Informed Consent Document for Clinical/Rehabilitation Psychology Services for Partners of People with Chronic Conditions
An effective informed consent document for clinical/rehabilitation psychology work with partners of individuals with chronic conditions should clearly outline both the psychotherapeutic and neurocognitive components of treatment, detailing specific risks, benefits, and expected outcomes while respecting patient autonomy and ensuring comprehension.
Purpose of Services
- This document outlines two interconnected areas of our work together:
- Psychotherapy focused on adapting to relationship changes due to your partner's chronic condition
- Neurocognitive interventions aimed at improving cognitive function and delaying progression of difficulties
Psychotherapeutic Component
Nature and Purpose
- Sessions will address psychological adjustment to changes in:
- Roles and responsibilities within your relationship
- Expectations for interpersonal connections
- Emotional responses to caregiving demands
- Strategies to prevent resentment and regret
Process and Methods
- Treatment will involve:
- Regular assessment of your emotional well-being
- Exploration of grief, loss, and identity changes
- Development of coping strategies for role transitions
- Communication skills training for evolving relationship dynamics
Potential Benefits
- Improved emotional regulation and stress management
- Enhanced communication with your partner
- Development of healthy boundaries
- Prevention of caregiver burnout and compassion fatigue
- Reduced risk of depression and anxiety 1
Potential Risks
- Temporary increase in emotional distress when processing difficult feelings
- Relationship adjustments as you implement new boundaries and communication patterns
- Challenges in balancing self-care with caregiving responsibilities
Neurocognitive Component
Nature and Purpose
- Sessions will address:
- Assessment of cognitive functioning
- Development of strategies to support your cognitive health
- Techniques to manage the cognitive demands of caregiving
- Approaches to help your partner maintain cognitive function
Process and Methods
- Treatment may include:
- Cognitive assessment to establish baseline functioning
- Cognitive rehabilitation strategies
- Group cognitive training when appropriate
- Education about lifestyle factors affecting cognitive health 2
Potential Benefits
- Improved cognitive functioning and mental clarity
- Enhanced ability to manage complex caregiving tasks
- Strategies to support your partner's cognitive needs
- Reduced cognitive burden and mental fatigue
Potential Risks
- Frustration during challenging cognitive exercises
- Temporary fatigue from cognitive training
- Awareness of previously unrecognized cognitive difficulties
Confidentiality and Its Limits
- All information shared during sessions is confidential with the following exceptions:
- Risk of harm to yourself or others
- Suspected abuse or neglect of vulnerable individuals
- Legal requirements and court orders
- Insurance billing requirements (if applicable)
Your Rights as a Client
- You have the right to:
- Ask questions about any aspect of treatment
- Decline specific interventions or suggestions
- Access your clinical records
- Seek a second opinion
- End treatment at any time 1
Voluntary Participation
- Your participation in both psychotherapy and neurocognitive interventions is entirely voluntary
- You may withdraw consent for either component at any time
- The consent process is ongoing and will be revisited throughout treatment 2
Understanding and Agreement
- This informed consent process is interactive and iterative, recognizing that psychotherapy is a process rather than a single procedure 3
- Your understanding of treatment will evolve as we work together
- We will revisit aspects of this consent as treatment progresses 4
By signing below, you acknowledge that you have read and understood this information, had the opportunity to ask questions, and agree to participate in the described services.
Client Signature Date
Psychologist Signature Date