Counselling and support for
children and young people
Call TeenTalk on
01225 667328

Client Support Agreement

Client Support Agreement

Thank you for agreeing to see us, this is an important first step and we are very pleased that you have agreed to allow us to try and support you.

This form includes some important information about our service and what you are agreeing to. Your counsellor/support worker will talk you through the form and answer any questions you have.

Once you have done this we will need to to sign the form to say you understand and agree to the client support agreement.

About your sessions

The Counsellor has spoken to me and we have agreed that we are making a commitment to meet each week for a 50 minute session unless either of us is unable to make it. We have agreed that if we are unable to make it we will let each other know as soon as possible giving at least 24 hours notice. If I give less than 24 hours notice that I am unable to attend our session I understand I may forfeit one of my agreed support sessions.

To let my counsellor know I can not attend or will be late I will call 01225 667328, or text 07557 634185

In this session I have:

  1. Been given information about TeenTalk’s confidentiality policy and I understand the kind of circumstances in which my Counsellor might need to share or record a concern.
  2. Discussed that in the event that my support needs change I can choose to provide contact details of an appropriate professional adult such as another support worker, doctor or social worker, who may be able to support me in addition to, or at the end of my TeenTalk support and that my Counsellor may then get in touch with this person with my permission.
  3. Understood I may be offered information about other services if my Counsellor feels that’s appropriate.
  4. Understood that my Counsellor will be keeping summary notes about our sessions and the work we have done together and that I can request to see these notes at any time should I want to. I understand that these notes are kept securely on Young Melksham’s database until such a time as the service feels it is appropriate to securely delete them.
  5. Been made aware that Young Melksham’s Teen Talk service works within the ethical framework set out by the British Association for Counselling & Psychotherapy (www.bacp.co.uk/events-and-resources/ethics-and-standards/ethical-framework-forthe- counselling-professions).
  6. Understood that should the Counsellor wish to record conversations or to specifically refer to issues I share in counselling as part of their training or professional Development, they will discuss this with me before doing so and if I agree I will sign the appropriate form.
  7. Understood that I will be given a copy of this Agreement to take with me for reference but if I have any further questions, I can call Young Melksham to speak to another member of staff at any time on the number overleaf.
  8. Understood that my Counsellor has the right to decline to work with me at any time if I present a risk to their health and safety or the health and safety of others or if my behaviour is deemed unacceptable in line with Young Melksham’s Acceptable Behaviour Policy.

Understanding all the above I give my consent for counselling to continue:

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We are able to deliver our services thanks, in part, to the generous support of these organisations
Big Lottery FundWiltshire Community FoundationMelksham Without Parish CouncilMelksham Town Council
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TeenTalk is a service provided by 4Youth (South West). 
4Youth (South West) is a company registered in England and Wales, Company Number 7871666.
Registered Office: The Canberra Centre, 56a Spa Road, Melksham SN12 7NY
Charity Registration Number: 1147394
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