Gambling Service Consent Form

Information and Confidentiality Agreement

ARA provides a free and confidential counselling service for people adversely affected by gambling. We will need to keep some information about you for governance purposes and some of these records are held electronically.  Counselling aims to reduce personal distress caused by problem gambling and increase coping skills. What you discuss with your counsellor remains confidential except in extreme circumstances; e.g. if your counsellor believes you are at high risk of significantly harming yourself or others (including risk to children). Where possible your counsellor will discuss situations where they feel they must break confidentiality with you first.

In line with best practice, Ara counsellors will keep records, including general and sensitive data, as defined in the Data Protection Act 2004 (DPA). All information is stored and used in accordance with the DPA and we will keep your records on file in order to contact you for follow-ups in the future. You have a right to view your records and, if you wish to do so, should speak with your counsellor about this.

By signing this form, you consent to Ara creating and storing your records in a secure manner. Your information will not be used for any other purpose than for the provision of counselling by Ara. Non-identifiable, pooled information may be used for research and evaluation purposes by Ara and other affiliated organisations.

Overcoming the impact of a gambling problem can take time. It is important to us that when you finish your treatment with us, your relationship with the service is not over. After your sessions end, GamCare will contact you at 3, 6 and 12 months (after last treatment appointment), to enquire about how things are going. This is called a `follow up’ and contact will be made by email or letter, based on your consent to contact. If at any point, you feel it would benefit you to return to counselling, you will have the opportunity to do so. The follow up will also provide you with an opportunity to assess how things are going for you, and whether you are satisfied with the progress, you have made. If you would like to discuss this with your counsellor, please do.

We require a commitment from you to attend your sessions regularly for counselling to be effective and you need to let us know as soon as possible if you cannot attend a session. If you miss two sessions in a row, without contacting us, we will assume that you no longer want counselling and we will make that time available to someone else. Please tick to acknowledge that you have read and understood the content of this document and agree to its terms.