Unless otherwise noted, therapy is voluntary process, and as such, you may withdraw at anytime. During the course of our work together, it is important that you provide me with feedback. If a client feels a lack of direction, it may become evident through a lack of progress or withdrawal in other ways, such as missed appointments or ending therapy altogether. The only way I can tell if therapy is helpful to you is through your own voice.
Please respect the fact that I come to my office to see you. I make every effort to be prompt and respectful of all my clients’ time. As a result, your promptness is appreciated since I will generally not be able to extend sessions.
I make every effort to protect your privacy. Because my practice is in a relatively small community, if I should see you outside the office, I will not approach you unless you let me know that it is okay. Information regarding our therapeutic relationship will be shared only in certain circumstances, with your permission (see Confidentiality section below).
In order to provide you with the best therapeutic services I can, and to continue learning and growing as a therapist, I may use your case material in supervision with supervisors and/or peers. In these cases, every effort will be made to protect your identity.
There are federal and state laws that protect your right to confidentiality with regard to our work together in my office. Without your written permission, I cannot discuss any information you share with me with another person or agency. The following are circumstances in which I do not have to adhere to the above regulations:
- DUTY TO WARN AND PROTECT: If a client reports an intention to harm him/herself or others;
- ABUSE OF CHILDREN AND VULNERABLE ADULTS: If a client reports or suggests that a child or vulnerable adult is being or has recently been abused, or it is suspected they may be abused, or is in danger of being abused;
- PRENATAL EXPOSURE TO CONTROLLED SUBSTANCES: If a client admits prenatal exposure to controlled substances that are potentially harmful;
- MINORS/GUARDIANSHIP: If a parent or legal guardian of non-emancipated minor clients request access to the client’s records;
- COURT ORDER: If I am required to provide records or information by a court order.
- INSURANCE: With your signed permission, I may provide protected health information to your insurance carrier, HMO, or billing office to procure payment for services rendered. Information that may be requested includes types of services, diagnosis, treatment plan, and description of impairment, progress of therapy, case notes, and summaries. Also, it is your responsibility to inform me of any changes to your insurance benefits as they occur.