Practice Policies APPOINTMENTS AND CANCELLATION No shows, cancellations, and re-scheduled sessions will be subject to a full charge if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you will lose some of that session time. Please remember to cancel or reschedule 24 hours in advance. Please note that if you are not feeling well due to symptoms of any illness resembling a common cold or the flu, you must make arrangements to re-schedule the appointment. Any indication that you have symptoms upon arrival to the session, please note that the session will be immediately terminated and as such, charged for the session. No exceptions. EMERGENCIES: I do not offer emergency services. If you experience an emergency, please call 9-1-1 or contact Colorado Crisis Services at (844) 493-8255. TELEPHONE ACCESSIBILITY If you need to contact me between sessions, please leave a message on my voice mail. I am often not immediately available; however, I will attempt to return your call within 24 hours. Please note that face-to-face sessions are highly preferable to phone sessions. However, in the event that you are out of town, sick or need additional support, phone sessions are available. If a true emergency situation arises, please call 911 or any local emergency room. SOCIAL MEDIA AND TELECOMMUNICATION Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept a friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet, and we can talk more about it. ELECTRONIC COMMUNICATION I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies. According to the Colorado Department of Regulatory Agencies (2011). Teletherapy Policy – Guidance Regarding Psychotherapy Through Electronic Means Within the State of Colorado, “TELETHERAPHY” means a mode of delivery of mental health services through telecommunications systems, including information, electronic, and communication technologies, to facilitate the assessment, diagnosis, treatment, education, care management, or self-management of a person’s mental health care while the person is located at an originating site and the provider is located at a distant site. The term includes synchronous interactions and store-and-forward transfers. If you and your therapist chose to use information technology for some or all of your treatment, you need to understand that: (1) You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled. (2) All existing confidentiality protections are equally applicable. (3) Your access to all medical information transmitted during a teletherapy consultation is guaranteed, and copies of this information are available for a reasonable fee. (4) Dissemination of any of your identifiable images or information from the teletherapy interaction to researchers or other entities shall not occur without your consent. (5) There are potential risks, consequences, and benefits of teletherapy. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs. Effective therapy is often facilitated when the therapist gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third-person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in therapy services, potential risks include, but are not limited to the therapist’s inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as your physical condition including deformities, apparent height, and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming, and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what he or she would consider important information, that you may not recognize as significant to present verbally the therapist. 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 more appropriately kept confidential. Minors age fifteen (15) and under must have the consent of a legal parental custodian in order to participate in therapy and must sign this form on the minor’s behalf. Please note that all parental members of legal custody must sign this consent for treatment to commence. The most recent legal documents indicating the allocation of parental rights must be provided before treatment can begin. Documents will be reviewed by legal representatives to ensure the authenticity of the provided documents. Falsified documents will result in an automatic decline of service. While parents and guardians may have access to information disclosed in the therapy sessions of the minors, it is important for you to understand that the integrity of the counseling process depends on trust. As such, I hope you respect the confidentiality of your child and trust that I will disclose any information that I feel is necessary for their safety or the safety of another. COUPLE, FAMILY AND GROUP COUNSELING Couple, Family and Group counseling pose a unique circumstance, in which I cannot guarantee that group members will maintain confidentiality. However, I strongly encourage each participant to maintain the confidential integrity of the counseling process and refrain from sharing information disclosed in the counseling sessions with anyone outside of the group. Please be aware that in these circumstances, records may not be released without the consent of all parties. With that, counseling within the family dynamic can create a power imbalance when secrets are kept from other members within counseling. I will not hold secrets for any member in the family. Anything discussed will need to be shared with all members who are within the counseling session. TERMINATION Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment after an appropriate discussion with you and a termination process if I determine that the psychotherapy is not being effectively used or if you are in default on payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified psychotherapists to treat you. You may also choose someone on your own or from another referral source. Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, I must consider the professional relationship discontinued. BY CLICKING ON THE CHECKBOX BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT. AcceptDecline
