accepted).

Waiting lists may be in operation and work on a first come first served basis but re-engagers may be at the top of the list (see policy below). Andrew will stay in touch with people on the list approximately monthly to check in and ask if service is still required. As many people find services while on the list, if people do not respond to the email to confirm that they still need the service they will be removed from the list.

Length of service will be variable depending on individual needs. Some clients complete in 6 sessions and others work with the service for years (but most are around 2-3 months). Goals should be defined and length of service is dependent on time it takes to reach these. Upon completion of all goals an ending process will occur. This can be over one session or many depending on length of time and anxiety about endings. Ultimately, the goals is to have all clients end as they recover. Clients can return after 2 months if something occurs (this to give the current treatment time to take).

Ad-hoc sessions are not recommended by professional bodies as there is evidence of treatment efficacy dropping with fortnightly sessions compared to weekly and a massive drop in success with anything less than fortnightly. However, there is a case for ad-hoc sessions among clients that have largely overcome their key issue who need occasional support to maintain their progress or phase their therapy out if we have been working together for a long time. This changes your contract to have no set allocation of sessions (weekly, fortnightly, etc.) with longer between disengagement (see policy below). You can request to be ad-hoc but key things to know are:

1) This will only be allowed in cases where your central mental health or wellbeing. Your issue is close to resolved and you just need support to keep the work going or if you have a bump in the road. Due to evidence on the need for treatment momentum it is not suitable for clients still in the midst of the issue as it may cause treatment to be ineffective. Therefore, ad-hoc sessions will not be possible until you get to that point.

2) Ad-hoc sessions still require some kind of therapeutic goal or issue you need psychological support with. Ethically, it is not permissible for me to let a client come in for a chat. This is considered to be cultivating dependence and potentially financial abuse since this is a paid service. Therapists sign up to this framework willingly as we would not wish to harm a client. This means that if everything is resolved I still have the option to end therapy.

3) Ad-hoc sessions are a bridge between regularly scheduled therapy and ending. Ethical requirements state that therapy is never permanent even if it has needed to last for many years it is not forever. The ultimate goal is getting to a point where you don’t need therapy anymore. It is not ethical to let someone access a paid service unless they need to so ad-hoc will be preparing you to end eventually.

4)Regular clients have a set allocation on my database where I try to hold an amount of time for them. Ad-hoc clients will not have a set allocation so not the amount of time for them. same level of certainty of an appointment. It should still be easy enough to get one as regular clients often go on holiday, cancel for work, etc so there are usually spare appointments. But we agree that these are first come first served.

Waiting lists for mental health treatments are an issue so it is important to have a system to end with people who are not engaged. Regular clients having no contact after 2 weeks will receive an automated email to check they are ok and ask if they still require the service. If they are feeling better, ending arrangements can be made. If a break is required, this can be discussed to prevent discharge, but longer term may require re-referall when they are ready. Anyone that has not replied to this email after one week will be considered to have disengaged.

Reengagement & Return:

A disengaged client will have 6 weeks to contact Andrew and will be considered a reengager. If a waiting list is in operation they will be placed at the very top of the list. If they disengage a second time they cannot be considered a reengager and will need to start from the bottom of the waiting list. After 6 weeks they are considered a returner and will need to refer again, beginning at the bottom of the waiting list if one is in operation.

Ad-hoc Clients:

If ad-hoc, you will be contacted after 4 weeks of no engagement and be considered disengaged a week later if there is no contact. If you need more time just let me know and you can have another 4 weeks. In this case, there will not be a system to reengage as you were preparing to end anyway (circumstances dependent will be taken into account).

Holiday leave will be announced with a minimum of two weeks notice. Leave may also be taken for training/CPD. It is an ethical requirement that therapists undertake the amount of CPD that professional bodies determine. In cases of emergency leave (such as sickness/ bereavement, etc) as much notice will be given as possible.

The therapist will take notes, make paperwork and have session recordings on audiotape. These will be anonymised where possible and kept in a secure locked cabinet. This supports treatment planning and enables clinical supervision.