Informed Consent & Practice Policies
GENERAL INFORMATION
The therapeutic relationship is unique in that it is both highly personal and a contractual agreement. For that reason, it is important that we reach a clear understanding about how our relationship will work and what each of us can expect. This framework is meant to guide our work together. Feel free to discuss any of it with me. New clients review and agree to this information before we begin.
THE THERAPEUTIC PROCESS
Deciding to seek therapy is a positive step. The outcome of treatment depends largely on your willingness to engage in the process, which may at times bring considerable discomfort. Remembering unpleasant events and becoming aware of the feelings attached to them can bring on strong feelings such as anger, depression or anxiety. There are no miracle cures, and I cannot promise that your behavior or circumstances will change. I can promise to support you, to do my best to understand you and your repeating patterns, and to help you clarify what you want for yourself.
CONFIDENTIALITY
Session content and all materials relevant to your treatment are held confidential unless you request in writing that all or part of them be released to a specifically named person or persons. There are limits to this confidentiality:
1. If a client threatens or attempts suicide, or otherwise acts in a way that creates a substantial risk of serious bodily harm.
2. If a client threatens grave bodily harm or death to another person.
3. If I have a reasonable suspicion that a client or other named victim is the perpetrator, an observer, or the victim of physical, emotional or sexual abuse of a child under 18.
4. If I have the same kind of suspicion regarding an elderly person.
5. If I suspect neglect of the people named in items 3 and 4.
6. If a court of law issues a legitimate subpoena for the information it names.
7. If a client is in therapy by order of a court, or if information is obtained for the purpose of an expert's report to an attorney.
Occasionally I consult with other professionals in their areas of expertise to provide the best treatment for you. Information about you may be shared in that context without using your name.
If we see each other by chance outside the office, I will not acknowledge you first, to protect your privacy. If you greet me, I am happy to speak briefly, but I will not hold a lengthy conversation in public.
APPOINTMENTS AND CANCELLATIONS
Please cancel or reschedule at least 24 hours in advance. Cancellations and rescheduled sessions received less than 24 hours in advance are subject to the full session fee, because a time commitment is made to you and held exclusively for you. If you are late for a session, you may lose some of that session time. The standard meeting time for psychotherapy is 50 minutes. If you would like a different session length, please discuss it with me so time can be scheduled in advance.
BETWEEN SESSIONS
If you need to reach me between sessions, please leave a voicemail. I am often not immediately available, but I will try to return your call within 24 hours. Face-to-face sessions are preferred, but if you are out of town, sick or need additional support, phone sessions are available. If a true emergency arises, please call 911 or go to your nearest emergency room.
SOCIAL MEDIA
To protect your confidentiality and avoid dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site. Adding clients as contacts can compromise confidentiality and privacy and blur the boundaries of the therapeutic relationship. If you have questions about this, please bring them up and we can talk more.
ELECTRONIC COMMUNICATION
I cannot ensure the confidentiality of any form of electronic communication, including text messages. If you prefer, I will use email or text for scheduling and cancellations. I may not respond immediately, so please do not use these methods to discuss therapeutic content or to request help in an emergency.
TELEHEALTH
Services delivered by electronic means, including telephone, internet, fax and email, are considered telemedicine under California law. If we use technology for some or all of your treatment, you should understand that: you may withhold or withdraw consent at any time without affecting your right to future care or treatment; all existing confidentiality protections still apply; you have access to information transmitted during a telemedicine consultation, and copies are available for a reasonable fee; your identifiable images or information from a telemedicine interaction will not be shared with researchers or other entities without your consent; and there are potential benefits and risks. Benefits can include more convenient access to therapy, better continuity of care, and less travel and lost work time. Risks include that, without being in the same room, I may be unable to observe things such as your physical condition, posture, mannerisms, grooming, eye contact and body language, and so may miss information I would consider important or that you may not think to mention.
MINORS
If you are a minor, your parents may be legally entitled to some information about your therapy. I will discuss with you and your parents what information is appropriate for them to receive and which issues are better kept confidential.
TERMINATION
Ending relationships can be difficult, so a termination process helps achieve some closure. Its length depends on the length and intensity of treatment. I may end treatment, after discussion with you and a termination process, if I determine that psychotherapy is not being effectively used or if payment is in default. I will not end the therapeutic relationship without first discussing the reasons. If therapy ends for any reason, or you request another therapist, I will provide a list of qualified psychotherapists, and you may also choose someone on your own or from another referral source. If you do not schedule an appointment for three consecutive weeks, unless other arrangements were made in advance, I must for legal and ethical reasons consider the professional relationship discontinued.