Information for Clients
Welcome to my practice. This document contains important information about my professional services and business policies. We can discuss any questions you have about the procedures at that time. You are entitled to ask for further clarification of any of the information below or other questions that you may have throughout your treatment.
Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychologist and patient, and the particular problems you are experiencing. There are many different methods I may use to deal with the problems that you hope to address. Psychotherapy calls for a very active effort on our part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you many experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress, but there are no guarantees of what you will experience. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what our work will include and a treatment plan to follow, if you decide to continue with therapy. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Therapy involves a large commitment of time, money, and energy, so you should be very careful about the therapist you select. If you have questions about my procedures, we should discuss them whenever they arise. If your doubts persist, I will be happy to help you set up a meeting with another mental health professional for a second opinion. As a client you have the right to refuse any suggested treatment and the responsibility to choose the psychologist and treatment best suited to your needs. You also have the right to request a change of therapy, referral to another therapist, or to discontinue therapy.
I earned a Master of Arts degree in Psychology including a concentration in Marriage and Family Therapy from California Southern University. I am a licensed Marriage and Family Therapist Associate in the State of Texas (203121). The State of Texas has approved my supervision under Thelma Jean Goodrich, PhD, LMFT (4875) as I work toward independent licensure. I am a member of the American Psychological Association and the American Association of Marriage and Family Therapists. My practice utilizes an eclectic approach, integrating elements of such therapies as Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and systemic solution-based focuses as appropriate. I abide by the highest of professional and regulatory ethics and standards of practice. If you have any questions about any aspect of our professional relationship or about the specifics of those ethics and standards, please discuss them with me. If you find no adequate resolution with me you can contact the State Board of Examiners of Marriage and Family Therapists, Austin, TX.
I normally conduct an initial evaluation that will last from 1 to 2 sessions. During this time we can both decide if I am the best person to provide the services you need in order to meet your treatment goals. If we decide to work together, psychotherapy sessions are usually scheduled for once a week for 50-minute sessions (one appointment hour of 50 minutes duration), although some sessions may be longer or more frequent as mutually deemed necessary. Individual therapy typically occurs for 6 to 18 sessions.
My appointment fee is $120 per hourly sessions. Appointments that run in excess of their scheduled time are prorated based on this rate. This proration policy includes sessions that run their full length despite beginning late due to client absence at the scheduled start time. If you become involved in legal proceedings that require my participation, you will be expected to pay for all of my professional time, including preparation and transportation costs, even if I am called to testify by another party.
Treatment of Minors
Treatment of children under the age of 18 years will be provided only with the consent of the legal guardian or parent. By signing the Practice consent form, you acknowledge that you are the guardian (as established by the state or the divorce decree) of any minor presented for treatment. Copy of the custody agreement in the cases of divorce must be provided.
Limits of Confidentiality
The law protects the privacy of all communications between a patient and a therapist. In most situations, I can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPAA. There are other situations that require only that you provide written advance consent. Your signature on the Practice form provides consent for those activities, as follows:
- As I am under supervision, I will discuss cases with my license Supervisor as means of ensuring that I provide the best care for each client. During supervision sessions, I make every effort to avoid revealing the identity of my client. My Supervisor is also legally bound to keep the information confidential. I may also occasionally find it helpful to consult other health and mental health professionals about a case. The same care and confidentiality is taken as in supervision sessions.
- You should be aware that I practice with other mental health professionals and administrative staff. In most cases, I need to share protected information with these individuals for both clinical and administrative purposes, such as scheduling, billing, and quality assurance. All of the mental health professionals are bound by the same rules of confidentiality. All staff members have been given training about protecting your privacy and have agreed not to release any information outside of the
practice without the permission of a professional staff member.
There are some situations where I am permitted or required to disclose information without either your consent or Authorization:
- If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, such information is protected by the mental health professional-patient privilege law. I cannot provide any information without your (or your legal representative’s) written authorization, or a court order. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.
- If a government agency is requesting the information for health oversight activities, I may be required to provide it for them.
- If a patient files a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself.
- If a patient files a worker’s compensation claim, I must, upon appropriate request, provide records relating to treatment or hospitalization for which compensation is being sought.
There are some situations in which I am legally obligated to take actions, which I believe are necessary to attempt to protect others from harm and I may have to reveal some information about a patient’s treatment. These situations are unusual in my practice.
- If I have cause to believe that a child under 18 has been or may be abused or neglected (including physical injury, substantial threat of harm, mental or emotional injury, or any kind of sexual contact or conduct), or that a child is a victim of a sexual offense, or that an elderly or disabled person is in a state of abuse, neglect or exploitation, the law requires that I make a report to the appropriate governmental agency, usually the Department of Protective and Regulatory Services. Once such report is filed, I may be required to provide additional information.
- If I determine that there is a probability that the patient will inflict imminent physical injury on another, or that the patient will inflict imminent physical, mental or emotional harm upon him/ herself, I may be required to take protective action by disclosing information to medical or law enforcement personnel or by securing hospitalization of the patient. If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary.