Cancellation/Lateness Policy

 

1. Cancellation of Appointment

If you fail to give less than 48 hours notice of your intention to cancel or postpone an agreed therapy session or if there is a repeat pattern of cancellations/DNA’s we reserve the right to charge in full for that session. It is understood that sometimes emergencies happen, that may make it necessary for clients to cancel their appointment last minute or fail to attend and are unable to provide notification. It is at the therapist/coach’s discretion if a fee will be charged in such emergencies, but where possible some flexibility may be provided or an alternative session offered.

 

1. Cancellation of Block Booking

If you have agreed to sign up for a fixed number of sessions (eg. a 6 session block) or a fixed time period programme (eg. a 3 month programme), no refund will be provided if you decide not to continue working with us for the full duration. If you have agreed to pay in monthly instalments, the full cost of the programme will still be due even if you have not continued with the programme. If you have difficulties or concerns in continuing with sessions or a programme which you have signed up for, please bring these concerns to your therapist/coach or to Elinor Harvey and we would be happy to see how we can help you continue with the work or make any necessary adjustments for you.

 

1. Late Arrival

The normal duration of each session is 50 mins, although we reserve the right to amend that time for therapeutic reasons. If for any reason you are late for a session, we will see you for the duration of the remainder but will be unable to work beyond the allotted time as this will disrupt the clinic for other clients who may be waiting.

 

In couples sessions, we will not start the session until all parties are present, unless previously agreed. The normal session fee will apply even if one or both partner’s absence prevents the session from starting on time.

 

Complaints Policy

 

1. In the event of you being unhappy with the service you receive, please discuss this with your therapist, coach or with Elinor Harvey. If you feel unable to do so or do not receive satisfactory resolution, then you have the right to complain to your therapist’s professional body, the NCPS, BACP, OR COSRT.

 

Confidentiality Policy

 

1. Purpose and Scope

The Relationship Therapy Practice is committed to the highest standards of confidentiality. This policy explains what is kept confidential, who may access information, and the limited circumstances in which confidentiality may need to be breached. It applies to all therapists, coaches, supervisors, and administrative staff.

1. What Confidentiality Means

Information shared by a client during therapy or coaching will not be disclosed to any third party without their express, informed consent — except in the limited circumstances described below. Clients are informed of this policy and its limits at the outset of their work with the Practice, and this is documented in the therapy contract.

1. What Information is Confidential

All information shared by a client is confidential, including:

• The content of all sessions
• Personal and biographical history
• Clinical notes and records
• Correspondence and communications
• Assessment findings and clinical formulations
• The fact that someone is attending therapy is also confidential.

 

1. Clinical Supervision

All practitioners engage in regular clinical supervision as required by their professional bodies. Client material may be discussed in supervision for the purpose of reflective practice and quality assurance. Supervisors are bound by their own confidentiality obligations. Where possible, identifying details are minimised. Clients are informed of this in the therapy contract.

 

1. Limits of Confidentiality

   1. Risk to Life

If a practitioner has serious concerns that a client or third party is at immediate risk of harm — including suicide or homicide — they may need to contact emergency services or other relevant parties to protect life.

1. Safeguarding

Where a child or vulnerable adult may be at risk of abuse or neglect, the Practice has a statutory duty to refer concerns to the appropriate authorities (see Safeguarding Policy). This may happen without the client’s consent if disclosure would put the person at further risk.

1. Legal Obligation

Practitioners may be required to disclose information by court order or under legislation such as the Terrorism Act 2000 or Proceeds of Crime Act 2002. Legal advice will be sought before any such disclosure.

1. Serious Crime

Where information indicates that a serious crime has been or is about to be committed, practitioners will seek guidance from their supervisor and professional body before taking action.

 

1. Sharing Information with Consent

With written client consent, the Practice may share information with GPs, other health professionals, solicitors, courts, or employers. Consent may be withdrawn at any time

1. Couples Therapy

In couples therapy, the approach to information shared individually by one partner (e.g., by phone or email outside of joint sessions) is agreed at the outset of the work and documented in the therapy contract.

1. Group Therapy

Participants in group therapy agree to maintain confidentiality about other members’ disclosures as a condition of participation. The practitioner holds responsibility for the group’s confidentiality framework.

1. After the Therapeutic Relationship Ends

Confidentiality obligations continue indefinitely after the therapeutic relationship ends. Practitioners must not share identifying information about former clients.

1. Breach of Confidentiality

Any actual or suspected breach of confidentiality must be reported to the Practice Director immediately. All breaches are documented and reviewed, and appropriate steps are taken to mitigate harm and prevent recurrence.

 

The Relationship Therapy Practice Privacy Statement

 

1. Who we are

The Relationship Therapy Practice Ltd is the data controller responsible for processing your personal information. If you have any questions regarding this Privacy Statement or how your data is handled, please contact us at hello@relationshiptherapypractice.com

 

1. What data we collect from you

The Relationship Therapy Practice may request personal information including your name, date of birth, telephone number, postal address and email address for the purposes of arranging appointments, maintaining contact with you and providing therapy services.

 

We may also request details of your GP surgery and any relevant medications in order to support safe practice, safeguarding responsibilities and to protect your vital interests in the event of a medical emergency.

 

Throughout therapy, you may choose to disclose sensitive personal information relating to your physical health, mental health, relationships and wellbeing. This information may form part of brief factual clinical notes which are recorded to support the provision of therapy, maintain continuity of care and meet professional, ethical and insurance requirements.

 

We may use secure online practice management systems and other professional service providers to confidentially store and process your information. All such providers are required to comply with data protection legislation and maintain appropriate security measures.

 

1. Lawful basis for processing your information

We process your personal information because it is necessary for the performance of our contract with you and for the provision of therapy services.

 

Where we process special category data, including information relating to your physical or mental health, we do so with your explicit consent and, where necessary, to protect your vital interests or the vital interests of another person.

 

1. Sharing your information

Everything you share within therapy is treated as confidential.

 

Your information will not be shared with third parties except in the following circumstances:

 

• Where it is necessary to protect your vital interests or the vital interests of another person, including situations involving a risk of serious harm.
• Where disclosure is required by law.
• Where disclosure is necessary for legal proceedings or the administration of justice.
• Where disclosure is necessary for medical purposes and is undertaken by a health professional or another person subject to an equivalent duty of confidentiality.
• Where disclosure is required as part of safeguarding responsibilities.

 

As part of our professional and ethical obligations, therapists may discuss their work with a clinical supervisor to ensure that they are practising safely and effectively. Supervisors are bound by the same professional and legal duties of confidentiality. Client discussions are anonymised wherever possible.

 

1. How we store your information

We take appropriate technical and organisational measures to protect your personal information against unauthorised access, loss, misuse or disclosure.

 

Your information will be stored securely throughout the course of therapy and for six years following the conclusion of therapy. After this period, records will be securely destroyed.

 

1. Data breaches

In the unlikely event of a personal data breach, we will take appropriate action to investigate and manage the incident. Where required by law, breaches will be reported to the Information Commissioner’s Office within 72 hours of becoming aware of the breach. Individuals affected by a breach will be informed where there is a high risk to their rights and freedoms.

 

1. Your rights

Under UK data protection law, you have the right to:

 

• Request access to the personal information we hold about you.
• Request correction of inaccurate or incomplete information.
• Request restriction of processing in certain circumstances.
• Object to certain types of processing.
• Request erasure of your information where legally applicable.
• Withdraw consent for the processing of special category data where consent is the basis for processing.

 

Please note that withdrawing consent or requesting deletion of records may affect our ability to provide therapy services safely and effectively and may not apply where we are required to retain records for legal, insurance or professional reasons.

 

1. Complaints

If you have any concerns about how your information has been handled, please contact us in the first instance at hello@relationshiptherapypractice.com.

 

You also have the right to make a complaint to the Information Commissioner’s Office:

 

Website: http://www.ico.org.uk

Telephone: 0303 123 1113

 

1. Marketing communications

If you choose to join our mailing list, we will use your email address to send occasional updates, resources, workshops and information about our services. You may withdraw your consent and unsubscribe at any time.

 

Equality, Diversity & Inclusion Policy

 

1. Purpose and Scope

The Relationship Therapy Practice is committed to equality, diversity, and inclusion (EDI) across all aspects of our work — in the services we provide, the practitioners we work with, and the culture we nurture. This policy applies to all staff, therapists, coaches, contractors, volunteers, and clients.

2. Our Commitment

We believe every person deserves access to high-quality, culturally sensitive therapy regardless of who they are or where they come from. We are committed to:

• Creating a safe, inclusive, and welcoming environment for everyone
• Treating all people with dignity, respect, and fairness
• Actively challenging discrimination and bias, including our own
• Continuously developing our cultural competence as a practice
• Ensuring our services are genuinely accessible to diverse communities

3. Legal Framework

This policy is underpinned by the Equality Act 2010. We do not discriminate — directly or indirectly — on the basis of any protected characteristic, including:

• Age
• Disability
• Gender reassignment
• Marriage and civil partnership
• Pregnancy and maternity
• Race, colour, nationality, and ethnic or national origins
• Religion or belief
• Sex
• Sexual orientation

4. Service Delivery

4.1 Accessible Services

We are committed to removing barriers to access. We offer online therapy as standard, removing geographical and mobility barriers. We consider reasonable adjustments for clients with disabilities, offer information in alternative formats on request, and offer a sliding scale of fees where possible.

4.2 Culturally Competent Practice

Our practitioners are expected to:

• Engage in ongoing reflection about their own background, biases, and privilege
• Seek appropriate training when working with populations new to them
• Not impose cultural, religious, or political values on clients
• Seek clinical supervision when working at the edge of their competence

5. Recruitment and Employment

We are an equal opportunities employer. All recruitment, promotion, and training decisions are based on merit, skills, and suitability. We actively seek to build a diverse team that reflects the communities we serve. We will not discriminate in any aspect of employment on the basis of any protected characteristic.

6. Harassment and Discrimination

The Practice will not tolerate any form of harassment, bullying, or discrimination — including verbal, physical, or online conduct. Staff or clients who experience or witness discrimination should report it to the Practice Director. Clients may also use the Complaints Policy. All reports will be taken seriously and handled confidentially.

7. Monitoring and Review

The Practice will monitor the diversity of its client group and workforce over time and use this to identify gaps and inform our EDI approach. This policy is reviewed annually.

8. Responsibilities

All staff and practitioners share responsibility for upholding this policy. The Practice Director has overall responsibility for its implementation, monitoring, and review.

 

Domestic Abuse & Personal Safety Plan

 

1.  Purpose and Scope

This policy supports The Relationship Therapy Practice in responding safely and ethically to disclosures of domestic abuse (DA) and intimate partner violence. It applies to all practitioners working within the Practice. The Practice recognises that domestic abuse affects people of all genders, ages, and relationship types.

 

1. Legislative Framework

This policy is informed by the Domestic Abuse Act 2021, Care Act 2014, NICE guidance on domestic violence and abuse (PH50), local authority MARAC protocols, and BACP/UKCP ethical frameworks.

 

1. Defining Domestic Abuse

Under the Domestic Abuse Act 2021, domestic abuse is behaviour by one person towards another with whom they are personally connected, that is abusive. This includes:

• Physical or sexual abuse
• Violent or threatening behaviour
• Controlling or coercive behaviour
• Economic abuse
• Psychological or emotional abuse

 

1. Recognising Domestic Abuse

Practitioners should remain alert to presentations that may indicate DA, including anxiety, depression, low self-esteem, isolation, unexplained injuries, fear of a partner, or accounts of controlling behaviour. No assumption should be made about the gender or relationship type involved.

 

1. Safe Enquiry

The Practice uses a safe enquiry approach — creating space for disclosure without direct questioning that could increase risk. Practitioners should:

• Ensure sessions are private and cannot be overheard or interrupted
• Never conduct DA-related sessions when the perpetrator may be present or listening
• Use open-ended, non-judgemental questions
• Believe and validate the client’s experience
• Avoid suggesting the client keep diaries or records (this can increase risk)

1. Risk Assessment

Where DA is disclosed, practitioners should use a structured risk assessment tool such as the DASH checklist to identify the level of risk. High-risk indicators include: threats to kill, use of weapons, harm to children, sexual violence, escalating frequency or severity, or the client reporting fear for their life. Risk assessments must be documented in clinical notes.

 

1. Immediate Safety

If a client is in immediate danger:

Encourage them to call 999 if safe to do so

Provide the National Domestic Abuse Helpline: 0808 2000 247 (free, 24 hours)

Consider MARAC referral via the local IDVA service for high-risk cases

 

1. Personal Safety Planning

For clients not in immediate danger, practitioners should collaboratively develop a Personal Safety Plan (see Appendix). This should include safe places to go, key people to contact, important documents to have ready, digital safety, and — where relevant — safety planning for children.

 

1. Couples Therapy and Domestic Abuse

Couples therapy is not appropriate where domestic abuse is a feature of the relationship. Joint sessions can increase risk by giving the abusive partner information to use for further control or harm. If DA comes to light during couples work:

• Pause couples work immediately
• See the disclosing partner individually to assess risk
• Discuss with clinical supervisor
• Do not share information from individual sessions with the other partner

 

1. Confidentiality and Reporting

DA disclosures are generally kept confidential. Confidentiality may be breached where a child is at risk (see Safeguarding Policy), a vulnerable adult is at risk, or there is an imminent risk to life. Any breach decision must be discussed with the supervisor where possible and always documented.

 

1. Referral Resources

National DA Helpline (Women’s Aid / Refuge): 0808 2000 247

Men’s Advice Line: 0808 801 0327

Galop (LGBTQ+ DA): 0800 999 5428

MARAC via local IDVA service

Local authority Safeguarding Adults or Children teams

 

Home Working Policy

 

1. Purpose and Scope

This policy sets out the requirements and expectations for practitioners at The Relationship Therapy Practice who conduct sessions from their own home. All home-based working must be approved by the Practice Director and must comply with this policy in full.

 

1. Eligibility and Approval

Practitioners wishing to work from home must:

• Obtain written approval from the Practice Director before seeing clients from home
• Confirm that their home working environment meets the requirements below
• Inform the Practice immediately of any changes to their home working arrangement

 

1. Workspace Requirements

The home working environment must:

• Be a private, enclosed space where sessions cannot be overheard by others in the household
• Be free from interruptions during session times (children, pets, other household members)
• Present professionally on video calls (neutral background, good lighting, no distracting elements)
• Have a reliable, secure broadband internet connection
• Have a door that can be locked or that provides reliable privacy

 

1. Data Protection and Confidentiality

Practitioners working from home must ensure:

• Client records are accessed only on password-protected, encrypted devices
• Paper notes are stored in a lockable cabinet, out of sight of others
• Screens are not visible to household members during sessions
• Video sessions use only GDPR-compliant platforms approved by the Practice
• No client information is discussed in shared spaces
• Work devices are not shared with other household members

 

1. Insurance

Practitioners must hold:

• Professional indemnity insurance that covers home-based practice
• Public liability insurance if any clients attend the home in person

Home insurers must be informed of business use. 

Practitioners are responsible for ensuring their home insurance is not invalidated by their work activities.

 

1. Health and Safety

Practitioners are responsible for maintaining a safe home working environment, including:

• Adequate lighting, heating, and ventilation
• An ergonomic workspace to prevent injury
• Completion of a home working risk assessment (template available from the Practice Director), reviewed annually
• Knowledge of emergency procedures (e.g., what to do in a fire)

 

1. Technology and Security

Practitioners must:

• Use a secure, password-protected Wi-Fi network (not a public or shared network)
• Keep devices and software fully up to date
• Use only the Practice’s approved clinical software and video platform
• Not store client data on personal cloud services without explicit Practice approval
• Report any data security incidents immediately to the Practice Director

 

1. Wellbeing

Home working can blur the boundary between work and personal life. Practitioners are encouraged to set clear working hours, take regular breaks, and develop a physical transition ritual between work and personal time. The impact of home working should be discussed in clinical supervision.

 

1. Review and Withdrawal of Approval

The Practice Director may review or withdraw approval for home working if the requirements of this policy are not met or if concerns arise about client safety or confidentiality. Home working arrangements are reviewed as part of the annual appraisal.

 

Letter & Report Writing Policy

 

1. Purpose and Scope

This policy sets out The Relationship Therapy Practice’s approach to the production of clinical letters and reports. It applies to all communications written by practitioners on behalf of the Practice — including letters to GPs, reports for courts, solicitors, employers, and insurance companies.

 

1. Types of Document

   1. Routine Clinical Letters

These include acknowledgement letters, discharge summaries, and letters to GPs or referring professionals confirming attendance or providing clinical updates. These are part of routine clinical practice and are included within standard fees.

1. Clinical Reports

Clinical reports are more detailed documents, typically requested by third parties. They include assessment reports, progress reports, medico-legal or expert witness reports, occupational health reports, and reports for family law proceedings.

 

1. Consent

No letter or report will be written about a client without their prior written, informed consent — except where required by a court order. Clients must understand:

• Who will receive the document
• What information will be included
• How it will be used
• Their right to review a draft before it is sent, where appropriate
• Consent must be documented in the client file prior to the work commencing.

 

1. Fees

Letter and report writing is charged separately from therapy sessions. Fees are confirmed in writing before work begins, and payment is required before the document is released unless otherwise agreed. Clients are informed of fees at the point of consent. Please contact the Practice for our current fee schedule.

 

1. Timeframes

Standard reports will be completed within 28 working days of receipt of a written request, signed consent, payment, and all necessary information. Urgent reports may be completed sooner where capacity allows and may attract an additional charge. Timeframes are confirmed in writing at the point of instruction.

 

1. Standards for Report Writing

All letters and reports must:

• Be factual, accurate, and objective
• Be clearly written and free of unexplained clinical jargon
• Be grounded in the practitioner’s clinical knowledge, without speculation beyond their competence
• Clearly distinguish between factual information and clinical opinion
• Include the practitioner’s name, professional credentials, and registration number
• Be dated and signed
• Be reviewed by a senior clinician or supervisor before release if complex or contentious

 

1. Expert Witness Reports

Practitioners should only produce expert witness reports if they hold appropriate training and experience in medico-legal work. Expert witness instructions must be approved by the Practice Director. Practitioners are reminded that their overriding duty is to the court, not to the instructing party.

 

1. Record Keeping

A copy of all letters and reports must be retained in the client’s clinical file. They are subject to the same retention periods as clinical records (see Data Protection Policy).

 

1. Third-Party Requests for Records

Requests from solicitors, courts, or other third parties for clinical records or reports must be directed to the Practice Director. Records will not be released without a valid court order or the client’s written consent.

 

Risk Assessment Policy

 

1. Purpose and Scope

Risk assessment is a core component of safe and ethical practice. This policy sets out The Relationship Therapy Practice’s approach to identifying, assessing, and managing risk. It applies to all practitioners working within the Practice.

 

1. Types of Risk

   1. Clinical Risk

Clinical risk refers to risks arising from a client’s mental health, wellbeing, or life circumstances, including:

• Risk of suicide or self-harm
• Risk of harm to others
• Domestic abuse or intimate partner violence
• Safeguarding concerns relating to children or vulnerable adults
• Substance misuse that affects safety
• Eating disorders or other conditions that may require medical monitoring

 

1. Operational and Environmental Risk

Including lone working risk, data security, and health and safety in the physical workspace. These are addressed in the Lone Working Policy, Data Protection Policy, and Home Working Policy.

 

1.  Initial Risk Assessment

A risk assessment must be completed at the first assessment session and documented in the clinical record. It should cover:

• Current mental health presentation and any diagnoses
• History of self-harm or previous suicide attempts
• Current suicidal ideation (using a structured approach — see the Crisis Plan)
• History of harm to or threats towards others
• Substance use
• Living situation and social support
• Any safeguarding concerns

 

The practitioner’s formulation should reflect their assessment of risk level: low, medium, or high, with a clear rationale.

 

1. Ongoing Risk Assessment

Risk is not static. Practitioners must:

• Review risk at every session, or more frequently as clinically indicated
• Document any change in risk level and the rationale for clinical decisions
• Increase frequency or intensity of sessions if risk escalates
• Consult with their clinical supervisor when risk is elevated
• Refer to other services (GP, CMHT, crisis team, A&E) when appropriate

 

1. Risk Management Planning

For clients presenting with elevated risk, practitioners should develop a collaborative risk management plan. This may include:

• A written safety plan completed with the client (see Crisis & Suicidal Ideation Safety Plan)
• Agreement on what the client will do if they feel unsafe between sessions
• Consent to contact the GP or emergency contacts in an agreed crisis scenario
• A clear escalation pathway if risk deteriorates

 

1. Documentation

Risk assessments and management plans must be documented clearly and contemporaneously. Notes should include: risk factors identified, risk level and rationale, any clinical decisions made and why, actions taken (referrals, emergency contacts, supervision sought), and the date and time.

 

1. Breaching Confidentiality

Where risk assessment indicates an imminent risk to life — either the client’s or a third party’s — the practitioner may need to breach confidentiality (see Confidentiality Policy). Such decisions must be discussed with the clinical supervisor wherever possible and always documented thoroughly.

 

1. Supervision

Clinical risk must be regularly discussed in supervision. Practitioners are expected to bring high-risk cases to supervision proactively. Between supervision sessions, practitioners should contact their supervisor for an urgent consultation if risk escalates significantly.

 

1. Training

All practitioners are expected to hold current suicide and self-harm awareness training (e.g., SafeTalk, ASIST, or equivalent), refreshed at least every three years.

 

1. Review

This policy is reviewed annually by the Practice Director and following any critical incidents.

 

Social Media Policy

 

1. Purpose and Scope

This policy sets out The Relationship Therapy Practice’s approach to social media use by practitioners and staff — both in a professional capacity on behalf of the Practice, and in their personal lives where conduct could affect the Practice or its clients. It applies to all platforms including Instagram, Facebook, LinkedIn, X (formerly Twitter), TikTok, YouTube, WhatsApp, and online forums.

 

1. Professional Social Media (Practice Accounts)

• All content posted on the Practice’s official accounts must be:
• Accurate, evidence-informed, and aligned with our brand voice: warm, professional, and accessible
• Free from unsubstantiated therapeutic or health claims
• Compliant with ASA (Advertising Standards Authority) guidance
• Approved by the Practice Director before publication, where created by a practitioner on the Practice’s behalf
• No client information — including details that could indirectly identify someone — may be shared on social media without explicit written consent.

 

1. Personal Social Media

Practitioners are entitled to a private life and need not disclose their professional role online. However, they must be aware that:

• Content posted on personal accounts can affect the Practice’s reputation if they are identifiably connected to it
• Public criticism of colleagues, clients, or the Practice on social media is not acceptable
• Any breach of client confidentiality on personal accounts — even unintentionally — is a serious professional and legal matter
• Practitioners should not post about specific cases or situations, even if the client is not named

1. Client Contact via Social Media

Practitioners must not:

• Accept friend or follow requests from current or former clients on personal accounts
• Search for or follow clients on any social media platform
• Communicate with clients via personal social media messaging
• Comment on, like, or engage with clients’ personal posts
• All client communication must take place through the Practice’s approved channels only.

1. Online Reviews and Feedback

Practitioners must not solicit reviews during the therapeutic relationship or in exchange for any benefit

The Practice will not confirm or deny an individual’s status as a client when responding to any online review

Negative reviews should be reported to the Practice Director and responded to at Practice level, professionally and without breaching confidentiality

Malicious or false reviews may be reported to the platform

 

1. Media Enquiries

Any media enquiry received via social media should be directed to the Practice Director. Practitioners should not give interviews, make statements, or be quoted on behalf of the Practice without prior authorisation.

 

1. GDPR and Online Safety

Social media platforms may not be GDPR-compliant and must not be used to share personal data about clients. Practitioners should assume that any content posted online is permanently accessible, even if subsequently deleted or set to private.

 

1. Breaches

A breach of this policy may result in disciplinary action and referral to the relevant professional body. Sharing client information online will be treated as gross misconduct. Any breach — actual or suspected — must be reported to the Practice Director immediately.

 

1. Review

This policy is reviewed annually and updated in response to significant changes in social media practice, regulation, or professional guidance.

 

Seizures Protocol

 

1. Purpose and Scope

This protocol guides practitioners at The Relationship Therapy Practice on how to respond if a client experiences a seizure during a session. It applies to both in-person and online sessions, with separate guidance for each. All practitioners must familiarise themselves with this protocol before working with clients.

 

1. Background

A seizure occurs when there is a sudden burst of electrical activity in the brain that temporarily disrupts normal brain function. Seizures vary widely in type and presentation. People with epilepsy or certain neurological conditions may be at higher risk, but seizures can also occur without any prior diagnosis.

 

1. Types of Seizures

 

1. Tonic-Clonic Seizure (formerly Grand Mal)

The person loses consciousness, their body stiffens (tonic phase), then jerks rhythmically (clonic phase). May involve loss of bladder or bowel control. Typically lasts 1–3 minutes.

 

1.  Focal Awareness Seizure

The person remains conscious but may appear confused, stare blankly, or make repetitive automatic movements. May be subtle and easily missed.

 

1. Absence Seizure

Very brief (usually 5–30 seconds). The person appears to “blank out” or stare. Common in children. May not be immediately recognised as a seizure.

 

1. First Response: In-Person Sessions

 

If a client appears to be having a tonic-clonic seizure:

• Stay calm and remain with the person at all times
• Note the time the seizure started
• Clear the immediate area — remove hard or sharp objects
• Do NOT restrain the person’s movements
• Do NOT put anything in their mouth
• If possible, cushion their head gently with something soft
• If the person is not already on the floor, help lower them gently
• Once the convulsive movements stop, gently turn them onto their side (recovery position)
• Monitor their breathing and responsiveness throughout
• Stay with them until they are fully recovered

 

1. When to Call 999

Call 999 immediately if:

• The seizure lasts more than 5 minutes
• A second seizure begins shortly after, without recovery in between
• The person does not regain consciousness after the seizure ends
• The person has been injured during the seizure
• The person is pregnant or diabetic
• It is the person’s first known seizure
• You have any concern at all about their safety or recovery

 

1. After the Seizure

Once the seizure is over:

• Maintain the recovery position until fully alert
• Reassure the person calmly — they may be confused, frightened, or embarrassed
• Do not offer food or drink until they are fully conscious and alert
• Do not leave them alone until they are fully recovered
• End the session — therapy should not continue immediately following a seizure
• Advise the person not to drive and encourage them to contact their GP

 

1. Online Sessions

If a client appears to be having a seizure during a video session:

• Do not end the call — remain on screen and speak calmly even if they cannot respond
• If another person is present in their household, call out to alert them
• If the seizure is prolonged or severe and no one else is present, call emergency services using the client’s address — this must be recorded in their file and kept up to date
• Remain on the call until emergency services have arrived or the client has recovered with someone present
• For this reason, all clients must provide their current address and an emergency contact at the outset of therapy. This information must be kept up to date and immediately accessible during sessions.

 

1. Documentation

Following any seizure during a session, the practitioner must:

• Document the incident fully in the clinical record: time, duration, type, and actions taken
• Report the incident to the Practice Director on the same day
• Complete an incident report form
• Follow up with the client at their next session to confirm appropriate medical follow-up was sought

 

1. Clients with Known Epilepsy

Where a client has disclosed a diagnosis of epilepsy, the practitioner should:

Record this in the initial assessment and client file

Ask about seizure type, frequency, known triggers, and what support is helpful

Ensure emergency contact details are recorded and current

 

1. Training

It is strongly recommended that all practitioners complete First Aid training inclusive of seizure management. At minimum, practitioners should complete the seizure first aid guidance provided by Epilepsy Action (www.epilepsy.org.uk) and refer to this protocol regularly.