Informed Consent in Psychotherapy

Informed Consent is probably one single important aspect of therapy that could set up the entire therapy process either for success or for failure from the get go and could either increase or decrease the risk of harm to a client. Both the therapist and the client are best protected when client is well-informed about a particular way in which the therapist works. Disclosing the therapist’s professional policies, methods and a general approach to work at the onset of therapy helps to decrease the risk of harm related to unrealistic expectations on the client’s part.

Most importantly, obtaining clients’ informed consent before therapy begins is one of therapists’ ethical obligations. The consent may be obtained either in writing or verbally (the rules are different in different jurisdictions), but many therapists prefer to have it documented and signed by clients to ensure that both parties are clear about the business policies, the methods, the conditions and the parameters of therapy.

As a client a.k.a consumer, you have to read the informed consent document carefully and to make sure you completely understand it, just as you would read and try to understand a contract with any service provider. Do not sign the consent until you believe that the therapist has answered all your questions to your satisfaction and that you have enough clarity about the therapy process to start it.

There may be no direct connection between the quality of service the therapist provides and how well they inform prospective clients about therapy process, but I believe that therapists who are transparent about how they practice and who willingly engage in discussing their policies, professional training, work philosophy, theoretical background and anything related to the work they do are those who are less likely to engage in unethical behavior.

The minimum amount of information to look for when you read the informed consent is the following:

  • The therapist’s business policies in regards to payments, appointment cancellations, the length and the frequency of sessions, vacations, therapy termination;
  • An explanation of how therapy works in general and how the therapist works in particular, the therapist’s approach to work, the methods he or she uses and what those methods are based on;
  • A disclosure of therapy’s limitations and the types of risks therapy could involve and the types of benefits therapy could bring;
  • A disclosure of the limits of the therapist’s competence, experience and scope of issues the therapist is able to work on;
  • Information about alternatives to the type of therapy the therapist provides and alternatives to therapy in general;
  • A disclosure about the limits of confidentiality that are imposed on the therapist by the laws of the jurisdiction in which the therapist practices.

There might be other important information you, as a consumer, would like to know in addition to what’s outlined above. You have the right to ask the therapist any question that pertains to their professional training, experience and the way they work and you should feel that your questions are welcome. If the therapist doesn’t seem to welcome your curiosity and resists giving you answers, do yourself a favor and move on to interviewing the next candidate for the job. You don’t want to get stuck with the therapist who doesn’t believe in informing clients about the nuts and bolts of their practice.

The most important thing to keep in mind when “shopping” for a therapist is that therapy is a collaborative work, which means that there has to be a mutually understood and agreed upon contract between you and the therapist about how the work will be conducted. The informed consent is essentially a representation of that contract you need to have before the work starts. This may not be enough to keep therapy on the right track but it certainly reduces the chance that you will get stuck with something you never wanted to sign up for.


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