It is your statutory right according to the General Data Protection Regulations approved by the EU Parliament on 14 April 2016 with enforcement from 25 May 2018 to request:
Copies of any record I keep of your identity, personal information and therapy records to be provided at a date negotiated between us.
Have your records deleted.
I am also required under this law to disclose to you the records I keep about you, how I store them, what I use them for and how I dispose of them.
Electronic Diary System
I use an electronic diary system on my office PC. This is synced to my mobile phone and iPad to enable me to access my diary where ever I am. All three of these electronic devices are password protected. I identify client appointments using initials and numbers. My diary is not shared. Should an emergency (e.g. I am taken seriously ill) occur my husband has the immediate responsibility of handing over practice information (e.g. client names and contact details) to my colleague who has agreed to act as executer for my Clinical Will. For more information about my Clinical Will see the end of this document.
Client Intake Sheet
This is an intake form, identifiable by a code letters and number only, consisting of a set of questions to ascertain your age, employment, pertinent family history, medical and psychological history, what you want to achieve in therapy, and any agreements we make. It is usually completed by me, in collaboration with you at the end of our initial meeting and if we agree to work together. The form is a paper document which is then transferred to my electronic filing system where it is identified by letters and numbers only. The paper document is then shredded (see paragraph headed “How I dispose of your records”).
Personal Information Record Card
This is an index card recording the name, address and contact details. It is kept in a filing system that is separate from therapy records and under lock and key when I am away from the office or there are others in the house. It is used for contact information purposes only.
Session Records and what I do with them
I have an electronic log system that records your attendance by your unique identifier. I also have a word file only identified by your unique number. In this word file I record a brief outline of your presenting issue and any end of session notes I keep. None of the information on the Personal Information Record Card appears in the log or word file. It should be noted the therapy records I keep are brief, i.e. literally a reminder of the key issue covered in the session. These records are not shared with any other person.
Electronic Accounts system
My practice accounts are set up on an excel spreadsheet which details the date of session, amount paid and payment method with client’s initials.
How I dispose of your records
Records are kept for a period of approximately 3 years from when counselling ends. When working with children and young people, this will be until they are at a minimum age of 19 years, and for a minimum of 3 years from when counselling ends. Records are then destroyed by shredding.
I will destroy all electronic records I keep about you should you request me to at the end of our work together.
Disclosure of information to other parties
Contact information for the medical professionals working with you is important to have in case I believe you need medical intervention. I will only contact these people if:
If I need to obtain more detailed records of your medical condition.
I believe that prescribed medication might need to be adjusted or changed.
I believe that you may harm yourself or another.
I will always tell you if I intend to contact your G.P. and/or Psychiatrist.
I retain the right to disclose to statutory authorities if I believe you are intending to engage in any activity that will harm another.
I have supervision on a regular basis. In this medium I will only use a first name to identify the client I am discussing with my supervisor.
I will never disclose any information about you to any other third party unless I am presented with a court order.
In the circumstance of my being unavailable to continue to work with you due to serious illness, incapacitation or death I have an agreement with a colleague whereby she will be informed of my circumstances by a member of my family, who will send your contact information to my colleague. My colleague will then contact my clients to discuss how they wish to go forward. The same member of my family also holds responsibility for the deletion of all electronic and paper records pertinent to my clients and professional practice in the scenario where I can no longer work.