Confidentiality and Office Policies
Psychotherapy conducted in a private practice setting is a business, and I do have some business guidelines. It can sometimes be hard to understand how an authentic relationship can exist within this context. However, I have found that if the guidelines and boundaries are clear and predictable, therapy will be a safer container in which client and therapist can truly be present.
Confidentiality is at the heart of the psychotherapeutic process. I will not discuss anything pertaining to your psychotherapy (even the fact that you are in therapy with me) unless you have signed a written release of information authorizing me to do so. There are a few, but important, legal exceptions to this. If I believe that you will hurt yourself or anyone else, or if I know or suspect that a child, an elder or a dependent adult has been, or is being, physically abused or sexually molested, confidentiality cannot be maintained.
I believe therapy is most effective if it is regular and consistent. I will schedule and hold a time for you (usually weekly for 50 minutes) and ask for 48 hour's notification if you need to cancel an appointment. Otherwise you will be charged for that appointment.
Fees will be set either before or by the end of the first session. I do not have a formal "sliding fee," but attempt to accommodate individual circumstances if my case load will allow it. I am not on managed care insurance plans, but will complete either a client statement or a HCFA form which you can submit to your insurance company for possible reimbursement. (Most insurance companies will not reimburse for charges for missed sessions.)
In compliance with the Federal Health Insurance Portability and Accountability Act (HIPAA), there are certain forms that will need to be completed before the end of your first session.
The first form is a brief intake form with demographic and contact information. The second form, Acknowledgement of Receipt of Privacy and Practices Notices simply states that you have received the next two documents--a notice of general office policies that spells out some of the expectations of the professional relationship, as well as the legal limits to confidentiality, and the final form is a HIPAA Privacy Notice that I am required to offer to you that details your privacy rights under HIPAA.
Please download the attached forms and print them. I need you to sign and return the first two, and either bring them with you to our first appointment or email them to me (firstname.lastname@example.org) with your signature.