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Coaching Welcome packet and release form

Welcome!

Thank you for considering working with me during this difficult time in your life. Betrayal trauma can feel so isolating, confusing, and overwhelming. My role as your coach is to walk alongside you with compassion, support, and tools to help you regain your sense of self, safety, and clarity.

I offer coaching from a client-centered, trauma-informed approach. If desired, I can incorporate a Chrisitan faith-based perspective, or we can focus on non-faith-based support…whichever serves you and your needs best.

I believe you are the expert in your own life. I also believe that you have the answers you need to move forward in your life to the place you want to be. I will help you peel back the layers to discover your own wisdom.

Coaching is a supportivce, goal focused process. It focuses on the present and the near future and can help with many issues ecountered in betrayal and beyond.

I offer coaching from a client-centered, trauma-informed approach. If desired, I can incorporate a Christian faith-based perspective, or we can focus on non-faith-based support...whichever serves you and your needs best.

What is coaching?

Coaching is a supportive, goal-focused process. It focuses on the present and the near future and can help with the following:

*Identify what you want or need

*Build emotional safety and stability

*Set boundaries that protect and empower you

*Work through feelings of betrayal, anger, grief, or confusion

*Reconnect with your identity and self-worth

Coaching is not therapy, medical treatment, or legal advice. It does not diagnose or treat mental health conditions. Coaching is about you, the client. Coaching is a thought provoking and creative process that inspires you to approach your issues differently. I believe that you are the expert of your life. My job is to help you to see things from a different perspective and empower you in your choices moving forward. If you need additional support I can encourage you, or help you find appropriate resources.

What to expect in sessions

Sessions typically last 45-60 minutes and take place via Zoom. If we are able to meet face to face we will

agree on the best place to meet.

You are in charge - You’ll guide what we focus on – I will listen, ask questions, reflect, and share tools or exercises as appropriate.

We may use, journaling, reflection, planning, grounding strategies, meditation, IFS principles, somatic practices, or other exercises, depending on your needs and preferences.

My Role

To create a safe, respectful space where you can explore, process, and grow.

To honor your preferences (faith-based or non faith-based support)

To help you develop resiliency as you clarify goals, explore challenges, and develop action plans.

To maintain confidentiality, with the exception of legal limits (e.g. if there is risk of harm to you or others).

I help by asking questions to help you to think about different choices/solutions that may work for you and helping you to approach things differently than you may have previously learned.

I do NOT diagnose, treat, analyze, or treat any mental disorders. That is the role of a mental health professional such as a therapist, psychologist, or psychiatrist.

Our conversations are not a substitute for counseling, psychotherapy, psychoanalysis, substance abuse treatment, process addiction treatment, medical, or mental health care.

Your Role

Come as you are. There is no “right way” to show up and there is no judgement. Showing up as authentically as possible will be beneficial for your progress.

Be open about what is working and what is not, so we can adjust as needed. Honesty is needed for an open and productive relationship.

Take responsibility or your own decisions and actions inside and outside of our sessions.

You are the driver of the relationship. You decide what we work on and you decide and communicate your needs and what we work on and work toward both long-term as well as short-term goals.

You are responsible for your own physical and emotional well-being, your own decisions, choices, actions, and results arising from the coaching relationship, sessions with the coach, and other interactions with the coach even if it is not in a formal session.

If you are under the care of a mental health care provider it is recommended that you inform them of the nature and extent of the coaching relationship agreed upon by your (the client) and me (the coach).

Cancellations: Please give 24 hours’ notice if you need to cancel or reschedule.

Confidentiality: Our sessions are private. I will not share what you say except as required by law (e.g. risk of serious harm to others or child pornography use)

Transparency: Dot is a new coach and is in the process of getting further certifications and credentials. That is why the fees are so low. Please understand that she is learning as well, yet is passionate about helping others to heal from betrayal trauma.

Privacy, Confidentiality, and Data Protection: Any information the client shares with the coach be it verbal or written will be kept in strict confidentiality. The relationship is also confidential. The coach will no disclose any personal information without the client’s written consent. Exceptions to this are public knowledge or the coach is required by statute, subpoena, or court order to disclose. The coach and client will comply as appropriate with applicable privacy/data protections legislation, court orders, judgement, decree, guidance, codes, policy, or standards. The coach will process all data lawfully, fairly, and in a transparent manner. The coach will collect data simply for record keeping, contact, and coaching purposes and will not collect data that is outside of that purview.

Information Release: Dot is currently seeking her certifications through the International Coaching Federation (ICF). The ICF required recordings and reporting to certify that certain experience hours are fulfilled and at times requires recordings of sessions with clients.

I understand that Dot The Coach may request permission to audio record, or audio and video record, certain coaching sessions for training, supervision, mentor coaching, credentialing, certification, quality improvement, or professional development purposes.

I understand that recordings may be reviewed by qualified mentors, supervisors, assessors, trainers, or credentialing organizations, including the International Coaching Federation (ICF), as part of coach training, evaluation, certification, or credentialing requirements. All reasonable efforts will be made to maintain the confidentiality of my personal information.

I understand that no coaching session will be recorded without my verbal agreement for that specific session. By signing this form, I am providing general authorization for recording when mutually agreed upon by both Dot The Coach and me at the beginning of a session.

I understand that I may decline recording for any session without penalty and may withdraw my consent to be recorded at any time before or during a session.

Release Options

I give Dot the Coach permission to record audio only from sessions for mentoring and credentialing purposes only.

I hereby grant permission for audio and video recordings to be made of me. I understand that these recordings may be used for lawful purposes including, but not limited to, educational, promotional, or commercial use. I confirm that I have read and understood this release.

I give Dot the Coach permission to recorde audio and video from session for mentoring and credentialing purposes only.

I rescind any previous permissions for recording of any kind from this date forward.

Name

Phone Number

Email Address

Secondary Contact Full Name (Preferably NOT your betrayer)

Secondary Contact Phone Number

Secondary Contact Email

Contact permmissions:

I give Dot the Coach permission to call my phone number for scheduling purposes.

I give Dot the Coach permission to leave a voicemail at my phone number.

I give Dot The Coach permission to text me for scheduling purposes

I give Dot the Coach permission to emial me about scheduling and logistical information.

I would like to terminate the Coaching Relationship

Spiritual considerations

I prefer a faith-based focus.

I prefer a non faith-based focus.

I have no preference.

Other

How did you hear about Dot The Coach?

What are your main goals for Coaching?

What challenges are you currently facing?

Preferred Scheduling (1X/Week - 2Xs/Week - Bi-weekly, etc.)

Additional Comments:

Please Sign Below:

Signature

Thank you for taking the time to read this document and fill in all required fields. I am looking forward to working with you.