Week 3 | Intake and Consent

Summary

Dr. Liandu introduces a learning capsule on intake and consent forms. The intake form is a questionnaire for clients at the Black Healing Center, collecting personal and health information to guide initial sessions with a Community Care Practitioner (CCP). The consent form is a legal document ensuring safety, confidentiality, and understanding in the therapeutic relationship. It also outlines the practitioner's duty to inform in cases of self-harm or harm to others. Students are encouraged to complete these forms for a realistic practice experience.

Takeaways

• 📝 The intake form is a questionnaire given to clients at the Black Healing Center to collect their contact details, medical history, mental health history, and the issues they need help with.
• 🤝 The intake form serves as the starting point for a Community Care Practitioner (CCP) when meeting a client for the first time, allowing them to understand the client's needs and conduct a risk assessment.
• 🔍 The CCP reviews every section of the intake form with the client, filling in gaps and using it to probe deeper into the client's challenges.
• 🌐 The Wheel of Life is a tool introduced to suggest different areas of life to consider for personal development or healing, which can be discussed during sessions.
• 👥 Practicing CCPs work in teams of two, taking turns to role-play as both the client and the practitioner to gain firsthand experience.
• 🗣️ Clients usually come to CCPs with specific issues they need help with, and the intake form can assist in clarifying these issues.
• 📑 The consent form is a legal document required for booking an appointment with a CCP, ensuring safety, understanding, and confidentiality within the therapeutic relationship.
• 🛡️ The consent form includes important statements about confidentiality and the practitioner's duty to inform in cases where clients are at risk of self-harm or harm to others.
• 📝 CCP trainees are also required to sign the Black Healing Center's consent form as part of their training and ethical practice.
• 📚 The script emphasizes the importance of reading and understanding the consent form, noting any questions for class discussion.
• 📆 The learning objective is to explain what an intake form and a consent form are, and to prepare for class by filling out the intake form and signing the consent form.

Q & A

What is the main purpose of an intake form according to the learning capsule?

The main purpose of an intake form is to collect information about the client, including their contact details, medical history, mental health history, and what they need help with, as well as their goals for the sessions with a community care practitioner.

What does the intake form contain for the community care practitioner's initial meeting with a client?

The intake form contains as much or as little information as the client chooses to reveal during the first session, which the community care practitioner reviews with the client to fill in any gaps and conduct a risk assessment.

What is the role of the Wheel of Life in the CCP certification program?

The Wheel of Life is a tool that suggests different areas of life to consider, such as family, career, and health. It helps CCP students to identify areas they may want to give more attention to during their practice sessions.

Why is it important for CCP students to fill out the intake form?

Filling out the intake form is important for CCP students to gain firsthand experience of how a client feels, and to practice the process of understanding a client's needs and challenges.

What is the significance of the consent form in the context of the black Healing Center?

The consent form serves as a legal document to safeguard both the center and the community care practitioner. It builds safety and understanding within a therapeutic relationship, emphasizing professionalism and confidentiality.

What does the consent form signify in terms of the therapeutic relationship?

The consent form signifies the establishment of a professional and confidential relationship between the client and the community care practitioner, and it is an essential administrative and ethical step in the process.

Under what circumstances does the duty to maintain confidentiality not apply in the therapeutic relationship?

Confidentiality does not apply when clients are at risk of harming themselves or others. In such cases, the community care practitioner has a duty to inform qualified professionals.

What is the expectation for CCP students when working on real subjects during class?

The expectation is for CCP students to work on real subjects that they feel comfortable disclosing, to ensure a genuine and felt experience that closely mirrors the actual experience of a client.

How often should CCP students sign the black Healing Center's consent form?

CCP students should sign the black Healing Center's consent form each week during class, as part of their training as community care practitioners.

What is the learning objective of this particular learning capsule?

The learning objective is for students to be able to explain what an intake form and a consent form are, and to prepare for class by filling out the intake form and signing the consent form.

How can students benefit from practicing with the intake form and consent form before class?

By practicing with the intake form and consent form before class, students can make the most of their class time for practical exercises and gain a deeper understanding of the processes involved in community care practice.

Outlines

00:00

📝 Understanding Intake and Consent Forms

In this learning capsule, Dr. Liandu introduces the concepts of intake and consent forms. The intake form is a questionnaire provided to clients at the Black Healing Center, designed to gather essential information such as contact details, medical and mental health history, and areas where the client seeks help. It serves as a starting point for the community care practitioner (CCP) during the first meeting with a client, allowing for a comprehensive understanding and risk assessment. The session also involves practicing these forms in a simulated environment, with students taking turns as clients and CCPs. The Wheel of Life tool is mentioned as a way to identify areas of life that might need attention, though clients typically present with specific issues. The importance of authenticity in the practice sessions is emphasized, encouraging students to work on real issues. Lastly, the consent form is highlighted as a legal document ensuring safety, understanding, and confidentiality in the therapeutic relationship, with special notes on the duty to inform in cases of risk.

05:01

🤝 The Role of Consent Forms in Therapeutic Relationships

This paragraph delves deeper into the purpose and importance of consent forms in establishing a therapeutic relationship. The form is crucial for building trust and understanding, emphasizing professionalism and confidentiality. It is an administrative and ethical necessity, ensuring that both the client and the community care practitioner are protected. Students are reminded to sign the Black Healing Center's consent form as part of their training, acknowledging the CCP's duty to inform in cases where clients are at risk of self-harm or harm to others. The instructor encourages students to review the consent form and prepare any questions for class discussion. The learning objective is to explain the functions of both intake and consent forms, and students are instructed to complete these forms prior to class to maximize practice time.

Keywords

💡Intake Form

An intake form is a questionnaire used by service providers to collect essential information about clients. In the context of the video, it is utilized by the Black Healing Center to gather a client's contact details, medical and mental health history, and to understand the client's needs and objectives for the sessions with a community care practitioner (CCP). The form serves as a starting point for the CCP to conduct a risk assessment and tailor the therapeutic approach to the client's specific needs.

💡Consent Form

A consent form is a legal document that establishes a clear understanding and agreement between the service provider and the client. It ensures the protection of both parties and outlines the terms of service, including confidentiality and the practitioner's responsibilities. In the video, it is mentioned that a consent form must be signed by clients before engaging with a CCP at the Black Healing Center, emphasizing the importance of safety and professionalism in the therapeutic relationship.

💡Community Care Practitioner (CCP)

A community care practitioner is a professional who provides support and care within a community setting. In the video, CCPs are responsible for reviewing the intake form with clients, conducting risk assessments, and offering personalized care based on the client's needs. The role of a CCP is central to the video's theme of establishing a supportive and understanding therapeutic environment.

💡Risk Assessment

A risk assessment is a process used to identify and evaluate potential risks associated with a client's situation. In the video, it is highlighted as an important part of the CCP's initial interaction with a new client, ensuring that the practitioner is aware of any potential dangers and can respond appropriately to protect the client and others.

💡Therapeutic Relationship

The therapeutic relationship refers to the connection established between a service provider and a client, characterized by trust, confidentiality, and mutual understanding. The video emphasizes the importance of this relationship in creating a safe space for clients to discuss their issues and work towards improvement with the guidance of a CCP.

💡Confidentiality

Confidentiality is the principle of maintaining the privacy of information shared between a client and a service provider. In the video, it is mentioned as a key aspect of the consent form and the therapeutic relationship, ensuring that clients feel secure in disclosing personal information to their CCP.

💡Mental Health History

Mental health history refers to the record of an individual's psychological well-being, including past diagnoses, treatments, and any significant events affecting mental health. In the video, it is part of the information collected through the intake form to help the CCP understand the client's background and provide appropriate support.

💡Personal Development

Personal development encompasses the process of improving one's skills, knowledge, and well-being. In the video, it is suggested that clients may seek the services of the Black Healing Center not only for healing but also for personal development, indicating the broad scope of support offered by the CCP.

💡Wheel of Life

The Wheel of Life is a tool used to assess and reflect on different areas of one's life, such as family, career, and health. In the video, it is mentioned as a way for CCP trainees to practice working with clients, helping them to identify areas they wish to focus on and improve.

💡Duty to Inform

The duty to inform is a professional responsibility that may require a CCP to disclose information about a client to qualified professionals when the client is at risk of harming themselves or others. The video notes that this duty supersedes confidentiality in certain situations, highlighting the ethical considerations that CCPs must navigate.

Highlights

Dr. Liandu introduces the learning capsule focused on intake and consent forms.

The learning objective is to explain intake and consent forms in the context of the Black Healing Center's services.

An intake form is a questionnaire for clients seeking services, collecting personal and health history information.

The intake form includes questions about client needs and session objectives with a community care practitioner (CCP).

The CCP reviews the intake form with clients, filling gaps and conducting a risk assessment.

A separate recording on risk assessments is available in the 'referral' learning capsule.

Students practice CCP roles in teams of two, using the Wheel of Life tool for personal development areas.

The Wheel of Life categorizes life activities such as family, career, and health for consideration.

Students are encouraged to choose real-life situations for practice to gain a felt experience.

Clients typically seek CCP support for specific issues, not necessarily for healing.

The intake form helps clarify client issues and the CCP's role in providing support.

A consent form is a legal document ensuring safety, confidentiality, and understanding in the therapeutic relationship.

Consent forms are an administrative and ethical necessity for CCPs and clients.

The form includes provisions for clients at risk of self-harm or harm to others, where confidentiality may be breached.

Students are required to sign the Black Healing Center's consent form as part of their CCP training.

The learning capsule concludes with a reminder to fill out the intake form and sign the consent form before class.

The recording emphasizes the importance of a real felt experience for students to fully benefit from the practice.

Dr. Liandu thanks listeners and looks forward to the next learning capsule.

Transcripts

hello and welcome my name is Dr liandu

and this learning capsule is

about

um intake and

consent in this recording our learning

objective is that you um are

able uh to explain what an intake form

is

and

what sorry explain what is an intake

form and what is a consent

form so the intake form is a

questionnaire we give to clients who

want to use the black Healing Center

Services the purpose of the intake form

is to collect information about the

client the information on the

questionnaire includes the client's

contact details medical history and

mental health history there are also

questions about what the client needs

help with and what they want to get out

of the sessions with a community care

practitioner when a CCP meets a client

for the first time the intake form is

their starting point it contains uh as

much or as little information as the

client chooses to reveal in that first

session with a new client the CCP

reviews every section of the in form

with the client um this is an

opportunity for the CCP to fill in the

blanks as needed and very importantly to

conduct a risk assessment there's a

separate recording about risk

assessments uh and you'll find it in the

learning capsule uh called the

referral you may recall from the

introductory learning capsule that we

used this image of a wheel of life in

the first 5 weeks of the CCP

certification program you'll be working

in teams of two to practice the work of

a CCP on each other uh you'll be in the

role of the client who wants to work on

something and your partner will be your

community care practitioner after 30

minutes you'll switch roles you'll be in

the role of the CCP who's holding space

for your classmate who's now your client

um whatever you answer in the intake

form doesn't necessarily have to be

about healing um you may have to do you

may you may have something you want to

do better maybe so it's maybe about

personal development or something right

um The Wheel of Life is simply a tool

that suggests different areas of Our

Lives to consider it uh categorizes many

of the activities that we juggle daily

family like family obligations career

Health Etc you can ask yourself if

there's an area in your life you'd like

to give more attention to and since you

will be asked to talk about a situation

choose something that you'd be at ease

to disclose right your CCP will listen

to you and ask probing questions to gain

a deeper understanding of your challenge

right this process will give you a first

um a firsthand experience of how your

client feels usually clients will come

to see us because of something specific

they need help with so people don't go

oh well you know usually they have

something and so they won't need a wheel

of Life they can just tell you what what

is bothering them um uh they may need

help to clarify the issue itself like

maybe something they're just they can

maybe tell you how they're bothered

without being able to to clarify where

it's coming from but something has been

bothering them enough that they feel

they they need support and so

right um using the link

provided uh fill out the intake form to

the best of your ability uh to benefit

fully from the practice you'll be doing

each week uh I ask that whatever you

choose to work on be real because I want

you to feel what it what it's like right

you can have one large subject you want

to work on over five weeks with your

classmate or you can also plan to work

on a series of different smaller

subjects each class it's up to you the

most important is that it be real right

because I I want you to really uh I want

it to be a felt

experience um anyone contacting the

black Healing Center to book an

appointment with a community care

practitioner will also be required to

sign a consent form a consent form

serves as a legal document to safeguard

both the Cent Cent and the community

care practitioner uh and the purpose of

the form is to build safety and

understanding within a therapeutic

relationship it speaks to

professionalism and

confidentiality it's an administrative

step not to be missed but it's also an

ethical piece

right since you will be working as a

community care practitioner in training

during each during class each week you

also need to sign the black healing

Center's consent form you'll notice the

form includes a statement about clients

who are at risk of harming themselves or

harming others in cases like that um

confidentiality no longer applies and

the CCP has a duty to inform qualified

professionals

um we'll talk about that in class um

especially in the context of our

community and how

um yeah we we'll talk about it some more

in in class uh about the the duty to

inform and

how how that can play out um but I want

you to read through the consent form and

make a note of any question I can answer

during

class in this recording our learning

objective was for you to be able to

explain what is an intake form and a

consent form and in preparation for

class please fill out the intake form

and sign the consent form ahead of time

so that we can use the class time for

practice thanks for listening and see

you in the next learning

capsule