Client Policies, Consent for Treatment, and Fee Agreement
The therapeutic relationship is unique: both highly personal and a contractual agreement. It is important that we begin with a clear understanding about how our relationship will work and what each of us can expect. Please feel free to ask me anytime about these policies, my background, and my treatment approach.
Benefits and Risks: Therapy is a dynamic process; its course is dependent on our mutual willingness to collaboratively continue, as well as on unforeseeable life events.
The benefits of therapy may include reduced stress, anxiety, negative thoughts, and self-defeating behaviors; improved relationships; increased comfort in social, school, and/or family settings; increased self-confidence; and a more hopeful attitude towards life.
The risks of therapy may include recalling painful memories and experiences, discomfort in analyzing current distress and problems, and experiencing strong feelings of sadness, anger, fear, or other difficult emotions. Changes in your perspective, thoughts, or feelings may have unintended outcomes, including changes in personal relationships. Over the course of therapy, you may feel worse before you feel better; this is natural and expected in any healing process.
Commitment: Therapy is a significant investment of time and money. I encourage you to make a commitment to getting the most from your sessions by attending regularly and being open to the experience of making a change in the direction of your goals.
Therapeutic Relationship: For this therapy to be safe and effective, our relationship must be limited to that of therapist and client only. I cannot have any business or social relationship with you, and I cannot have any romantic or sexual relationship with a former or current client, or anyone close to a client. To preserve your confidentiality, if we run into each other in public, I will not initiate contact (although you are free to).
Availability/Emergencies: I am available for regularly scheduled appointments. Telephone contacts between sessions are welcome but are best kept brief, as important issues are better addressed in person. You may leave a message anytime on my confidential voicemail, and I will respond within one business day. I do not offer emergency services. In the event of an emergency involving a threat to your or another’s safety, please call 911 or go to your nearest emergency room.
Complaints: The Board of Behavioral Sciences receives and responds to complaints regarding services provided within the scope of practice of marriage and family therapists. You may contact the board online at www.bbs.ca.gov, or by calling (916) 574-7830.
Minors: Communications between a therapist and a client under age 18 are confidential. Upon request, in the exercise of my professional judgment, I may provide parents or guardians with only a general summary of the treatment progress of a minor client.
No Secrets: If you participate in an individual session with me while concurrently in couple therapy, the information you reveal in your individual session may be used by me in your joint session, based on my professional judgment.
Termination of Therapy: The length of your treatment depends on your treatment plan and progress. We will discuss a plan for ending therapy as you approach the completion of your treatment goals. You may discontinue therapy at any time. If you are not benefitting from treatment, either of us may initiate a discussion of treatment alternatives including referrals, changing your treatment plan, or terminating your therapy.
Fees: My fee is $240 per 50-minute session or $360 per 80-minute session. Payment is required at the beginning of each session by Venmo, Zelle, or credit card. I do not accept insurance. Your PPO may partially reimburse you if you submit a claim to them with the superbill I can provide for you. Interest is charged on past due amounts. If you cannot continue paying for therapy, please let me know, and I will do my best to provide appropriate options.
Additional Charges: If you request other professional services from me such as reading and responding to emails and messages, phone conversations, meetings with professionals, or preparing reports, the fees are half your regular fee for 11-30 minutes, and your full fee for 31-50 minutes. The first 10 minutes are free. As my focus is treatment, I do not normally attend legal proceedings, unless required to by law. My fee for preparing for and attending legal proceedings is $500 per hour.
Cancellation Policy: To cancel or reschedule, you must notify me at least 24 hours before your appointment, or you are responsible for payment of the session, which will be charged to your credit card on file, unless we are able to reschedule you during the same week. Exceptions may be made in case of extreme illness or emergency.
Good Faith Estimate: You have the right to receive a Good Faith Estimate explaining how much your mental health care will cost. Under the law, health care providers must give patients who don’t have insurance or are not using insurance an estimate of the expected charges for any non-emergency psychotherapy services. You can ask your health care provider for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For more information, visit www.cms.gov/nosurprises or call (800) 985-3059.
Electronic Communication: I do not conduct therapy via email or text message. Email and texting are non-secure and non-confidential forms of communication. Unauthorized users can attempt to access such communication, and firewalls or programs to detect spyware, viruses, or other dangerous software cannot be 100% guaranteed. Also, electronic communications are stored in cyberspace and authorities can access them under some circumstances. However, if you indicate your permission below, I may use email or text to handle certain questions/issues that pertain to therapy and related content if they can be easily and simply handled over electronic communication, and I may use email or text to respond to emails and texts that you send me. You agree that if you send me an email or text and request a response via electronic communication, you are willing to accept the above-stated risks.