Coaching Informed consent

Introduction

This Agreement is intended to provide the client listed above (Herein “Client”) with important information regarding the practices, policies, and procedures of Dena McComb (herein “Coach”), and to clarify the terms of the professional relationship between Coach and Client.

Any questions and concerns regarding the contents of this Agreement should be discussed with Coach prior to signing it. 

Coach Background and Qualifications

Coach is a Certified Life Coach and has been working with individuals, couples, and families since 2016.

Coach has mainly worked with individuals and families who have experienced Complex PTSD (C-PTSD), Adoption, Parental Narcissistic Abuse, Childhood Trauma, Neurodivergence (Autism/ADHD), and Chronic Pain.

Coach has worked traveled the US, Mexico and Canada working with adoptive families and individuals as well as private practice settings.

Coach has received specialty training in trauma-informed therapeutic practices, whole brain-training, mind-body coaching, EFT (emotional freedom technique), mindset/mindfulness, yoga, health coaching, somatic experiencing.

Coach is committed to continuously expanding her expertise to better serve her clients.

What is Coaching?

“Coaching" is a form of consultation where the Coach aids the client in setting and reaching goals, producing better results, acting more effectively with greater agility, and accomplishing more than was possible without the aid of a Coach…

The Coach assists the client in attaining lasting excellence, while at the same time attaining fulfillment and balance.” (The Therapist, Nov/Dec 2007).

A coach is not a licensed professional psychiatrist, counselor, financial advisor, doctor, health professional, business expert or the like. 

A coach is not qualified to diagnose any medical condition or provide psychological counseling, behavioral counseling or psychotherapy/psychoanalysis.

Risks and Benefits of Coaching

Coaching is a process in which the Coach and Client discuss a myriad of issues, events, and experiences for the purpose of creating positive change so the Client can experience his/her life more fully.

There are a number of benefits from participating in coaching sessions. Coach can provide support, problem-solving skills, and enhanced coping strategies for presenting issues and goals.

Simply put: It is often helpful to have someone on the "outside" looking in. Coaching can provide a fresh perspective on a difficult problem or goal or point you in the direction of a solution. The benefits you obtain from coaching depend on how well you use the process and put into practice what you learn.

Participating in coaching may also involve some discomfort, including remembering and discussing unpleasant events, feelings, and experiences. The process may evoke strong feelings of sadness, anger, fear, etc.

There may be times in which Coach will challenge the Client’s perceptions and assumptions, and offer different perspectives. The issues presented by the Client may result in unintended outcomes, including changes in personal relationships.

The client should be aware that any decision on the status of his/her personal relationships is the responsibility of the Client.

Personal growth and change may be easy at times but may also be slow and frustrating. The client is encouraged to address any concerns he/she has regarding his/her progress in coaching sessions with the Coach.

Confidentiality

Since Washington law does not recognize Coaching as a regulated profession and, thus, there are no limitations on or exceptions to confidentiality, to withholding, or divulging of information from the Coach/Client relationship is solely as defined and understood by the parties involved.

Therefore, this Coach agrees to maintain confidentiality with all information disclosed by the Client.

No information disclosed by the client will be shared with a third party without written authorization by the Client, except where required or permitted by law. Exceptions to confidentiality include, but are not limited to,

• reporting child/elder/dependent adult abuse,

• when the client is a serious threat of violence towards a reasonably identifiable victim,

• or when a client is a danger to him/herself.

Should the client become involved in litigation, information revealed by the client could be discoverable, as there is no Coach/client privilege in Washington.

Coaching via Email/Telephone/Skype/FaceTime

Coach often conducts sessions via telephone and videoconference. This includes consultation, coaching, transfer of data, and education via interactive audio, video, or data communications. Such practices will be conducted with the same agreement of confidentiality as established in previous paragraphs (Confidentiality).

At times, the transmission could be disrupted or distorted due to technical failures or the transmission of information could be intercepted/interrupted/accessed by unauthorized persons. The client should discuss any concerns regarding the risks and benefits of telemedicine with the Coach.

Record-Keeping

Coach may take notes during the session and will produce other notes and records regarding the Client’s sessions. These notes constitute Coach’s business records and are the sole property of Coach.

Client Litigation

Coach will not voluntarily participate in any litigation, or custody dispute in which Client and another individual, or entity, are parties. Coach has a policy of not communicating with Client’s attorney and will generally not write or sign letters, reports, declarations, or affidavits to be used in Client’s legal matter. Coach will generally not provide records or testimony unless compelled to do so. Should Coach be subpoenaed, or ordered by a court of law, to appear as a witness in an action involving Client, Client agrees to reimburse Coach for any time spent for preparation, travel, or other time in which Coach has made herself available for such an appearance at an hourly rate of $200 an hour.

Fee and Fee Arrangements

The usual and customary fee for service is $149 per month for 4 sessions per month.

Coach reserves the right to periodically adjust this fee and will notify the Client in advance. The agreed fee between Coach and Client is $149/month.

Coach will provide an invoice prior to the first appointment and payments will continue automatically each month until cancelled.

Cancellation notice can be left on Coach’s voicemail or via email.

Coach accepts cash, credit cards, and PayPal.

Coach’s Availability

Coach’s voicemail is confidential. Coach will make every effort to call Client back within one business day. Coach is unable to provide 24-hour crisis service. In the event the Client is feeling unsafe or requires immediate medical or psychiatric attention, he/she should call 911 or go to the nearest emergency room.

Termination of Relationship

Coach reserves the right to terminate the business relationship at her discretion. Reasons for termination include, but are not limited to,

• untimely payment of fees,

• failure to comply with homework and tasks,

• and conflicts of interest.

The client has the right to terminate the business relationship at his/her discretion.

Coach will attempt to provide a smooth transition to another opportunity and provide necessary referrals to client.

Acknowledgment

By signing below, Client acknowledges that he/she has reviewed and fully understands the terms and conditions of this Agreement.

Client has discussed such terms and conditions with Coach and has had any questions with regard to the terms and conditions of the Agreement and consents to participate in coaching answered.

Client agrees to hold Coach free and harmless from any claims, demands, or suits for damages from any injury or complications whatsoever, save negligence, that may result from coaching.

I understand that I am financially responsible to Coach for all charges, including unpaid charges by my insurance company or any other third-party payor.