Parental Approval for Therapy & Safe Harbor Agreement
Parental Approval for Therapy
Due to the importance of having parents involved in and supportive of their child’s treatment, and to respect the rights of each parent, make sure to obtain the signatures of both parents and bring to the first session. If one parent no longer has parental rights or other guardianship has been established, please bring a copy of the court records indicating this to the first session. Therapy for your child will not proceed without the signatures of both parents / guardians. If parents/guardians are involved in a custody dispute or parental discord of any kind, the Safe Harbor Agreement below MUST be signed to proceed with therapy.
Safe Harbor Agreement
- Parties to this agreement: Please fill out below.
- The therapeutic goal is for children to have a place where they feel safe and are able to speak to a mental health provider without any fears, concerns or issues regarding custody and know that what they say will not be used to interfere with or create problems in their relationship with either parent.
- Safe Harbor. To make the stated goal happen, the parents acknowledge the importance of the therapist’s office being a safe harbor - a place where children can be truthfully assured that what they say will not be used in custody disagreements.
- AGREEMENT: Therefore, to create a safe harbor for the children, the parties agree to the following:
- No court/no dispositions. Neither parent shall, nor will either parent permit his or her attorney to subpoena the therapist to testify or present his/her notes at a trial, hearing, or arbitration. Child’s therapist is not a professional mediator for custodial situations. Any custody court issues will be referred to an outside professional referral source such as a parenting mediator or professional trained in custody studies.
- No interrogations. Neither parent shall, nor will either parent permit their attorney to demand answers from either the therapist or the children regarding the content of the therapy sessions.
- Testimony. Therapist will not offer any opinion regarding custody or visitation, as to do so is contrary to the competency of any Clinic for Christian Counseling therapist acting in a therapeutic role. Please Note: A judge may decide not to honor this agreement and require the therapist to be a witness.
- Disclosure. The therapy sessions between children and therapists remain confidential and the therapist will not disclose the content to either parent, attorney or Guardian Ad Litem (except required disclosures around the Child Abuse Reporting Act, or other safety concerns). This includes clinical notes. However, the therapist will provide a general summary to either parent per discussion during the informed consent process.
- Communication. Communication with one or both parents is at the discretion of the therapists at Clinic for Christian Counseling, LLC. The therapist is not obligated to share clinical information with both parents. It is up to the therapist to decide if information from the child’s therapy should be shared with one or both parents. The information will be shared with the parent in which the therapist believes needs to know the information to help the child. Treatment plan and review will be shared with both parents.
- Guardian ad Litem and other providers. Custody evaluators, parenting assessors, parenting
consultants, parenting time expeditors, and/or guardian ad litem may have access to medical records
and/or information related to the child(ren)'s therapy, as deemed appropriate by the therapy team and consistent with state law. Therapist will not make any recommendations regarding state law. - Documentation. A copy of the divorce decree or other legal documents (i.e. court orders for protection, retaining orders, custody/visitation); requested by the therapist pertaining to this children’s care shall be provided and will be kept in (minor child(ren)’s) mental health record.
- Enforcement. Any party, or his/her attorney, who seeks to interrogate or subpoena the therapist shall be liable for all attorney fees and costs incurred to resist answering discovery requests or to quash a subpoena. Therapist time will be priced at $180 per hour.
