Consent for Spiritual Direction

Before we begin care, we want to properly ensure consent from you as the client. Please carefully read below, initial where needed, and print your name below. The the initials and printing of your name will act as a binding signature. 

Consent is key! And you are the one who can give and revoke consent. Practice with us!

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E-mel *
Client's Name (first and last)
Preferred Pronouns (check all that apply)
GENERAL INFORMATION

The relationship between a client and practitioner is exceptional as it combines the personal aspect with a contractual agreement. To ensure a smooth working relationship, it is crucial for us to establish a clear understanding of how we will work together and what each of us can anticipate. This consent form will serve as a comprehensive framework for our collaboration. Should you have any questions or concerns, please don't hesitate to bring them up during our discussions. 

Kindly go through this document thoroughly and confirm your agreement at the bottom. 
Spiritual Direction | Spiritual Directors 
A trained spiritual director journeys with another person by listening to that person’s life story and experiences with an ear for the movement of the spirit, the presence of the sacred, and/or the insights that come from making deep meaningful connections. By offering supportive responses as appropriate and encouraging deepening reflection, clients can open up to new understandings and paths of growth.

While spiritual direction is a one-on-one relationship, it is not a substitute for therapy or mental health care. Spiritual accompaniment is typically conducted in monthly sessions that range from 45 - 60 minutes.

Our Spiritual Directors are trained and skilled in the practice of accompanying clients and inciting reflection as to where spirit is moving.

Currently you can read on our website the different profiles of our Spiritual Directors and get fuller sense of their style, praxis model, and overall insight as to how they approach Spiritual Direction and the Care CAYA strives to provide.

All Spiritual Directors are currently under the supervision and guidance of Marchaé Grair (they/she) with Still Harbor, an organization that centers spiritual direction in the pursuit of collective liberation.

All practitioners are have a care partner whose main job is to care for the practitioner as they care for you. There is an entire team dedicated to your wellness and health.
Framework
Our Spiritual Directors have a collective value and focus here at Come As You Are Collective: seeing the unseen and providing affirming care. Spiritual Care is focused on the LGBTQ+, BIPOC (Black Indigenous Persons of Color), and those deemed anxious and unsettled with a relationship with Spirit.

Please review the website profile of our individual Spiritual Directors to gain more insight as to how they can best take care of you, connect with you, and support you.

All practitioners are certified practitioners who have a continued participation in supervision and continuing education.
Group Supervision
As an accountability measure, all of our practitioners in “Group Supervision,” a facilitated meeting for spiritual directors who want to give and receive feedback about their work and be accountable for that work in community with other spiritual directors.

Part of Group Supervision is sharing anonymous snippets from spiritual direction sessions. I will never share identifying information about you in these sessions. By agreeing to sign this form, you consent to me sharing anonymous summaries from our sessions in Group Supervision.
Confidentiality 

Rest assured that the content discussed during our session, as well as any related materials concerning your treatment, will remain strictly confidential. However, if you wish to grant permission, you can request in writing to disclose certain portions or the entirety of the content to a designated individual or group. It is important to note that there are certain limitations to the confidentiality privilege, which are outlined below for your understanding.

  1. In situations where a client expresses thoughts of self-harm or exhibits behavior that poses a significant risk of physical harm, appropriate action will be taken.
  2. If a client makes threats of severe bodily harm or intends to bring harm upon another individual, immediate intervention will be implemented.
  3. If there are reasonable suspicions that a client or any named individual is involved in the perpetration, witnessing, or experiencing physical, emotional, or sexual abuse of children under the age of 18, the practitioner is obligated to report such concerns. 
If we happen to cross paths outside of our spiritual direction sessions, we will refrain from acknowledging you initially. Rest assured, your privacy and confidentiality are our top priorities, and we will never compromise them. We are more than willing to converse with you if you initiate it. We do encourage lengthy conversations to be held in the session space. 

SIGNATURE(S) AND DATE
By signing this form, you acknowledge an understanding of everything presented in this document and agree to spiritual direction services with Come As You Are Collective, under the terms listed in the document. 

You certify that:
  • You have read or had this form read and/or had this form explained to you.
  • You have been given ample opportunity to ask questions and that any questions have been answered to your satisfaction and in your language of proficiency.
BY TYPING MY NAME AND DATING BELOW, I CONSENT TO CARE WITH COME AS YOU ARE AS OUTLINED ABOVE. I REQUEST THIS BE AS SUFFICIENT AS MY SIGNATURE

(write full name of client below, along with the date)
BY TYPING BELOW, THE CLIENT'S LEGAL REPRESENTATIVE CERTIFIES THAT THEY CONSENT TO CARE WITH COME AS YOU ARE AS OUTLINED ABOVE. THEY REQUEST THIS BE AS SUFFICIENT AS THEIR SIGNATURE

(write the full name of the client's legal representative along with the date below , if applicable)
INTERPRETER’S ATTESTATION (if applicable)
I certify that I am fluent in the language of the person providing consent. I certify that I have accurately and completely interpreted the contents of this form, and that the person giving consent has indicated their understanding of the contents.
SIGNATURE OF INTERPRETER (if applicable)
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