Informed Consent for Treatment and Consultation

What follows is a statement all students are asked to read and sign when they first come to the Counseling and Career Center. The statement details how we many many aspects of our services, including confidentiality, risks and benefits of counseling, eligibility and appropriateness for services, referrals, consultation and supervision, audio and videotaping, scheduling and missed appointments, and email communications.
 

UM Counseling & Career Center

INFORMED CONSENT FOR COUNSELING SERVICES

The Counseling and Career Center offers free and confidential short term services to all currently enrolled, degree-seeking UM students as well as UM faculty and staff. Services are provided based on the urgency of the concern and appointment/treatment availability.
 

Confidentiality. Federal and state laws along with professional and ethical standards prohibit the disclosure of any information you provide us unless we have your prior written consent. Thus, if a UM official or your parents or anyone else inquires about your receiving services here, we would not be able to disclose any information about you without your written permission. Even so, there are a few exceptions to the laws and standards of confidentiality wherein your counselor is legally obligated to inform proper authorities as well as others in some situations. The limitations to confidentiality are as follows:

• If you provide information indicating abuse of a child or dependent adult.
• If your counselor is court ordered to disclose information about you.
• If your counselor believes you or someone else identified needs protection from serious and foreseeable harm.
   

In the event you become potentially dangerous to yourself or someone else, please indicate an emergency contact:

Name__________________________  Relationship_____________ Phone_________________

Risks and Benefits of Counseling. Research indicates that most people who engage in counseling benefit from the experience; even so, it's possible for things to get worse before they get better. Counseling may involve the risk of remembering unpleasant events and may arouse strong emotional feelings. Counseling can impact relationships with significant others. The benefits from counseling may be an improved ability to relate with others; a clearer understanding of self, values, goals, increased academic productivity; and an ability to deal with everyday stresses. Taking personal responsibility for working with these issues may lead to personal growth.

Eligibility and Appropriateness for Services. Eligibility for services is contingent upon a student remaining currently enrolled and degree seeking. The Counseling and Career Center staff will decide on appropriateness and delivery of services, which is contingent upon the conditions and needs presented. No student suspected to be currently under the influence of alcohol or drugs will be seen.

Referrals and Termination. Should services outside the scope of the Counseling and Career Center be needed, a referral to a more appropriate resource will be given to better meet your needs and goals. Clients have the right to terminate the counseling relationship at any point during the process.

Consultation and Supervision. In order to provide you with the best services possible, your counselor may choose to consult with other Counseling and Career Center staff members or other specialists. In addition, graduate level interns providing counseling services are supervised by a licensed counselor or a team that includes a licensed counselor. Colleagues who provide consultation and/or supervision are subject to the same confidentiality restraints as your counselor. In an attempt to provide the best possible client service, the counseling supervisor has the capacity to observe intern sessions live and, if necessary, to provide immediate supervisory intervention.

Audio and Videotaping. Counseling sessions may be audio or videotaped for the purposes of staff training or clinical supervision. These tapes are treated confidentially and are erased after use. Any concerns about taping can be discussed with your counselor. Taping will never occur without your consent.

Email Communications. The Counseling and Career Center cannot ensure your email communications are confidential, are received, or are addressed in a timely manner. You are encouraged to visit the Counseling and Career Center or call 665-6262 if you have routine or urgent needs.