Survivors Voices Cafe

Introduction

The Survivors Voices Cafe is a supportive space for adults who have experienced abuse or trauma. The cafe is hosted by Sebastian Etienne and supported by Deborah J Crozier, Trauma-Informed Practitioner and Founder of A Positive Start CIC. It offers a calm, respectful environment where survivors can connect with others who understand. There is no pressure to speak - you are welcome to simply listen and be present.

What You Can Expect

Participants can expect a supportive and respectful space where people are welcome to talk, listen, and connect with others who understand. The cafe will include opportunities for open conversation, gently facilitated discussions, short, talks, creative activities such as poster creation, and occasional workshops focused on healing, awareness and survivor voice. There is no pressure to speak or participate in any activity - you are free to take part in whatever way feels most comfortable for you.

Confidentiality Agreement

To help create a safe and respectful space for everyone attending the Survivors Voices Cafe, we ask all participants to agree to the following: I understand that personal stories and experiences may be shared within the group. I agree to respect the privacy of others and will not share or repeat any personal information or identifying details discussed during the cafe outside of the group. I understand that this space is built on trust, respect, and confidentiality.
Name(Required)
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Address

End of Therapy Review and Closure

Section 1 - About Your Support

Choose from the dropdown options

Section 2. What Has Changed?

On a SUD (subjective units of distress) Scale of between 0-10
On a SUD (subjective units of distress) Scale of between 0-10
Choose one answer from the dropdown that best describes you experience.

Section 3. You Experience of Therapy

On a Scale of 1. Strongly Agree > Strongly Disagree
11. My therapist was:
(Tick all that apply)
On a Scale of 1. Strongly Agree > Strongly Disagree
Choose one

Section 4. Service Feedback

Choose one

Section 5. Closure Confirmation

18. I understand my therapy sessions have now ended.(Required)
19. I know I can contact A Positive Start CIC in the future if i need further support.(Required)
On a Scale of 5. Very Satisfied > 1. Very Dissatisfied

Thank you

Thank you for taking the time to complete this reflection. Your voice matters to us, and your feedback helps us continue creating safe, compassionate spaces for others. We wish you continued growth, strength, and gentleness with yourself as you move forward. With warmth, A Positive Start CIC

Practicum Student/Student Placement Application Form

This field is for validation purposes and should be left unchanged.

A Positive Start Student Placement Application

Thank you for your interest in a student placement with A Positive Start CIC. We are a trauma-informed, person-centred organisation supporting community wellbeing through counselling, education, and relational safety. This form helps us understand your training requirements, readiness for placement, and how we can support you safely and ethically. Completion Time Approx: 10 - 15 mins. If you need adjustments to complete this form, please email Deborah at info@apositivestart.org.uk

Your Details

Name(Required)
Address(Required)
Email(Required)

Your Provider

Who are you studying with?
Name of course provider
How many years are you studying over?

Regarding Placement

Trauma Awareness & Understanding

3000 characters

Emotional Regulation & Self-Awareness

3000 characters

Reflective Capacity

3000 characters

Supervisor Details

A Positive Start CIC we will provide ongoing support and guidance, however you are also required to have your own supervisor outside of the placement.
Name

References

Referee 1

This should be your tutor or course provider
1. Name(Required)
Address(Required)
Email(Required)

Referee 2

This should be someone who knows you personally
Name(Required)
Address(Required)
(Preferred)
(if known)
What days are you available?(Required)
What times are you available?(Required)

Thank You

Thank you for considering A Positive Start CUC for your placement. We truly appreciate your interest in the work we do and the values we hold. We wish you every success in your studies and in the continued development of your practice. It is always a privilege to support students as they grow in confidence, knowledge, and professional presence. We are delighted to play a small part in your journey and to support the development of the next generation of trauma-informed practitioners, who will go on to create safer, more compassionate spaces for those they work with.

Participant Consent Form

Study Details

Exploring Emotional Freedom Techniques (EFT) for Supporting Cravings and Emotional Regulation Researcher: Deborah J Crozier University: UWS Course: MSc Contemporary Drug & Alcohol Studies

Overview of Consent

You are being invited to take part in a small research study exploring whether a simple self-help technique called Emotional Freedom Techniques (EFT) may support people in managing cravings and emotional responses related to substance use. Before deciding whether to take part, it is important that you understand what participation involves. If you agree to take part: You will be invited to attend up to four EFT sessions focused on understanding and managing cravings and emotional regulation. You will be asked to complete very simple rating questions (for example, rating cravings or how settled you feel) before and after sessions. You may be invited to complete a short feedback form at the end of the sessions. Participation is completely voluntary. You are free to stop taking part at any time without giving a reason. Taking part will not affect any services or support you currently receive. EFT is a supportive technique, not a medical or addiction treatment. Your information will be treated as confidential and anonymised. Your name will not appear in any report. If there are serious concerns about safety or risk of harm, confidentiality may need to be broken in line with safeguarding responsibilities. Please take time to read the statements in the consent section carefully before signing. If anything is unclear, you are encouraged to ask questions before deciding whether to participate.
Please read each statement carefully and tick to confirm

Participant Details

Name
How would you like to be contacted to discuss taking part in this in-person study?
MM slash DD slash YYYY

Host Us

Host Us

Bring Emotional Safety, Body Confidence & Regulation To Your Children At A Positive Start CIC, we work with schools, nurseries, community groups and organisations to support children’s emotional wellbeing, confidence and safety through music-based, trauma-informed learning. If you would like to invite The River Room Songbook and My Body Is My Body programme to your school, setting or community — we would love to hear from you.

What We Offer

We deliver gentle, engaging sessions for: Nurseries & Early Years Primary Schools Community & Family Groups Parent Workshops Professional / Staff Sessions Our sessions combine: 🌊 Emotional regulation through music 🛡 Body safety & confidence (MBIMB) 🌿 Nervous system calming tools 🎵 Interactive songs & movement 🤝 Parent & staff guidance

Who We Are

Who We Are Deborah J Crozier Founder — A Positive Start CIC MBIMB Ambassador & Board Member Lesley Redshaw and Stephanie Davies - APS CIC Volunteers A Positive Start CIC are official partners bringing My Body Is My Body to Scotland, helping children learn body confidence, safety and how to use their voice. Our safeguarding work is supported by the NSPCC.

Invite Us To Your Area

We can visit: Schools Nurseries Community centres Family hubs Events Training settings Sessions can be tailored for: ✔ Age group ✔ Setting size ✔ Parent involvement ✔ Staff training

How To Invite Us

Please complete the Host a Session Form below and we will contact you to discuss: Your setting Age group Group size Location Possible dates Your needs and goals We aim to respond within 3–5 working days.

Basic Details

Name(Required)
Please choose from the following options
Location(Required)

Practical Info

Indoor Space Available?
Equipment Available?

Counselling Agreement and Information Sharing Consent

Purpose of Counselling

Counselling provides a supportive, confidential space to explore emotional wellbeing, life experiences, challenges, and coping strategies. The aims of counselling include: *Supporting emotional understanding and regulation *Encouraging healing and personal growth *Strengthening coping strategies *Enhancing wellbeing and stability *Supporting safer, healthier relationships Counselling is a collaborative process and works best when both client and therapist engage openly and respectfully.

Therapist Role and Approach

Your therapist works using a trauma-informed, person-centred approach that is: *Respectful and non-judgemental *Boundaried and professional *Focused on emotional safety *Supportive of autonomy and empowerment The therapist does not replace medical, legal, or social care services, but may work alongside other professionals where appropriate.

Safeguarding Commitment

The safety and wellbeing of clients, children, vulnerable people, and the wider community is a priority. This means: *Counselling will always prioritise harm prevention and safety *Behaviour that places yourself or others at risk will not be supported or encouraged *Safeguarding procedures will be followed when required Safeguarding is about protection, care, and prevention - not punishment.

Confidentiality and It's Limits

What you share in counselling is treated with respect and confidentiality within legal and ethical boundaries. Confidentiality may be broken if: *There is serious risk of harm to you or others *There is risk to a child or vulnerable person *There is a legal requirement to disclose information. Where possible, this will be discussed with you openly and transparently.

Respect and Behaviour in Sessions

The counselling space is built on mutual respect. You agree to: *Treat the therapist and therapy space respectfully *Avoid abusive, threatening, discriminatory or inappropriate behaviour *Engage in sessions in a way that supports emotional safety. Strong emotions are welcome. Harmful behaviour is not.

Boundaries of the Therapeutic Relationship

To maintain safety and professionalism: *Contact outside sessions will follow agreed professional boundaries *The counselling relationship is not social or personal *Therapy is limited to scheduled session times This supports clarity, safety, and healthy independence.

Feels and Payment

This service operates on a fair-access slide scale model to balance sustainability and accessibility. Please select the option that best reflects your circumstances:
Choose Your Session Fee(Required)
Where flexibility is needed, an alternative fee may be agreed. This structure reflects the professional responsibility, emotional labour, and safeguarding complexity involved in this work.

Payment Expectations

Payment is due at or before each session unless otherwise agreed. Please inform your therapist in advance of session if your financial circumstances change. Fees may be reviewed periodically by mutual agreement. Open communication supports transparency and sustainability.

Additional Professional Time (Meetings/Reports)

The session fee covers the counselling time only. Attendance at external meetings (such as case conferences, multi-agency meetings and reviews) and the preparation of written reports, summaries or professional correspondence are not included in the session price, and are charged at £65 per hour in 15-minute increments. This will be discussed and agreed in advance wherever possible. Where additional professional input is requested or required: *This will be discussed in advance wherever possible. *time will be charged separately at an agreed rate *Consent will be sought before information is shared This ensures transparency, fairness, and appropriate recognition of the additional time and responsibility involved.

Cancellation and Attendance Policy

A minimum of 24 hours notice is required to cancel or reschedule appointments. *Cancellations with less that 24 hours, notice or missed appointments may be charged at the agreed session rate. *Exceptions may be considered in genuine emergencies. *Please communicate as early as possible if you are struggling to attend This policy protects the therapist time and allows appointments to be offered to others.

Information Sharing & Support Network Consent

Purpose of Information Sharing

You may choose to allow your therapist to share relevant information with selected professionals or trusted individuals involved in your care. This may support: *Joined-up care *Emotional and practical support *Risk management and safeguarding *Coordination of services You remain in control of this choice.
What Information May be Shared (Tick All That Apply)(Required)
Online relevant information will be shared on a need-to-know basis

Who You Give Permission To Share Information With

Person/ Service 1(Required)
Person/Service 2

How Information Will Be Shared

Information will be shared: *Respectfully and professionally *With your awareness where possible *In line with safeguarding responsibilities *Only when relevant and appropriate

Safeguarding Note

There may be circumstances where information must be shared without consent if there is: *Serious risk of harm to you or others *Risk to a child or vulnerable person *A legal requirement to disclose information This is done to protect safety and wellbeing.

Duration of Consent

Please select one:(Required)
MM slash DD slash YYYY
Client Name
MM slash DD slash YYYY

Counselling Contract with Safeguarding

Purpose of Therapy

The counselling space exists to support emotional understanding, regulation, and healthier coping, alongside the accountability processes already in place through probation and specialist programmes. Therapy does not excuse harmful behaviour. It supports responsibility, growth, and safer future choices. The aim of this work is to: - Increase emotional awareness and self-regulation. - Understand personal patterns linked to distress and coping - Strengthen internal restraint and choice - Support identity repair and healthier relationships - Reduce risk of future harm

Role of the Therapist

The therapists role is to provide trauma-informed emotional support and psychological containment. This therapy does not replace: - Legal supervision - Probation requirements - Specialist offence-focused treatment programmes Where appropriate, this work sits alongside these supports.

Safeguarding Commitment

The safety of children, vulnerable people, and the wider community is a priority in this work. This means: - Therapy will not include exploration of illegal sexual material or explicit content. - Behaviour that places others at risk will not be supported or normalised. - If information is shared that indicates current or future risk of harm, safeguarding procedures will be followed. Where possible, this will be discussed openly and transparently. Safeguarding is about protection, prevention, and responsibility - not punishment.

Confidentiality and It's Limits

What you share in counselling is treated with respect and confidentiality within legal and ethical boundaries. Confidentiality may be broken if: - There is risk of harm to a child or vulnerable person - There is serious risk of harm to yourself or others - There is a legal requirement to disclose information The responsibility exists to protect safety and wellbeing.

Responsibility and Accountability

Engaging in counselling means accepting responsibility for personal behaviour and choices. This includes: - Being honest about emotional struggles and urges - Taking ownership of actions without minimising or blaming others - Actively engaging in change - Practising agreed coping and regulation strategies - Seeking support rather than hiding difficulties Growth requires participation, not just attendance.

Respect and Behaviour Within Sessions

This counselling space is built on mutual respect. You agree to: - Treat the therapist and therapeutic space respectfully - Avoid abusive, threatening, discriminatory or sexually inappropriate behaviour - Engage in sessions in a way that supports safety and professionalism Strong emotions are welcome. Harmful behaviour is not.

Boundaries of the Therapeutic Relationship

To maintain safety and clarity: - Contact outside scheduled sessions will follow agreed professional boundaries. - The therapeutic relationship is not social, personal or informal. - Dependency on the therapist as the sole source of support is discouraged. This work supports healthy independence and wiser relational support.

Collaboration With Other Services

Where appropriate and with your awareness: - Information may be shared with relevant professionals involved in your care - This supports joined-up safeguarding and consistent support

Commitment to Change

By continuing counselling you agree to: - Engage with honesty and openness - Practise emotional regulation skills - Work toward healthier coping strategies - Remain accountable for your behaviour - Prioritise safety - for yourself and others. This work is about building a safer future.

Therapist Commitment

The therapist commits to: - Providing a trauma-informed, non-judgemental approach - Maintaining professional boundaries and safeguarding responsibilities - Supporting emotional growth and regulation - Working with integrity, clarity and transparency.

Cancellation and Attendance Policy

To support fairness and the sustainability of this service, a minimum of 24 hours, notice is required to cancel or reschedule an appointment. - Cancellations made with less than 24 hours notice, or missed appointments without notice, may be charged at the agreed session rate (min £20 - Exceptions may be considered in genuine emergencies or unforeseen circumstances. - If you are struggling to attend, you are encouraged to communicate this as early as possible. This policy exists to protect therapist time, support service sustainability, and allow appointments to be offered to others who may be waiting for support.

Fees & Payment

This service operates on a fair access and sliding scale model to support both sustainability and accessibility. You are invited to select the fee level that best reflects your current circumstances:
Name Your Price(Required)
Price per one hour session. Concession Rates - (for students, low income or financial hardship) Supported Access - Donation Option (For clients on very low or no income, a donation-based option is available. This option exists to ensure that financial circumstances do not become a barrier to accessing emotional support and therapeutic care.

Payment Expectations

- Fees are payable before each session unless otherwise agreed - Payment links are sent via #myclienthub - Please communicate openly if your financial situation changes - Missed sessions or late cancellations may be subject to the organisation's cancellation policy Open communication helps maintain fairness and sustainability for everyone.

Agreement

I understand the purpose, boundaries, and responsibilities of this counselling relationship and agree to engage in this work with honesty, accountability and commitment to safety.
Full Name(Required)
MM slash DD slash YYYY

Counselling Contract and Agreement

A Positive Start CIC | Counselling Contract & Consent (Online and In-person Sessions)

8 Sandbed, Hawick, TD9 0HE, Scottish Borders E. info@apositivestart.org.uk T. 01450 367422 Company Reg: SC581017

Between Counsellor and Client

This form explains how counselling works and helps ensure clarity, safety, and shared understanding before sessions begin. Please read each section carefully and tick the boxes at the end to confirm your consent.

1. About Counselling

Counselling offers a confidential, supportive space to explore thoughts, feelings, and experiences at your own pace. Sessions may take place online (via secure video) or in person, depending on what has been agreed. The format may change over time and can be discussed with your counsellor. Counselling is a form of psychological or talking therapy that offers you the opportunity to explore difficulties, develop insight, and work towards positive change. The length of the therapeutic process varies depending on individual needs. Some people prefer an open-ended agreement, while others choose a fixed number of sessions followed by review. We will review the therapeutic process every six sessions to ensure your needs are being met and to adjust goals if required.

2. Confidentiality

Everything shared in counselling is treated as confidential. Confidentiality may only be broken if: - There is a serious risk of harm to you or another person - There is a safeguarding concern involving a child or vulnerable adult -Disclosure is required by law or professional duty Where possible, this will be discussed with you first.

3. Safeguarding

Safeguarding is a shared responsibility. If information shared suggests that: - a child or vulnerable adult may be at risk, or - there is a serious and immediate safety concern the counsellor may need to seek advice or make a safeguarding referral. This will be done with care, proportionality, and transparency wherever possible.

4. Online Sessions

For Online Counselling: - Sessions take place via a secure platform (#myclienthub) - You are encouraged to use a private, quiet space where you feel safe - Technical difficulties may occasionally occur; if this happens, the counsellor will attempt to reconnect or contact you by telephone. Online counselling is not a crisis or emergency service.

5. In-Person Sessions

For in-person counselling: - Sessions take place in a private, professional setting - Clear boundaries around time, space, and safety are maintained. - If you feel unwell or unable to attend, please make contact where possible

6. Crisis & Emergency Support

Counselling is not an emergency service. If you are in immediate danger or feel unable to keep yourself safe, please contact: -Emergency services (999 UK) - Your GP, local crisis team, or Samaritans: 116 123 (UK) Support outside of agreed session times cannot be provided.

7. Attendance & Missed Sessions

Sessions are held at an agreed time. If you are unable to attend, please let us know where possible. If you do not attend and no contact is made, a brief check-in message may be sent to ensure your wellbeing. There is no obligation to explain missed sessions.

8. Fees & Payment

Fees are agreed during the initial consultation and are based on individual circumstances. Upton 12x Free, low-cost or donation sessions are currently available via our student placement service. Payments are made online in advance of the appointment via #myclienthub and are required via the agreed payment method agreed unless otherwise arranged.

9. Professional Boundaries

The counselling relationship is professional and boundaried. Contact outside sessions is limited to - Appointment scheduling - Practical arrangements - Brief wellbeing check-ins if a session is missed. Therapeutic support is provided within sessions, not via messaging or social media.

10. Your Choice & Autonomy

You are encouraged to: - Engage at your own pace - Share only what feels safe - Ask questions if anything is unclear - Let your counsellor know if something doesn't feel right, You are always in control of what you bring to counselling.

11. Ending Counselling

You may end counselling at any time. Where possible, a planned ending session is encouraged but not required. The counsellor may also end counselling if it is no longer appropriate or safe to continue, with care and signposting where possible.

12. Records & Data Storage

We keep minimal records, including personal details, relevant background information, confidential case notes, and this counselling agreement. You may request access to information held about you in writing. If you have any questions about record-keeping or confidentiality, you are welcome to discuss these with your counsellor.

13. Data Protection (GDPR)

Your personal information is stored securely and handled in line with GDPR. Information is used only for: - Providing counselling - Administration related to your support You may request access to your data at any time in line with GDPR regulations.

14. Cancellation Policy

Cancellations with less than 24 hours’ notice incur the full session fee. This helps protect the time reserved for your session and ensures the sustainability of the service. If something unexpected happens, please feel free to reach out so we can talk through options.

15. Alcohol & Substances

Counselling sessions cannot go ahead if a client is under the influence of alcohol, other substances, or if there is any aggressive behaviour. This is to ensure safety, emotional wellbeing, and a supportive environment for both you and your counsellor.

Client Information

Name

Counsellor Name:

A completed copy of the contract, including your counsellors details will be forward to you.

Individual Counselling Fees

60 minutes
Choosing a lower amount does not affect the care, respect, or quality of support you receive. Appointments are confirmed once payment has been completed
Print Name
MM slash DD slash YYYY

Student Counsellor Consent & Contract

This field is for validation purposes and should be left unchanged.

Summary of Agreement - Student Counselling

By entering into this agreement, you are confirming that you understand and agree to the following:

Confidentiality

Counselling sessions are confidential. Information shared will not be disclosed to others except where there is a concern about serious harm to yourself or others, a safeguarding concern involving a child ore vulnerable adult, or where disclosure is required by law. Wherever possible, this would be discussed with you first.

Safeguarding

A Positive Start CIC has a duty to act where there are safeguarding concerns. Any action taken will be proportionate, respectful, and focused on safety and wellbeing.

Supervision

Student counsellors work under regular professional supervision. Sessions may be discussed anonymously in supervision to support safe and effective practice. No identifying information is shared unnecessarily.

Session Structure & Review

Student counselling is typically offered for up to 12 sessions initially. At session 12, the work will be reviewed and next steps discussed. Continued sessions are not guaranteed and depend on suitability and availability.

Attendance & Cancellations

Attendance is important. If sessions are missed without notice or repeatedly cancelled, student counselling may be withdrawn. Wherever possible, 24 hours' notice is requested if you need to cancel or rearrange a session.

Fees Free & Donation

Sessions are provided by carefully selected counselling students in advanced training and fully supported through professional supervision. This service offers accessible, trauma-informed support.

Ending Counselling

You are free to end counselling at any time. Where possible, a planned ending session is encouraged to support reflection and closure, though this is always your choice.

Concerns or Complaints

If you have any concerns about your counselling, you are encourage to raise these with your counsellor in the first instance. If this does not feel possible, you may contact A Positive Start CIC directly for support or guidance.

Records & Data Protection (GDPR)

Brief counselling notes are kept securely and in line with GDPR requirements. Notes are used to support safe practice and continuity of care and are not shared without your consent, except where required by safeguarding or legal obligations.
Name Your Price(Required)
Please select the option that best fits your current circumstances. There is no judgement — accessibility and safety come first.

Consent & Agreement (Complete & Submit)

By agreeing to student counselling, you confirm that you have read and understood the above and have had the opportunity to ask questions.
Client Name(Required)
Client Name(Required)
Student will return a completed copy.
Consent Statements(Required)
Please tick to consent
Recording Consent (Very Important)(Required)
Please choose
Optional Donation(Required)
Student counselling sessions are offered free of charge as part of a supervised placement. If you would like to make a voluntary donation, you may do so. Donations are entirely optional and have no impact on your access to therapy or the care you receive.

Section Break


Client Details Form

Client Details Form

Registration for therapy

This field is for validation purposes and should be left unchanged.
Name(Required)
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Do you have any dependents?
This helps us understand your circumstances.
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Address(Required)
Employment Status(Required)
Name
to Next of kin
Next of Kin
Write 'Next of Kin' if Emergency contact is same as next of kin.
Emergency Contact
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Known illnesses, Physical Fitness, Quality of Diet etc.
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