PAR Program Registration Form

Limitations To Confidentiality / Clients Rights Limitations

The confidentiality of Thrive Counselling clients is of utmost importance to all staff.  The agency is required to obtain your informed written consent before releasing or obtaining any information except where authorized by legislation or directed by the courts.  These exceptions are as follows:

1. In certain limited circumstances your counsellor/therapist is required by law to disclose client information, and must comply with these mandatory obligations. These circumstances include, but are not limited to:  significant concern about the safety of a child (physical or sexual safety) or significant emotional harm (which includes situations and/or behaviours that seriously interfere with a child’s development or functioning); files being subpoenaed; search warrants.
2. In addition, it is a condition of the counselling relationship that your counsellor/therapist will release what would otherwise be confidential information if there is reason to believe that you represent a significant and immediate threat of death or serious injury to yourself or others. Thrive Counselling will take whatever steps necessary to avert danger to a client or others.  The threat of harm will always take priority over confidentiality.  Thrive Counselling has adopted this policy for the welfare of our clients, staff and the community at large.

Additionally, in an agency such as ours, there is sometimes a need for your counsellor/therapist to share pertinent personal information within the agency to other professional staff, administrative staff, and appropriate accredited bodies, who are ethically and strictly bound to maintain confidentiality.

If you are concerned about any aspect of these limitations to confidentiality, please discuss your concerns with your counsellor/therapist.

Partner Contact

I understand that while I am attending the program, services will be offered to the victim of the offence for which I was charged, and to my current partner if I am in a new relationship.

I understand that my victim/partner will be contacted to:

  inform them when I start the program

  inform them when I stop attending or complete the program

  refer them to programs that may benefit them or the children

  give them any information deemed necessary for their safety

  Give them an overview of the program as well as...

  a summary of my participation.

Program Expectations

While attending the program, I understand that I must:

1. Participate in and complete a 12-session program within the time frame specified on the court order or as specified by the referral.
2. Join sessions on time.
3. Not join a session if under the influence of alcohol or drugs that were not prescribed for me by a physician.
4. If participating in a group session, not discuss or reveal the identity of another group member or any information that could identify the group member or their partner with anyone outside of the group.
5. Ensure participation in a session occurs in a private space and that no one is able to view or overhear the session.
6. Expect to be discharged if I miss more than 1 session.
7. Behave respectfully to agency staff, group facilitators, and the other group participants.
8. Complete written work assignments.
9. Not interfere with contact between the agency and my victim/partner.
10. Not to bring a weapon to the group.
11. Pay my fee, as agreed.
12. Comply with the following additional requirements related to online program participation:
    a) Do not record or take pictures of the screen or other members of the group during your online sessions.
    b) Dress appropriately for the group session. (Shirt and pants required)
    c) Attend the online program from a location within Ontario.
    d) Enter the online space with my first name only. No surnames assists confidentiality.

I further understand that:

1. Personal information gathered by PAR program staff may be used by the PAR program or the Ministry of the Attorney General for research or program evaluation purposes. No information that could identify me will be in any research or evaluation report.
2. My enrolment, attendance, participation, completion or discharge from the program will be reported to Probation and Parole, Halton Regional Police, or the Crown Attorney’s office, whichever is appropriate as determined by the court order.
3. I may be discharged from the program for being disruptive or abusive during group sessions or refusing to pay my fees.
4. The Ministry of the Attorney General may review my information as part of a program compliance review.
5. My client file will be kept for a period of ten years by this or another PAR service provider serving this jurisdiction.
6. I will keep confidential all information about other group members, their situation, and their partner’s situation.
7. Sessions are recorded for supervisory purposes and may be observed by the staff team at Thrive Counselling. All recordings are stored securely until destroyed.

OR

2. Halton Regional Police Service

I agree to an exchange of information between Thrive Counselling and the Halton Regional Police Service regarding my counselling, attendance and participation in services offered as well as any information about my charges.

3. Court or Crown Attorney’s Office

I agree to an exchange of information between Thrive Counselling and the Crown Attorney’s Office or referring Court regarding my counselling, attendance and participation in services offered as well as any information about my charges.

Next Steps

Upon form submission you will be able to schedule your orientation meeting. Only once that has been attended, can we set a start date for you to begin your 12 sessions of PAR.

Thank you.