Jenn Pagone, IFS Trauma Recovery Coach Pagone Trauma Recovery Coaching Services, LLC PO Box 405, Marengo, IL 60152 773-339-7949 | ifs-traumarecoverycoach@equid-nexus.com IFS Trauma Recovery Coaching Agreement This coaching agreement outlines what you can expect from our coaching relationship and my scope of practice as an IFS Trauma Recovery Coach. Permission and informed consent are very important elements of trauma-informed care and therefore this document details the coaching approach, expectations of the relationship, coaching scope and limitations, client safety protocols, confidentiality and data privacy, session appointments, termination, limited liability, and professional code of ethics and complaint protocols. My coaching approach is based on the Internal Family Systems (IFS) model. I am certified and Level 3 trained. I support individuals through the modality of coaching with or without equine engagement. As a mental health professional, it is important to distinguish between coaching and therapy. Coaching differs from therapy as it focuses on the present and builds upon the strengths of the client, while therapy focuses on the past to help treat mental health challenges. Our coaching relationship is one of a peer-to-peer approach rather than treating a “condition”. You are the expert of yourself and I am merely a guide to help you heal from your trauma experiences. My coaching intention is to help clients work within their internal system and get acquainted with parts of yourself that are protecting from getting hurt again in relationships and believe that they need to keep you safe. We will identify the obstacles within your life that make it difficult to have fulfilling relationships with yourself and with others. I have a neuro-relational viewpoint on coaching and have extensive training in trauma, attachment, and neuropsychology. I believe that we heal through connection; within ourselves and with others, and I am delighted to walk beside you on your journey. Important information on the Coaching Relationship 1. Coaching is a collaborative process that amplifies self-awareness and authenticity by focusing on the connection with yourself and within our coaching relationship. The purpose is to inspire your personal, relational, and/or professional goals, and to support you in developing and carrying out a plan for achieving those goals. 2. I use a trauma-informed, client-led approach which integrates coaching, mentoring, educating, and resourcing. To reiterate, a coach is not a licensed medical professional, psychotherapist or counselor, and coaching is not intended as a replacement for, nor should it be construed as, counseling, psychiatric interventions, treatment for mental illness, or professional medical advice. 3. As your coach, I am on this journey with you as a peer and equal, and our relationship will evolve through ongoing feedback and growth of your coaching goals. We will jointly set the agenda for each session, and you will be asked to define goals and try new approaches. I commit to being 100% present and focused on you during our sessions, and to compassionately encourage you on your journey. 4. Ultimately you are solely responsible for making your own decisions, choices, actions, and results throughout the process. Accordingly, you agree that I, as the Coach, am not and will not be liable or responsible for any actions or inaction, or for any direct or indirect result of any coaching services provided. Coach and Client Expectations As your coach, you can expect me to: - Be on time for sessions and 100% focused on you for its entirety.
- Be honest and direct, ask straightforward questions, and offer ideas to help you keep moving forward.
- Be knowledgeable about trauma and share evidence-based research and resources about trauma with you.
- Honor your voice, choice, and agency throughout our time together. I will share tools and exercises that I believe could help you reach your goals, but these are always options, not requirements. You are the expert on you and have the power to choose what resonates most for your highest and greatest good.
As my client, I expect you to: - Be on time for sessions and 100% focused for its entirety.
- Fully commit to working on your goals and action steps.
- Be open to trying new ideas and challenging old ways of doing things.
- Communicate openly and respectfully about your needs, wants, triggers, and what is or isn’t working well for you in our coaching relationship. Your voice is very important to me and I welcome any feedback at any time during our coaching relationship.
General Coaching Expectations 1. Coaching may result in changes in the way you interact with your family, friends, and colleagues. This may lead to unexpected termination of some existing relationships, as well as healthy changes in the types of relationships you form moving forward. 2. Third parties (e.g. partner, family, friends) should not be invited to a coaching session without my express agreement. We first need to discuss your goals, purpose, and confidentiality before a third party is included in any way. 3. Please do not be under the influence of alcohol or drugs during our coaching sessions. If you are struggling with any substance abuse issues, I welcome you to let me know so we can talk about it and work to get you any help that you might need. If you repeatedly come to a session under the influence but do not tell me or fail to acknowledge that you are impaired if I ask you whether you are, this may result in my ending our coaching relationship. Coaching Scope and Limitations I believe in a collaborative and multidisciplinary team approach to meeting your personal, professional, and mental health needs. As a coach, there are certain areas which are outside my scope of expertise to work with you on in your journey, including: - treating or diagnosing mental illness
- giving advice or information about medication, including psychotropics
- working with minors, families, or couples
Coaching is not a substitute for psychotherapy or counseling so if you choose to also see a therapist or other health practitioners, we can discuss how to integrate our respective services so that you receive the holistic care you deserve. Client Safety Protocols Your safety is of utmost importance to me. If you are in a place where there are risks to your health and/or safety (such as suicidal thinking, self-harm, addiction or substance abuse, or criminal activity), we will immediately implement the client safety protocols which I’ll explain during our initial sessions. My professional standards also require that I help you find someone who is competent to deal with the particular safety issues you’re experiencing. We can continue our coaching sessions, but we must also bring in another professional who has the expertise with to help you with those issues. Please be advised that if you find yourself in crisis due to safety issues such as suicidal ideation, significant self-harming or violence within a relationship, please dial 911 for assistance or please reach out to your physician or health insurance crisis hotline in your state. Other resources include the National Suicide Hotline (1.800.273.8255) and RAINN’s Crisis Line (1.800.656.4673) or their online chat feature. You may also reach out to the Crisis Text Line at 741741 or https://www.crisistextline.org. Confidentiality and Data Privacy 1. Please be aware that the Coach-Client relationship is not considered a legally confidential relationship (unlike medical or legal professions) and thus communications are not subject to the protection of any legally recognized privilege. 2. However, I do respect and protect your privacy and confidentiality at all times. Anything you share with me (written, verbal or otherwise) as part of our coaching relationship (“Confidential Information”) is kept strictly between us, unless I have your prior informed and written consent to share it with a third party. There are a few exceptions when I am required to break confidentiality, including but not limited to:
o If I have been issued a court order, subpoena, or other legal mandate, o If I have reason to believe you are at imminent risk of harming yourself or another person, o If I become aware that a minor, elderly person, or person with disabilities is currently being abused, or may be in danger of being abused, I am mandated to report the abuse to the appropriate governing agency (i.e. I act as a Mandatory Reporter).
Please be aware that Confidential Information does not include information that: o Was already in my possession before you shared it with me, o Is generally known to the public or in your industry, o Was obtained by me from a third party, without breach of any obligation to you, o Is independently developed by me without use of or reference to your Confidential Information, or o Involves illegal activity.
3. All virtual coaching sessions take place via Zoom. I use a paid and licensed version of Zoom which is covered by a Business Associate Agreement that is HIPAA compliant. For more information, please refer to the Zoom website. Please make every effort to ensure that you are in a distraction-free space during our sessions in order to focus on our work together. 4. Coaching files, forms, contracts, and notes on client sessions are stored on a HIPAA software platform. I retain client data on this system for three years after the coaching agreement has terminated. You may request a copy of your files at any time up to five years after the termination date of our coaching agreement. You may be required to pay any costs associated with providing this data, e.g. shipping or storage fees. 5. In between scheduled appointments, I may email you with follow-up resources relevant to our discussions. You may also send me confidential messages through the Dubsado portal. Should you use my Gmail email (ifs-traumarecoverycoach@equid-nexus.com) please be aware that it is not HIPAA compliant, and I can’t guarantee the privacy or confidentiality of communications sent via Gmail email or by text message. 6. I cannot and do not guarantee the security, privacy or confidentiality of any third-party service providers such as Zoom and Therapy Appointment. 7. I do not record our Zoom coaching sessions unless we both mutually agree to do so. If a session is recorded, I will share the recording with you and with no one else unless you give me written consent. By accepting the Zoom notification of the recording and proceeding with our coaching session, you agree to being recorded. If at any time you wish to stop the recording, I will do so immediately at your request. Recordings are stored on Zoom’s cloud platform and deleted within 30 days after the appointment. 8. From time to time, I may consult with other coaches or mental health professionals in peer or supervisory capacities, without revealing personally identifiable information, to improve the quality of your care. 9. Testimonies, stories and feedback given during our coaching sessions may be anonymized and shared publicly for advocacy, educational and promotional purposes. Session Appointments, Payments, Cancellations, and Refunds 1. Sessions are to be initiated and scheduled by you through the Dubsado portal. You may change or cancel appointments up to 24 hours in advance without charge. Should you cancel within 24 hours or miss a coaching session you will be charged the full session fee of $165. 2. Sessions are 55 minutes in duration unless an extended or intensive session is discussed and scheduled appropriately. Sessions will be forfeited if you are 15 minutes late and the full session fee will be charged. 3. Session payments are charged on the day of session to the credit card provided upon registration and secured through Dubsado/Stripe. If the card on file does not work, a new card must be added and session fees must be paid prior to the next session. 4. Every effort should be made to join all sessions as scheduled. Sessions should not be cancelled or rescheduled except in the case of an emergency. I understand that last minute things come up and ask that you provide me with at least 24 hours notice if you need to cancel or reschedule a session. Please inform me as soon as possible via phone message or text if you need to miss an appointment. I will do my best to accommodate unexpected circumstances via make-up appointments, but I cannot guarantee session availability. 5. If I have an emergency and need to cancel, you will not be charged the session fee, and I will make every effort to reschedule you within the week. 6. Due to session fees being charged to your credit card after sessions, there are no refunds. Should you choose to pay upfront for sessions and cancel and appointment prior to 24 hours notice the credit will be applied to your next scheduled session. If you are a “no call no show” or cancel under 24 hours notice, you will be charged the session fee. Limited Liability I make no guarantees, representations, or warranties of any kind or nature, express or implied, with respect to the coaching services provided. In no event shall I be liable to you for any indirect, consequential, or special damages. You and only you are responsible for your thoughts and behavior. Termination of the Coaching Relationship Trauma Recovery Coaching is client led and collaborative and therefore any time off from coaching sessions or termination of the coaching relationship will be discussed and explored within session prior to termination to close the relationship with mutual respect and understanding. Professional Code of Ethics and Complaint Protocols I am required to let you know that I educated as a Trauma Recovery Coach credentialed by The International Association of Trauma Recovery Coaching. As part of my student agreement and future certification, I am bound to uphold the Association’s Code of Ethics. If at any time you feel I have failed to abide by the Association’s Code of Ethics or wronged you in another way you are welcome to contact the Chairperson of the Association’s Professional Standards Committee by e-mailing grievance@iaotrc.com. The Chairperson can send you a grievance form to complete and submit, as well as let you know the process that will take place after they receive your grievance. All reports and grievance actions are held confidential by the Professional Standards Committee. Changes to these Policies, Terms, and Conditions I may update policies, terms, and conditions from time to time. I will notify you of any changes through the secure online portal. You will access to a copy of this agreement in your client file. Client Acceptance By booking and inputting your credit card information into the client portal for a coaching session, you acknowledge that you have read, understood, and accept these policies, terms, and conditions in their entirety. Questions? If you have any questions about these policies, terms, and conditions, please contact me at 773-339-7949 or ifs-traumarecoverycoach@equid-nexus.com. | 