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The following information outlines my office policies regarding providing psychotherapy services and consultation, confidentiality, record keeping, telephone availability and emergencies. Should you have any questions regarding these policies, please do not hesitate to raise them during our first phone consultation or session. (A printable form can be found here)
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Psychotherapy Services, Informed Consent & Consultation
Psychotherapy varies considerably with respect to theoretical orientation, choice of intervention/technique, and duration of treatment. People enter psychotherapy for many reasons - some related to a specific issue or difficulty, some to learn more about what motivates their choices and behaviors. Beginning psychotherapy involves a thoughtful commitment of time, energy, and financial resources, and choosing the right therapist will greatly improve your ability to utilize therapy effectively.
Informed Consent: The LCSW’s responsibility is to provide services to clients only in the context of a professional relationship based, when appropriate, on valid informed consent, and to use clear and understandable language to inform clients of the purpose of your services, risks related to your services, limits to your services because of the requirements of a third-party payer, relevant costs, reasonable alternatives, the clients’ right to refuse or withdraw consent, and the time-frame covered by the consent.
Beginning Treatment: For individuals, I conduct an initial assessment, which typically lasts 3 sessions. Our first meeting will be 75-minutes in length, prorated according to my standard fee for a 50-minute session. Subsequent sessions during the evaluation phase will be 60-minutes in length. For couples or relationship therapy, the consultation consists of an initial 90-minute session, followed by two individual 60-minute sessions, and a final 90-minute conjoint session.ÂÂÂÂ During these initial sessions, I gather information regarding your current difficulties, relationship and family history, answer your questions and concerns, and inquire about past psychiatric and medical treatment. Upon completing this evaluation, I will discuss with you my clinical impressions, and recommended treatment plan. It is also possible that at this time I will refer you to a trusted colleague who I think would be better matched to meet your needs and circumstances. When psychotherapy begins, I typically schedule one 50 or 60 minute session per week. When your needs are more immediate, or your areas of challenge longer-standing, more frequent sessions may be necessary or suggested.
Orientation: I am trained in psychoanalytic psychotherapy. Additionally, I have received post-graduate training in providing time-limited dynamic psychotherapy and both Dialectical Behavioral Therapy and Cognitive Behavioral Therapy. Depending on what you are hoping to achieve in therapy, the duration for which you are able to commit to therapy, and the nature of your identified concerns, I will apply those interventions that are best suited for your circumstances. Often, I will use a combination of approaches, sometimes referred to as an "eclectic approach." For specific issues, or areas of stress, time-limited, behaviorally-informed approaches may be indicated. For broader kinds of exploration, and for seeking to resolve deeper-seated challenges and patterns, longer-term, intensive psychotherapy is the approach of choice.
Ending Treatment: Just as every individual is complex and unique, so is every course of psychotherapy. The exact duration of treatment is difficult to know. However, the progress and process of therapy is very important to address and to continually discuss with your psychotherapist. Typically, therapy ends when initial "objectives" or goals have been met, and both client and therapist feel that significant progress has been made. If at any time during the treatment relationship, you wish to consult with or transfer to another therapist, I encourage you to raise this in one of our sessions. I am able to help you find a qualified clinician with whom I will be able to consult with your written consent. If at any time you wish to end treatment, you have the right to do so.
Because psychotherapy is a different kind of relationship, it is important to discuss your plans to end therapy prior to doing so. This will enable us to review progress made, engage in a process of termination, and make way for your next course of therapy. Though endings in therapy can be difficult, awkward or sometimes reminiscent of past experiences of loss, they are extremely important to discuss and acknowledge. On some occasions, it is the therapist who may choose to end a therapeutic relationship. Some reasons for this are: a patient is unable or unwilling to attend therapy regularly, a patient's use of behaviors that make therapy ineffectual, the patient's need for services I am unable to provide (such as treatment for an area outside of my expertise and training), minimal progress despite appropriate treatment, and/or reasons related to my own circumstances or limitations.
If you commit violence towards me, verbally or physically threaten or harass me, or my family, I reserve the right to terminate your treatment unilaterally and immediately. Failure or refusal to pay for services after a reasonable time is another condition for termination of
services.
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Fee Related Policies
Fees: My fee is $250 for individual 50-minute sessions, $300 for individual 60-minutes sessions, $465 for 75-minute couples sessions and $550 for 90-minute couples sessions. Fee will be discussed at the time of our initial phone contact, and confirmed before or at your first session. During the initial consultation session(s), payment is due at the time of service. If we decide to work together, I will bill you at the end of each month (at your last session of the month), and payment in-full is due at that time unless other arrangements have been made. Payment is accepted by cash or check.
Insurance: I am an out-of-network provider. If you intend to use your insurance, I recommend you contact your insurance provider to verify the specifics of your coverage prior to our first meeting. Upon request, I am able to give you a receipt or "super bill" for you to submit to your insurance company. Please remember that my services are provided and charged to you, not your insurance company, so you are responsible for payment.
Fee Reduction: I have limited availability for lower-fee slots. I typically reserve these spots for graduate students, or current patients experiencing financial hardship or a undergoing a major life transition. I encourage you to discuss finances if they are a concern. If I cannot accommodate your financial situation, I will provide you with referrals and relevant community resources.
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Confidentiality
Your privacy in working with/being under the clinical care of a Licensed Clinical Social Worker (LCSW) is protected by law, and your disclosures are generally held to be confidential. In the case of these sessions, you hold the legal right of privileged communication, which means that in a court of law, a Licensed Clinical Social Worker (LCSW) may not reveal any information your have revealed in session, unless compelled by a court order or a valid subpoena. In general, a mental health professional may not reveal any personally identifiable information about you to anyone, unless you first provide authorization by signing a consent form (exceptions discussed below).
For example, in the event that it would be beneficial to discuss aspects of your treatment with a third party (e.g., consultant, referring psychiatrist, physician, etc.), when you would be personally identified, I would first discuss this with you and obtain your written consent. I may occasionally find it helpful to consult about a case with other professionals. In these consultations, I make every effort to protect your identity. The consultant is also legally bound to maintain confidentiality.
Exceptions to Confidentiality: There are circumstances when a Licensed Clinical Social Worker (LCSW) may break confidentiality, or is required to break confidentiality. Should such a circumstance arise, I will make every reasonable effort to discuss with you my ethical or legal obligations to disclose confidential information before doing so. Exceptions to confidentiality include, but are not limited to, the following circumstances.
Disclosure is required by law as follows:
1. If I have reasonable suspicion that a minor/child (age 18 and below), elderly person (age 65 and above), or a dependent person (age 18-64) is being abused or neglected, I must report this to the appropriate agency.
2. If I believe a patient is threatening serious bodily harm to another individual, I am required to take protective actions, which may include notifying the potential victim, notifying the police, and/or seeking appropriate hospitalization for your child.
3. If I believe a patient is threatening serious bodily harm to him/herself, I may be required to seek hospitalization for the client, or to contact family members or others who can provide protection.
Disclosure may be required as follows:
1. If you have not paid your bill for treatment for a long period of time, your name, payment record and last known address may be sent to a collection agency or small claims court.
2. In couples or family therapy, confidentiality and privilege do not apply between the couple or family members. At the start of our work together, we will discuss my "no secrets policy" and how information will be shared with the couple or family.
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Record Keeping
I am required by both the law and the standards of my profession to maintain appropriate treatment records. These may include diagnosis, therapy goals, progress in treatment, documentation of mandated disclosures (e.g., report of child abuse), and other information. You have a right to review and/or receive a copy of your records unless in my professional opinion, I find that doing so would be likely to cause you substantial harm, endanger your life or physical safety, or pose a significant risk of harm to another individual. Alternately, I can prepare an appropriate summary of these records. Given their inclusion of professional language, these records may be difficult to interpret or understand. If you wish to review your records, I recommend you review them in my presence so we can discuss their content.
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Telephone Availability & Emergencies
I strive to return phone calls as promptly as possible, typically within one business day. For calls made on weekends, I will return calls on the next business day. If your call is urgent, I will return it as soon as is reasonably possible. I do not answer the phone if I am in a session with another patient, consulting with a colleague, or attending a training/meeting. Should you need to speak with me urgently in-between scheduled sessions, I will bill you on a pro-rated basis, after the first 5 minutes, for that time. Please note, I do not provide emergency services. In an emergency situation, please call 911, contact your primary care doctor, or go to the nearest hospital emergency room. If I am unavailable for an extended period of time (e.g., due to illness, professional conferences or vacation), I will provide the name and number of another clinician whom you may contact if necessary.
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Cancellation
Consistency is essential for effective therapy. When we agree to work together, I reserve a weekly spot spefcifically for you. During the initial consultation phase, I ask for 24 hours or 1 business day notice to cancel a session without charge. Once we agree to work together, I ask for 24 hours or 1 business day notice to cancel a session without charge, and I allow for 2 cancellations/year. I will be happy to explain my cancellation and rescheduling policy during your initial consultation.
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