Privacy and Use of Information
Protection of Privacy
The information provided in the intake form and other feedback forms that may be used in the course of providing therapy, and information received while in therapy and after completing therapy at Aulneau Renewal Centre will be protected and kept in confidence by Aulneau Renewal Centre Centre.
Any information provided in any administrative function, will be compiled anonymously with others, so that individuals will not be identified or known by anyone reading the data.
More specifically, the information will be used to:
- Process the request for therapy
- Assist the therapist in providing services
- Enhancing outcome measures for funding and reports
The privacy of all personal information will be protected, as outlined by the Personal Health Information Act (PHIA).
Terms of Engagement between Aulneau Renewal Centre And the Client(s):
Aulneau Renewal Centre is committed to working in the best interest of the client. When the client is a child whose parents have separated or divorced, the focus will always be directed towards the needs of the child.
Given the emotional/stressful nature of the separation/divorce process, one or both parents may feel the need to process their own issues or concerns about the other parent. However, to avoid drawing the focus from the child’s need, no time will be spent addressing the parents’ issues/concerns. The counsellor assigned to the child, may encourage parent(s) to seek out their own individual counselling.
This document confirms the following:
- That you have requested/consented to counselling and therapeutic services
- That you are prepared and committed to allow the Aulneau Renewal Centre to work alongside your child(ren) through any personal struggles and challenges they may face
- That you have advised us that you have completed court proceedings regarding separation/divorce and that no time will be spent discussing issues related to the past court proceedings;
- That you have been advised that we are prepared to provide the counselling and therapeutic services within our mandate;
- That you are prepared to take responsibility for bringing your child(ren) to their scheduled counselling sessions (during periods of care and control)
- That you have been advised and that you have agreed to fund the services as discussed with the intake worker
- That neither party shall make derogatory comments about the other while the child(ren) is/are present; and
- That you have agreed that these services are provided on the condition that:
- The counselling and therapeutic services are offered in confidence, in accordance with normally accepted legal standards;
- The therapists and counsellors providing the service will not be called by either party to testify in any Court Proceedings against the other.
- The therapists and counsellors providing the service will not provide reports for any court purpose or to any third party.
Electronic Communication Consent
For many people, electronic communication is an important part of life. This includes – but is not limited to – cell phones, texting, email, social media, and video chatting, as well as any other form of electronic communication. At Aulneau Renewal Centre, we want to make sure that we meet the needs of our clientele, and take cautionary means about privacy.
Occasionally, counselling staff at Aulneau Renewal Centre may use electronic communication to arrange, cancel/confirm appointments, or provide clients with information about upcoming events or services (this includes workshop information sent through Constant Contact or Schedulicity). Staff and Therapists will not be able to contact you without your permission.
If you wish to contact us using electronic communications, please know that:
- We cannot guarantee the absolute privacy of electronic communication
- Email, cell phones, and other electronic means are not 100% secure or confidential
- Our scheduling program (Schedulicity) is web-based, and will send out email confirmations and reminders around scheduled appointments
- Electronic communication between client and therapist at Aulneau Renewal Centre may become part of the client file
- You can revoke your consent without penalty at any time.
Aulneau Renewal Centre Supervision and Recording Permission
I (we) understand that my (our) therapist will discuss my (our) therapy interviews with his/her clinical supervisor and/or therapy team, that information provided about myself (ourselves) will be handled professionally and confidentially, and that these discussions will be for my (our) benefit.
I (we) understand that during Modified Interaction Guidance therapy, my (our) therapy will be subject to direct observation. Audio and/or video footage from these recordings will be used only by my (our) therapist, and his/her supervision team, where appropriate.
Information provided to the therapist and all others associated with your file at Aulneau Renewal Centre is kept in strict confidence. Because we are mandated by our lawful obligations, in situations that meet the criteria below, the appropriate authorities will be notified. These criteria are:
1) When sexual, physical, or emotional abuse of a child is disclosed
2) When the life of a client or any other person is in danger.
Aulneau Renewal Centre’s therapists have not had experience and/or education about legal proceedings. For this reason, staff are unable to advocate on behalf of clients in court. We ask that such requests are not made of therapists.
Please note that, in the event that an client becomes involved in legal proceedings, therapeutic services will be suspended until such a time as the client is no longer involved in legal proceedings.
CONSENT TO PARTICIPATE
Counselling at the Aulneau Renewal Centre involves taking part in a process of addressing personal challenges with a professionally trained counsellor, in order to achieve more fulfilling individual lives, or couple/family relationships. This process of change will be unique to your particular situation. It will consist of clearly defining problem areas, establishing therapeutic goals, determining an intervention plan and participating in an evaluation. Successful counselling and problem resolution requires your active participation, as well as a serious commitment; therefore it should not be entered into lightly.
Prior to agreeing to this process, individuals have a right to ask the counsellor about their qualifications, background, and orientation. In addition to a qualified counsellor, the match between client and counsellor will influence the outcomes of counselling. Clients are encouraged to voice any concerns to ensure services are best suited to their, needs. To best deliver therapeutic assistance to children, individuals, couples and families we have developed certain policies and procedures. They are as follows:
- APPOINTMENT SCHEDULING: Clients are asked to attend each session as scheduled. The sessions are 50 minutes in length. Should it become necessary to cancel an appointment, we require a minimum of 24 hours’ notice; otherwise there will be a regular session amount charged to the client account. Please note that after two consecutive cancellations, the file will be reviewed and either closed, or placed back onto the waitlist. The sliding scale program is based on a maximum of 12 sessions.
- CONFIDENTIALITY: According to professional ethics and federal and provincial laws, all counselling sessions are strictly confidential. However, there are certain limitations to confidentiality. Examples include a court ordered release of information; when a child is being harmed; or when a client is considering harming self or others. When the counselling services are being funded by Child and Family Services, Aulneau Renewal Centre counselors will on occasion share relevant information with and/or write reports for social workers, if applicable. They may also on occasion consult with each other and/or a clinical supervisor.
- STUDENT PLACEMENT- Aulneau Renewal Centre is committed to lifelong learning and is a placement site for many students. Students are supervised with mentors and receive clinical supervision. Different students have different roles. At times, you may have a student counsellor or may be asked to have a student observe. For observation purposes, therapists will ask if the client is comfortable. This may be done in person or through an observation mirror. If you have any concerns, please let your therapist know.
- CLIENT SATISFACTION: Clients are asked if Aulneau Renewal Centre is able to contact them at 6 and 12-month intervals, in order to collect anonymous feedback in regard to services received at Aulneau Renewal Centre. Participation is not mandatory.
- WRITTEN REPORTS: Fees equivalent to the session fees will be charged for the generation of any reports.
- SUPERVISION: While at the Centre children under the age of 12 must be supervised by adult; please note that children must be supervised at all times while in the waiting area. We are unable to provide supervision.
- FEES: Fees are to be paid prior to each appointment. We accept cash, cheque, Visa, MasterCard, and debit. Non-payment of two sessions can result in immediate suspension of service. If an outstanding balance exists on an account, a payment plan may be put in place where the balance cannot be paid in full. If financial circumstances change during the time you are a client with our centre, we must be informed in order to reassess fees. Please note that clients will be asked for proof of current income (Notice of Assessment), in order for us to accurately assess fees.
- TERMINATIONS: Clients have the right to terminate counselling at any time without permission or agreement. However, we encourage discussion with the counsellor so that sufficient closure can take place. Please note that, due to Aulneau’s limitations regarding legal involvement, we cannot provide services to individuals actively involved in legal proceedings. In the event that a client is found to be involved in such circumstances, services will be terminated. Once legal proceedings are completed, services can be resumed.
- CRISIS SERVICES: Emergency services are not provided by Aulneau Renewal Centre. If you are in need of immediate assistance, the following are some resources available:
• Klinic Crisis Line at 204.786.8686,
• Crisis Stabilization Centre at 204.940.1781,
• Youth Crisis Stabilization System at 204.949.4777,
- Manitoba Suicide Line at 1.877.435.7170
Confidentiality & Your Rights
Aulneau Renewal Centre respects your right to privacy and will ask only for information that is relevant to the therapy. We require your consent to obtain this information. Our policies and procedures for the collection, use, and disclosure of your personal information, conform to the Personal Health Information Act (PHIA).
The Personal Health Information Act (PHIA) provides access to information and protection of privacy rights concerning personal health information. PHIA allows individuals to examine and receive a copy of their own personal health information from a trustee holding this information. PHIA imposes obligations on trustees for the protection of personal health information, specifically its collection, use, disclosure and security.
PHIA applies to trustees who maintain (have custody or control of) personal health information. Trustees are:
- all public bodies that fall under FIPPA
- health professionals licensed or registered to provide health care or health professionals (such as doctors, nurses, physiotherapists, psychologists, etc.);
- health care facilities (such as hospitals, personal care homes, psychiatric facilities, medical clinics, laboratories, and community health centres or other health care facilities designated in the regulations)
- health services agencies providing health care under an agreement with another trustee (such as the Victorian Order of Nurses and We Care).
Personal health information is information about an identifiable individual that relates to an individual’s health and health care history including genetic information, the provision of health care to the individual, or payment for health care provided to the individual. This includes such things as your Personal Health Information Number (PHIN) assigned by Manitoba Health, as well as any identifying information collected in the course of providing health care services.
For more information about PHIA, please check the following websites:
Limits of Confidentiality
It is important that you understand the confidential nature of your relationship with your therapist. Information that you disclose about your situation will be treated as confidential. No one at Aulneau Renewal Centre will release your name, or information about you, or your counselling, to anyone outside of the agency without your informed, voluntary, and written consent, except as outlined below:
- If we obtain information which leads us to suspect that a child (18 and under) is at risk for, or has been, physically abused, sexually abused, emotionally abused, or neglected, we are legally obliged to make a report to Child and Family Services.
- If you inform us about any intent to commit an act which could result in the injury or death of you or another/others, we are legally obliged to contact the police or emergency services.
- If a counsellor has concerns that you are a danger to yourself, she/he will discuss with you any plan that they may need to take on your behalf (e.g. call a family member or family physician). However, in situations where your counsellor is unable to discuss this with you, they may need to proceed without your consent to fulfill their obligation to ensure your safety.
- If we are ordered by a court subpoena to release information to a third party, such as a lawyer, we will need to follow protocol.
- In order to ensure accountable, ethical, and effective clinical service your therapist may consult with a Clinical Consultant, and/or colleagues, for clinical consultation. Identifying information will be kept to a minimum during any such clinical consultation.
- If you are a CFS client attending therapy, CFS does ask for reports on a regular basis. This is to ensure that goals for treatment are being met and to ensure CFS to continue to support the family.
Release of Information
If you need your therapist to release information to a third party, such as a, doctor, or lawyer, you must provide us with informed, written, and voluntary consent. A form must be completed before any release of information.
Client Bill of Rights
As a client of Aulneau Renewal Centre, you have the right to…
- Refuse to attend therapy, but we ask that you inform Aulneau Renewal Centre if you no longer want to attend. If you have scheduled an appointment and do not provide 24 hours notice, you must pay for the session. However any appointments cancelled before this time frame will not result in any payment. Please advise reception or the therapist if you wish for us to close your file.
- End therapy at any time, for any reason, unless you have been mandated to attend. Again, please advise the therapist and reception that you will no longer be attending therapy.
- Decline to work with a particular therapist if you do not feel comfortable with them, or the therapist’s office.
- Request to work with a therapist of a particular gender.
- Have the content of your sessions kept strictly confidential and any exceptions to confidentiality should be explained to you before therapy
- Ask the therapist questions about their training and approach
- Refuse to answer any question the therapist asks that you are not comfortable answering
- Provide the therapist with feedback about your session
- Ask the therapist questions and/or request clarification at any point
- Have all fees and policies explained to you prior to starting the therapy process
- Be spared from questions that solely benefit the therapist, for example, if you have expertise in an area or have a particular skill set which is not related to your reasons for attending therapy
- Bring a support person with you to your sessions or to refuse another person’s attendance, if requested
- Work with a therapist that you do not know personally as it may be a conflict of interest.
- Have a therapist who respects your ethnicity, race, sexual orientation, gender identity, relationship status, age and religion
- Have therapy in a physically safe environment.
- Have professional boundaries respected; your therapist does not initiate social contact with you outside the therapist relationship at all
- Access your file. There is a process to request access to the information in your file; please make this request through the intake coordinator: email@example.com
- Not have information about you released without your signed consent
- Request information about your progress or planning around your therapy
For information about the terms of service, please contact firstname.lastname@example.org.