Family Coaching Agreement
Successful relationships are based on clear working arrangements and mutually agreed-upon goals and expectations. The Coaching Agreement below is presented to assure that we have clarity and the same understanding of how we will work together and what we will be working toward in the coaching relationship.
Coaching is a partnership (defined as an alliance, not a legal business partnership) between a coach and a client (and sometimes other family members) in a thought-provoking, creative, and collaborative process that inspires the client to maximize personal and professional potential. A coaching relationship is designed based on the client’s interests, needs, and goals. Discussion, questions, education at the point of need, and reflections are used to assist you as you explore possibilities, uncover talents and strengths, make decisions, and identify prompts and actions you are willing to take to reach desired goals.
Initial term: 3 months (100 days) - Paid in full, or split into three monthly payments
Start date: Date of initial payment
Intake Session: One 90-120 minute session completed in-home or via video conference
Number of Sessions: One per week
Session Duration: 30-45 minutes per session
Between Sessions: It is expected the coach and client will be in regular communication between sessions. A majority of this communication is performed via text message or other chat services. The coach will be available to the teen by phone for as needed “check-in” calls. There is no billing for calls lasting less than 15 minutes.
If the need for check-in calls is greater than an average of one each week, an extra session may need to be booked. Any extra sessions will be billed to the credit card on file at the discounted rate of $75 per extra session. Parent(s) and Coach must agree to the need for an extra session before it is scheduled and billed.
Additional time: Parent(s) may request that Coach speak with various professionals related to the success of their teen. These professionals may include but are not limited to, psychiatrists, psychologists, counselors, guidance counselors, academic success advisors, and teachers. Meetings with any professionals will be billed to the credit card on file at a rate of $50 per 30-minutes.
The following will be provided by email after your first payment. All blanks will be filled in with your and your teen’s information.
This is to acknowledge that Coach Keith Griffin, ACC has been retained by _____________, Parent(s), to provide 3 months of coaching services to support their child, ___________________. Coach will meet with Parent(s) and Child for a 90-120 minute intake session to get to know him/her, to start the goal-setting process, and become familiar with the family. After the intake session, the teen is entitled to one coaching session per week.
We will set a day and time for your teen’s weekly sessions. Each session is expected to last between 30 and 45 minutes each. It is preferable that we pick a day and time that will work for your teen on a weekly basis. Doing so is a great way to build a bit of structure into your teen's life, and can help them prepare for our sessions.
There is no accrual for missed weeks nor is there an extra charge for months containing more than four weeks. After three months the Parent(s) may extend this program on a monthly basis.
As Your Coach
While I, as an ADHD coach, have expertise in ADHD, coaching skills, and the change process, you bring knowledge about yourselves and your teenager impacted by ADHD. I will encourage your teen to self-advocate by asking for help, explaining what they are learning about themselves and their ADHD, and share their goals with you.
Research has demonstrated that the relationship-based skilful listening and questions provided by trained coaches through professional coaching lead to reflection, new learning, and successful application of learning in clients’ daily lives. Coaching does not offer any guarantee of success or definitively changed behavior, but the more one is committed to change, the more beneficial the experience can be. Coaching takes a holistic view and invites one to explore how all the different parts of your life are connected and affect each other.
As an ICF Credentialed ADHD Coach, I subscribe to the Code of Ethics of the International Coach Federation (coachfederation.org) and the Standards of Ethical Conduct of the Professional Association of ADHD Coaches (paaccoaches.org). I am happy to provide copies of these codes of ethics upon request. I invite you to discuss any concerns or questions that may occur during as I work with your child.
Confidentiality and privacy are a high priority. I protect the confidentiality of my clients. I will only release information about our work with your and/or your teen’s written permission or if I am required to do so by a court of law. Please see the Confidentiality section below for specific information on protecting your confidentiality.
Our Coaching Relationship
We understand that coaching is an investment in the current development and future success of our child and family. We can financially afford the coaching fee at this time. We agree to pay promptly by the agreed-upon date for the following month’s fee.
We shall be solely responsible for the payment of Coach’s fee.
We promise that we will make the time needed to fully engage in this coaching process and to provide the time for our teen to participate in the coaching sessions. We will help our child prepare and be prepared ourselves for each coaching session by doing any of the agreed-upon preparation work.
We understand and acknowledge that long-term sustainable change takes time, and the development of skills, systems, and habits occurs over time and needs consistent reinforcement. While this Agreement is for an initial three months of coaching, it is likely that we will want to continue coaching through the school year. Should we wish to continue beyond the initial three-month commitment, this Agreement remains in effect until we give two weeks’ notice of intention to stop.
Although one or more of us may have a diagnosis of ADHD, anxiety, depression, LD, and/or other conditions, we understand that coaching is not intended as a treatment or cure for that condition. By signing this Agreement, we are agreeing that we understand that coaching is not a one and done treatment, a replacement for medication, or a magic pill that will change brain wiring, and we agree to get appropriate additional professional help if recommended or deemed necessary for the coaching to succeed.
We understand that Coaching does not involve the diagnosis or medical treatment of mental disorders as defined by the American Psychiatric Association. We understand that coaching is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care, or substance abuse treatment, and we will not use it in place of any form of diagnosis, treatment, or therapy. If Coach sees the need for other professional supports, he/she will recommend them.
We promise that if any of us are currently in therapy or otherwise under the care of a mental health professional, that we have consulted with the mental health care provider regarding the advisability of working with a coach and that this person is aware of our decision to proceed with the coaching relationship.
We acknowledge that our understanding of ADHD may need to be developed or expanded upon so that we don't inadvertently undermine the coaching process. If it becomes apparent to Coach that we need some education or coaching to support our child’s success, Coach may suggest or require it.
We agree to keep an open mind and be willing to support our child in trying new behaviors and learning to advocate for him/herself.
We understand that Coach will not be put in the position of speaking for the child to me. The child will be encouraged and supported to self-advocate, and Coach may facilitate a conversation between parties as part of the learning and growth of the child and the family overall.
Because the child may not have awareness or appreciation of his/her behavior, it may be necessary for Coach to ask for and/or receive input from outside sources to identify and support coaching goals. We may be asked to sign a release for such information (from teachers, educational or mental health professionals, etc.) to be given to Coach, and we agree to sign such a release. The child will be informed, as appropriate, that such information is being received by Coach.
We commit to making note of positive behavior changes, acknowledging our child, and sharing them with Coach.
We understand that Coach may, for the purposes of professional credentialing or renewing a credential, be required to produce a client coaching log that lists client names and hours coached. We understand there is never any disclosure of coaching content, and these professional organizations will handle all information with the highest regard for confidentiality. We agree to allow disclosure of the number of hours coached on Coach’s client coaching log for credentialing and credential renewal purposes.
We understand that a person cannot be coached on something he or she is not willing to be coached around. Coach can only work on the goals you and the child agree upon. We acknowledge that our ideas and wishes may not be addressed if they are in conflict with what the child is willing to work on.
We understand and agree that we are fully responsible for our physical, mental, and emotional well-being during coaching sessions, including our choices and decisions. We realize that our success depends largely on how we conduct our lives, how we think, how we feel, and what we do. We accept full responsibility for meeting our goals and other agreed-upon outcomes. We are aware that blaming anything or anyone, including ourselves, won’t help any of us to succeed.
We are being coached to improve our lives. That means we are willing to change how we think, feel, act, and how we treat our child and ourselves, if necessary, to be successful. We know that we must experiment with different ways of being, doing, having, and communicating in order to find ways that suit us best. We realize that trying out new ways will at times feel awkward, artificial, uncomfortable, and even frightening at first. Discomfort during change does not necessarily mean that a behavior is wrong; only that it may as yet feel unfamiliar.
We understand that information will be held as confidential unless we state otherwise, in writing, except as required by law. We recognize that in certain rare and unusual situations, Coach may be required by law or ethical considerations to reveal confidential information. (See exceptions below.) We understand that what is said between our Child and Coach is confidential unless Coach hears drug or other self-abuse or hears imminent potential for harm to the child or toward another person. We accept that Coach will notify us (Parents) in the case of situations listed in the Confidentiality section below.
We will do our best to be on time for our sessions and will give 24 hours’ notice if we need to cancel or reschedule the session. If we do not give 24 hours’ notice or if we are more than 10 minutes late or misses a session without prior notice, we acknowledge that we will be charged for the session and it will not be made up.
Cancellation and No Show Policies
If you need to cancel or reschedule a session, please give 24 hours’ notice. I am aware that emergencies sometimes arise, and we’ll deal with those together. However, forgetting does not count as an emergency. Please understand that it is difficult to reschedule. If you have to change an appointment with 24 hours’ notice, it will be rescheduled. If you change an appointment with less than 24 hours’ notice, I will do what I can to reschedule, but make no promises. If you miss an appointment with no notice, it is not rescheduled and you forfeit that appointment. You are responsible for setting and using sessions. Missed sessions will be rescheduled during the month of occurrence; they may not be carried forward. Any sessions paid for but not scheduled or used within the month are forfeit.
If your teen is not present within 15 minutes of the session’s scheduled starting time, it will be considered a ‘no show’. Payment is still required in the event of a no-show. If you arrive late for a session, that session will still end at the scheduled time.
True emergencies are rare exceptions, not weekly occurrences, and they will be evaluated on a case by case basis. If on occasion, I choose to waive billing for a missed session, it does not mean the policy has changed.
If I have to change or cancel an appointment, I will always reschedule it and make sure your child has access to the sessions you've paid for. In some instances, I may credit your account prior to the next month's billing.
Conflict of Interest and Mutual Non-disclosure
I agree to comply with the ICF and PAAC codes of ethics which require me to avoid conflicts of interest or the appearance of conflicts of interest. If at any time I become aware of any actual or potential conflicts of interest, or if the information provided herein becomes inaccurate or incomplete, I will promptly notify you in writing.
You and I mutually recognize that we may discuss your future plans, financial information, job information, goals, personal information, and other private and/or proprietary information. I will not voluntarily communicate your information to a third party without your specific direction to do so. In order to honor and protect my intellectual property, you expressly agree not to disclose or communicate any proprietary information about my practice, materials, or methods to any third parties without my specific approval to do so. We agree to be bound by this mutual non-disclosure agreement during and after the termination of our coaching relationship.
The following are instances where I would be obligated by law to break our confidentiality agreement without your child’s permission:
If I assess during our sessions that abuse or neglect of children, disabled, or elderly is occurring.
If in my presence, you or your child threatens to kill or harm another individual, and I am convinced that you/your child will act on this threat, or that you/your child may lose control of personal behavior.
If at any time during our sessions, I determine that you or your child are a danger to yourselves, I will inform you (the Parents) of that opinion and make every effort to keep you/your child from endangering your lives. In some cases, this may include notifying the police or family members.
I retain administrative help for such things as bookkeeping, filing, etc. In the course of performing such duties, this professional help may have access to confidential client data. Reasonable good faith efforts will be made to ensure that privacy and confidentiality are maintained throughout all such processes and by all such individuals.
You should be aware that it is impossible to protect the confidentiality of your client information which may be transmitted electronically, i.e., electronic mail and other information stored on computers connected to the internet, by mobile telephones and other similar telecommunication and computer equipment. Therefore, it is agreed between us that unless you utilize encryption and other forms of security protection, you waive any action legal or otherwise against me, the coach, and hold me harmless for any interception of your client information resulting from the use of the above-mentioned equipment.
We understand that what is said between the Child and Coach is confidential unless one of the above conditions occurs.
Coach Disclaimer of Liability
We hereby employ Keith Griffin, ACC as Coach for the purpose of advising and coaching ________ with respect to his/her life, skills, developing interpersonal relationships, and setting and achieving his/her goals. Coach has experience in such matters and agrees to render such coaching services.
We understand and Coach agrees that he is not an employment agent, a business manager, a financial analyst, a medical doctor, a psychotherapist, or a tutor and that she has not promised, shall not be obligated to, and will not: (1) procure or attempt to procure any employment, business, or sales for the Client; (2) perform any business management functions such as accounting services, tax or investment consulting, or advice with regard thereto; (3) diagnose or prescribe for any medical condition; (4) act as a therapist, providing psychological counseling, psychoanalysis, or behavioral therapy, or (5) act as a subject matter tutor in any subject.
All parties have received and accepted a copy of this Agreement for Coaching Services. All parties agree to be accountable for this Agreement, including any changes or additions made. By signing, we confirm that we have read, understand, and agree with all elements of this Coaching Agreement.
Refunds and Credits
We understand that all fees paid are considered non-refundable and no credit will be given for unused sessions/time.
Revised January 2019