This document will form the basis of our working relationship following our recent telephone conversations. My visit to you is agreed for ... DATE ... and by signing this document you agree to pay me the fee of £... for my work with your family that begins today and continues for the next three months. There are no other charges or expenses connected with my involvement with you.

The day’s consultation (I will be available for another day’s consultation should this be necessary) is followed by 3 months of weekday phone support finishing on ... DATE ...

Not an easy process Children and adolescents are time-consuming and the amount of time that a particular child needs cannot be defined objectively. They are incapable of modifying their need for your supervision and attention because of your busy life. Our work together depends on your acceptance that your child(ren) are as trapped by their behaviour as you are and that the solution to your child(ren)’s problems is located in changes to the responses that you have been previously using. In other words if you do not carefully change how you speak to them and what you say their behaviour will not change. It is inefficient (and not fair) to ask your children to control and change their behaviour when you are not consistently in control of yours. The speed of success you achieve will be directly related to your improving ability to modify your own behaviour. I strive not to gratuitously offend my clients but I believe my near 100% success rate is based on “telling it as it is”. In the past three clients made the decision not to continue because I strongly pointed out the unfairness of blaming children for behaviour that they were themselves modelling or rewarding. Should you decide not to continue for this or another reason any partial refund of fee will be entirely at my discretion.

Recordings and Videos
As so much of the success of the intervention depends on the careful control by the parent of the verbal interactions with their child(ren), parents are asked to provide recordings (videos are more difficult but very useful) of their interactions preferably each day prior to phoning . These can be played over the phone or Skype or sent via email etc. - but are, in whatever form received, only used for the immediate training that follows and are of course completely confidential.

Confidentiality
All the discussions and interactions and recorded material that we share are kept completely confidential

Disclaimer
You will be asked to sign this and a separate disclaimer document accepting that you retain sole responsibility for your own safety and the safety of each member of your family and accept my advice on a nil-liability basis.

Evaluation
I always evaluate the work that I do - so I need a commitment from you that you will complete a simple evaluation process when the intervention is concluded. Warwick Dyer..…………………………………

I /we have read and accept all the points made in this document and agree to be bound by its terms and conditions and accept your advice on the nil liability basis described above. I/we agree always to consider for ourselves our child(ren)’s emotional and physical well-being and safety (and our own) and make entirely our own decisions about what is the best way to respond to our children during and following all our conversations. I confirm that no other person or agency has objection to our/my receipt of your advice for the children concerned.

Signed__________________________            Signed__________________________


Printed_________________________            Printed__________________________


Relationship to child___________                        Relationship to child____________


Behaviour Change Consultancy 24 Rochdale, 66 Harold Road, London, SE19 3TF 020 8653 9768

Although all of my clients to date have found my suggestions helpful (only three of all my previous clients did not go on to complete their interventions successfully ), there will always be circumstances particular to your child(ren) (whom I usually never actually see) of which I am not aware. I work solely on the information given to me by you and do not do any observations to see what is happening for myself. This, and the fact that my skills are practically acquired - I have over 25 years of experience but no formal medical/psychological qualifications in this area - leaves a large possibility for misunderstanding and error and must leave the responsibility for whatever happens within your family during and following my involvement entirely with you as your child(ren)’s parents.

By signing this document you are stating that you have told me about all the previous medical/professional involvement with your child(ren) and that these professionals have been informed about my involvement with you and are happy that your child(ren)’s behaviour can be safely handled with the use of rewards and sanctions. I do not accept responsibility for any adverse occurrence that might be deemed to have stemmed from your attempts to implement advice received from me. You will have to accept all responsibility for any and all outcomes that result from your decision to use, or not use, suggestions I have made. I agree to suggest alternative strategies or augment strategies that you have used in the past. I agree also to discuss your implementation of the strategies. It is your responsibility to make up your own mind whether or not any strategy suggested by me is likely to be effective and whether it is safe to use as circumstances change.

Parents of children with serious, violent, intimidatory behaviour are often advised by Child Psychiatrists to always avoid confrontation - this might mean giving the child what it wants. This advice could prevent a serious violent act from occurring. Where a child is seriously disturbed this may well be the best current advice.

On the other hand, if the problems are merely associated with behaviour management then others think that parents should not accede to demands that are not in the best interests of the child or demands that are aggressively or rudely made. This, they feel, will prevent even more serious behaviour developing in the future. However, I have as already said, for a seriously disturbed child the Child Psychiatrist’s advice may often be the safest option.

I work with you only on the assurance given to me by you that you have sought professional advice and that you have been advised that none of your children are seriously disturbed and that they are in need of, and can cope with, changes in “behaviour management”. You need to make sure that you have received and will continue to receive the best professional advice as your intervention with the child(ren) proceeds so that you and I can be sure none of them are, or become, seriously disturbed.

Although, to date, there has never been a serious adverse outcome from any of my interventions, since I never actually see the child(ren) of the parents with whom I work and rely entirely on second-hand accounts of what is happening between you and your child(ren) I am never, and can never be, considered accountable for their or your emotional or physical safety or for any subsequent adverse outcome.

Please sign and indicate that you accept my involvement with your family on the nil liability basis described here. Although I have years of experience, I have no medical or psychological qualification. You must keep this fact firmly in mind and always consider for yourself your child(ren)’s emotional and physical well-being and safety (and your own). You must make entirely your own decisions about what is the best way to respond to your child(ren) during and following all our conversations. This document functions as a complete disclaimer and, if you sign it, you waive all rights to any legal redress for any adverse outcome that you might wish to claim in the future to have resulted from my involvement with your family. By signing below you specify that you take complete responsibility for all outcomes that result from our meetings and ‘phone conversations and your actions and responses to your child(ren).

I have read and accept all the points made in this document and agree to be bound by its terms. I confirm that no other person or agency has objection to our receipt of your advice for the children concerned.



Signed__________________________            Signed__________________________


Printed_________________________            Printed__________________________


Relationship to child___________                        Relationship to child____________


Behaviour Change Consultancy 24 Rochdale, 66 Harold Road, London, SE19 3TF 020 8653 9768