Informed consent

Lizabeth Tong, Psychology Council Member, Clinical Psychologist

Obtaining consent from clients prior to providing them with psychological services is a fundamental given. ‘Informed consent’ is a procedure that involves providing clients with comprehensive information about the psychological service and gaining their agreement to take part in the service (1). Consent must be ‘informed’ (therefore, ‘consent’ will be used throughout the rest of this article to indicate ‘informed consent’).

The NSW Department of Justice defines consent as follows:

  1. That the person seeking treatment has the capacity to provide their own valid consent.
  2. That the person understands the nature and effect at the time the intervention is required.
  3. That the person does ‘know’ what the intervention is.
  4. That the person understands what the treatment involves.
  5. That the person is aware of other options and, if choosing between options, the person must understand what each option is, what each option involves and the effects of each option.
  6. That the person understands the ‘effect’ of the treatment.
  7. That the person is aware of the main benefits and risks of treatment (2).

Most people understand information from their psychologist about their condition and proposed treatment and can provide consent to treatment. However, the psychologist needs to be aware of the following components involved to form valid consent:

  • The client must be considered competent – that is the psychologist needs to determine whether the person has understood the information provided.
  • Consent needs to be given voluntarily – that is freely and without coercion.
  • It must be specific – with the scope of what is agreed to being made clear.
  • The information provided must be understood – that is communicated in language that the client comprehends (3).

Whilst there is no legal requirement to document the provision of consent, the Australian Psychological Society (APS) Code of Ethics (adopted by the Psychology Board of Australia for the profession) instructs psychologists to document a client’s consent prior to the provision of a service. Where signed consent is not feasible (e.g. if the agreement is made over the phone) it is strongly recommended that a file note is made, outlining the discussion and provision of consent. This, however, does not provide the psychologist or client with the same protection in a legal context as a signed consent form.

While verbal consent may be considered adequate, having written consent provides added protection for the psychologist and the client if any agreement about services needs to be revisited (3). The APS has developed a template consent form that complies with the Australian Privacy Principles. It is also strongly recommended that psychologists revisit client consent regularly, including during the same episode of service provision – particularly if the purpose, nature or focus of the psychological service alters.

For further information, please visit the following sites.

  1. Managing informed consent, resource from the APS: https://www.psychology.org.au/inpsych/2014/august/qanda (APS membership login required)
  2. The Capacity Toolkit, NSW Department of Justice and Attorney General (2008): http://www.justice.nsw.gov.au/diversityservices/Documents/capacity_toolkit0609.pdf
  3. InPsych, 2017, Vol. 39: Documenting informed consent: https://www.psychology.org.au/inpsych/2017/august/alerts (APS membership login required)