Practice Policies  

NOTICE OF PRACTICE POLICIES

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BENEFITS AND RISKS OF PSYCHOTHERAPY​

You have taken a very positive step by deciding to seek therapy. The outcome of your treatment depends largely on your willingness to engage in this process, which may, at times, result in considerable discomfort. Remembering unpleasant events and becoming aware of feelings attached to those events can bring on strong feelings of anger, depression, anxiety, etc. Often people feel worse when beginning therapy, prior to feeling better. Couples therapy may bring to the surface old wounds or uncomfortable feelings, leading to more distress initially. There is always the risk that despite our best efforts, a patient / client does not feel better, life circumstances get worse, or relationships deteriorate.

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There are no miracle cures. I cannot promise that your behavior or circumstance will change. However, I can promise to support you and do my very best to understand you and your repeating patterns, as well as to help you clarify what it is that you want for yourself. Science backs up psychotherapy as one of the best ways to improve emotionally, mentally, and behaviorally. Learning to set and achieve meaningful goals, practicing new coping skills, and/or gaining greater understanding and clarity in your relationships, all lend themselves to less anxiety, less depression, and better functioning.

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CONFIDENTIALITY

You have a right to confidential communication with regards to psychotherapy treatment.  As such, the session content and all relevant materials to your treatment will be held confidential unless you request in writing to have all or portions of such content released to a specifically named person/persons.  Exceptions to confidentiality are made where the law requires it and most of those legally required disclosures are described in the enclosed Notice of Privacy Practices.

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Limitations of such client held privilege of confidentiality exist and are itemized below:

1. If a patient / client threatens or attempts to commit suicide or otherwise conducts themselves in a manner in which there is a substantial risk of incurring serious bodily harm.

2. If a patient / client threatens grave bodily harm or death to another person.

3. If the therapist has a reasonable suspicion that a patient / client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional or sexual abuse of children under the age of 18 years.

4. Suspicions as stated above in the case of an elderly person who may be subjected to these abuses.

5. Suspected neglect of the parties named in items #3 and # 4.

6. If a court of law issues a legitimate subpoena for information stated on the subpoena.

7. If a patient / client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert’s report to an attorney.

8. In marriage, couple, or relationship therapy, or when different family members conduct individual assessments or psychotherapy sessions, confidentiality and/or client privilege do not apply between the couple or among family members.  Clinical judgement, ethical and legal considerations will inform how information is disclosed. 

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It should be noted that specifically as it relates to risk of harm to self and/or others, abuse and/or neglect of a minor, and abuse and/or neglect of an elder, any legal requirements for reporting and limiting confidentiality are intended to help avoid actions being taken that could potentially lead to negative consequences for the client / patient and which would interfere with achieving psychotherapy and life goals.

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For minors, (under the age of 13 in Washington State; under the age of 12 in California), your parents and/or legal guardians may be entitled to some information regarding your therapy. During the initial session, we will discuss and decide what kinds and under what circumstances, certain forms of information may be provided to parents and what will remain confidential.

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Occasionally, I may need to consult with other professionals in their areas of expertise in order to provide the best treatment for you. Information about you may be shared in this context without using your name.

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ELECTRONIC COMMUNICATION

I cannot always ensure the confidentiality of electronic forms of communication such as email, texts, voicemails, etc. I use a HIPPAA compliant platform, Simple Practice, for electronic record keeping, as well as to provide you, the patient / client, a secure platform for communicating with me. You may use the patient / client portal provided upon enrolling in services for such routine communication such as scheduling requests, or general questions.

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Although not recommended, if you choose to use any commercial email services, or SMS text messages to communicate with me, I cannot ever guarantee a timely response, although I will attempt to get back to you within 48 business hours. I am requesting that you do not use any of these electronic forms of communication for exchanging any therapeutic content, as confidentiality cannot be guaranteed. I also request that you do not use any of these electronic forms of communication for requesting assistance for emergencies or for emergency services. If a true emergency situation arises, please call 911 or any local emergency room.

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STANDARD SESSION LENGTH

The standard meeting time for an Initial Diagnostic Assessment, sometimes referred to as an Initial Assessment or as a Biopsychosocial Assessment (BPSA), is 90 minutes. This is the minimum amount of time required to gather a preliminary understanding of you, your presenting concerns, history of your concerns, family / social context, and to render a diagnosis if warranted or required. The standard meeting time for psychotherapy is 50 minutes. On a case-by-case basis and upon discussion with you, the client / patient, I will consider providing 80- minute sessions. The 80-minute session will incur an additional fee.  

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SHOWING UP LATE TO APPOITNMENTS ​

If you are running late for your scheduled appointment, if possible, please call or message me to let me know you are running behind. If I do not hear from you after 10 minutes, I will attempt to call you and may assume you are not planning to attend the session. If you are late for a session, you will lose some that portion of your session time and we will end at the previously scheduled end time so that I am able to be on time for other clients.

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CANCELLATIONS AND MISSED APPOINTMENTS

Please remember to cancel or reschedule 24 hours in advance. Cancellations and re-scheduled session 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. After a missed appointment, I will send you a message via the client portal to inform you that your absence was noted, to inquire if there are any barriers (material or emotional) hindering you from attending your scheduled sessions, and to request a suggested date and time to reschedule the missed appointment. If you miss two consecutive appointments within 30 days, three consecutive appointments within 45 days, and /or I have made two unsuccessful attempts to contact you to reschedule your missed appointment, then I will send you a message notifying you of my ethical obligation to terminate the therapeutic working relationship between me and you. You will be notified of the reasons for ending the relationship and a list of alternative psychotherapists and other resources that may be helpful to you may be provided at your request.​​

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TERMINATION

Ending the therapeutic relationship can be a difficult part of the therapeutic process. Yet, under certain circumstances, it may be necessary. Discharging or termination of the therapeutic relationship is a deliberate and collaborative process between myself and you, the patient / client. That process involves a discussion of whether or not the current course of treatment appears to be effective or helpful towards you achieving your goals. It involves determining to what extent we believe you have achieved your goals and what portion of those goals are left to be achieved. It also involves a discussion of whether your needs and concerns may best be addressed with a different therapist or another resource outside of my professional scope of practice.

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I will always provide you with an explanation of why I am recommending or initiating termination, and I will also provide you with a list of other licensed and qualified psychotherapists and/or additional resources that may better help address your needs. You are also free to choose a different therapist from separate referral source. You also have the right to terminate the therapeutic relationship at any time.

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FEES AND PAYMENT ARRANGEMENTS

If not using health insurance to pay for therapy, my standard fees are as follows:

90-minute Initial Assessment - $200. 

55-minute Individual Therapy Session - $160

55-minute Couples Therapy Session - $180

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All private pay (non-insurance) payments can be made using Check, Debit, Credit (Visa/MC/Discover/AE), HAS/FSA Cards and can be securely processed through the payment portion of the client portal provided at the start of therapy. 

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If you are using health insurance with whom I am IN NETWORK provider, then the fee is determined by my contract with the insurance company and you are responsible for any co-payment or co-insurance in accordance with your plan.  If you have an insurance plan that allows you to work with me as an OUT OF NETWORK (OON) provider, then you will be responsible for the full fee for therapy and I will provide you with a superbill or receipt that you may be able to use for reimbursement, in accordance with you particular plan. 

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Unless we have made another arrangement in writing and signed by you and me, then the full payment amount for each session is due at the start of each session. A grace period will be allowed as long as payment is received by 5pm the day following the completed therapy session. No future therapy sessions can be scheduled until payment has been received for the previous session.  Balances of more than 2 therapy sessions are not allowed in order to prevent you from incurring debt.  If you or I believe that paying for sessions on time has become a burden or a barrier for you, then I will discuss the best next steps for you; either pausing therapy or accessing resources that are a better fit for you financially.    

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Finally, all fees may be subject to an annual increase.   You will be given ample prior notice if and when such fee increases are planned. 

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GOOD FAITH ESTIMATE

For anyone seeking healthcare services with an out of network provider, that provider must notify you of your rights and protections against surprise billing, in accordance with the No Suprises Act of 2022.   As a Mental Healthcare provider, I will provide you with a “Good Faith Estimate” which lists the expected costs of therapy or counseling. For more information on Good Faith Estimates, click here.​

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If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. To learn more and get a form to start the process, go to www.cms.gov/nosurprises. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call (800) 368-1019.

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