Terms, Conditions and Privacy Notice/Agreement
This Consent Awareness Agreement is entered into between the undersigned counselee, an observer of the counseling process, or the counselee's parent or legal guardian (hereafter referred to as as "I," "me," "my" "counselee," or "client") and PeaceBrooke Biblical Counseling, LLC. and it's employed or contracted counselors (hereafter referred to as PeaceBrooke). PeaceBrooke's Biblical counselors will also hereafter sometimes be referred to simply as "counselors."
Hours, Sessions and Refunds
I understand that sessions are 50 minutes long and must be paid for in advance before they can be scheduled. I also understand that sessions are available only during the following business hours (excluding holidays and vacations):
• 9:00 – 9:50 AM
• 10:00 – 10:50 AM
• 11:00 – 11:50 AM
• 1:00 – 1:50 PM
• 2:00 - 2:50 PM
• 3:00 – 3:50 PM
• 4:00 - 4:50 PM
I understand that if I have paid for sessions and they cannot be scheduled at times that work out for me, my session fees will be refunded.
I agree to cancel or reschedule a previously scheduled session at least 24 hours in advance. Should I fail to do so, I understand that I will forfeit what I have paid for that session. If I forget a session or am not available for a session, and fail to notify PeaceBrooke of this at least 24 hours in advance, I also understand that I will forfeit what I have paid for that session. If I am late for a session, I understand that as a result, my session will not be for the full 50 minutes, and I will forfeit the unused time I have paid for, since my counselor will have others scheduled after me.
PeaceBrooke's Convictions
I realize that I am contracting with PeaceBrooke to provide Biblical counseling, which is counseling from the perspective of the Bible. I understand that this means PeaceBrooke's counselors will confront me and encourage me to repent if I am engaging in behavior that the Bible teaches is sinful. I understand that PeaceBrooke's counselors seek to be obedient to God and to His Word in all things, even if that conflicts with what is socially or politically accepted or results in difficulties or persecution. I realize that I may be challenged by my counselor to be obedient to God and His Word even if I am reluctant to do so, and will not hold PeaceBrooke liable if I disagree with the Bible or my counselor's interpretation of the Bible regarding what constitutes sinful behavior.
I understand that the Bible teaches that certain behaviors are sinful and that my counselor will urge and encourage me not to commit these sins. This includes all sexual relations that are not between a birth-assigned man and a birth-assigned woman who are married to each other. (An exception to this is those who are medically proven to have been born intersex, but even in such a case, we believe that such persons should commit to their chosen gender role and sexual relations must be within marriage.) I realize that according to the Bible, sinful behavior includes lying, cheating, stealing, murder, greed, witchcraft, wizardry, horoscopes, bestiality, pedophilia, outbursts of anger, foul or filthy speech, idolatry, child or spousal abuse, breaking the law (except in cases where the higher law of God conflicts with it), adopting the characteristic dress of the opposite sex, adopting the behavior characteristic of the opposite sex, taking the hormones of the opposite sex or surgically altering oneself to appear like the opposite sex, prostitution, kidnapping, slave trading, sex trafficking, abortion, infanticide, entertaining the desire to commit adultery, homosexuality or fornication, and other behaviors forbidden by the Bible. In light of this, I will not sue, press charges against, or hold my counselor or PeaceBrooke liable if his or her perception of what Biblically constitutes sin is different from my own and this offends me or makes me feel humiliated or discriminated against in any way.
I also understand that because PeaceBrooke's Biblical counselors follow the Bible, they are complementarians. Although they believe that husbands and wives are equal in worth, they do not believe they should be equal in leadership authority within the family. PeaceBrooke's counselors believe that a husband should be a servant-leader, love his wife as Christ loved the church, be kind to her, heed wise counsel from her, carefully consider her opinions, be respectful of her, not be harsh, cruel or dictatorial with her, and treat her as a treasured gift from God. Likewise we believe that a wife should respect her husband and follow and submit to his leadership (unless He asks her to disobey God or his Word, break the law, or it appears that submission will result in him abusing or harming her). An exception to this would be if the husband becomes ill or mentally incapacitated so that he is no longer capable of adult decision making, in which case he should submit to his wife's leadership (though she should still treat him with love, honor and respect and submit to him when she can reasonably do so).
I understand that all counseling will be conducted in accordance with the counselor's understanding of the Scriptures. I also understand no human being is infallible in interpreting the Bible, so a PeaceBrooke counselor could possibly make some mistakes. I agree not to hold PeaceBrooke or it's counselors liable if that happens. I also understand that PeaceBrooke's counselors do not know all there is to know about Biblical teaching and its applications to life. I agree not to hold PeaceBrooke or its counselors liable if I realize that something important was overlooked that could have been shared with me.
Right to Terminate Counseling
I understand that if my counselor believes that I am unwilling to use the Bible as the final authority, or unwilling to follow it's teachings, or unwilling to do any homework assigned, my counselor may cancel having future sessions. My counselor may also cancel future sessions if he or she believes that PeaceBrooke cannot help me, or that PeaceBrooke and I are not a good "fit" for each other.
I also understand that at any time during the counseling, either myself or the counselor will have the option of terminating counseling for any reason, and neither party shall be obliged to explain the reason for it. The burden of the entire cost of a session will be upon the party that terminates a current session. Should PeaceBrooke terminate counseling in the middle of a session, PeaceBrooke will refund the entire cost of that session and any unused sessions I have purchased. Likewise, should I terminate counseling in the middle of a session, PeaceBrooke will be entitled to the entire cost of that session, but will refund to the counselee the cost of any unused sessions. An exception to this will be if it is determined, either by PeaceBrooke or the elders of the counselor's church, that the counselor has violated professional ethics in Biblical counseling. In that case I will be entitled to a full refund of the session.
Confidentiality
I understand that PeaceBrooke will keep Biblical counseling sessions confidential, with the following possible exceptions:
1. Peacebrooke may share information with a counselee's legal guardian(s) or a minor counselee's parents.
2. If the counselor believes that a counselee is in danger of taking his or her own life, of harming someone else, or committing a crime, PeaceBrooke may share information with others, including law enforcement, that can hopefully prevent this. I agree that if such harm is about to occur, and a PeaceBrooke counselor fails to recognize this in time, or makes a misjudgment, not thinking it is necessary to contact someone, and counselee harms himself or herself or someone else, neither PeaceBrooke not its fulltime or contracted counselors shall be held liable for this.
3. In relationship counseling such as family counseling, marriage counseling, couple's counseling, or premarital counseling, information may be shared, at the counselor's discretion, with others in that relationship who are also being counseled, unless the counselor is specifically asked by the counselee not to share that information. The counselee is given the opportunity to make that request when he or she fills out the intake form.
4. If the counselee is referred by formal letter to PeaceBrooke by a doctor, psychologist, therapist, pastor, or other professional, case information may be confidentially shared with the referrer if I request this on the intake form. Or if I grant permission to a doctor, pastor, counselor, or other professional to view my PeaceBrooke case information, I understand it will be sent to that professional.
5. I understand that it is a common and accepted practice for counselors to share information regarding cases without identifying the counselee for teaching, collaboration or illustration purposes.
6. If the law requires that case information or a recording of a session be turned over to law enforcement, as in the case of a subpeona, PeaceBrooke will comply with the law.
7. I understand that PeaceBrooke's staff may view case files for administrative purposes such as filing or at a counselor's request, but have signed an agreement to keep cases confidential.
8. I agree not to hold PeaceBrooke liable if records of my case are burglarized, broken into, hacked or stolen.
Professional Ethics
I understand that it is a violation of ethics for a counselee or counselor to attempt to enter into any form of romantic relationship with the other or to engage in flirting, sexual harassment, sexually suggestive remarks, etc. and agree to keep the counseling relationship strictly professional. I understand that if I engage in any such behavior, counseling may be terminated. I also understand that I likewise may terminate counseling and request a full refund of my session and any unused sessions if I believe that my counselor is engaging in any such behavior with me, whether my perception is correct or not. I understand that a refund given under such circumstances is merely a professional courtesy, and is not at all an admission of guilt.
I also understand that it is a violation of ethics for me to ask my counselor for money, gifts, or free or reduced sessions, or to drop hints hoping to be given gifts or money. I agree not to do that. If I cannot afford further counseling but need more, I will apply for low-cost counseling through PeaceBrooke instead.
Complaints
I agree that the Bible provides us with the right way to resolve complaints:
“If your brother or sister sins, go and point out their fault, just between the two of you. If they listen to you, you have won them over. But if they will not listen, take one or two others along, so that ‘every matter may be established by the testimony of two or three witnesses.’ If they still refuse to listen, tell it to the church; and if they refuse to listen even to the church, treat them as you would a pagan or a tax collector." (New International Version, Matthew 15:18-17)
In keeping with these Biblical principles, if I have a complaint against PeaceBrooke or my PeaceBrooke counselor regarding anything, including a disagreement, remark, procedure, action, perceived violation of professional ethics, perceived offense, or a remark or action I perceive to be humiliating or discriminating, I agree to keep it confidential and not share it with anyone else, including on social media or internet ranking services, unless first 1) I have shared it with PeaceBrooke's office administrator (appointments@peacebrooke.org) and given PeaceBrooke the opportunity to resolve the complaint between me and my counselor, 2) then if that fails to resolve the problem, gone through the conflict resolution process described below, and 3) both PeaceBrooke and my counselor will not follow the decision and directions of the church arbitration panel.
Conflict Resolution
At PeaceBrooke we believe it is important that a counselor be accountable to his church. If a complaint, conflict, disagreement, perceived violation of professional ethics, dispute, perceived offense or a remark that is regarded as humiliating should arise between PeaceBrooke and the Biblical counselor, or between the counselee and PeaceBrooke, and it cannot be resolved by them in private correspondence or conversation, both parties agree to resolve it in private arbitration that will be led and judged by the elders (or leadership equivalent) of the counselor's church. The elders shall make their judgment according to their understanding of Biblical doctrine. Arbitration arrangements will be made by PeaceBrooke and will take place at a time acceptable to all parties. Should the counselor's church elders determine that the Biblical counselor has violated professional or Christian ethics, all PeaceBrooke counselors have agreed (1) To be subject to rebuke and church discipline by their church (including excommunication), (2) Possible suspension by PeaceBrooke without pay for what the elders deem to be less serious infringements of concern, (3) Forbidden to counsel for PeaceBrooke until the elders decide that repentance and reliability has been demonstrated for more serious infringements, and (4) Termination by PeaceBrooke, along with being reported to legal authorities by the elders if the law has been violated and that law is deemed by them to be just and in accordance with the New Covenant in the Bible. Financial compensation, if the elders believe it is merited, shall be decided by the counselor's elders and will be limited to seven times the cost of sessions that have been taken, payable from the counselor's personal funds. If the counselor cannot afford to pay this in one lump sum, the elders may set monthly payment amounts. If the counselor is suspended, that counselor of course will no longer be utilized by PeaceBrooke until the suspension is withdrawn by his elders and the leadership of PeaceBrooke believes the counselor is repentant and can be trusted not to repeat similar offenses.
Georgia 43-10A-7 (11)
I understand that PeaceBrooke and it's counselors are located in the state of Georgia, and practicing under the provisions of Georgia 43-10A-7 (11), which allows “persons engaged in the practice of a specialty in accordance with Biblical doctrine in public or nonprofit agencies or entities or in private practice” to provide counseling without state licensure. (In most states, in fact, ministers provide counseling according to the doctrines of their religion without having to be licensed by the State. This is in keeping with the US Constitution, which forbids prohibiting the free exercise of religion. ) I understand that unless otherwise stated in my Biblical counselor's biography, my biblical counselor is not a psychiatrist or other medical physician, psychologist, state-licensed counselor, or state-licensed therapist. Instead, as is appropriate for a Biblical counselor, my Biblical counselor's qualifications, as described in his or her biography, are by means of ministerial license or ordination, a theology degree, Bible-related degree, Biblical counselor degree, pastoral counseling degree, Christian counselor degree, or Biblical counselor certification.
Privacy
Except within the context of the business-related activities described above, PeaceBrooke we will not share your email address, phone number or mailing address with anyone outside of PeaceBrooke without your permission. We will never sell this information to anyone. We may send you appointment reminders, homework and other helpful correspondence concerning your counseling sessions or issues you are working through, and perhaps birthday or holiday wishes. We will not send you our newsletter, mailing list, blog or devotional posts unless you subscribe to them.