Counselling Process

Counselling Process

Before You Begin Your Work With Clients…

If you are starting your practicum by practicing the CBT or Healthy Relationships Coaching Programs with a peer, here are a few guidelines for this practice:

  • Each intern already has an owl “client” account under their supervisor. When you begin practicing with a peer please email Haleema to assign the client intern file to you. Please do not create a new client file for your peer.
  • Once you are done practicing, please let Haleema know so you can be removed from your peer’s client file
  • It is your responsibility as a counsellor to respect the privacy of your peer and to not access any files or notes in their client files other than the notes you recorded (please see the FAQ titled ‘I share a client file with another counsellor, what are my ethical responsibilities?’ on the FAQ page of our website for a detailed description of your responsibilities).
  • When practicing with a peer, make sure you schedule sessions, and record notes for each of the coaching sessions (as you would with any other client).

*Note: If you are seeing a client who also happens to be an intern at MFFS, you would create a client file as usual, these guidelines do not apply in this case.

Contacting Client for Intake

*How many times should you attempt to contact a client to do an intake (and to schedule a first session as the counsellor)?

If the client has an answering machine:

  • Leave one message with very basic details (in case someone else will hear the message), for example: “Hello my name is  (your name) I am calling from Moving Forward for (Name of client), please call me back at (your phone number).
  • Make another attempt to call a few days later, but you do not need to leave another message.
  • Make sure to record each attempt to contact in the ‘non session notes’ section of the client’s file
  • If the client never responds to attempts, you can then set the client file to ‘inactive’

If the client provides an email address and a phone number:

  • You can leave a voice mail (see above example)
  • The next step would simply be to send an email.
  • Make sure to record each attempt to contact in the ‘non session notes’ section of the client’s file
  • If the client never responds to attempts, you can then set the client file to ‘inactive’

If the client doesn’t have an answering machine:

  • Make 2-3 attempts, a few days apart. Make sure to record your attempts on the ‘non session notes’ tab of the client’s file
  • If the client never answers the phone, make sure you have recorded your attempts to contact the client in the ‘non session notes’ section of the client’s file and then set the client file to ‘inactive’

Intake Process

Self-Referral/Referral Received: Intake is done through the Hushmail form process or the phone/ text process (see document above for detailed review of the two intake processes), depending on how the client contacted Moving Forward.

Client Assignment: Gary will pass clients along – through another email – counsellor@movingforwardfamilyservices.com and an encrypted program (meets protection of personal info regulations) called hushmail (which allows for secure sharing of client info).

Gary will ask if you want the client, and then you would reply back to let him know if you’d like to take it on or not (if you don’t think it would be a good fit, or you feel the presenting issues are beyond your capacity) – please reply within 24 hours to that email.  

  • If submitting information (i.e. client transfer form) to Gary and/or Intake Manager use this link: https://hushforms.com/counsellor
  • If submitting information that contains client information via regular email to your supervisor or peer, please password protect the document: How To Password Protect Word and PDF Documents.
  • You can also sign up for a free protonmail email (visit their website to learn more about this option)

Once you confirm you will be taking the client on, you will then go ahead and create a client file on owl and enter the information from the intake form to owl (you would not hear from supervisor unless there are any additional instructions required – so proceed with contacting client and creating file once you’ve accepted client). For guidance please see this document How to create a client file on owl or  watch the video demonstrations on our owl orientation page: How to create a client file on owl  and how to create a client portal

Once  the client file is created please make sure to upload the intake document to the client file on owl. If you cannot upload it as a document, please copy and paste the information from the intake document to a non-session note.

Call and schedule the initial session with the client (make sure to also schedule it on owl)

Email consent to services and cancelation/no show policy form either using these forms or send directly through OWL (see detailed review of how to send consent form through OWL in the document below titled ‘Moving Forward Consenting Process for Online Services’ or watch the demonstration on the owl orientation page).

During the first session with the client you will:

  • Review and sign consent form
  • Collect their exact physical address, their date of birth*, and their gender identity**
  • Other information to be collected:
  • Emergency contact (if they have one)
  • Whether they would like automatic email/text reminders
  • If required, review risk assessment form

Receiving a Transferred Client File

Some counsellors like reviewing notes from a previous counsellor when they start their work with a transferred client. Other counsellors prefer to start “fresh” with the client without any preconceived ideas. Both are okay! But before you review notes please keep in mind:

  • If you begin work with a client who was transferred to you from another intern, you would review the transfer form to confirm that the client is ok with you reviewing their previous notes.
  • If the transfer form does that indicate whether the client consented to your review or not, please do not review their previous notes until you speak with the client to schedule their first session, at which point you can ask them if they would be ok with you reviewing their notes.
  • If the client does not want you to review the notes, you would respect their wishes
  • If a client wants you to review their notes even though you don’t generally like to do so, please also respect their wishes as they may not want to repeat certain things they have previously shared.
  • That being said, if you feel comfortable, you are welcome to explain to the client the reason why you would rather not review their notes (at least until after the first session or at all).

Consenting Process

Moving Forward Consenting Process for Online Services

Couples Consent Process

MFFS Consent for Online Services (word doc)

Cancellations & No-shows Policy

How to to discuss recording sessions with clients

Important note to discuss during consent (when relevant)

MFFS Single parent consent


Services for children 12 years of age and under require consent from any and all legal guardians.


In cases where parents are separated or divorced, court rulings regarding custody or guardianship may limit the rights of one parent to take a child to see a counsellor without the consent of the other.


In completing this referral, you are agreeing that you either have the agreement of the other parent to bring your child to therapy or that you have the legal right to bring your child for therapy without the other parent’s consent.


Please note:

  • We will not put the child(ren) in positions where they feel they have to speak out against one of their caregivers.
  • We do not provide assessments for Family Court
  • We will not provide letters that are critical of the other caregiver’s parenting.
  • By submitting this referral request for counselling for a child, you understand and accept the above information and confirm that you are legally entitled to provide consent for child therapy.

Responsibilities in Relation to Client Payment and Invoicing

You are required to  have a conversation around payment and payment option with your client at the start of your counselling work together. If the client is paying:

  • Make sure they know what are the ways they can make a payment
  • Ask clients to forward you the automatic e-transfer deposit confirmation after each transaction.
  • Send clients an invoice at the frequency you agreed on (after every session, every two or three sessions)
  • Once you receive the confirmation you will then go to their client file and record the payment (see video tutorial on the ‘owl orientation page’)
  • Recording payment will automatically generate a receipt of payment which you can then send to the client.
  • If a client does not send you payment confirmations, please gently remind them as they may have just forgotten to do so. An example of how you can word it: “Just remember to forward me the etransfer confirmations so I can record your payment on the system and issue a receipt”.
  • If a client continuously doesn’t send you the confirmations, you can email Gary to inquire if he has received any e transfers from the client (please use client owl id number not their name!!). If the client is expected to pay and has not been making payment, you might need to have another conversation with them about payment.

Session Overview and Suggested Guideline

REMINDER: Create OWL file as soon as you accept a client


Once you accept a client, you need to create a file – even if efforts to follow up with client have been unsuccessful, or client ultimately declines services — that way we (supervisors) know it has been followed up on, and any efforts to contact are documented under non clinical session notes. Quite often clients claim no one has contacted them, when in fact someone has (in some cases I think they are being outright dishonest but in my experience it is often the case that they are so depressed/stressed/unwell that it doesn’t register for them that someone had in fact contacted them) – so we need that documentation to determine what took place.

Contacting client for the first time

While email is acceptable, it should not be the only form of contact made (unless the client has requested that contact only be made by email). Initial contact by emails should be followed up within 1-2 days if the client has not responded.

If emailing client here is a suggested script:

My name is _____. I am a counselling intern at Moving Forward Family Services. I received your request for services/intake form from my supervisor. Please let me know of some dates/times that would be convenient to connect for an initial appointment.

Sincerely,

_____

Counselling Intern, Moving Forward Family Services

your email

your phone contact  

Session 1

Please make sure to use this form to guide you through the information you are required to discuss with the client: First session checklist. Once you completed the items on this checklist, please upload the completed form to the client’s file on owl

When taking case notes:

Imagine that your client is standing over one shoulder, looking over what you are writing; imagine that a family court or criminal court judge / lawyer is looking over the other shoulder at what you are writing.

Would they be upset/confused/question what you have written? Would they take what you have written and interpret it in a manner you never intended? Consider these perspectives before writing the note.

Session 2

Pre-session assessments for anxiety and depression (can use these forms even if client presenting issues are not anxiety/depression): burns_anxiety_assessment / burns_depression_assessment

Session 3
  • SMART goals formulation: SMART Goals
  • Session rating scale: Session-Rating-Scale (with numbers – if counsellor doing it over phone/online), Session-Rating-Scale (without numbers – if in person client can complete it themselves)
  • Discuss other options for client (group programs, other programs in community)  see ‘Benefits of Group Programs’ (note only discuss group option if client is stable enough to attend a group)Benefits of Group Programs

Session 2-4

Community Resource Form

Every counsellor at this agency is required to discuss with their clients the additional supports offered in the community. This form is required to be completed within the first few sessions of therapy. These resources can be also be found on our website at movingforward.help;  counsellor can also be direct clients to additional resources not listed on our website if they are able to. The purpose of this exercise is to ensure clients are not simply relying on you as their only resource – part of counselling entails assisting clients in finding other resources within their communities to access. You should not have to shoulder the weight of all your clients needs alone

Second-to-last Session

Post-session assessments for anxiety and depression

Discharge report – completed after second-to-last session and reviewed with client in final session. Discharge-or-Transition-Report (pdf) Discharge-or-Transition-Report (word)

Final Session
  • Share discharge report with client
  • Provide client with feedback form: client feedback

*For guidance on what to do with a client file after the end of therapy, see ‘What do I do with a client file on owl once the client has moved on from counselling’ on the FAQ page.

12-Session Summary

This form is mandatory for any clients who have attended for 12 sessions. While the agency advocates for longer-term therapy, we also need to ensure that clients who have had 12 sessions are still actively engaged and have clinical goals they are still working on. We also need to ensure new clients are being supported in a timely fashion and therefore must balance their needs with the needs of clients who have already had a substantial amount of service. This is also a time that anyone who has been receiving free services needs to be switched to ‘pay what you can’  

This form is to be submitted to Gary via ‘hushmail’ and a copy would also be included in client file.

12 session file review (1)

Closing Client Files and Transferring Files at the End of Your Practicum

For all clients please fill out this form at the end of your work with them and upload it to their owl client file: Discharge/ Transfer form

For clients who are ending counselling and will not be transferred to another counsellor- you would simply fill the discharge form, upload it to their client file on owl, and mark their file as inactive.

For  who wish to transfer to another intern you would fill the form, and send it to Gary via the hushmail link: https://hushforms.com/counsellor

** Please also ensure that any client who received free services is advised that continued services would be under ‘pay what you can’.

End of Practicum CheckList

Session Notes

See this BCACC document for standard of session notes content:

After you record your session notes on OWL, please ensure you sign the note, and do not modify the notes once they are complete and signed. To sign the session notes though OWL: In the note window, click on the ‘sign’ button on the left tool bar. This will add  your name and date and time stamp to the note.

Read this article for an example of how one therapist begins and ends their counselling session: How I Begin and End a Counselling Session

Also please review these short videos on case notes:

And this video about theory vs. Techniques

What is Informed Consent?

 

Informed consent is a document that therapists use to make sure that their clients understand what therapy is about, and what their rights are.

·      It is the therapist’s responsibility to make sure that the client fully understands the information in the document before they sign it.

Informed consent describes the purpose of counselling, the benefits, and the possible risks.

·      Benefits could include:

o  Gaining new skills.

o  Changing unwanted behaviours.

·      Risks could include:

o  Opening painful memories.

o  Producing strong emotions.

Informed consent includes the therapist’s qualifications and what professional associations they belong to.

·      It should also provide contact information for filing a complaint against the therapist, if the client feels that they need to.

Informed consent explains the purpose for collecting information about the client, how the therapist uses it, and to whom they might share this information with.

·      It should also explain the client’s right to access their information.

Informed consent explains confidentiality,and the limits to it.

Informed consent explains that the client has a right to say no or withdraw from any part of therapy at any time.

Informed consent can be given by a minor if the therapist believes that they fully understand what they are agreeing to.

Informed consent can be given in written form, verbally, or through an action such as a head nod or thumbs up.

·      During the first therapy session, however, informed consent should be formal and the client should provide written consent whenever possible.

o  This is also true when exercises that might cause strong emotions are going to be used.

Informed consent is created to protect the client’s rights and provides proof that the therapist has done their job to make sure the client understands all aspects of therapy.

·      Informed consent does not protect the therapist from any inappropriate or harmful behaviour towards theclient.

An informed consent document helps clarify who the client is.

·      For example, if a parent brings their child in for individual counselling the child would be considered the client.

Informed consent should discuss the therapist’s fee policy, and what happens for cancelled or missed appointments.

Informed consent is continuous - this means that the therapist might need to ask for consent more than once.

·      A therapist should ask for consent again when any new aspect of therapy is being introduced.

 

 

 

 

 

 

 

 

 

References

BritishColumbia Association of Clinical Counsellors (2010, October). Standard forInformed Consent to Clinical Counselling and the Collection, Use and Disclosureof Personal Information. Retrieved from https://bc-counsellors.org/wp-content/uploads/2015/09/1BCACC-Standards-Informed-Consent-2010.pdf

Pope,K.S., & Vasquez, M.J.T (2016). Ethics in Psychotherapy and Counseling: Apractical guide. Hoboken, New Jersey: John Wiley and Sons.

 

What is Confidentiality?

 

Confidentiality means that the therapist has a responsibility to the client to make sure that what is discussed in therapy is not shared with anyone else.

There are certain circumstances where the therapist must break confidentiality. These circumstances include:

·      When the client has given the therapist reason to believe that they are going to harm themselves, or others.

·      When there is reason to believe that a child is being harmed or neglected.

·      When there is reason to believe that adults who can’t protect themselves, such as elderly or disabled individuals, are being harmed.

·      If the client’s records have been requested by the courts.

o   The records should only be provided by the therapist after they have talked with a lawyer to understand what they must provide.

·      If others, such as employers or insurance providers – known as a third party – request client information, it may have to be provided.

o   The therapist should discuss this with their client and let them know what is being asked and why.

o   If the third party takes legal action to obtain information about the client the therapist should talk to their lawyer about what information they must submit,if any.

·      In the case of family or couples counselling, secrets will not be kept by the therapist.

o   This means that what one person says to a therapist might be discussed with the other people that are considered a client.

·      When the therapist shares information about the client with their supervisor.

o   This information is shared to ensure that the therapist is providing the best possible care for their client.

·      Confidentiality must be kept by the therapist, except in the case of any of the above circumstances.

·      It is illegal and/or unethical for thetherapist to break confidentiality.

References

British Columbia Association of ClinicalCounsellors (2014, May). How private is        private?A detailed consideration of a clinical counsellor’s legal duty of                              confidentialityand the exceptions created by the duties to report or                warn. Retrievedfrom https://bc-                                                                                                     counsellors.org/app/uploads/2015/10/140501-How-Private-Is-Private-                           REVISED.pdf

 

How can I work with an 'unmotivated' client?

Helping Clients find Reasons for Change

  • Ask questions regarding what they care about, value, and genuinely want
  • Help them discover options
  • Focus on what is working, instead of what isn’t
  • Remind them that change can be gradual, meaning that results might not be seen overnight but will occur over time
  • 40% of client change is due to the therapeutic relationship
  • A strong therapeutic alliance is necessary for change to occur
  • 40% of client change is due to what is occurring outside of the counselling sessions
  • 15% of change is due to hope
  • Ask clients why they are hopeful
  • Communicate that you are hopeful for them
  • People are cured more by the words they hear, than what they speak
  • 15% of change is due to the therapeutic approach that is used
  • Need to ensure that the approach you are using is helpful to the client
  • Can do so by asking for feedback from the client
  • A useful approach to gathering feedback is to use scales

Helping Clients Open Up

  • Use assumptions
  • Can say things like, “I’m assuming you’re here because you want your parents to stop bothering you.”
  • Continue to make assumptions until a response is generated
  • Ask questions regarding:
  • What is important to them
  • What is happening for them in life
  • What their interests, hobbies, and plans are
  • Be genuine, caring, and transparent
  • Communicate the boundaries of trust
  • Explain to them that they are in a safe space to share what is going on for them
  • Explain confidentiality and under what circumstances you would have to break it
  • Make people feel good about themselves
  • Be culturally appropriate
  • Remember and use their names
  • Use humour, when appropriate
  • Talk about common interests without oversharing
  • Meaning that comments about yourself must be brief, relevant, and tie back to the client


Helpful Approaches for the First Session

  • Ask clients
  • What they are hoping to get from your initial meeting together
  • How you can be helpful
  • What isn’t helpful
  • What their past experiences of counselling, if any, have been like for them
  • Avoid using professional jargon; instead, use client language

Working with Resistant/Unmotivated Clients

  • Don’t force change
  • Don’t work harder than your client!
  • Acknowledge what the client says and reflect it back
  • Ex: if they tell you that everyone else is always wrong, you would say, “So you feel that you are never wrong.”
  • Use a double-sided reflection
  • Ex: If a student is talking about school being so hard they just want to drop out but also feel stressed about their student loans, could reflect back, “On one hand you would like to quit, but on the other hand you recognize that you have borrowed money which you must complete school to pay back.”
  • Could talk about consequences
  • Ex: Could say, “It seems like you want to quit your anger management program. I’m wondering if quitting the program is worth going back to jail?”
  • Reframe the resistance in a positive way
  • Ex: If someone is talking about their parents butting into their life, you could say, “You have your own ideas, and you want to be in control.”
  • Emphasize the client’s choice and control
  • Ex: Could say, “You are in control of your own life and I am not going to force you to change; you have choices
  • Focus on a different issue altogether
  • Ex: A client might be mandated to come to counselling due to a work-related problem. However, it might be that a personal issue is causing their work issues. In order to help them be a better employee, they must work through their personal problem first.

Are You the Right Fit?

  • Recognize populations that you don’t feel comfortable working with
  • Recognize when clients aren’t willing to work with you and refer out
  • Ex: A woman coming from an abusive relationship might not want to work with men

Does Moving Forward work with clients who have pending ICBC, Worksafe BC, Crime Victim Assistance Program (CVAP), Family or Criminal Justice Court Matters?

Yes we do. However, if a client wants to work with an intern,you must explain to them (either at intake or at first session – whenever you learn that they may have such a case) that our interns, as students and newcounsellors, are not in a position to provide comprehensive reports/ assessments/diagnoses/ recommendations that ICBC, courts, Worksafe, CVAP, etc. may want. Therefore,the client should be seeing a registered therapist who has experience in suchwork. Note we have several registered therapists who are affiliated with MovingForward and can provide those services – for minimum fees.

In the case of ICBC,the client needs to determine if they can have their counselling covered – something they need to discuss with their lawyer or the ICBC Adjuster. For Worksafe BC cases, they should be speaking to Worksafe Rep as they have their own contracted counsellors that they can refer clients to.

Clients want 'pay what can' couples counselling. What are the protocols?

If they chose  'pay what you can' couples counselling then frankly they need to accept our parameters - that our interns will see them first individually before bringing them together, and only when intern (in consult with supervisor) feels it is appropriate (this allows the intern to assess for safety and motivation of each person - plus it is more comfortable for that new intern counsellor to do it this way as they don't have to manage what could be a highly conflictual couple from the outset -when clients opt for higher fee-based services they would see a more experienced therapist who can manage those dynamics).

Couples counselling is rarely ever free or 'pay what you can'  and ultimately anyone wanting that service needs to agree to our service parameters (that they will first be seen individually). Anyone paying $200 per session (about the traditional rate for couples counselling with an RCC) has a lot more say (and while I don't want to generalize as there are exceptions the clients paying $200 per session tend to be more committed to working on their relationship, whereas those receiving free/'pay what you can' may not necessarily have same level of motivation)

So if the couple refuses to come individually first then they can go elsewhere - in my experience that doesn't happen as they won't find the free/low fee couples counselling services anywhere.


Client is outside of BC - can we work with them?

Yes! The protocol is listed on our website:

Protocol is listed on our site

https://hushforms.com/counsellor2955

"While service is available Canada-wide, be advised we follow regulations related to counselling practices within British Columbia."

What do I do when a client never responds to my first attempts to contact them?

It is natural for clients to request counselling and then change their minds or their motivation changes between the time they contacted us and the time we contact them. This is partially the reason we work hard to contact clients as soon as possible.

If you have made all the efforts to contact a client (twice if they have an answering machine and or email, and 3 times if no answering machine or email), and recorded your attempts to contact on their client file, you can move on to accept other clients. At that point you can set the file inactive and you do not need to let anyone know, as long as you make sure all attempts to contact were recorded under the ‘non session notes’ section of the client file. This will ensure that when the client contacts us again we can be sure that previously attempts were made to contact them.

I replied back to email that I will take on a client: what's next?

Once an intern says they will take client then they would undertake next step of creating file on OWL and reaching out to client within 24-48 hours to book appointments (Gary doesn't reply back once they say they will take a client - assumption from that point is intern will follow up and reach out to client. Intern notes all efforts to contact clients in non-session notes). The expectation is that you contact a client within 24-48 hours from when Gary sends you the client information.  One of the things that sets MFFS apart is our quick response time. We want to instil hope in clients and often we have found that when interns take a week or even a few days to contact the client, the client may have changed their mind about counselling which is why we want to make sure we reach out to the client quickly.  You don't have to have the sessions within that time frame, but at least make the first contact and schedule their appointment for the following week

I have a lot of questions but don't want to inundate my supervisors - what should I do?


Ask away! We would rather you check than proceed if uncertain. At the same time please ensure you have reviewed all orientation materials. Also you can bring your questions to group supervision as well as ask it in our Whatsapp Group Chat.

I'm a bit stuck with a client. She's struggling hard with anxiety and I am currently doing the CBT Coaching with her and she has now also asked that I provide general therapy as well. Can I do both?



Our services are not crisis nor urgent (so please provide #s to crisis lines and Wellness Together Canada line. The coaching especially is not direct therapy and if she wants to discuss things that are outside the set structure then she also should opt for general therapy. However, that additional support should be done with another therapist. You can let her know it's agency policy - clients can do both CBT coaching and general therapy simultaneously, however it needs to be two different counsellors - and the rationale is that the agency does not want clients to become over-reliant on one person. So, agency wants them (clients)  to expand their network of support ... and while clients may decide not to proceed the agency is firm about that (and  while you would not share with point with client but what is going on i.e. their regularly messaging you and relying on you to help them feel better is the reason why have this policy).


Also reminder that we have a policy that emails/texts are just for passing along homework/next appointment reminders, not for therapy/sharing info that is best left to discuss at the next session.

Can a client do coaching sessions with someone else? (i.e. HR coaching with their partner)


No, these sessions are to be done one-to-one. If the partner also wants to do it, then they would need to do it separately

The reason it is one-to-one only is that it's not counselling yet it may bring up a point of contention that can lead to conflict so we will not see couples together  - and the only way to ensure this cannot happen is to do it one-to-one

If they want to attend together they would need to ask for general therapy (and there are fees for it)


If they have any issues with and of this they can speak to me at 778-321-3054  

My client has asked me to write a character reference letter for court/to their social worker/to their Probation Officer, etc. Can I do that?


We do not offer character references - instead you would stick to tangible points such as number of sessions attended, general areas discussed, and some 'positive' comments i.e. that client attends sessions as scheduled and is engaged in sessions.


We will not do 'character' references that may imply that the client is a better parent than their ex, or the ex is abusive, etc. (as you have not met their ex nor were you  assessing their or their ex's relationship/ability to parent - even if you have interacted with them you are not in a position to assess them) or that the client is 'healed' from what brought them to counselling ... I've had people ask me to write a letter that indicates that they won't drink/do drugs/get violent again and I say I won't do that as a judge would discount everything I wrote if I am making such comments (i.e. how can I say such things as I can't predict the future?) plus it hurts my credibility to make such sweeping statements so again I won't do it. In fact such comments can hurt the client as basically anything that is more tangible and positive would all be discounted.


Remember that any letters need to be reviewed by Gary before sending out.

My client wants to continue with me after internship, is that possible?

Yes it is possible, but you would need to first discuss this with Gary. Ultimately taking clients with you into private practice without speaking to Gary would be a significant practice/ethical concern – especially as Gary would likely support the plan.

Some considerations:

  • The client would be transferring from being a Moving Forward Family Services client to one of your private practice clients.  You would be responsible for maintaining client file from that point forward (from our perspective the file we have would be closed)
  • You would not have access to OWL – our contract with OWL (the reason we receive a very reasonable rate) is the services are provided by students and we charge low fees. Private practice therapists need to find their own platforms to use
  • Some get their own OWL, JANE or other platform
  • Others decide to use zoom, Doxy.me or some other platform and then do paper-based notes, with files they keep at home in locked file cabinet
  • Do you have insurance in place? As an intern you had insurance and the agency had coverage – however as the client is now seeing you in private practice, you would need your own  insurance. Again from the agency perspective the client is no longer an MFFS client and thus you are not covered by our insurance – some interns’ insurance allows them to practice beyond their internships however they should check on that (as their insurance quote may have been premised on notion that they were being supervised – once in private practice that would change).  Sometimes graduates have a gap between when they graduate and when they register and get insurance – you would be putting yourself at risk if during that gap you are seeing clients and are not insured. I do believe you are able to get insurance for that time period between internship end and when you register – though it can be somewhat pricey (so you should ask if it is worth it, especially if clients are paying low fees?)
  • While we are in no position to dictate how much you should charge, I would say to ask yourself, is it worth your while to charge $20 or less? Client was aware when they started with you that you were an intern, and eventually would be graduating and moving on: they accepted this arrangement and quite frankly no other public service would have every given them the amount of sessions they already received (and traditional private services would have likely been financially out of reach for them). So of course the client can ask to continue with you (and it is credit to you and the therapeutic relationship that they want to), but such a request is well beyond what any other service would have ever offered (so you should not feel any sort of obligation to do it).  So, they have already received a great deal of quality services and support – and you also need to think about your future (especially after all this time and money you’ve spent on your studies).

If they want to pay $20 or less then I would suggest they continue with an intern however again I’m not going to tell you what you should charge; I just say take a critical lens to the situation – it is understandable that client wants to continue with you however you need to consider if it is really worth it for you to continue when you have every right to earn more. If you do proceed then continue to be critical – if they are paying low fees for therapy but revealing they are spending a great deal on non-essentials elsewhere, you should probably reconsider the low fees.

I would recommend strongly NOT to take clients on for pro-bono after internship – the purpose of agency is offering low fee/free services to those who would not otherwise receive it, with interns – with the caveat that eventually intern would move on … so the client can continue with another intern in this case. They were aware of this arrangement and frankly if they had accessed public services they would have been dropped after 6-8 sessions … so it is not only a fair arrangement but it is well beyond what they would have received anywhere else. Of course a client would prefer to stay with one therapist for as long as possible but that is not a realistic expectation


How long is a typical couples or family counselling session

Couples and family sessions can be anywhere between 55-90 minutes long.

What do I do if a clients asks for more than one session per week?

We need to ensure that clients are not dependent on their counsellor to get them through the week- that they are seeking out additional resources/support if they need them (i.e. our coaching programs, groups and other programs in the community). If we keep accommodating them (giving extra sessions, answering their calls outside the allotted session time) we are quite possibly enabling what is ultimately a maladaptive coping strategy (a client relying on one resource rather than their having many resources one can rely on).

We want clients to not be solely reliant on one therapist to support them – We want them to access other resources and I know that while it is convenient and comfortable for them to work with one person, they need to expand their support networks, and there is no incentive to do that if we just accommodate such a request.


Furthermore, we  want our counsellors to have a diverse range of clients so by seeing a client more than once you are limiting your experiences (as that is one less spot you have to see another client).

We ultimately need to make sure that other clients get the same kind of prompt service this client got - and by giving them an extra session we are potentially delaying support for the next client reaching out

So typically cannot provide more than one session per week (but feel free to check with Gary)

One other note to consider: when a service has a fee clients will consider whether they want to invest the extra fees for extra sessions - but when it is free they sometimes do not value it as much. If client pays and is willing to pay for the extra session I'm more inclined to approve it than someone wanting additional free services from same intern.

My client only came once and never came back - what did I do wrong?

You will no doubt experience this often, and while important to reflect, I know there are some reasons why client may discontinue that have to do with counsellor (i.e. not a good fit) while there are exponentially more reasons why client may discontinue that have nothing to do with the counsellor at all. Ultimately if you did everything you can to be genuine, empathetic and respectful, then you did all you could do (all that you had control over). You had zero control over all those other external reasons why the client may have discontinued. I have had clients that came to me seeking concrete action and directions, and thus never returned when I didn’t do that for them.  Ultimately it was not a good fit but I was comfortable with that rather than doing and acting in ways that I didn’t feel were appropriate (though if had no doubt they would have continued with me, and even been satisfied even though I had done little to help them develop their own skills to deal with their own issues). Even if the client felt it was not a good fit, you have to be true to who you are and what you do… which it sounds like you were, in that you were willing to let them know that you can assist them in seeing someone else.  I suspect if it was an issue of fit they would be receptive to further dialogue – and maybe in future they will be – but for now I suspect it is one of those hundred other reasons (again all external to you and your abilities) why they discontinued. Definitely something to debrief with your supervisor – also if comfortable bringing it up in group supervision. I’m confident most interns have had similar experiences.

Why we always need consent from any and all guardians of a client who is 12 years old or under

We absolutely cannot provide services to children 12 or under if the other parent also has guardianship as they have a say in any major decisions regarding their children (unless there is a family court order that says otherwise, and we need to see proof of that). I always frame it as if someone decided to put my kids into counselling without my knowledge – I would not be happy about that, to put it mildly.  So we definitely need consent from any and all legal guardians.  The only way around that is if it were a direct referral from MCFD (Ministry of Children and Family Development) where they cite a certain statute ('Section 96') that gives them the authority to request counselling or again if there is a family court order that gives one parent the authority to request counselling. In some cases the parent wants kids to get counselling not necessarily because they care about their child’s wellbeing (although that might be part of the consideration) but because they are case building for family court (wanting kids to get counselling in order to establish that they are the better parent). Because of such issues we need to be clear about not proceeding with counselling unless we have consent from those (and every one of those) who have legal authority to give it.

My client was referred by their Probation/Parole Officer - are there any specific considerations in working with these clients?

Probation Clients 101

Many of you are seeing ADULT clients who are on probation. Here is a brief summary of the types of clients on probation that are typically referred to us.

Generally, clients have a court-ordered condition that requires anger management (most often anger that was directed, via threats or physically, towards an intimate partner such as spouse or girlfriend), substance abuse or mental health.

Generally clients who perpetrated a fairly serious offence would be assessed by probation as ‘medium’ or ‘high’ risk to re-offend. In those instances, probation officers are required to refer them to their own in-house programs. These programs can include (I just mention it as you may hear a client speak about it):

  • SAM (substance abuse management)
  • RR (Respectful Relationships – facilitated by POs) and RVPP (Relationship violence prevention
  • program, facilitated by contracted counsellors).
  • VPP (Violence Prevention Program, for anger that didn’t involve a spouse/partner)

Often the clients we get are rated ‘low’ risk – although sometimes a client is ‘low’ risk simply because it’s the first time they got caught – so there is certainly some grey areas and the assessment is generally only as good as the information the PO has available to them.

You may hear the term ‘Peace Bond’ as it is often given to clients who were charged with relationship violence. It basically means ‘keep the peace and be of good behavior’ for a year, and complete counselling as required, and the client will not have a criminal record. A ‘conditional discharge’ is basically the same thing. A ‘suspended sentence’ usually means a criminal record (technically means the judge suspends sentence but can change their mind and re-sentence the client in the future if client is not abiding by court ordered conditions – though this rarely if ever happens).

A client on probation (versus a client coming on their own free will) may tend to be resistant and unmotivated. Now we can certainly turn them away, basically say ‘come back in the future if you feel the need for counselling’ but usually I encourage you to take the client on.  I do this for a few reasons:

  • By continuing to see them you may be able to use motivational interviewing or other skills and help them move from the unmotivated stance
  • The other reason is that chances are we are the most flexible service around, so if we don’t see the client then chances are PO will refer them to another program. Generally when clients know this they are more apt to continue with you (especially when you let them know you are not an extension of the court / probation system and that our goal is ultimately to work with client with whatever they are struggling with as well as help them get through the system they find themselves in).

Clients often want to know how often they will come. I suggest that’s something they can ask PO but a general rule of thumb (based on my own experiences) is 8 sessions is generally sufficient -enough of a number that will satisfy the PO and the court condition. Anything less and PO may send them elsewhere – again an incentive to complete the 8 sessions.

Sometimes POs will reach out to find out if a client is attending / what is being covered – you cannot disclose any information without expressed consent from the client (written consent whenever possible should be obtained… the PO can fax a signed consent form to us) … prior to following up you should consult with your supervisor.

What is our No show and late cancelation policy?
  • Missed appointment fees may be charged for any missed appointments (appointments missed or not cancelled with at least 24-hours notice). The charge for such missed appointments would be 50 per cent of the rate ( rate may be different based on if the client went with ‘pay what you can’ or $20)
  • Two missed appointments will result in discontinuation of services and client will need to reapply for services with another intern counsellor  (and potentially have to pay for missed appointment fees before sessions can resume)
  • In this case, if the client contacts the counsellor after 2 missed appointments, the counsellor will direct them to reapply.


What should I include in my case notes?

Tips about Case Notes

1.     Remember clients have the right to review their case records.

2.     Think about what you are going to write before you put anything down.

3.     Be sure you are recording in the proper client file.

4.     Ensure that there is a date for every entry.

5.     Notes should be brief, concise and written as soon as possible (within 24 hours) following the counselling session.

6.     Imagine that your client is standing over one shoulder, looking over what you are writing; imagine that a family court or criminal court judge / lawyer is looking over the other shoulder at what you are writing. Would they be upset/confused/question what you have written? Would they take what you have written and interpret it in a manner you never intended? Consider these perspectives before writing the note.

7.     Notes should include specific client information that is supported by behavioral observations, assessment measures, and client statements, not just your opinion of what you observed (best to steer clear from opinions).

8.     Imagine that you are not going to work with the client any further (even if you are not); there should be enough information that another provider would be able to continue quality care (that they could pick up where you may have left off)

9.     Watch abbreviations-use only industry standardized jargon/terminology.

10.  Use proper spelling, grammar and sentence structure.

11.  Do not use slang or overly informal terminology.

12.  Avoid curse words unless directly quoting – and even then, think about whether including that is necessary.

13.  Avoid labelling, judging and using terminology that may be stigmatizing to the client.

14.  Use client language/quotes that are clinically pertinent. Use descriptive terms.

15.  Describe what you observed, not just your opinion of what you observed.

16.  Reference identified problems from the treatment plan.

17.  Avoid providing client with a diagnosis; instead list client symptoms and any recommendations for follow-up with family physician or referral to psychiatrist.

18.  Use power quotes:

                          i.          “Client remains at risk for__________ as evidenced by____________”

                         ii.          “The current symptoms include ____________________________”

                       iii.          “Limited progress in _______________________________”

                       iv.          “ Continues to report as being depressed as evidenced by____________________”

19.  Proofread before signing off on note.

I am having difficulties with someone else in Moving Forward (my peer/my supervisor/a staff member, etc.) or I would like to provide some feedback to Moving Forward, who can I talk to about this?

It is natural for conflict to arise in a workplace between co-workers, employees and their supervisors, or employees and the company. Moving Forward is similar to a work environment in that conflict may arise. There is an open door policy in Moving Forward, encouraging constructive feedback. We want to hear from you if you have had an experience that caused you discomfort, or even if you just have an idea for a way to facilitate growth within the agency. We realize that sometimes knowing who to talk to can be overwhelming. Here is how we encourage you to address any conflict or issues you are having during your practicum with Moving Forward.

  • It is always best to open up a conversation with the person you might be having an issue with. Whether it’s your supervisor, another student, or a staff member.
  • If you have opened up a conversation but the issue persists, or if you feel uncomfortable approaching the specific person, you can talk to your supervisor.
  • If your supervisor is the person you are having the issue with, you can talk to Gary or another staff member (who can then approach Gary about the issue without mentioning names).
  • Intern representative: If you are uncomfortable bringing up the issue with any of those people, we encourage you to share it with a fellow student who may then share it with Gary.

As mentioned, we always welcome constructive feedback and encourage an open dialogue as long as it is done respectfully and professionally. Moving Forward mimics a work environment and learning to resolve conflict peacefully and constructively is an essential skill for future practice and working with other professionals.

What should I do if 10 minutes before session end a client brings up something BIG

Some suggested responses:

  • That is important but we don’t have much time but that is definitely something we will pick up on at next session
  • Ask at the start of each session: Is there any big topic you would like to bring up? I ask this as I want to make sure we have enough time to actually deal with it.
  • This is an important and significant topic you are bringing up. We have discussed several things in the past few sessions – I’d like us to narrow it down for the next few sessions so we can really get deep into those topics before we move on to another topic.

I share a client file with another counsellor, what are my ethical responsibilities?

In some cases two counsellors may have access to the same client file and will both have to record notes for the same client. This happens if

  • The client is seeing an individual counsellor and is participating in a group counselling program through Moving Forward
  • The client is seeing an individual counsellor and is doing the healthy relationship or Moving Forward Life Skills coaching program
  • The client is seeing an individual counsellor as well as a couple’s counsellor

In those cases, and others, it is the ethical responsibility of each counsellor to respect the privacy of their client and avoid looking in the session notes of the other counsellor. The only circumstance under which one counsellor can review the other counsellor’s notes is if the client signs a release of information form (verbal consent can also be noted, but written consent should be sought – discuss with supervisor if this is not possible) and indicates they would like one counsellor to be aware of the other counsellor’s notes.

My supervisor can't see some of my clients's files

Please make sure to review all your client files and ensure that your supervisor’s name appears on the file. To do that: Go to the client’s file–>contact and clinical–>clinical details–>in the ‘basics’ column make sure your supervisor’s name appears under ‘primary supervisor’. If it doesn’t, click edit at the bottom right of the page–>choose your supervisor under default supervisor.

When you are creating a brand new client file, please ensure that your supervisor’s name is automatically populated as supervisor, just under your name as the therapist (which is automatically populated when you are the one creating the file).

If you are having any issues, please email coordinator

Do I need to do an intake if I have already taken the client?

The main purpose of an intake is for a supervisor to review the client’s circumstance and determine who would be the best fit. Sometimes a referral/self-referral will come with enough details that the supervisor will pass along the referral and ask if you want to take it on; in this case, you do not have to complete an intake. However, you are welcome to do an intake if you wish (this is totally up to you). If you do an intake, ensure you upload it to OWL afterwards. Or you can simply proceed with first session. Regardless of if you do decide to do a complete intake or not, please make sure you have the client’s address, prior to beginning counselling.

Do I need to review and ask client to resign the consent form if they have been transferred to me?

In general it is good practice to review and re-sign the consent form with client that has been transferred to you to ensure they are aware and familiar with the policies and limits to confidentiality.

What is my supervisor's role during my practicum?

Primary Supervisor:

  • Oversees the 25 hours of direct supervision required for BCACC registration (if you are registering under another body i.e. CPCA, ACCT, BCCSW, CCPA – please review their specific requirements). According to the BCACC requirements those hours include:
  • Sitting in and observing live sessions
  • Review, discuss, and provide feedback on video recordings of sessions
  • Review, discuss, and provide feedback on audio recordings of sessions
  • Counselling alongside interns
  • Facilitating groups alongside interns
  • Direct supervision sessions are typically weekly one-hour long sessions.

Secondary Supervisor:

  • To meet the BCACC supervision requirements for registration, interns are required to complete 75 indirect supervision hours. Those indirect hours are overseen by the secondary supervisor, and according to the BCACC requirements include:
  • Consulting about cases
  • Oversees group supervision hours
  • Reviews case files
  • General case management hours

Other governing bodies have different criteria and it is up to intern to be aware of what the required hours are.

What happens if a client has not followed up in several weeks or longer?

You are welcome to send an email to them. Here is the format to use:

Hope all is well.I was just checking in to see if you are still interested in individual services? Agency protocols require any file that is inactive for a month or longer to be closed it. If you are not interested in continued services at this time, feel free to disregard this email, and feel free to reach out again anytime in the future. If the need arises in the future please do not hesitate to reach out – a self-referral can be completed via the secured link found on Moving Forward Family Services’ website at movingforward.help

or

I will be completing my internship with Moving Forward soon. I wish you all the best and wanted to let you know that if still interested in services, you are welcome to reapply to Moving Forward Family Services and you will be assigned a new intern counsellor – or if your financial circumstances have changed, you may wish to see a private registered therapist – all the various options are listed on the website at movingforward.help

or

Hello, due to multiple misses, I will be closing your file. I wish you all the best and wanted to let you know that if still interested in services, you are welcome to reapply to Moving Forward Family Services and you will be assigned a new intern counsellor – or if your financial circumstances have changed, you may wish to see a private registered therapist. Please note any unpaid balances for services would need to be cleared prior to any resumption of services and that future missed sessions would incur missed appointment fees.


I am trying to log into owl for the first time but it doesn't recognize my email as a user name
  • If you already have an account make sure you are using the mffs specific owl link https://mffs.owlpractice.ca/login. You will not be able to login through the generic owl practice link, so please ensure you save this link for future use.
  • If this is your first time logging in to owl, your account may have not been created yet. To create an account, please email meirav.r.mffs@gmail.com and include the following information in your email:
  1. Your full name
  2. Your preferred email address (which will be used as a username and will not be accessible to clients)
  3. Your phone number (for organization records, it will not be accessible to clients)
  4. Your mffs supervisor’s name

What do I do with a client file on owl once the client has moved on from counselling?

When a client has moved on from counselling you can deactivate their file (NOT DELETE) so it no longer appears under your active client files (you will still be able to view the client file if you remove the ‘active’ filter from the ‘clients’ tab view). Steps to complete before you inactivate a client:

  1. Check they don’t have another therapist: Go to the client’s file→ contact and clinical→ clinical details →‘basics’ section→‘other therapists’. If there is a name under ‘other therapist’, do no inactivate the client file! It is also important to check the ‘primary therapist’ and make sure your name appears there, if someone else seems to be the primary therapist, and you are the ‘other therapist’ also do not inactivate the file. Instead, email Gary and let them know you are no longer working with this client.
  2. If you are the only therapist, make sure all the session notes have been signed and if you have been keeping track of the client payments, ensure their balance is $0.
  3. To inactivate the client file: Go to ‘clients’ tab→ click on the square by the name of the client you want to inactivate→ click ‘change status’ at the top of the screen→ choose ‘inactive’. The client file should be removed from your current screen.
  4. If you ever need to take a look at this client file or need to reactivate it: Go to ‘Clients’ tab→make sure the title of the screen is ‘all clients’→ under all clients you should see highlighted in green ‘client status: active’→ click the x→ a list of all your past and present clients should now be on your screen
  5. To reactivate a client, simply follow the third step but choose ‘active’ instead of ‘inactive’.

*See video guidance for this process on the OWL orientation page.

How many times should I attempt to contact a client for an intake (or to schedule a first session)?

If the client has an answering machine:

  • Leave one message with very basic details (in case someone else will hear the message), for example: “Hello my name is  (your name) I am calling from Moving Forward for (Name of client), please call me back at (your phone number).
  • Make another attempt to call a few days later, but you do not need to leave another message.
  • Make sure to record each attempt to contact in the ‘non session notes’ section of the client’s file
  • If the client never responds to attempts, you can then set the client file to ‘inactive’

If the client provides an email address and a phone number:

  • You can leave a voice mail (see above example)
  • The next step would simply be to send an email.
  • Make sure to record each attempt to contact in the ‘non session notes’ section of the client’s file
  • If the client never responds to attempts, you can then set the client file to ‘inactive’

If the client doesn’t have an answering machine:

  • Make 2-3 attempts, a few days apart. Make sure to record your attempts on the ‘non session notes’ tab of the client’s file
  • If the client never answers the phone, make sure you have recorded your attempts to contact the client in the ‘non session notes’ section of the client’s file and then set the client file to ‘inactive’

What should I do if my client doesn’t want to continue counselling or never responds to my initial contact?

If the client doesn’t want to continue, make a note of that in the session notes on owl. If the client never responded to the initial contact, record your attempts to contact them in the ‘non session notes’ section of their file on owl. In general, two attempts of contacting a client is sufficient.

What should I do when an individual client wants the sessions to become family or couples counselling?
  1. If your client is thinking of doing some individual and some family sessions, you should keep doing the individual sessions with the individual client and the family or couple should see someone else for the family/couple sessions. Having another person join some sessions, but not others may create some unforeseen issues (which we want to avoid)- For example, the other member or members of the family may see you, the counsellor, as the individual’s counsellor so whatever you say/do will be viewed through that lens (if there is a conflict between them, they might perceive you as being on the side of the individual). Another issue that may come up is that the individual might try to communicate with you outside of the sessions to discuss what the other member/s did or ask you to pass messages to the other member/s during the sessions. The potential for triangulation is quite high especially with high conflict relationships
  2. Once the option of seeing a second counsellor for the family/ couple counselling was discussed with the client and they accept these settings, email Gary who will assign the couple/ family to another counsellor
  3. However, if their plan is to switch to sessions together and to proceed that way, so there would be no individual sessions going forward, then you can go ahead and work with the couple/family. However, make sure the client/s is aware that if this is the plan then you would not go back to doing individual sessions with just the individual, that moving forward, sessions would be family/ couple only. Again, this avoids the pitfalls described above.

How can clients pay?

Regarding client payments: you would not use OWL for any payment related matters – you would verbally let them know / email them the info (you can create a free email using any of the free ones (google, hotmail, yahoo) i.e. tom.mffs@gmail.com and then let them know of the payment options)

1.Etransfer to movingforwardfamilies@gmail.com (Please indicate in the subject line/memo/ comment the name of your counsellor)

2. Credit Card or Paypal – enter movingforwardfamilies@gmail.com in the “send to” option (with paypal you can choose to pay by paypal or instead by credit card). (Please indicate in the subject line/memo/ comment the name of your counsellor)

3.Mail Cheque to

Moving Forward Family Services, 101 – 12827 76th Avenue, Surrey, V3W2V3

(Cheque is payable to Moving Forward Family Service)

See this document for guidance on how to discuss payment with clients Discussing Payment with Clients

Why do we ask for fees?

Evidence shows that when clients pay, they tend to miss less appointments and show greater commitment to counselling. Even a few dollars (versus free) can make a significant difference in terms of motivation/commitment. No one will be refused service due to their financial circumstances but clients also need to know we are not funded by those responsible for counselling services (Fraser Health, MCFD, Schools, Corrections) and every dollar helps to cover our costs so that we can continue to offer low barrier services.

We also have clients who, when services are free, use such services to ‘dump’ their weeks’ worth of frustrations without taking tangible steps (that it is ultimately their prerogative but we do not need to enable that) – and once they are asked to pay they choose to discontinue -so it becomes a way to end the therapy when therapy doesn’t seem to be progressing … but ultimately they chose to end it. Clients who do pay even a few dollars tend to have tangible clinical goals they are working on (they don’t just dump).

And finally as someone who has been around a while, I have heard clients talk about their Caribbean Vacations, second home in White Rock, about how much they love their BMWs, their regular  fancy shoe shopping sprees, how they cannot go a day without getting their fancy drink from Starbucks, but then  plead poverty when asked to pay. So I don’t have nearly as much empathy for those situations as I do with multi-barrier clients living in poverty or can barely survive on their wage – especially since we receive no funding from government entities responsible for publicly funded counselling (MCFD, Health Authorities, School Districts, Corrections). Such clients, if showing up and being engaged, will never have to worry about having to afford their counselling.

How long is our waitlist
  • Clinical Counselling: No wait (it may take up to 1-2 days for clinical counsellor to connect)
  • $20 option with an Intern: 1-2 week wait
  • Pay what you can/free services: 4-8 weeks wait

Where are our locations?
  • We have offices in Surrey, but in-person services are currently only with private therapists and mininimum fees apply.

Do we offer phone counselling and online counselling?
  • Yes, we offer free (for those who do not work/have no income and are live in poverty) and online counselling services with an Intern. We advise that proof of low income may be required. If client asks what proof is required:
  • For proof of low income, basically a tax return and/or income slip … having said that we don’t need to see it, but after 4 free sessions I (the supervisor) may ask – during those free sessions, if client is talking about their fancy car or vacations then the counsellor will know they can afford something … you wouldn’t tell them that but that is something you will probably be able to figure out .. so all you tell client is no proof required at this time but supervisor may ask after 4 free sessions

*DUE TO COVID-19 ALL COUNSELLING IS CURRENTLY ONLINE OR ON THE PHONE

Does insurance cover counselling?
  • Some insurance companies  may cover clinical counselling sessions (with registered therapists), you will have to speak with your insurance company to find out
  • In supervisor’s experience insurance companies will not cover services from an intern (also – we are clear that our low barrier services are for those who do not have coverage – if they have coverage they should be accessing services with clinical counsellors)
  • We do not offer direct billing to insurance agencies

Orientation to MFFS (Pt. 1)

Please view this short (approximately 3 minutes) video:

“Having some psychotherapy is just about the most significant and interesting thing you could do to improve your chances of contentment – in relationships, at work, and with friends and family.”

Next review this video on Basic Skills of a Counsellor:

click on this link to review Orientation manual:

MFFS Orientation Manual 2020

Watch this video of a role play for an initial session:

Suicide Risk and Safety Planning Part 1

Suicide Risk and Safety Planning Part 2

Suicide Risk and Safety Planning Part 3

Clinical Documentation