Feelings Basecamp Handout
COUNSELING AGREEMENT
Our Safe Space and Ground Rules
Student:
Date:
What is Confidentiality?
Confidentiality means what you say, play, or draw in this room stays private between you and me. It is a safe place to share your true thoughts and feelings.
The 3 Safety Exceptions:
I am legally required to break privacy and tell another adult if:
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- You talk about hurting yourself
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- You talk about hurting someone else
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- You share that someone is hurting you
Growing & Trying
We are here to practice and learn new skills. This is a safe space to grow without judgment.
🎯
Try Your Best: It's okay if things are hard.
✏️
Mistakes Help Us Learn: Making mistakes is normal.
💬
Be Honest: Speak honestly about your feelings.
All Feelings Are Welcome
It is completely natural to feel angry, sad, worried, or happy. Every emotion is allowed to be felt in this room!
Our Safe Actions Rules:
All feelings are okay to have, but we must keep our behavior safe.
- We use words, talking, art, or play
- We keep hands, feet, and bodies safe
- We treat room items and toys with respect
My Coping Toolbox
If you feel overwhelmed or need a quiet break, you are welcome to use any of these coping tools:
🛋️ Quiet Corner
🎨 Art Supplies
🌀 Fidget Tools
🧘 Breathing Cards
Our Counseling Pact
"I agree to participate in counseling with an open mind, to keep myself and others safe, and to work as a team with my counselor."
Student Signature
I agree
Counselor Signature
I support you
Basecamp Facilitation Guide
ERMHS Clinical Resource
Counseling Facilitation Guide
Straightforward protocols and scripts for introducing space rules and boundaries
Session Target Initial Intake / Week 1
Session Objectives & Purpose
Introduce the therapeutic environment, establish legal and school-based boundaries of safety and confidentiality in a straightforward, supportive manner, validate emotions, and model a collaborative growth mindset.
Pacing & Talking Protocols
Step 1: Welcome & Setup (5 min) Warm Icebreaker
Welcome the student. Explain that this is a safe counseling space where they will learn new coping skills, talk about their life, and practice managing stress and emotions.
Step 2: Confidentiality & Privacy (10 min) Privacy Limits
Hand over the handout. Walk through the concept of Confidentiality. Explain privacy boundaries clearly and directly.
"Everything we talk about or do in here is private. However, I am legally required to share our conversations with other trusted adults to keep you safe if you tell me you want to hurt yourself, hurt someone else, or that someone is hurting you. Does that make sense?"
Step 3: All Feelings & Coping Tools (10 min) Emotional Regulation
Validate all emotional states. Focus on how behavior must remain safe regardless of the feeling. Walk through the classroom's concrete coping tools.
"You are allowed to feel angry, sad, or worried in here. Every emotion is completely okay. But we must keep our actions safe. We can use art, writing, or toys to help us, but we do not hurt bodies or items. What tools do you like to use when you feel upset?"
Step 4: Counseling Pact (5 min) Co-Signature
Read Our Counseling Pact together. Sign the agreement lines alongside the student. Emphasize that it represents teamwork and a commitment to working together.
Straightforward Discussion Prompts
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"Where in your body do you feel anger or stress first?"
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"Why do you think we have rules about privacy in counseling?"
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"What is one coping strategy you have tried before?"
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"How can I best support you when you feel overwhelmed?"
Clinical Reminder: Keep a copy of the signed agreement in the student's chart. Refer back to these guidelines directly to remind students of boundaries during emotional escalation.
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