Confidentiality is essential to the therapy process in that it provides you with a safe context within which you can discuss things that are personal and private. However, there are some exceptions to the rule and it is important that you understand what they are. Under the following circumstances your case will be discussed with others:
- Sometimes it is important for me to discuss your situation with other professionals, your family, or others involved with you with whom consultation may be helpful. If I feel this is the case, I will talk it over with you, and if you agree, I will ask you to sign a “Release of Confidential Information” that will specify with whom, for what purpose, and what type of information will be discussed.
- If I determine that there is a threat of violence to yourself or others, or if I learn of any abuse of children, spouse, elders, or others with whom you are involved, I am required both legally and ethically to make a report to the proper authorities.
- In order to assure my clients of continued quality of care, I routinely review my caseload with other therapists with whom I have contracted for consultation. Whenever I am doing case review, however, I am careful to disguise identifying information.
Missed Appointments
If you need to miss a scheduled appointment please let me know as soon as you can so that I can make that hour available for someone else. I will ask you to pay for your missed session if you give me less than a 24 hour notice. If you miss more than a few, I will ask you if missed appointments reflect some ambivalence about therapy that would be worth exploring.
Forms:
If we decide to work together, I will ask you to fill out and sign several forms. These will include a “Personal Information Form,” a consent form for online therapy or “telehealth,” and a “Assignment of Benefits” form if we arrange for me to bill your insurance company for payment.
- The “Personal Information Form” gives me a way of learning a lot about you quickly. It helps me to understand your concerns and goals, something about your interests, relationships, and your faith journey. I also ask about previous therapy, medications, and any potential risks to your safety.
- The “Telehealth Consent Form” describes the potential risks of internet communication. My platform is encrypted, but technology is not always as secure as we hope.
- The “Assignment of Benefits” form gives me your permission to disclose protected health information to your insurance company for purposes of billing. In addition to your name, address, phone, and DOB, this information will include a diagnosis and dates of service
I will send these forms to you via email attachment in a Word document. I recommend that you print them and fill them out by hand and return them to me via snail mail.