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Consent Form

Please read the following information carefully. This form is meant to support clarity, collaboration, and mutual understanding.

What is Somatic Experiencing?

Somatic Experiencing is a body-oriented approach to healing trauma and chronic stress. It helps restore the nervous system’s natural ability to regulate and supports the completion of protective responses that may have been interrupted or stuck during overwhelming experiences.

SE may involve tracking body sensations, images, emotions, movements, and behaviors — with an emphasis on going slowly, following what feels safe, and avoiding retraumatization.

-> SE is not about revisiting trauma stories in detail. -> There is no requirement to talk about anything you don’t feel ready to. -> You are always in charge of the pace and direction of the work.

What to Expect in a Session?

Sessions are collaborative, experiential, and may include moments of quiet, allowing for slowing down and integration or guided exploration of body awareness.

You may be invited to notice internal sensations (interoception), movement impulses, images, or emotions.

You can always say no, pause, or ask questions.

Because SE follows the body’s natural rhythms, no two sessions look the same. Sometimes the work is very subtle. You may feel changes during or after a session — or you may feel like “nothing happened.” All responses are valid, and integration often happens over time.

We go slowly to allow your system to stay within a range that feels manageable and steady. This is called working within your capacity. You will never be pushed to revisit painful memories or sensations before you're ready.

My role is to hold a grounded, supportive space for whatever arises, even if it’s confusion, silence, or uncertainty. I will:

-> Help you notice your body’s subtle signals and responses. -> Offer gentle guidance and invitations but never pressure. -> Act as a steady presence and container when difficult sensations or emotions emerge. -> Help you return to safety or neutrality if you feel overwhelmed. -> Healing doesn’t require reliving trauma. Often, we work with what didn’t happen, allowing for completion, choice, and connection in a way that may not have been possible at the time.

Preparing for Your Session

How your body is physically supported and grounded is actually the very first step in our work together. Settling into a comfortable position is how we signal to your nervous system that it’s safe to open up and connect.

To support the pacing and physical nature of this work, please prepare your environment with the following in mind:

-> You can use a laptop, tablet, or phone—whatever works for you! The only rule is that your device needs to be placed on a stable surface. Please avoid holding your phone or resting your laptop on your lap. We want your hands free and your body ready to move, as we often integrate movement into our sessions.

-> You definitely don’t have to sit in a rigid office chair. A comfy couch, a pile of cushions, or sitting right on the ground are all great. Just make sure you have solid back support available. Also, please avoid taking the session from your bed; having direct, easy access to the floor is important for the tracking we do.

-> Grab a glass of water, and maybe pull over a few extra pillows or blankets. Having extra support for your back, arms, or joints makes a world of difference.

-> Your session does not have to take place in a closed, traditional room. You are welcome to be outdoors or in an open space, provided you have total privacy and feel genuinely comfortable, safe, and able to express yourself freely in that environment.

Commitment to the Process & Pacing

Nervous system work is fundamentally a process of deep repatterning, relational repair, integration, and sustainable change. Because we are working with adaptations and physiological patterns that often took decades to form, this work cannot be approached as a "quick fix" or a one-time experience.

To honor this type of work and build a secure therapeutic space, I work with clients over a minimum initial period of three months and I do not offer one-off sessions. This foundational period is essential to:

-> Establishing a secure relationship and shared language. -> To familiarize yourself and your nervous system with this type of work.

-> Ensuring your nervous system has the capacity and stabilization required before moving toward deeper layers.

-> Allowing the nervous system the time it biologically needs to reorganize, integrate, and stabilize new patterns so that change is sustainable.

Every individual's timeline varies; some may notice changes more quickly, while others need more time. This three-month commitment ensures the work is grounded, safe, and built to last.

Confidentiality

Sessions between the therapist and the client are strictly confidential. Any notes taken by the therapist during therapy shall be kept confidential and secure by the therapist at all times and shall not be disclosed to anyone without any prior written consent by the client, except for certain limitations, such as:

-> If the client poses a danger to others.If the client poses a danger to themselves. -> Release a client’s file if there is a court order to do so. -> Report to appropriate individuals if there is suspicion of a child being at risk or in need of protection due to neglect, or physical, sexual, or emotional abuse.

Supervision is a requirement for any therapist in client contact. The clients being seen by the therapist are taken to supervision in a manner that is respectful of the client and at the same time, maintains their confidentiality.

Clients have the right to access their own records and discuss therapy goals or approaches at any time.

Clients have the responsibility to communicate openly and honestly with their therapist and to inform them of any changes or updates to their personal information.

Regarding interactions outside of therapy sessions, if we happen to see each other in public, I won't approach you out of respect for your privacy. However, if you choose to approach me, I would be happy to connect with you.

Session Information and Cancellation Policy

Sessions are 50 minutes long and held online via Zoom.

Sessions are booked at least 48 hours in advance, after which slots become closed on the calendar.

To support depth and continuity in our work together, I offer sessions in packages:

-> 6-session package: 510 USD -> 12-session package: 960 USD

To ensure we get the best results, I always start with an initial package. After we've successfully moved through that first phase, and depending on your needs and therapy goals, we may discuss the possibility of moving to a more flexible pay-per-session arrangement at 100 USD per session.

I understand that financial circumstances differ, and I want this work to remain accessible. If the standard fees present a barrier, sliding scale and flexible payment options are available — please don’t hesitate to reach out. No one will be turned away for financial reasons.

Please know that in the case you are on an installment plan, it is not a pay-as-you-go arrangement. It simply breaks up the full package fee into smaller payments to make things easier. The full package fee applies once you begin, even if you need to pause, cancel, or space out your sessions, unless otherwise agreed upon.

Payments can be made via bank transfer using the following details: Name: Fareeda Salah Nazmy Taha Bank Name: Commercial International Bank Egypt Branch: Rehab City IBAN: EG130010009100000100071926812

Kindly send your payment at least 72 hours before our first session and share a screenshot via WhatsApp to confirm.

Please choose the package you would like to start with

6 sessions

12 sessions

Please confirm here the payment plan or sliding scale option we've discussed via WhatsApp or email for record-keeping purposes: (please add the dates each installment is due)

Your session time is set aside just for you. If something comes up and you need to reschedule or cancel, I kindly ask for at least 48 hours' notice so that the slot may be offered to someone else who may be waiting for support.

If I don’t receive notice within that window, your appointment will be automatically confirmed.

I trust that you’ll honor the time we’ve set aside together. I also understand that life happens, so kindly keep me in the loop as best as you can.

🚨🚨 Because we are working within an initial three-month commitment, consistency is key. Our baseline structure is to meet every week to keep your progress moving forward.

I totally understand that life happens and schedules shift, but to maintain your momentum, we need to meet at least once a month. I only hold a limited number of active spots in my practice to protect the quality of this work. If a full month passes without a session, I will need to open that spot to someone else.

While your package sessions never expire, I won't be able to guarantee that a spot will be open the moment you’re ready to schedule again, and you may have to wait until the next opening becomes available.

By checking the boxes below, you confirm that you have read and agreed to the following:

You understand the nature and goals of Somatic Experiencing as described above.

You understand the information above and voluntarily consent to the collection of your personal information for the purpose of receiving therapy services.