Brainspotting Pre-session Form

This form is to further clarify what to expect from your Brainspotting session, and for me to gather some information to ensure Brainspotting is a good fit for you.

As we will likely be working with trauma together, even at a very gentle level, I also please need you to read and confirm your agreements with the information points about your session, below. Please tick each box to indicate your understanding / agreement.

I look forward to working with you.

First name

Last name

Address

Telephone number

What is your reason for wanting to do this free Brainspotting session?

I acknowledge and appreciate your courage – that you are taking a risk to experience something new, possibly with somebody you do not know / know well. I also acknowledge and appreciate the commitment you are making to yourself for healing, by spending this time with me.

You understand that Brainspotting is a transformative modality that works to identify, process and release our neurophysiological sources of emotional and / or physical pain, trauma, dissociation and various other challenging symptoms. Refer here for a more detailed description of Brainspotting.

My commitment to you is that I am appropriately qualified to safely provide this session for you. I will meet you wherever you are at and hold the space and intention for your healing to be facilitated by the session.

As a Brainspotting practitioner, I participate in supervision. As part of this supervision, I share elements of my sessions with my supervisor. Any and all such sharing is done anonymously and hypothetically. No confidential information will be shared at any time, unless I have reason to believe that there is an imminent or likely danger of harm to you or others.

You understand that you are solely responsible for creating, managing and implementing your own physical, mental and emotional well-being and for your own decisions, choices, actions and results that may arise from your Brainspotting session.

You understand that Brainspotting is different to psychotherapy, mentoring, counselling and therapy. You also understand that Brainspotting is not a substitute for any of these modalities.

The consistent experience from Dr David Grand, the founder of Brainspotting, my teachers, colleagues and myself, is that the session will leave you lighter and happier. Because we work at the pace set by your own body and nervous system, we will not be going into “unsafe” territory and / or leave you in a position where you are feeling “undone” after our time together.

(Please note: if you have a different experience, it doesn't mean anything is wrong. Please do contact me if you are concerned).

If you are experiencing severe emotional distress such as serious depression, overbearing anxiety or acute trauma symptoms, I encourage you to also pursue more traditional treatment routes in addition to this session, such as psychotherapy and/or medical treatment. If you are already in treatment with a therapist or another specialist, you may like to inform your therapist of this session.

Following your session, you will have an opportunity to communicate any feedback about your session with me. You will also have the opportunity to provide a testimonial and / or a referral, should you choose to. This will be facilitated by a short feedback form sent by email the day after your session.

Please feel free to share any additional information about yourself that you would like me to know before our session.

Thank you for taking the time to complete this form. I look forward to working with you.