Consultation Agreement Co-Creation

A structured, collaborative dialogue to jointly define roles, rights, boundaries, and logistics of the therapeutic relationship—used at intake or early engagement to build alliance and clarify expectations.

Prompt

Initiate a clear, non-authoritarian conversation inviting the client to review and co-sign (or verbally affirm) core responsibilities: attendance, disclosure, confidentiality limits, fee/time logistics, and mutual rights. Use plain language; pause for questions; explicitly name exceptions to confidentiality (e.g., harm risk). Anchor each point in shared goals—not rules.

Objective

establish transparent working alliance and informed consent framework

Applicable Signals

• client asks 'What will we do?', 'How long is this?', 'Do you tell anyone else?', 'Can I stop anytime?'
• client appears hesitant, withdrawn, or overly compliant during intake

Contraindications

• client is mandated and refuses collaboration
• imminent safety escalation requires immediate action over discussion

Intervention Moves

• collaborative framing
• plain-language translation
• invitation to question
• verbal summarization check

Workflow Steps

• 1. Introduce purpose: 'To make sure we’re both clear and comfortable, let’s walk through how we’ll work together.'
• 2. Review 3–5 core items: attendance/rescheduling, openness in session, confidentiality + its limits, session length/frequency, rights to pause or end.
• 3. Invite client input: 'Is anything unclear? Is there something important to you that we haven’t covered?'
• 4. Confirm verbal or written affirmation: 'Does this match your understanding? Would you like to say it back in your own words?'

Constraints

• Must occur before clinical intervention begins
• Confidentiality limits must be explicitly named—not implied
• Client must have opportunity to ask questions and negotiate wording where appropriate

Cautions

• Avoid jargon like 'informed consent' without explanation
• Do not present agreement as static contract—frame as living framework open to revisiting

Output Contract

• Both parties sign or verbally affirm shared understanding of ≥3 core responsibilities (e.g., attendance, disclosure, confidentiality limits).

Example Therapist Responses

Example 1

• Client/Input: Client: 'I’m not sure what happens in these sessions—or if you’ll tell my parents.'
• Therapist/Output: Therapist: 'Great question. What happens here stays private—unless there’s serious risk to you or someone else. We’ll talk more about that now, and you can decide if this feels safe enough to continue.'
• Notes: Names confidentiality limit plainly; invites choice.

Example 2

• Client/Input: Client: 'Do I have to come every week? What if I miss one?'
• Therapist/Output: Therapist: 'We usually meet weekly—but life happens. If you need to reschedule, just let me know 24 hours ahead. And if you ever feel unsure about continuing, that’s okay to talk about too.'
• Notes: Normalizes flexibility while upholding structure.

Objective

establish transparent working alliance and informed consent framework

Applicable Signals

• client asks 'What will we do?', 'How long is this?', 'Do you tell anyone else?', 'Can I stop anytime?'
• client appears hesitant, withdrawn, or overly compliant during intake

Contraindications

• client is mandated and refuses collaboration
• imminent safety escalation requires immediate action over discussion

Intervention Moves

• collaborative framing
• plain-language translation
• invitation to question
• verbal summarization check

Workflow Steps

• 1. Introduce purpose: 'To make sure we’re both clear and comfortable, let’s walk through how we’ll work together.'
• 2. Review 3–5 core items: attendance/rescheduling, openness in session, confidentiality + its limits, session length/frequency, rights to pause or end.
• 3. Invite client input: 'Is anything unclear? Is there something important to you that we haven’t covered?'
• 4. Confirm verbal or written affirmation: 'Does this match your understanding? Would you like to say it back in your own words?'

Constraints

• Must occur before clinical intervention begins
• Confidentiality limits must be explicitly named—not implied
• Client must have opportunity to ask questions and negotiate wording where appropriate

Cautions

• Avoid jargon like 'informed consent' without explanation
• Do not present agreement as static contract—frame as living framework open to revisiting

Output Contract

• Both parties sign or verbally affirm shared understanding of ≥3 core responsibilities (e.g., attendance, disclosure, confidentiality limits).

Example Therapist Responses

Example 1

• Client/Input: Client: 'I’m not sure what happens in these sessions—or if you’ll tell my parents.'
• Therapist/Output: Therapist: 'Great question. What happens here stays private—unless there’s serious risk to you or someone else. We’ll talk more about that now, and you can decide if this feels safe enough to continue.'
• Notes: Names confidentiality limit plainly; invites choice.

Example 2

• Client/Input: Client: 'Do I have to come every week? What if I miss one?'
• Therapist/Output: Therapist: 'We usually meet weekly—but life happens. If you need to reschedule, just let me know 24 hours ahead. And if you ever feel unsure about continuing, that’s okay to talk about too.'
• Notes: Normalizes flexibility while upholding structure.

Files

• references/evidence.md

• references/evidence_manifest.json

Triggers

• beginning of first session or after major rupture
• client expresses uncertainty about process or boundaries

Examples

Example 1

Input:

Client: 'I’m not sure what happens in these sessions—or if you’ll tell my parents.'

Output:

Therapist: 'Great question. What happens here stays private—unless there’s serious risk to you or someone else. We’ll talk more about that now, and you can decide if this feels safe enough to continue.'

Notes:

Names confidentiality limit plainly; invites choice.

Example 2

Input:

Client: 'Do I have to come every week? What if I miss one?'

Output:

Therapist: 'We usually meet weekly—but life happens. If you need to reschedule, just let me know 24 hours ahead. And if you ever feel unsure about continuing, that’s okay to talk about too.'

Notes:

Normalizes flexibility while upholding structure.