Consent for a Supervised Trainee to Observe Your Session

Please read this before your session. Saying no is completely fine and changes nothing about your care.

A psychology intern on our supervised training programme has asked to observe one of your sessions. We will not go ahead unless you agree, in advance and in writing, on this form.

Who would be present

Client name

Date of session

Name of trainee who would observe

Name of supervising practitioner

This consent applies only to the single session named above. We will ask you again for any future session.

What you are agreeing to

The observer is a trainee, not a qualified counsellor. They are on a supervised internship and are still learning.

The trainee will watch silently. They will not take part in the session, ask you questions, or offer you any advice or opinion.

The supervising practitioner named above stays fully responsible for your session and for the trainee's conduct.

One more person will hear what you say. This is the main effect on your confidentiality, and we want you to weigh it before agreeing.

De-identified details may be discussed in supervision for teaching — with your name, school, city and any identifying detail removed or changed.

Nothing will be recorded, photographed or copied by the trainee, and no notes or files about you will be given to them.

The trainee is bound by confidentiality permanently, including after their internship ends.

You can say no, and you can change your mind. You may decline now, or withdraw at any moment — including part-way through the session. If you do, the trainee leaves immediately and you do not have to give a reason. Your care, your price, and how soon you are seen will be exactly the same either way.

If the client is under 18

Where the client is below 18 years of age, the DPDP Act, 2023 requires the verifiable consent of a parent or lawful guardian. Both sections below must be completed:

I am the parent or lawful guardian of the client named above, and I consent to the named trainee observing this session.

The student has been asked in their own words and is comfortable with the trainee being present.

The student's wishes come first. If the young person is not comfortable, no trainee will attend — even where a guardian has consented.

Client signature

Name & date

Parent / guardian signature (if client is under 18)

Name, relationship & date

Supervising practitioner

Name & date

Consent withdrawn (office use)

Date, time & who recorded it

Lume Live · +91 7015671280 · hello@lumelive.co.in
To ask a question or raise a concern about this form, contact us on the details above. See our Internship Ethics & Consent Framework and Privacy Policy.