You will be asked to confirm that you have read and understood this Informed Consent Agreement during the registration process. Please take a moment to review the terms here, and feel free to contact me before proceeding if you have any questions or concerns.
Informed Consent Agreement
IMPORTANT! The following document contains information about the professional services I provide, my business policies, and your rights as a client. Please review it carefully before proceeding
ABOUT YOUR THERAPIST
My name is Karen Lemke, and I am a Registered Psychologist in the province of Alberta (Registration #3652). I am registered with the College of Alberta Psychologists (www.cap.ab.ca). I am also a member in good standing of the Psychologists’ Association of Alberta (www.psychologistsassociation.ab.ca).
I completed a Bachelor of Arts (B.A.) in Psychology at the University of Alberta in 2006, and a Master of Arts in Counselling Psychology (M.A.C.P.) at Yorkville University in 2008. I have gained experience in a variety of mental health settings over the course of my career, including private practice, provincial and federal corrections, and forensic psychiatry.
I completed the Certificate Program in Cybercounselling, Level 1: A 12-week web-based continuing education program sponsored by the Factor-Inwentash Faculty of Social Work, the University of Toronto, and Worldwide Therapy Online Inc. in December, 2011. I completed the Certificate Program in Cybercounselling, Level 2 in December, 2012.
THERAPY APPROACH
I often incorporate elements of cognitive-behavioural and experiential therapies into my work, but generally, my approach to counselling is very person-centered and largely based on your individual needs as a client. I believe that you are the expert of your own experience and are capable of identifying the solutions that are going to work best for you. I see my role in the therapy relationship as that of a supporter and collaborator, walking beside you on your journey toward emotional health and well-being.
CONFIDENTIALITY
Confidentiality is the foundation of any client-therapist relationship, and I am ethically and legally obligated to safeguard your information and the manner in which I collect, use, and share it with others. It is important for you to know that there are some specific situations in which your confidential information may be disclosed to others without your informed, written consent. These include:
1) Where there are reasonable and probable grounds to believe that your safety or the safety of another person is at risk,
2) Where there are reasonable and probable grounds to believe that a child or vulnerable adult is in need of protection, or
3) When information is subpoenaed by a court of law for the purposes of legal proceedings.
In the case that your information has been or must be shared without your consent, you will be notified of this disclosure at the earliest possible opportunity. Disclosure will be limited only to what is necessary to be shared, and only to those who reasonably need to know.
Additionally, there are some circumstances under which I may seek professional supervision or consultation in order to provide the most effective and appropriate service. Some of your personal information may be shared in this case.
Your client records will be maintained for a minimum of 10 years, as per standards outlined by the College of Alberta Psychologists. They will be stored on a secure, encrypted server -- the same platform on which all of our secure online sessions will take place.
POTENTIAL RISKS AND BENEFITS
There are benefits and risks to engaging in any form of counselling or psychotherapy. The potential risks are considered to be relatively few, but may include the following:
Despite these risks, therapy has generally been shown to benefit those who choose to engage in it. While some uncomfortable feelings may emerge in the short term, therapy often leads to a significant long-term reduction in feelings of distress, increased satisfaction in relationships, greater personal awareness and insight, and development of more effective coping skills. Therapy will require hard work and active effort on your part, both within and outside of sessions, to be maximally beneficial.
Please feel free to bring up questions or concerns you may have at any time during the therapy process so that we can discuss them. In the case that we decide it would be best not to continue working together, I will be glad to explore other options with you, such as a referral to another mental health professional who might be more suitable to address your individual needs.
SECURITY AND ENCRYPTION
All therapeutic interactions will occur using the Hushmail.com email account you have been asked to create, ensuring full encryption and security. You can read more about Hushmail.com's encryption technology at: https://www.hushmail.com/about/technology/
Please take care to protect your email password in order to ensure that your account will not be accessed by anyone else but you.
The use of technology for therapeutic purposes presents some unique challenges and risks to client confidentiality. Some of these risks may include:
These risks are greatly reduced with the use of secure encryption software.
ONLINE THERAPY SESSIONS
I have been trained in delivering a particular type of online counselling, called therapeutic email. It is important to keep in mind that this is not a usual form of email communication. Recognize the depth and importance of our work together, and allow yourself plenty of time to read, think about, and respond to the therapeutic emails you receive. Since you would spend about an hour in my office if we were doing face-to-face therapy, I will encourage you to spend about the same amount of time composing your replies to me. Likewise, I will spend at least 50 minutes thoughtfully composing my therapeutic responses to you (with an additional 10 minutes allotted for administrative activities). This is how one "session" of online counselling will be defined.
PROFESSIONAL FEES
Fees are $150 per session, where one session is equivalent to one therapeutic email response, which takes approximately 50 minutes to compose with an additional 10 minutes allotted for administrative activities. You may also opt to purchase a package of three sessions at a discounted rate.
All payment is due in advance of receiving a therapeutic email reply and may be made via PayPal or email transfer.
For ease of reference, please note that the recommended fee schedule endorsed by the Psychologists’ Association of Alberta is currently $180 per hour for individual therapy.
NON-THERAPEUTIC CONTACT
You may contact me at any time via email (kmlemke.psych@hushmail.com) if you have specific questions or concerns of a non-therapeutic nature (e.g., administrative issues, fee payment, etc.). I will make every reasonable effort to respond to your message within 24 hours. You are encouraged to send such messages from your Hushmail.com account, as this will ensure that all communication will remain encrypted and confidential.
Please note that, given the delays associated with services of a strictly online nature, I cannot provide crisis counselling; nor can I guarantee I will be available at all times to respond to urgent messages. If you are currently in crisis, please contact your nearest emergency department or a Crisis Intervention Hotline in your area (links can be found on my website at kmlcounselling.com).
YOUR RIGHTS AS A CLIENT
FORMAL COMPLAINTS
You have the right to recourse if you feel that your psychologist has not properly fulfilled his or her professional and ethical obligations to you. The College of Alberta Psychologists encourages you to discuss your concerns directly with your psychologist. Often, misunderstandings can be corrected and better ways of working together can be found. If you are unable to resolve your concerns with your psychologist, you can contact the College of Alberta Psychologists directly. Staff can review your concerns with you and determine if some way can be found to resolve them. You may also file a formal complaint.
The College of Alberta Psychologists
#2100, 10123 - 99 Street
Edmonton AB T5J 3H1
Phone: 780-424-5070 / Toll-Free: 1-800-659-0857
E-mail: psych@cap.ab.ca
Website: www.cap.ab.ca
If you are dissatisfied with the therapy you are receiving, I hope that you will feel comfortable talking with me about your concerns so that we can work together to resolve them. Your concerns will be taken seriously and handled with the utmost care and respect.
ABOUT YOUR THERAPIST
My name is Karen Lemke, and I am a Registered Psychologist in the province of Alberta (Registration #3652). I am registered with the College of Alberta Psychologists (www.cap.ab.ca). I am also a member in good standing of the Psychologists’ Association of Alberta (www.psychologistsassociation.ab.ca).
I completed a Bachelor of Arts (B.A.) in Psychology at the University of Alberta in 2006, and a Master of Arts in Counselling Psychology (M.A.C.P.) at Yorkville University in 2008. I have gained experience in a variety of mental health settings over the course of my career, including private practice, provincial and federal corrections, and forensic psychiatry.
I completed the Certificate Program in Cybercounselling, Level 1: A 12-week web-based continuing education program sponsored by the Factor-Inwentash Faculty of Social Work, the University of Toronto, and Worldwide Therapy Online Inc. in December, 2011. I completed the Certificate Program in Cybercounselling, Level 2 in December, 2012.
THERAPY APPROACH
I often incorporate elements of cognitive-behavioural and experiential therapies into my work, but generally, my approach to counselling is very person-centered and largely based on your individual needs as a client. I believe that you are the expert of your own experience and are capable of identifying the solutions that are going to work best for you. I see my role in the therapy relationship as that of a supporter and collaborator, walking beside you on your journey toward emotional health and well-being.
CONFIDENTIALITY
Confidentiality is the foundation of any client-therapist relationship, and I am ethically and legally obligated to safeguard your information and the manner in which I collect, use, and share it with others. It is important for you to know that there are some specific situations in which your confidential information may be disclosed to others without your informed, written consent. These include:
1) Where there are reasonable and probable grounds to believe that your safety or the safety of another person is at risk,
2) Where there are reasonable and probable grounds to believe that a child or vulnerable adult is in need of protection, or
3) When information is subpoenaed by a court of law for the purposes of legal proceedings.
In the case that your information has been or must be shared without your consent, you will be notified of this disclosure at the earliest possible opportunity. Disclosure will be limited only to what is necessary to be shared, and only to those who reasonably need to know.
Additionally, there are some circumstances under which I may seek professional supervision or consultation in order to provide the most effective and appropriate service. Some of your personal information may be shared in this case.
Your client records will be maintained for a minimum of 10 years, as per standards outlined by the College of Alberta Psychologists. They will be stored on a secure, encrypted server -- the same platform on which all of our secure online sessions will take place.
POTENTIAL RISKS AND BENEFITS
There are benefits and risks to engaging in any form of counselling or psychotherapy. The potential risks are considered to be relatively few, but may include the following:
- You may experience uncomfortable feelings, such as sadness, guilt, fear, anxiety, frustration, anger, or loneliness, because the process of therapy often explores some of the more difficult aspects of your life.
- You may find yourself recalling unpleasant memories either during or in between sessions, which is a normal part of the therapy process.
- Your relationships with the people closest to you may begin to change, as you begin to learn more about yourself and find new ways of coping and problem solving.
- You may find therapy is simply not a good fit for you.
Despite these risks, therapy has generally been shown to benefit those who choose to engage in it. While some uncomfortable feelings may emerge in the short term, therapy often leads to a significant long-term reduction in feelings of distress, increased satisfaction in relationships, greater personal awareness and insight, and development of more effective coping skills. Therapy will require hard work and active effort on your part, both within and outside of sessions, to be maximally beneficial.
Please feel free to bring up questions or concerns you may have at any time during the therapy process so that we can discuss them. In the case that we decide it would be best not to continue working together, I will be glad to explore other options with you, such as a referral to another mental health professional who might be more suitable to address your individual needs.
SECURITY AND ENCRYPTION
All therapeutic interactions will occur using the Hushmail.com email account you have been asked to create, ensuring full encryption and security. You can read more about Hushmail.com's encryption technology at: https://www.hushmail.com/about/technology/
Please take care to protect your email password in order to ensure that your account will not be accessed by anyone else but you.
The use of technology for therapeutic purposes presents some unique challenges and risks to client confidentiality. Some of these risks may include:
- The possibility that messages may not be received,
- The possibility that messages sent via email may be permanently recorded on certain servers, and
- The possibility that confidentiality may be breached by unauthorized monitoring or interception of messages sent.
These risks are greatly reduced with the use of secure encryption software.
ONLINE THERAPY SESSIONS
I have been trained in delivering a particular type of online counselling, called therapeutic email. It is important to keep in mind that this is not a usual form of email communication. Recognize the depth and importance of our work together, and allow yourself plenty of time to read, think about, and respond to the therapeutic emails you receive. Since you would spend about an hour in my office if we were doing face-to-face therapy, I will encourage you to spend about the same amount of time composing your replies to me. Likewise, I will spend at least 50 minutes thoughtfully composing my therapeutic responses to you (with an additional 10 minutes allotted for administrative activities). This is how one "session" of online counselling will be defined.
PROFESSIONAL FEES
Fees are $150 per session, where one session is equivalent to one therapeutic email response, which takes approximately 50 minutes to compose with an additional 10 minutes allotted for administrative activities. You may also opt to purchase a package of three sessions at a discounted rate.
All payment is due in advance of receiving a therapeutic email reply and may be made via PayPal or email transfer.
For ease of reference, please note that the recommended fee schedule endorsed by the Psychologists’ Association of Alberta is currently $180 per hour for individual therapy.
NON-THERAPEUTIC CONTACT
You may contact me at any time via email (kmlemke.psych@hushmail.com) if you have specific questions or concerns of a non-therapeutic nature (e.g., administrative issues, fee payment, etc.). I will make every reasonable effort to respond to your message within 24 hours. You are encouraged to send such messages from your Hushmail.com account, as this will ensure that all communication will remain encrypted and confidential.
Please note that, given the delays associated with services of a strictly online nature, I cannot provide crisis counselling; nor can I guarantee I will be available at all times to respond to urgent messages. If you are currently in crisis, please contact your nearest emergency department or a Crisis Intervention Hotline in your area (links can be found on my website at kmlcounselling.com).
YOUR RIGHTS AS A CLIENT
- You are free to withdraw your consent and terminate therapy at any time, without obligation to your psychologist.
- You have the right to considerate, safe, and respectful care.
- You have the right to ask questions about any aspect of your treatment or about your psychologist's specific training and experience.
- You have the right to expect that your psychologist will maintain a professional relationship with you at all times, and that he or she will avoid all other forms of interaction that could compromise this professional relationship, including friendship, romantic or sexual relationships, business or financial relationships, and collegial or student relationships.
FORMAL COMPLAINTS
You have the right to recourse if you feel that your psychologist has not properly fulfilled his or her professional and ethical obligations to you. The College of Alberta Psychologists encourages you to discuss your concerns directly with your psychologist. Often, misunderstandings can be corrected and better ways of working together can be found. If you are unable to resolve your concerns with your psychologist, you can contact the College of Alberta Psychologists directly. Staff can review your concerns with you and determine if some way can be found to resolve them. You may also file a formal complaint.
The College of Alberta Psychologists
#2100, 10123 - 99 Street
Edmonton AB T5J 3H1
Phone: 780-424-5070 / Toll-Free: 1-800-659-0857
E-mail: psych@cap.ab.ca
Website: www.cap.ab.ca
If you are dissatisfied with the therapy you are receiving, I hope that you will feel comfortable talking with me about your concerns so that we can work together to resolve them. Your concerns will be taken seriously and handled with the utmost care and respect.
