Information for Clients
I appreciate your giving me the opportunity to be of help to you. The following information is intended to answer some of the questions that clients often ask about therapy. I believe that our work will be most helpful to you when you have a clear idea of what we are trying to do.About Psychotherapy
I strongly believe that you should feel comfortable with the therapist you choose and hopeful about the therapy. When you feel this way, therapy is more likely to be most helpful to you.I usually take notes during our meetings. You may find it useful to take your own notes, to remember important points or the steps you plan to take.
By the end of our second or third session, I will tell you how I see your case at this point and how I think we should proceed. I view therapy as a partnership between us. You define the problem areas to be worked on; I use my specialized knowledge to help you make the changes you want to make.
I expect us to plan our work together. In our treatment plan, we will list the areas to work on, our goals, the methods we will use, the time commitments involved, and some other things. I expect us to agree on a plan that we will both work hard to follow. From time to time, we will look together at our progress and goals. If we think we need to, we can then change our treatment plan, its goals, or its methods.
An important part of your therapy will be practicing new skills that you will learn in our sessions. I will ask you to practice outside our meetings, and we will work together to set up homework assignments for you. I might ask you to do exercises, keep records, and read to deepen your understanding. You can learn new ways of looking at your problems that will be very helpful for changing your feelings and reactions.
How Long Therapy Might Take
Most of my clients see me about once a week for 3 – 6 months. After that, we meet less often for several more months. Therapy then usually comes to an end. The process of ending therapy, called “termination,” can be a very valuable part of our work and well worth spending our time on. Stopping therapy should not be done casually, although either of us may decide to end it if we believe it is in your best interest. If you wish to stop therapy at any time, I ask that you allow for at least one final session, to review our work together. We will review our goals, the work we have done, any future work that needs to be done, and options. There are times when a client’s needs or the severity of issues exceeds that which I am safely or adequately able to attend to or a client may need a particular service or treatment that I don’t offer. In this case we will discuss and plan for termination and I will provide referrals to more appropriate services, resources, and supports.The Risks and Benefits of Therapy
During the initial evaluation or the course of therapy, you may remember unpleasant events, and experience considerable discomfort, such as strong feelings, anxiety, depression, and insomnia. I may challenge some of your assumptions or propose different ways of thinking about or handling situations. This may cause you to feel upset, angry, or disappointed. Attempting to resolve issues that brought you into therapy may result in changes that you did not originally intend. Psychotherapy may result in decisions to change behaviors, employment, substance use, schooling, housing, or relationships. Change can sometimes be quick and easy, but more often it can be gradual and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results.While you consider these risks, you should know also that many benefits of therapy have been shown by scientists in hundreds of well-designed research studies. Most clients will find their symptoms greatly lessened, will feel more confident and relaxed, and will improve their daily functioning. People who are depressed may find their mood lifting. Other clients may no longer feel afraid, angry, or anxious. In therapy, people have a chance to talk things out fully until their feelings are relieved or the problems are resolved. Clients’ relationships and coping skills can improve greatly. They may get more satisfaction out of social and family relationships. Their personal goals and values may become clearer. They may grow in many directions—as persons, in their close relationships, in their work or schooling, and in the ability to enjoy their lives.
I do not take on clients I do not think I can help. Therefore, I will enter our relationship with optimism about our progress.
Consultations
If you could benefit from a treatment I cannot provide, I will help you to get it. You have a right to ask me about such other treatments, their risks, and their benefits. Based on what I learn about your problems, I may recommend a medical exam or use of medication. If I do this, I will fully discuss my reasons with you, so that you can decide what is best. If you are treated by another professional, I will coordinate my services with him or her and with your own medical doctor if you want me to.What to Expect from Our Relationship
Clinical Social Work services are best provided in an atmosphere of trust. You expect me to be honest with you about your problems and progress. I expect you to be honest with me about your expectations for services, your compliance with medication, and any other barriers to treatment.As a professional, I will use my best knowledge and skills to help you. This includes following the standards of the National Association of Social Workers, or NASW. In your best interests, the NASW puts limits on the relationship between a therapist and a client, and I will abide by these. Let me explain these limits, so you will understand that they don’t apply just to you and me. I am Licensed Clinical Social Worker (LCSW) | Psychotherapist, state laws and the rules of the NASW require me to keep what you tell me confidential (that is, just between us). You can trust me not to tell anyone else what you tell me, except in a few unusual situations. I explain what those are in my Notice of Privacy Practices. For example, I try not to reveal who are my clients. This is part of my effort to maintain your privacy. If we meet on the street or socially, I may not say hello or talk to you at all. I am not ignoring you; it is a way to maintain the confidentiality of our relationship.
If you ever become involved in a divorce or custody dispute, or any other legal matters (such as a lawsuit over injuries), I want you to understand that I will not provide my records, or evaluations, depositions, or testimony in court. There are several reasons for this: (1) I may not possess the professional skills to make decisions about issues besides those we deal with in therapy; (2) therapy often involves full disclosure of information that you might not want to have revealed in court; (3) if you are holding back information because of that fear, our work will not be as productive as it could be; (4) my statements will be seen as biased in your favor because we have a therapy relationship; and (5) what I might say in testifying or being deposed might change our therapy relationship, and I must put that relationship first. If you want custody evaluations and recommendations, I will be happy to refer you to those with this expertise.
Even though you might invite me, I will not attend your family gatherings, such as parties or weddings.
As your therapist, I will not celebrate holidays or give you gifts. I may not notice or recall your birthday and may not receive any of your gifts eagerly.
About Confidentiality
I will treat with great care all the information you share with me. It is your legal right that our sessions and my records about you be kept private and confidential. That is why I ask you to sign a “release-of-records” form before I can talk about you or send my records about you to anyone else. In general, I will tell no one what you tell me.In all but a few rare situations, your confidentiality (that is, the privacy of what you tell me) is protected by federal and state laws and by the rules of my profession. Here are the most likely situations where your confidentiality is not protected:
1. If you were sent to me by a court or an employer for evaluation or treatment, the court or employer expects a report from me. If this is your situation, please talk with me before you tell me anything you do not want the court or your employer to know. You have a right to tell me only what you are comfortable telling.
2. Are you suing someone or being sued? Are you charged with a crime? If so, and if you tell the court that you are seeing me, I may then be ordered to show the lawyers my records. Please talk to your lawyer about what to say to me.
3. If you make a serious threat to harm yourself or another person, the law requires me to try to protect you or that other person. I simply cannot promise never to tell others about threats you make.
4. If I believe that a child, older adult, or other dependent person has been or will be abused or neglected, I am legally required to report this to the authorities.
As a therapist, my legal and moral duty is to protect your confidentiality, but I also have a duty under the law to the wider community and to myself if there is harm, threat of harm, or threat of neglect.
Parents and/or guardians with legal custody can be told about their child’s diagnoses, the counseling methods used and recommended, significant safety concerns, and the progress of treatment, either as needed or when requested.
There are two times when I might talk about you with another therapist. First, when I am away from the office for a few days, I may arrange for a trusted fellow therapist to be available to you in emergencies. He or she will need to know some things about your situation. Of course, this therapist has the same laws and rules as I do to protect your confidentiality. Second, I sometimes talk with other therapists or other professionals about my clients, because it helps me to provide high-quality treatment. These professionals are also required to keep your information private. I maintain your privacy with them.
If your records need to be seen by another professional, or anyone else, I will discuss this with you. If you agree to share these records, you will need to sign a release-of-information form. This form says exactly what information is to be shared, with whom, and why. You may read this form at any time. If you have questions, please ask me.
It may be beneficial for me to confer with your primary care physician or referring provider with regard to your treatment or to discuss any medical problems for which you are receiving treatment. In addition, Medicare requires that I notify your physician, by telephone or in writing, concerning services that are being provided by me unless you request that notification not be made.
It is my office policy to destroy clients’ records 10 years after our last meeting. Until then, I will keep your case records in a safe place and make them available when you authorize their release.
If I must discontinue our relationship because of illness, disability, or other presently unforeseen circumstances, I will transfer your records to another clinician (Custodian of Records) who will make sure they are kept safe, confidential, and available when you want them, and then destroy them someday.
If we do family or couple therapy (where there is more than one adult present), and you want to have my records of this therapy sent to anyone, all of the adults present will have to sign a release of information.
As part of cost control efforts, health insurance companies will ask for information on your symptoms, diagnoses, progress, and outcomes. My policy is to provide only as much information as the insurance company will need to pay your benefits. This information will become part of your permanent medical record. I will let you know whether a company has asked for this and what it has asked for. If the company does not get the information it asks for, it may refuse to pay your benefits for our treatment. Please understand that I have no control over how these records are handled once they leave my office. For more on these issues, please read my Notice of Privacy Practices.
You can review your own records in my files at any time. You may add to them to correct errors or provide more information, and you can have copies of them (but you will have to assume the risks of loss of confidentiality when you receive and store your copies). If I believe that it might be in some way harmful for you to view your records, I may suggest that we review them together or that I provide you with a summary of the records in place of the entire record. You may not examine records created by anyone else that you have had sent to me.
In some very rare situations, I may temporarily remove parts of your records before you see them. This may happen if I believe that the information will be harmful to you, but I will discuss this with you.
You have the right to ask that your information not be shared with family members or others, and I can agree to that limitation. You can also tell me if you want me to send mail, or phone you at a more private location or number than, say, your home or workplace. If this is of concern to you, please tell me so that we can make arrangements.
About Our Appointments
The very first time I meet with you, we will need to give each other a lot of basic information. For this reason, I usually schedule 1 full hour for this first meeting. Following this, we will usually meet for about 55 - 60 minute session once or twice a week, then less often.Cancellations and No-Shows
I consider our meetings very important and make them a priority over other activities and and I ask you to do the same. An appointment is a commitment to our work. A cancelled appointment slows our progress, so please try not to miss sessions if you can possibly help it. Your session time is reserved for you. We agree to meet at my office or your home and to be on time and ready for session. If I am ever unable to start on time, I ask your understanding and promise that you will receive the full time agreed to or be charged proportionately. If you are late, we will probably be unable to meet for the full time, because it is very likely that I have another appointment after yours.I am rarely able to fill a cancelled session, so you will be charged a fee of $25.00 for sessions cancelled with less than 24 hours’ notice, for other than the most serious reasons. Your insurance will not cover this charge.
Fees, Payments, and Billing
Payment for services is an important part of any professional relationship. This is even more true in therapy; one treatment goal is to make relationships and the duties and obligations they involve clear. You are responsible for seeing that my services are paid for. Please review the full Notice of Financial Policy Policies posted on this website.My current regular fees are as follows:
Fee: $125.00 per session. The intake assessment is charged at $150.00 per session
Telephone consultations: If I need to have telephone conferences with other professionals as part of your treatment, you will be billed for these at the same rate as for regular therapy services. We will discuss this in advance, so we can set rules that are comfortable for both of us. Of course, there is no charge for brief calls about appointments or similar business.
Extended sessions: Occasionally it may be better to go on with a session, if possible, than to stop or postpone work on a particular issue. This extension time will be charged on a pro-rated basis. It is also likely that your insurance will not pay for extra time, and so I will bill you.
Reports: I will not charge you for my time spent making routine and simple reports. However, I will have to bill you for any long or complex reports (requiring more than 5 mins of time).
Other services: Charges for other services, such as hospital visits, consultations with other therapists, home visits, or any court-related services (such as consultations with lawyers), will be based on the time involved in providing the service at my regular fee schedule. Some services may require payment in advance.
I realize that my fees involve a substantial amount of money, although they are well in line with similar professionals’ charges. For you to get the best value for your money, we must work hard and well.
I will assume that our agreed-upon financial arrangements will continue as long as I provide services to you. I will assume this until you tell me in person, by telephone, or by certified mail that you wish to end it. You have a responsibility to pay for any services you receive before we end the relationship.
I ask that you pay your bill within 10 days of the date that you receive it. If your insurance company does not pay me within a reasonable period of time (60 days), I will expect you to pay the full amount and that you will wait for your insurance company to reimburse you.
After you have made payment I will send you a statement for all services rendered and payments received. This statement can be used for health insurance claims, as described in the next section. It will show all of our meetings, the charges for each meeting, how much has been paid, and how much (if any) is still owed. If there is any problem with my charges, my billing, your insurance, or any other money-related point, please bring it to my attention immediately. I will do the same with you. Such problems can interfere greatly with our work. They must be worked out openly and quickly.
If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, I have the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small-claims court. In most collection situations, the only facts I release regarding a client’s treatment are his or her name, the kind of services provided, and the amount due. If such legal action is necessary, its costs will be included in the claim.
If you think you may have trouble paying your bills at times, please discuss this with me. If you are unable to pay your bills, I must stop therapy with you. We will discuss and plan for this and I will provide you with referrals to other counseling services.
If You Have Health Insurance
I have chosen not to join or participate in most health insurance plans or panels. I am a Medicare Part B Provider and Accept Assignment. If you choose to use your insurance (Non-Medicare), I will not file claims for you, but I will give you a receipt or statement for my services with the information the insurers need to pay you back if allowed by your insurance contract. This information will include standard diagnostic and procedure codes, the times we met, my charges, and your paymentsBecause I am a Licensed Clinical Social Worker (LCSW), many health insurance plans will help you pay for psychotherapy and other services I offer. Because health insurance is written by many different companies, I cannot tell you what your plan covers. Please read your plan’s booklet under coverage for “Outpatient Psychotherapy” or “Behavioral Health,” or under “Treatment of Mental and Nervous Conditions.” Or call your employer’s benefits office to find out what you need to know.
Please keep the following in mind:
1. If you subscribe to a health maintenance organization (HMO) or preferred provider organization (PPO), or have another kind of health insurance with a managed care organization (MCO), decisions about what kind of care you need, from whom, and how much of it you can receive will be reviewed by the plan. The plan has rules, limits, and procedures that we should discuss. Please bring your health insurance plan’s wallet card or description of services to our first meeting, so that we can talk about it and decide what to do.
2. Your health insurance policy is a contract between you and your insurance company, and does not guarantee payment for my services. I had no role in deciding which services will be covered, which will not be covered, and how much you have to pay. You are responsible for checking your insurance coverage, deductibles, payment rates, copayments, and so forth. Your insurance coverage is a contract between you and your company; it is not between me and the insurance company.
3. You—not your insurance company or any other person or company— is responsible for paying the fees we agree upon. If you ask me to bill a separated spouse, a relative, or an insurance company, and I do not receive payment on time, I will then expect this payment from you.
4. As a service to you, I will provide information about you to your insurance company only with your informed and written consent. My office will try its best to maintain the privacy of your records, but I ask you to understand that I have no control over what happens to your records after they leave my office.
Your MCO can ask for and review all my records as part of its regular audits of providers and services. It may be satisfied with a phone discussion or a summary. It will usually be looking to see that the services are compatible with the severity of your limitations and diagnoses. This is called “evaluating the medical necessity of treatment.” I will tell you if this happens.
Your MCO can ask for and review all my records as part of its regular audits of providers and services. It may be satisfied with a phone discussion or a summary. It will usually be looking to see that the services are compatible with the severity of your limitations and diagnoses. This is called “evaluating the medical necessity of treatment.” I will tell you if this happens.
If You Need to Contact Me
I cannot promise that I will be available at all times. I do not take phone calls when I am with a client. You can always leave a message on my voicemail, and I will return your call as soon as I can. Generally, I will return messages within 48 hrs except during holidays or weekends. During times I am scheduled to be away for more than few days, another professional may be available for urgent issues.Please check my outgoing msg.
If you have a behavioral or emotional crisis and cannot reach me, you or your family members should call one of the following 24/7 365 community emergency agencies:
National Suicide Prevention Hotline
1-800-273-8255
Suicide Prevention Service of the Central Coast
1-877-663-5433 and or 831-458-5300
County of Santa Cruz Adult Mental Health Dept.
1-800-952-2335
Santa Cruz Psychiatric Health Facility
2250 Soquel Ave. Santa Cruz, CA 95062
Phn: 831-600-2801
I find that telephone therapy does not work as well as face-to-face therapy, and so I discourage it. I will generally suggest scheduling an appointment for as soon as possible. In special or urgent situations, I will make special arrangements for a check in phone call or extended phone call and this service will be charged at the pro-rated usual fee.
Other Points
You may not make any kind of electronic recording of our sessions without my written consent.Many clients use email and text messaging, but these are not secure and could lead to a loss of confidentiality.
I will charge you at my regular rate for letters, reports, and similar documents you ask me to create for you.
As part of the confidentiality that I offer you, I ask you not to disclose the name or identity of any other client being seen in this office.
I cannot be responsible for any personal property or valuables you bring into this office. You will be charged for any damage to, or theft of, property in this office or outside by you.
Shared Office Space
Although I share this office space with other professionals and we use some office equipment together, we are not in business together as partners, employers, or employees. Records Issues
If, as part of our therapy, you create and provide to me records, notes, artworks, or any other documents or materials, I will return the originals to you at your written request but may retain copies.If I am unable to provide continuing care to you due to my illness or disability, I have made arrangements with other fully qualified and confidential clinicians for your immediate care and for maintenance of your records. These arrangements are in effect as long as I am in practice.
Statement of Principles and Complaint Procedures
It is my intention to abide by all the rules of the National Association of Social Workers (NASW) and by those of my state license – Licensed Clinical Social Worker. Problems can arise in our relationship, just as in any other relationship. If you are not satisfied with any area of our work, please raise your concerns with me as soon as possible. Our work together will be slower and harder if your concerns with me are not worked out. Some issues that arise between us may be clinically relevant to other relationships in your life. I will make every effort to hear any complaints you have and to seek resolution. If you feel that I (or any therapist) have treated you unfairly or have broken a professional rule, please tell me. You can also contact the state licensing board for the discipline under which any therapist practices (psychologist, psychiatrist, licensed professional counselor, or social worker). Staff members there can help clarify your concerns or tell you how to file a complaint.In my practice as a psychotherapist | Licensed Clinical Social Worker, I do not discriminate against clients because of any of these factors: age, sex/gender, sexual orientation, marital or family status, race, color, religious beliefs, ethnic origin, place of residence, veteran status, physical disability, health status, or criminal record unrelated to present dangerousness. This is a personal commitment, as well as being required by some federal, state, and local laws and regulations. I will always take steps to advance and support the values of equal opportunity, human dignity, and racial, ethnic, and cultural diversity. If you believe you have been discriminated against, please bring this matter to my attention immediately.
The Board of Behavioral Sciences receives and responds to complaints regarding services provided within the scope of practice of (marriage and family therapists, licensed educational psychologists, clinical social workers or professional clinical counselors).
