Informed consent

Informed consent means a person freely choosing whether to access a service, knowing its benefits and risks. Effective practice means the psychologist: (a) gives clients information they can understand before seeking consent (section 3.2); (b) checks that they have understood; (c) leaves enough time for questions and a considered decision; (d) works within the client's capacity to decide, including for children and young people according to maturity, understanding and the nature of the service, and considers whether consent is also needed from a parent, carer, guardian, legal representative or other substitute decision-maker; (e) gets informed consent, or that of the substitute decision-maker where the client lacks capacity, before a service begins (an emergency may make this impossible) or before involving the client in teaching or research, including the material risks and expected outcomes; (f) tries to engage and gain agreement from clients who cannot consent, following the consent process as far as is reasonable; (g) tells clients how long their consent will be relied on if nothing significant changes; (h) seeks consent afresh when that period ends or the service or relationship changes significantly; (i) tells clients they can withdraw consent at any time and talks through what withdrawal would mean; (j) gets financial consent by discussing fees openly with clients, associated parties and third parties, covering the cost of all services required, and gets broad agreement on the nature of the service, ideally before it starts; (k) explains the benefits, costs and risks when referring a client on for further investigation, treatment or services; and (l) documents consent properly, with written consent for any assessment or procedure involving physical contact (section 4.8).

• Signed informed consent forms stating service nature, risks, expected outcomes, the period of consent and the right to withdraw
• Fee schedule and financial consent signed before the first session
• Capacity assessments and substitute decision-maker or parent consent on file for clients lacking capacity, including minors
• Notes of consent being revisited when the period lapsed or the service changed
• Written consent for any assessment or intervention involving physical contact

• Consent taken once at intake and never revisited
• No record of the client being told they could withdraw consent
• Mature minor consent assumed without assessing capacity
• Fees disclosed only after the service began