Consent Form - BWRT

Please fill out the following consent form prior to first session 
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BrainWorking Recursive Therapy® (BWRT®)

 

Informed Consent to Treatment

BrainWorking Recursive Therapy® is a neuroscience-based process that has been shown to be useful to help reduce or alleviate the symptoms, and causes of symptoms, associated with Anxiety, Phobias, PTSD, Depression, Low confidence, Low self-esteem, and many other psychological issues. It works in a unique way to ‘defuse’ the psychological triggers of the symptom pattern before they reach the part of the brain that activates the emotional responses. In this way the symptom is either alleviated or greatly reduced in severity. BWRT® mimics the way the brain and psyche acquire the difficulty in the first place and is therefore a totally natural process. The work does not require you to divulge any intimate details of your personal life or of any event that you wish to keep private that might have been the cause of your symptom. While there is not a therapy in the world that works for everybody every time, BWRT® is considered by many to be among the most reliable of psychological methodologies.

 

BrainWorking Recursive Therapy® was discovered in 2011 by Terence Watts, MCGI, a UK therapist, author and trainer in full-time private practice since 1989. After development and many practical trials with volunteers, BWRT® was taught for the first time in October 2013. One of the first students of the new technique was South African Clinical Psychologist Rafiq Lockhat whose extensive experience in the world of psychology led to him being quickly appointed as Terence’s research partner and ‘Mr BWRT South Africa.’ Terence and Rafiq continued to refine the process into the elegant system that it is today.

 

All trainers of this relatively new model of psychopathology are selected by The Terence Watts BWRT Institute and all adhere to the same training programme to ensure, as far as possible, consistency in technical expertise across the globe.

 

I was trained by: Terence Watts

 

By signing below, you indicate that you understand and accept the following (presented in no particular order):

 

  1. BWRT® is designed to help neutralise triggers for the symptom(s) you experience.

  2. There are three levels of BWRT® and your practitioner will ask you some questions that will help them decide which is the most appropriate level for you.

  3. There are a few conditions in which BWRT® is not a suitable therapy and when this is the case, the practitioner will advise you accordingly.

  4. The number of sessions you will need vary according to several circumstances and the practitioner will advise you where possible. Many situations respond well to between one and four sessions, though some more serious issues may need more.

  5. You will not have to tell the practitioner anything you would rather keep private but there are some situations when secrets might inhibit therapy. The practitioner will advise you if this is the case.

  6. If your presenting problem could be caused by a medical or physiological condition, you will need to have had a medical consultation before working with BWRT®.

  7. Straightforward issues such as smoking cessation, phobias, fears and specific anxieties will not normally need any medical consultation before BWRT®.

  8. There is no need for prolonged investigation into your early (childhood) years but if you feel they might have a bearing on your symptom, you can tell the practitioner and they will take that into account.

  9. If your symptom was triggered by a past situation or trauma, you will be required to recall it for just a few seconds so that the degree of discomfort can be assessed via the Perceived Arousal Level (PAL). This also allows assessment of the degree of improvement after the process has been applied.

  10. The practitioner may sometimes use their voice in a way that sounds unusual or strange to you. This need not concern you and is just part of the BWRT® Process

  11. There are several different ways that BWRT® can be conducted and the practitioner will be able to make the best choice for you and your presenting issue.

  12. If the symptom or difficulty for which you are seeking help is part of, or likely to be part of, any legal proceedings, please take legal advice before embarking on treatment, since BWRT® changes your perception and responses to past events.

  13. You may be asked if we can use the results of the work anonymously. This is completely optional with anonymity guaranteed (we use only the data), and if you do give consent you can withdraw such consent at any time.

Further, I acknowledge that BWRT® is not a medical procedure nor is it a practise of medicine.  I also acknowledge that success and failure of this BWRT® depends upon many unknown factors and it is impossible to ascertain what responses I will exhibit during my BWRT® sessions and there is no guarantee in achieving the specific goals.

 

I, hereby release and forever indemnify Ms. Karen Armstrong or anyone working for her or assisting her in her practise or organizations associated with her, and shall not make any claim against the above referred individuals or organizations for any injuries or other damages I suffer arising from the BWRT® sessions even if such damages or injuries arise out of their negligence.

 

I also understand that for all legal purposes, the services provided by Karen Armstrong will be considered to be provided in Alberta, Canada and that the Courts of Alberta shall have exclusive jurisdiction to hear any complaint, demand, proceeding or cause of action, whatsoever arising from or in connection with the BWRT® services or from any other aspect of the professional relationship between myself and Karen Armstrong.

 

All information will be treated as confidential and will not be released to anybody, except upon your written request.

By signing below, you confirm that you have read and understood the above information and that you subsequently consent to BWRT® for your condition.

 

Please note: For clients under 18 years old, a parent or legal guardian must sign