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Collateral Visit Agreements

What are they?
What do you need to know?
What should be included in the Collateral Contract?

Clinical Update
By Zur Institute

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Collateral Visits

A collateral visit is when, besides your client and yourself, the clinician, you also see 'collateral(s)' in your office. Collaterals may include the patient's parent/s, child, sibling, partner, colleague or friend.

The goal of a collateral visit is to enhance the treatment goals of the identified client. This can be achieved by getting to know a client's collateral(s), learning more information from them, and having the patient communicate directly with them.

It is important to note that the collateral is NOT your client and is neither responsible for your fees nor has access to the records.


Collateral Visits -- The Basics

  • A collateral can attend a session with the therapist with or without the client present.
  • The main reason for a collateral visit is to further or enhance the treatment goals and interests of the patient.
  • Unlike patients, collaterals do not have the right to access records of the session.
  • A collateral is not responsible for the fees of the session/s, unless he/she has been responsible for the fees all along, as often happens when the collateral is the parent of a minor patient.
  • Collaterals are not your patients. You do not have the same responsibility for collaterals as you have for your patients.
  • Information about the collateral may be entered into the clinical records with a varied range of details, depending on the clinician, the situation, the relationships between the patient and the collateral and the communication between the therapist, client and collateral.
  • Clinicians who work with children often treat them in the context of their family which often includes parents, siblings, or extended family members. Such family members are often included in sessions as collaterals. Parents, in particular, have more rights and responsibilities in their role as collaterals than do collaterals in situations where the identified patient is not a minor.
  • If in your evaluation you feel it is appropriate, you may offer a referral to the collateral for a follow up with another mental health professional.
  • Child or adult abuse and similar reporting laws are applied to collateral visits.
  • Seeing the collateral without the patient present can raise issues of secrecy or a sense of exclusion on the part of the client.
  • The identified patient is not mandated to sign an authorization to release information to the collateral when a collateral participates in therapy with the patient. The presence of the collateral in the session means there is 'implied consent' by the patient. In contrast, the collateral must sign a 'Collateral Visit Agreement'.



What should be included in a 'Collateral Visits Agreement'?

  • Explanation of what a Collateral Visit is and the role/s of collaterals in therapy.
  • Confidentiality issues and limitation of confidentiality.
  • Responsibility for fees.
  • Clarification that the collateral is not a patient and is not the recipient of mental health services by the therapist during the visit.
  • Who has access to the clinical records of the collateral visit(s).
  • What may be included in the records of the collateral visit session.
  • Therapist's responsibilities and duties.
  • Potential risks (i.e., intense emotions, anxiety, worry) and benefits (i.e., helping the patient, improved understanding and relationships with patient) to collateral as a result of the visit.


Online Resources for Collateral Visits



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