CONFIDENTIALITY AND INFORMED CONSENT FORM
This letter serves to inform you of the professional services and modalities offered in each session. By engaging Ashleigh Marlow-Hally, the client acknowledges that they have familiarised themselves with the information below, before signing. It is understood that they have the opportunity now and in future to discuss any questions they may have. The client agrees to the policies, procedures and fees explained herein. The signing of this document represents an agreement between the client and practitioner, and the nature of their professional relationship.
Ashleigh’s Background and Training
I am a qualified Therapeutic Arts Practitioner with a Graduate Diploma from the MIECAT Institute, and certified Clinical EFT Practitioner with EFT Universe. I have advanced certification in Guiding and Teaching Meditation from ACMM, with additional training in the chakra energy systems, mindfulness, and Buddhist psychology. I hold a Reiki III certification in Usui Shiki Ryoho Reiki.
My compassionate, trauma informed facilitation style is underpinned by 10+ years of self-work and personal development. I have personal experience with Non-Violent Communication, somatic healing practices and psychic development. I may employ aspects of several different techniques and modalities during our sessions. As a natural clairsentient, I may sometimes offer insight into what I am sensing emotionally for you. Please know that these insights are in no way a diagnosis and will only be used to inform our sessions together with your consent.
My personal and professional experiences have led me to support people affected by chronic illness, family violence and assault, mental, physical and/or sexual abuse, trauma and mental health ailments. I provide a gentle and empathetic space, with non-judgement, embodiment, and mind-body-spirit synergy as our focus. My offering is to support you emotionally and energetically, to aid the relief of stress and discomfort.
Creative Arts Therapy
CAT is an experiential psychotherapeutic approach to emotional, cognitive, physical and spiritual well-being. The technique is rooted in the idea that creative expression can help people to develop self-awareness and learn about their needs and values. Through different artistic modalities and modes of communicating which are alternative to cognition and speech, the client may access their subconscious mind and innate embodied wisdom. With this access, the client is guided to explore emotions and address unresolved emotional conflicts. Arts therapy modalities such as painting, collage or movement, can help clients to gain insight, create new coping skills and develop their relationship with self.
Clinical Emotional Freedom Technique
EFT is often referred to as ‘tapping’ due to the technique of using two fingers to tap on one’s own body. With the client mindfully tuning into their physical sensations, emotions and experiences, the facilitator will guide them to tap on a sequence of emotional meridian points around their own physical body, while repeating phrases of positive affirmation. The technique is known for releasing stress and emotional charge behind unresolved emotional issues. It connects your mind-body energy system to help dissolve energetic blocks in the meridians. On occasion, a client may feel overwhelmed by their emotions and fall into a freeze response reaction and become unable to tap on themselves. When safe to do so, with the client’s permission, the facilitator may offer to tap on them physically or energetically.
Meditation and Mindfulness
For millennia, the practices of meditation and mindfulness have been utilized to cultivate inner peace and clarity of the mind. Lessons rooted in Buddhist psychology are taught to develop an individual’s self-awareness, acceptance, and sense of compassion. Through mindfulness the client may be guided to tune into their felt sense and become the observer of their thoughts and feelings. Meditation may be used to take the client on a guided journey to receive messages of healing and insight. With many methods available, the techniques are successful in creating space for deep relaxation, creating the relaxation response in participants.
Reiki and Vibrational Therapies
By utilising universal lifeforce energy, Reiki is channelled through the hands of the practitioner, and applied directly onto the physical and ethereal bodies of the client. An in-person-session involves the fully clothed client laying on a massage table or sitting comfortably. The practitioner will place their hands on the client’s body and hold their hand position still for a few minutes before moving to another hand position. The practitioner’s hands may feel warm and tingly, and the client may notice sensations and the movement of energy in their own body. Reiki can also be sent via distance healing, and may be applied to comfort emotional, physical, and energetic issues.
Sessions are 60 minutes in length and are scheduled at a time we agree upon. 90-minute sessions are available if required and arranged prior to meeting. While some clients’ may need only a few sessions, others may benefit from ongoing support with regular sessions over a longer period. You are in complete control and may end the sessions at any point. You are responsible for providing a minimum of 24 hours advanced notice upon cancellation of any scheduled sessions. Upon failure to do so, you will be responsible for paying the full session fee.
Consent to Participate in Sessions
By reading the following statements and signing below, the client confirms that they are informed about the parameters of our sessions and the nature of our professional relationship. If the client has any questions, it is their responsibility to discuss them as they arise.
- I am aware that Ashleigh Marlow-Hally is a certified Therapeutic Arts and Clinical EFT Practitioner, Meditation and Mindfulness Teacher, and Usui Shiki Ryoho Reiki Facilitator. I freely give Ashleigh permission to facilitate my inner exploration during consultation.
- I am aware of the limitations of these modalities and that Ashleigh Marlow-Hally is not qualified to provide diagnosis, treatment and/or cure for any physical or mental health conditions. I understand that I am advised to continue consultation with my current licensed health-care professionals and to continue any prescribed medications. I understand that Ashleigh offers emotional and energetic support, and those services should be used in conjunction with licensed medical and mental health services. I am aware that any recommendations made by during our session are not prescribed nor cures, and I may take part at my own choosing. I understand that I am required to disclose any diagnosed disorders and/or ailments with Ashleigh prior to consultation.
- I understand that if I am running late for a session, the session will end at the scheduled time with no reduction to the initial agreed upon fees. I am responsible for providing a minimum of 24 hours advanced notice for cancellation of any scheduled sessions. If I fail to provide 24 hours prior notice, I am aware that I am responsible for paying the full session fee. I understand that I may terminate my sessions at any time and that, at termination, a closure session is generally recommended.
- I have been informed of the professional fees for the services provided by Ashleigh Marlow-Hally and agree to the terms. I agree to pay for each session prior to or at the time it is held. In the case that I receive an invoice for any outstanding payments, I agree to pay this invoice within 24 hours.
- I understand any information I provide during these sessions with Ashleigh Marlow-Hally is confidential. I am aware that Ashleigh will maintain records of each session, and that I may request a copy of these records in writing. Ashleigh will not disclose my private information without my consent except when legally required as indicated below:
- Any information that indicated neglect or abuse of a child, dependant adult or elder
- If I demonstrate a credible threat to harm others or myself.
- I give my permission for Ashleigh Marlow-Hally to use touch if she and I consider it appropriate for facilitating my exploration. I understand that this touch is not intended to manipulate tissue, is non-sexual, and is only used to support the session. I understand that it is my responsibility to inform Ashleigh if I am at any time uncomfortable with touch.