A look at the ‘contract' between therapist and client

At the start of therapy, the client and therapist do something called ‘contracting'. This is where they agree on the ‘terms and conditions' of the therapy work. The contract creates a structure for the therapy.

Part of the contract concerns confidentiality. An essential aspect of therapy is that the client can feel able to speak freely, so it helps the client to know that ‘what's said in the room, stays in the room'. Unlike when speaking to family or friends, it is hoped the client feels able to say whatever they want, including their secret feelings. Simply being able to do this can be enormously refreshing: it is rare to be able to speak so honestly, and simply doing this can be surprising liberating, while generating useful insights. It's not unusual for clients to say something out loud, and then to say, ‘I didn't realise I thought that!' or ‘It feels more real now I've said it out loud'.

There are a few exceptions to confidentiality, the gist of which is that if it seems there is a risk of serious harm to the client or another person then the counsellor may intervene having contracted in advance with the client that it is ok for them to take steps to protect people's well-being.

The contract also seeks to establish clear guidelines around timing and money.

Regarding timing, the therapist promises to be available at a certain time, on a certain day. How often have people let us down by not turning up when they said they would - or by not committing to an arrangement - or by changing their minds at the last minute, etc.? Part of a healthy relationship is reliability and the ability to keep promises, which is something the therapist seeks to do. For the client, it can be healing to have an experience of a reliable person.

For the client, their job is to turn up. This is an opportunity to show they are able to commit to something. If they don't turn up, the therapist might wonder about the client's willingness to engage with their issues. If the client ‘forgets' a session, this could be a sign of the client's unconscious unwillingness to participate. If the client arrives late or wants to leave early, again this can suggest that something about the therapy is too challenging for the client - or it could mean the client isn't getting what they want but is afraid to voice this. The experienced therapist will be curious about the client's attendance - or lack of attendance - not to punish, but to enquire into it because it may reveal useful information about the client's approach to life.

As well as turning up, the client has to pay. The therapeutic relationship is a close one - at times it can resemble a friendship or a parent-child dynamic - but payment reminds both client and therapist that there is professional work being done. The therapeutic relationship can feel very important but, ultimately, it is hoped the client doesn't come to rely on it so much that they neglect to develop other relationships in their life.

The client's attitude to payment can be revealing. The client may pay early or late, or forget to pay, or haggle over the cost; and if the client doesn't pay at all, the therapist will have to end the therapy. Again, an experienced therapist will be curious about all of this because it can reveal insights into the client's beliefs and attitudes. For example, it is not uncommon for a client to feel angry with their therapist, but rather than say so (which would be interesting material to explore in the therapy), the client will act out their anger by not paying.

The above may seem a bit over the top. But, basically, therapy is about putting the client's life under the microscope. Everything the client does - including what they do around attendance and payment - is useful material that can be investigated. The goal is to gain insight into the client's inner world. Sometimes, the client isn't aware of how they think and feel, but these things can sometimes be seen by looking at what they do, for example around attendance and payment.

By Mike Brooks, counsellor & psychotherapist