CSP OFFICE POLICIES
Welcome to Counseling Services of Portland (CSP). Your investment in therapy can lead to a more rewarding life. Here are the guidelines for our work together. If you have questions regarding your counseling, please feel free to ask. The information below covers areas that protect you, and let you know how we operate.
Independent Contractor Therapists: CSP contracts with licensed mental health therapists who have their LPC, LMFT, LCSW, PsyD, or PhD to provide mental health counseling to our clients. They are not employees of CSP. They are independent contractors and have their own private practices. They do however, have signed agreements with CSP and their contracted insurance companies, to provide you with the best care possible, following guidelines and best practices as mandated by theri licensing boards. If you find that you and your therapist are not a good fit, do not hesitate to let them know and also contact our office for us to find you a better fit. Your therapist will appreciate any feedback you have about how your treatment is going and should also be able to transfer you to a therapist or work with another therapist to fully support you in the best way possible.
We are also contracting services with Registered Associates with the Oregon Board of Licensed Counselors and Therapists and Board of Licensed Social Workers. They are all working towards their licensure but require to fill an average of 2 years worth of client hours before they can fully get their license.
CSP contracts with the Registered Associates to provide quality mental health services to you as part of their Post-Masters clinical training. During this process, your Associate therapist will be supervised by an Oregon Board-licensed supervisor. Your therapist will receive weekly consultation about you and the services they provide you for quality and care coordination and assurance. If you are using Kaiser insurance, your therapist will bill your insurance through their supervisor’s contract and credentials as allowed by Kaiser PNW. You will receive the same benefits as working directly with the supervisor.
If you were matched with a Registered Associate therapist, you will receive their contact information, their supervisor’s contact information and licensure information via email, in case you have any questions. Their webpage will also give you their supervisor information.
Confidentiality: Limits on Confidentiality. The law protects the privacy of all communications between a patient and a psychotherapist. In most situations, we can only release information about your treatment to others if you sign a written Authorization form that meets legal requirements imposed by HIPAA. There are other situations that require only that you provide written, advance consent. Your signature on this Agreement provides consent for those activities, as follows: Your therapist may occasionally consult other health and mental health professionals about a case. We make every effort to avoid revealing the identity of the patient. The other professionals are also legally bound to keep the information confidential. If you don’t object, your therapist will not tell you about these consultations unless they feel that it is important to your work. All consultations will be noted in your Clinical Record. (which is called “PHI” in the attached Notice of Privacy Practices used to protect the privacy of your health information).
We employ administrative staff and use Independent Contractors to provide mental health services to you. In some cases, we need to share protected information with these individuals for both clinical and administrative purposes, such as scheduling, billing and quality assurance. All 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 information outside of the practice without the permission of a professional staff member.
We also have contracts with a software billing company. As required by HIPAA, we have a formal Business Associate Agreement with our Independent Contractors, billing and email software company, in which they promise to maintain the confidentiality of this data except as specifically allowed in the contract or otherwise required by law.
When Disclosure Is Required By Law: In some circumstances the law requires that we report. These situations include: a reasonable suspicion of child, dependent or elder abuse or neglect; where you might be in danger of harming yourself, others, property, or are gravely disabled, or when your family member(s) or other person(s) communicate to CSP (Counseling Services of Portland) staff or clinicians that the you present a danger to self or others.
When Disclosure May Be Required: We may also have to disclose if there is a legal proceeding by or against you. If you place your mental status at issue in litigation initiated by you, the defendant may have the right to obtain the therapy records and/or testimony by your therapist. In couple and family therapy, or when different family members are seen individually, even over a period of time, confidentiality and privilege do not apply between the couple or among family members, unless otherwise agreed upon. Your therapist will use his or her clinical judgment when revealing such information. Your therapist will not release records to any outside party unless she or he is authorized by all family members age 15 or over, who are/were part of the treatment.
Emergencies: If there is an emergency during your work with a CSP therapist or in the future after termination where your therapist becomes concerned about your personal safety, the possibility of you injuring someone else, or about you receiving proper psychiatric care, they will do whatever possible, within the limits of the law, to prevent you from injuring yourself or others and to ensure that you receive the proper medical care. For this purpose,they may also contact the person whose name you have listed as your emergency contact.
Health Insurance & Confidentiality of Records: If you use your health insurance, we may need to disclose confidential information to your health insurance company HMO, PPO, MCO or EAP in order to process the claims. If you instruct your therapist to bill your insurance, only the minimum necessary information will be communicated to them. Your therapist has no control or knowledge over what insurance companies do with the information they submit or who has access to this information. Submitting a mental health invoice for reimbursement carries some risk to confidentiality, privacy or to future capacity to obtain health or life insurance or even a job. Mental health information is likely to be entered into insurance companies’ computers and is likely to be reported to the National Medical Data Bank. Accessibility to companies’ computers or to the National Medical Data Bank database is always in question as computers are inherently vulnerable to break-ins and unauthorized access. Medical data has also been reported to be legally accessed by law enforcement and other agencies, which also puts you in a vulnerable position.
Consultation: Your therapist consults regularly with other professionals regarding his or her clients; however, the client's identity remains completely anonymous, and confidentiality is fully maintained.
Litigation Limitation: Due to the nature of the therapeutic process and the fact that it often involves making a full disclosure with regard to many matters which may be of a confidential nature, it is agreed that, should there be legal proceedings such as, but not limited to, divorce and custody disputes, injuries, lawsuits, etc., neither you nor your attorney, nor anyone else acting on your behalf will call on your therapist to testify in court or at any other proceeding, nor will a disclosure of your counseling records be requested unless otherwise agreed upon.
Emails, Cell phones, Computers and Faxes: Computers, email and cell phone communication can be accessed by unauthorized people and can compromise confidentiality. Emails, in particular, are vulnerable because servers have unlimited, direct access to all emails that go through them. Your therapist’s emails are not encrypted. Faxes can be sent to the wrong address. Some texts are never received. Your therapist’s computers are equipped with firewall, virus protection and password. All backups are stored securely. Please notify Your therapist if you decide to avoid or limit the use of any or all communication devices. If you communicate confidential information via email or text, your therapist will assume that you have made an informed decision that such communication may be intercepted, and he or she will assume you desire to correspond on such matters via email. Please notify us if you decide to avoid or limit, in any way, the use of any or all communication devices, such as email, cell phones or faxes. Please, be aware that emails are part of your medical record. Please do not use email, text or faxes for emergencies.
Email and Phone Consulting: Occasionally, a client will request counseling via phone or email rather than in person in the therapist’s office. At this point, we only offer in-person therapy and telehealth therapy, based on what insurance will agree to pay for those services. During your first visit, your therapist should discuss with you what to do when you have an emergency and when you need to reach them and how.
Records and Your Right to Review Them: Both the law and the standards of Your therapist’s profession require that we keep appropriate treatment records for seven years from your last session. Unless otherwise agreed to be necessary, your therapist retains clinical records only as long as is mandated by Oregon law. If you have concerns regarding the treatment records please discuss them with your therapist. You have the right to review or receive a summary of your records at any time, except in limited legal or emergency circumstances or when Your therapist assesses that releasing such information might be harmful in any way. In such a case your therapist will provide the records to an appropriate and legitimate mental health professional of your choice. Considering all of the above exclusions, if it is still appropriate, upon your request, your therapist will release information to any agency/person you specify unless your therapist assesses that releasing such information might be harmful in any way. When more than one client is involved in treatment, such as in cases of couple and family therapy, your therapist will release records only with the signed authorizations from all the adults (or all those who legally can authorize such a release) involved in the treatment.
Telephone & Emergency Procedures: If you need to contact your therapist between sessions, please leave a message and your call will be returned as soon as possible. If an emergency situation arises, indicate it clearly in your message. If you need to talk to someone immediately, call the Multnomah County Crisis Line at 503-988-4888. For Kaiser, call the Emergency Psych Line at 503-331-6425. You can also go to your nearest emergency room. If you are under the influence of a substance or otherwise unable to drive, have someone else take you or call a taxi. Depending on his or her individual procedures, your therapist may also give you an emergency contact number where he or she can be reached more immediately. Please do not use email, texts or faxes for emergencies.
Payments & Insurance Reimbursement: Unless otherwise arranged, payment or co-payment is processed by your therapist after each session, never before. You can pay by check, credit card or cash. Checks can be made out to your counselor’s name or business. If you need a reduced fee, ask your counselor to go over the “Reduced Fee Worksheet” to help make your therapy affordable for you. This will only apply if you are not using insurance for your sessions.
Telephone conversations, site visits, report writing and reading, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify your therapist if any problems arise regarding your ability to make timely payments.
As a courtesy to you, CSP will bill and collect copays and deductibles for your insurance company as long as the provider you are seeing is In Network with your Insurance Provider. However, our services are provided and charged to you and not the insurance company, and you are ultimately responsible for payment. As was indicated in the section Health Insurance & Confidentiality of Records, please be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues, conditions and problems which are dealt with in psychotherapy are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage.
Out-of-Network Insurance Billing: We do not bill Out-of-Network Insurance. We can, however, give you a superbill or receipt for you to provide to your insurance company if you need one.
Good Faith Estimate: Under the law, health care providers need to give patients who don't have insurance or are paying out of pocket without using insurance, an estimate of their bill for health care items and services before those items or services are provided.
You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
If you schedule a health care item or service at least 3 business days in advance, make sure your healthcare provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your healthcare provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
If you receive a bill that is at least $400 or more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate and the bill.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.
Mediation & Arbitration: If a dispute arises we will seek mediation before, and as a precondition of, the initiation of arbitration. The mediator will be a neutral third party mutually agreed upon by you and your therapist. The cost of such mediation, if any, shall be split equally, unless otherwise agreed upon. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Washington County, Oregon in accordance with the rules of the American Arbitration Association in effect at the time the demand for arbitration is filed.
The Process of Therapy and Scope of Practice: We see counseling as a cooperative effort geared to resolving problems or issues that you present. Your active participation with your thoughts, feelings and actions help to create success. Therapy is simply a means to an end and most beneficial when guided by your goals. We will regularly review your goals as well as your thoughts and feelings expressed regarding the therapy process. We like to begin by getting to know you and hearing your concerns, what you have tried so far, what has not helped and what has improved your situation. Then we usually discuss what successful completion of therapy would look like for you. We then set a course to achieve your goals. Using this plan, we will know what you are achieving, and when you are done. Sometimes difficult emotions arise, and we have found that open and honest feedback from you can be a turning point in getting you the results you desire.
Therapy may result in decisions about changing behaviors, employment, substance use, schooling, housing or relationships. Sometimes a decision that is positive for you may at times be challenging for others in your life. We use a number of approaches to help you achieve your goals. These include: behavioral, cognitive-behavioral, cognitive, psychodynamic, transpersonal, Jungian, existential, system/family, developmental (adult, child, family), humanistic, SoulCollage®, Somatic Experiencing®, psychoeducational, guided imagery, hypnosis, EMDR, Gottman-method couples therapy and others. Your therapist does not provide custody evaluation recommendations, medication or prescription recommendations or legal advice, as these activities do not fall within his or her scope of practice. Any communications regarding the above should in no way be construed as advice.
Therapy can be as short as one session, or as long as a few years, depending upon the breadth and depth of your goals, and your own change process. Research shows that 50% of patients make noticeable improvement after 8 sessions. And 75% of individuals in therapy improved by the end of 6 months. There are many people for whom therapy is a deeper, longer-term process that may require a longer course of treatment to achieve their goals. Additionally, many clients come for a course of treatment, finish up, and then return later to achieve other goals or for “tune-ups.” This is a perfectly normal part of the therapy process and the therapeutic relationship.
Discussion of Treatment Plan: Once you’ve started, your counselor will discuss with you the problem(s) that brought you to treatment, and together you will create a plan to reach your goals. The more active role you take in describing the problem and the goals you want to achieve, the better. We are the experts in the change process. You are the expert in “you”. If at any time you are uncomfortable with the way things are going, please let us know and together we can make a course correction.
Termination: After the first couple of meetings, we will assess if the therapy process can benefit you. We don’t accept clients who we are unable to help and we would like our counselors to be the best fit for your needs. If at any point during therapy your therapist assesses that they are not effective in helping you reach your goals, he or she is obligated to discuss it with you and, if appropriate, to terminate treatment. If this happens we will give you a number of internal (CSP) or external (outside CSP) referrals that may help you. If you request it and authorize it in writing, your therapist will talk to the counselor of your choice to help with the transition. If at any time you want another professional’s opinion or wish to consult with another therapist, your therapist will assist you with referrals, and if they have your written consent, they will provide the essential information needed. You also have the right to terminate therapy at any time.
Dual Relationships: A dual relationship happens when you have contact with your therapist outside the counseling office. Not all of these relationships are unethical or avoidable. However, therapy never involves a sexual or romantic relationship with a client. Your therapist will assess carefully before entering into non-sexual and non-exploitative dual relationships with you. You may bump into someone you know in the waiting room or into your therapist out in the community. Your therapist will never acknowledge working with anyone without your written permission. Many clients choose their therapist because they know of him or her before they enter into therapy or are personally aware of his or her professional work and achievements. Nevertheless, your therapist will discuss with you the complexities, potential benefits and difficulties that may be involved in dual or multiple relationships. Dual or multiple relationships can enhance trust and therapeutic effectiveness but can also detract from it and often it is impossible to know that ahead of time. Please let your therapist know if the dual or multiple relationship becomes uncomfortable for you in any way. Your therapist will always carefully listen and respond accordingly to your feedback and will discontinue the dual relationship if he or she finds it interfering with the effectiveness of the therapy or the welfare of the client and, of course, you can do the same at any time.
In-person visits during COVID-19 or any public health crisis: If you agree to meet in the clinic with your counselor for some or all your sessions during Covid-19 period or any public health crisis, we understand that you will be assuming the risk of exposure to the Covid or other public health crisis situations. If there is a resurgence of the pandemic or if other health concerns arise, however, you may stop the clinic visits and opt to meet via telehealth. If you have concerns about meeting through telehealth, you may talk about it with your counselor first and try to address any issues you both have.
If you decide at any time that you would feel safer staying with, or returning to, telehealth services, your counselor will respect that decision, as long as it is feasible and clinically appropriate. Reimbursement for telehealth services, however, is also determined by the insurance companies and applicable law and if there are any foreseen issues, your counselor will notify you.
Your therapist may also express concern if there is a resurgence, sometimes based on the safety of other clients or their own personal situation and may request to see you virtually. If you do not feel that you are able to do that, you may discuss with your therapist if they can suggest other options or if seeing another therapist in-person is a better option for you if it is for a long period of time.
Tele-health or Tele-counseling: This involves the use of electronic communications to enable health care providers at different locations to share individual patient medical information for the purpose of improving client care. Providers may include any licensed mental health practitioners.
The information may be used for diagnosis, therapy, follow-up and/or education, and may include any of the following:
• Client therapy records
• Live two-way audio and video
• Output data from computer or medical devices and sound and video files
Electronic systems used will incorporate network and software security protocols to protect the confidentiality of client identification and information and will include measures to safeguard the data and to ensure its integrity against intentional or unintentional corruption.
You have the following rights under this agreement: You have a right to confidentiality with Telehealth under the same laws that protect the confidentiality of your mental health information for in-person psychotherapy. Any information disclosed by you during the course of your therapy, therefore, is generally confidential.
There are, by law, exceptions to confidentiality, including mandatory reporting of child, elder, and dependent adult abuse and any threats of violence you may make towards a reasonably identifiable person. You also understand that if you are in such mental or emotional condition to be a danger to yourself or others, your therapist has the right to break confidentiality to prevent the threatened danger. Further, you understand that the dissemination of any personally identifiable images or information from the telehealth interaction to any other entities shall not occur without your written consent.
While psychotherapeutic treatment of all kinds has been found to be effective in treating a wide range of mental health issues and disorders, personal and relational issues, there is no guarantee that all treatment of all clients will be effective. Thus, while you may benefit from Telehealth, results cannot be guaranteed or assured.
There are risks unique and specific to Telehealth, including, but not limited to, the possibility that your therapy sessions or other communication by your therapist to others regarding your treatment could be disrupted or distorted by technical failures or could be interrupted or could be accessed by unauthorized persons. In addition, Telehealth treatment is different from in-person therapy an if your therapist believes you would be better served by another form of psychotherapeutic services, such as in-person treatment, you may see your therapist in the office if they have in-person office hours or you will be referred to a therapist at Counseling Services of Portland or elsewhere who may provide such services.
Cancellation: Since the scheduling of an appointment involves the reservation of time specifically for you, a minimum of 24 hours notice is required for re-scheduling or canceling an appointment. Unless we reach a different agreement, $130 will be charged for sessions missed without 24 hours notice. Insurance companies do not reimburse for missed sessions. If you are not able to meet your therapist in person, talk to them to see if tele-health is an option so that you do not miss your appointment.
Complaints: If you believe your privacy rights have been violated, you may file a complaint with Counseling Services of Portland (CSP) or with the Secretary of the Department of Human Services. To file a complaint with CSP, call 503-342-2510 or email at gethelp@counseling-pdx.com. You will not be penalized for filing a complaint
CONTACT OFFICERS: Jonelle Richards, LCSW or Christine McCulloch, MBA, 7100 SW Hampton St, Suite 223, Tigard, OR 97223. This form is educational only and doesn’t constitute legal advice, and only covers federal law, not state law (March 20, 2024)