ACCESS TO YOUR MEDICAL INFORMATION/CONFIDENTIALITY: The law requires me to protect the privacy of your health information. This means that I will not use or let other people see your health information without your permission except in the ways I tell you in this notice. I will safeguard your health information and keep it private. This protection applies to all health information I have about you, no matter when or where you sought services. When you are in my office, I will not allow any unauthorized person to interview, photograph or record you without your written permission. I will not tell anyone if you sought, are receiving, or have ever received services from me unless the law allows me to disclose that information. If I see you in public outside of my office, I will not approach you or act as if I recognize you. It is important for you to know that there are some situations in which I am required to break confidentiality:
1) If I determine you are a danger to yourself or someone else;
2) You disclose abuse, neglect, or exploitation of a child, elderly, or disabled person;
3) You disclose sexual contact with another mental health professional or clergy;
4) I am ordered by the court to disclose information;
5) You direct me to release your records; or
6) I am otherwise required by law to disclose information
I will ask you for your written permission to use or disclose your health information. If you give your permission to use or disclose your health information, you may take it back (revoke it) at any time. If you revoke your permission, I will not be liable for using or disclosing your health information before I knew you revoked your permission. To revoke your permission, send a written statement signed by you to the office address where you gave your permission, providing the date and purpose of the permission and stating that you want to revoke it.
Confidentiality Statement Specifically for Couples
Relationship therapy works best when the focus of my work is on your relationship. When working with you, it is expressly understood that my patient is both your relationship and each of you as individuals. This document describes my policies on confidentiality when I am working with couples. In my experience, it is best when these issues are talked about and understood from the start of treatment.
In individual therapy, any information obtained by having contact with a client is confidential and cannot be shared with anyone without the specific consent or authorization of the client, or except by law. However, in couple therapy, the psychotherapist may meet individually with one spouse, and the therapist will be influenced by this individual contact when meeting with the other spouse. There are also many instances when the therapist may use knowledge gained from individual sessions with the other spouse. An example is when the therapist makes a statement such as: “When I speak to your wife/ partner, I get the impression that she is interested in making your relationship better for both of you”. Therefore, in this way a couple therapist cannot promise complete confidentiality to each individual in joint therapy.
On the other hand, individuals may have some feelings, thoughts, or actions that they would like to keep confidential. While I will not agree to keep any secrets learned from individuals, I believe in respecting these confidences or sensitive topics if possible. Therefore, any information provided to me, regardless of whether the partner/spouse was present, may be either withheld or disclosed to the other party at my discretion. Additionally, both parties must understand and agree that in order to keep proper records, I may make written record of any information provided by either party or any observation made of either party’s behavior.
Another kind of exception to confidentiality occurs when keeping an individual’s confidence places me in a position of behaving dishonestly. An example of this kind of situation would be a husband who tells me in private about plans to leave his wife or to continue an affair, but wants to continue the couple’s therapy as if he planned to stay in the marriage and was being honest. I would need to work with him to help him to tell his wife, since we could not continue therapy if we were deceiving her. The time frame for maintaining confidentiality in this work is at my discretion.
To summarize, my rules for confidentiality, with couples specifically, are as follows:
1. I will maintain the same standards of confidentiality and privacy as in individual therapy when I contact anyone outside the couple.
2. I am willing to keep confidences as long as they do not conflict with the law, do not place me in a position of being deceitful with the other spouse, or I do not think they are inappropriate therapeutically. However, it must also be understood that I cannot guarantee the maintenance of confidences between spouses, and there is always a small but real possibility that a confidence will be accidentally revealed to the other spouse. There are also occasions when I may advise that a confidence be revealed or I may set a time frame in which one member must voluntarily reveal information we have talked about individually. I cannot guarantee that others will always agree with my choices.
3. In addition, I would like to explain that my commitment is to the well-being of all individuals in the marriage. When both partners wish to work on their relationship, we will make a commitment to the relationship as long as it is the choice of both partners. It is my position that only the partners can make the decision about keeping a relationship together or separating, and realistically, divorce or separation may be a possibility. I must also be free to discuss the possibility of divorce or separation with either partner when I believe that this discussion is appropriate or necessary.
4. In regards to the Clinical Record involving a couple or family members, if an “outside” third party wishes to access the file, signatures of both partners/spouses will be required in order to release the requested information. Certain exceptions to these confidentiality and access provisions may be required by law.
TWOFOLD AI (HEALTH SCRIBE)
I have a legal and ethical responsibility to make my best efforts to protect all communications that are part of our sessions. I have chosen to use Twofold Health's AI transcription tool to provide the best care to my clients. This tool provides an automatically generated summarization of our sessions. Twofold Health's system is HIPAA compliant and uses up-to-date encryption methods, and multiple layers of security and privacy technology to keep your information private and secure. By signing this form, you consent to our sessions being processed using Twofold Health's system.
Details
1. Data Collection and Use
● Transcription and Summarization: Recordings of our sessions will be transcribed and summarized by Twofold Health’s HIPAA-compliant technology. Twofold Health does not store the recordings.
● Retention of Summarized Notes: I may choose to keep the summarized notes as part of your confidential medical record.
● Anonymized Data: Twofold Health only keeps anonymized data to help improve the tool. As with any technology, there are certain risks and benefits, which are listed below:
2. Risks and Mitigations
● Confidentiality: All technology carries a risk of confidential information being disclosed. Twofold Health mitigates this risk by ensuring up-to-date technological security and storing the data with minimal identifying information.
● Bias in Summarization: The system may contain unknown biases in the way it generates the session summary and presents clinical information. This risk is mitigated by my commitment to review and modify the notes as needed using my clinical expertise.
● Twofold Health researchers will have access to your de-personalized transcripts (with names, emails, and other identifying information removed) solely for the purpose of improving the product and for specific customer support inquiries, when requested.
3. Benefits
● Focus on Care: The technology allows me to focus more on care.
● Reduction in Administrative Workload: Removes the need for taking notes during the session, reducing the administrative workload and potentially helping with compassion fatigue.
● Improved Clinical Insights: The technology may provide additional clinical insights, helping to improve outcomes in the care process.
CUSTODY AND CONTROL OF RECORDS: All of our communication becomes part of the clinical record. Records are the property of Courtney Miller Psychotherapy. All client records are disposed of 7 years after the file is closed; this applies to both adult and minor clients. In the event of my death or incapacity, or the termination of my counseling practice, the custody and control of your records will be given to Gina Watson, LMFT.
COURT PROCEEDINGS/SUBPOENA OF RECORDS: It is understood that the purpose of marital/couple therapy is for the amelioration of distress within a relationship. Therefore, if both partners request my services as a licensed professional counselor, they are expected not to use information given to me during the therapy process against the other party in a judicial setting of any kind, be it civil, criminal, or circuit. Likewise, neither party shall for any reason attempt to subpoena my testimony or my records to be presented in a deposition or court hearing of any kind for any reason, such as a divorce case.