INFORMED CONSENT

to receive psychological and supervisory services from Olena Chebotaieva (TIN 2954706520)

PART I. GENERAL PROVISIONS

1. General principles

This Informed Consent is a public offer and defines the terms and conditions for the provision of psychological and supervisory services in the following formats:

·       individual psychological counseling;

·       couples (family) psychological counseling;

·       professional supervision;

·       therapeutic group.

The text of the Informed Consent is publicly available on the official website mindful.land.

The fact of payment by the Client for the relevant service is considered a complete, voluntary, and conscious confirmation that the Client:

·       has read the text of the Informed Consent;

·       understands its content;

·       has accepted all the terms and conditions without reservation;

·       has consented to their application,

which is equivalent to a handwritten signature on the Informed Consent form.

2. Legal and professional basis

Services are provided in accordance with:

·       The Law of Ukraine "On the Mental Health Care System" dated January 15, 2025, No. 4223-IX;

·       the current legislation of Ukraine;

·       the principles of professional ethics for psychologists.

Psychological counseling and supervision:

·       are not medical care;

·       do not replace psychiatric or other medical treatment;

·       does not involve the prescription of medication;

·       do not guarantee a specific result, as the effectiveness of the work depends on many factors, including the active participation of the Client.

3. Voluntary nature and limits of responsibility

The Client's participation in counseling or supervision is voluntary.
The Client has the right to terminate the services at any time, subject to the agreed financial and organizational conditions.

The consultant is not responsible for the Client's decisions made outside of sessions, nor for the consequences of the independent use of the recommendations received.

4. Confidentiality and its limits

All information obtained in the course of work is confidential.

Exceptions to confidentiality are possible only in cases provided for by law, in particular:

·       real threat to the life or health of the Client or other persons;

·       suspicion of violence against children or vulnerable persons;

·       official request from a court or other authorized bodies.

5. Processing and storage of personal data

The consultant has the right to keep professional notes:

·       in electronic format;

·       in compliance with the principle of personal data minimization;

·       with a storage period of up to 3 years after the end of cooperation.

Access to these materials is restricted to the Consultant, unless otherwise provided by law.

6. Online format and technical conditions

Services may be provided online using electronic means of communication.
The Consultant is not responsible for communication interruptions, technical failures, or other circumstances beyond their control.

The Client undertakes to ensure the confidentiality of their space during online sessions.

7. Payment for services

The cost of services is specified on the mindful.land website, unless otherwise agreed in writing between the Consultant and the Client.

Payment is made in advance and confirms:

·       acceptance of this Informed Consent;

·       agreement with the format, rules, and limits of liability.

8. Interaction between the Client and the Consultant

The Client:

·       is responsible for openness and active participation in the process;

·       has the right to refuse to perform any tasks that contradict their values;

·       undertakes to notify of the cancellation or postponement of a meeting no later than 48 hours in advance.

In case of cancellation of a meeting without valid reasons, the Client undertakes to pay for one hour of the Consultant's work at the agreed rate.

The consultant has the right to change the terms of cooperation or terminate it in case of systematic violations of agreements or lack of interest of the Client in joint work.

9. Emergency and crisis assistance

If there is a need for emergency or crisis psychological assistance between meetings, the Client may contact the relevant specialized psychological assistance services.

PART II.

SPECIFIC CONDITIONS OF INDIVIDUAL COUNSELING

Individual counseling is aimed at supporting psychological well-being, developing awareness, self-regulation, and adaptability.

The consultant has the right to terminate the work and recommend referral to another specialist in case of high risks for the Client or the need for specialized assistance.

PART III.

SPECIFIC TERMS OF COUPLES (FAMILY) COUNSELING

Couples counseling focuses on relationship dynamics, communication, conflicts, and boundaries.

The counselor does not act as an arbitrator and does not take the side of either partner.
Confidentiality applies within the couple, and information that directly affects the process of joint work is not kept secret from the other partner.

PART IV.

SPECIFIC CONDITIONS OF SUPERVISION

Supervision is professional support for mental health specialists and is not psychotherapy.

Within the scope of supervision:

·       professional cases are discussed without identifying client information;

·       responsibility for the primary work remains with the supervised professional.

The use of supervision materials for public or educational purposes is only possible with separate written consent.

PART V.

SPECIFIC TERMS AND CONDITIONS FOR THE PROVISION OF SERVICES IN THE THERAPEUTIC GROUP FORMAT

1. General characteristics of a therapeutic group

A therapeutic group is a form of psychological work in which the Consultant (group facilitator) provides a professional, structured, and safe space for psychological interaction between group members for therapeutic purposes.

Participation in a therapeutic group is aimed at:

·       psychological growth and awareness;

·       developing emotional regulation and interaction skills;

·       exploring interpersonal patterns in a safe environment;

·       support and integration of personal experience.

The therapeutic group is not a training course, does not replace individual psychotherapy, and is not medical or psychiatric care.

2. Voluntary participation and limits of responsibility

The Client's participation in the therapeutic group is voluntary.
The Client has the right to:

·       determine a comfortable level of self-disclosure;

·       refrain from discussing certain topics;

·       terminate participation in the group at any time in accordance with the organizational and financial conditions.

The consultant is not responsible for the actions, statements, or interpretations of other group members outside of their professional role.

3. Confidentiality in a group setting and its limitations

Confidentiality is a fundamental principle of the therapeutic group.
All group members agree not to disclose any information obtained during group sessions, including:

·       personal stories;

·       emotional reactions;

·       statements made by other participants;

·       the very fact of other people's participation in the group.

At the same time, the Client understands and accepts that the Consultant cannot legally guarantee confidentiality by all group participants, as they are not in an employment or contractual relationship with the Consultant.

For their part, the Consultant:

·       establishes and maintains group rules;

·       regularly reminds participants of the principle of confidentiality;

·       intervenes in case of violation within the limits of his/her professional competence.

4. Group dynamics and emotional reactions

The client is informed and agrees that participation in a therapeutic group may be accompanied by:

·       intense emotional experiences;

·       a temporary increase in anxiety, tension, or vulnerability;

·       reactions related to interpersonal triggers.

Such manifestations are a normal part of the therapeutic process and are not considered harmful, provided that professional standards and group rules are followed.

5. Rules of conduct in the group

Participants in the therapeutic group undertake to:

·       comply with the established rules of the group;

·       refrain from insults, humiliation, pressure, or violent forms of interaction;

·       speak in the first person ("I-statements");

·       respect the boundaries of other participants and the Consultant;

·       not to use the group space to give advice, moralize, or diagnose other participants.

Systematic or gross violation of the rules may be grounds for termination of the Client's participation in the group.

6. Consultant's right regarding the Client's participation in the group

The Consultant has the right to:

·       refuse the Client's participation in the therapeutic group before it begins or terminate participation during the process;

·       recommend individual psychotherapy or another form of assistance

if:

·       the Client's participation poses a risk to themselves or other participants;

·       the Client's condition requires individual or medical assistance;

·       group rules or professional boundaries are violated.

7. Use of group materials

Any use of group work materials (for educational, public, or research purposes) is possible only in a generalized, anonymized form and only if the participants' identifying information is not included.

8. Confirmation of informed participation

Payment for participation in the therapeutic group confirms that the Client:

·       has read the terms and conditions of participation;

·       understands the specifics of the group format;

·       is aware of the confidentiality restrictions;

·       voluntarily agrees to participate in the therapeutic group under the stated conditions.

 

FINAL PROVISION

This Informed Consent shall become effective upon:

·       the Client pays for the service, or

·       the actual receipt of services,

whichever occurs first.