When a family is confronted by parental separation or divorce, it is very difficult for everyone, especially children. When parents are in conflict, it is even more important that therapy presents an emotionally safe environment. Therefore, Integrated Behavioral Care, LLC / Integrated Behavioral Care-New England, LLC (IBC) wishes to be clear about its policies and procedures relating to the confidentiality of its patients and its position regarding any legal proceedings, particularly those related to separation, divorce and custody. IBC’s involvement will be strictly limited to therapy or evaluations that will benefit your child. We do not provide forensic or custody evaluations. Each parent must sign this form and by doing so acknowledges their understanding of the foregoing and the terms below.
IBC recognizes the difference between “legal” and “physical” custody and will presume that parents share “legal” custody unless there is a court decree/order stating otherwise. IBC requests copies of all court decrees/orders pertaining to custody in order to ensure its compliance with the court’s directives.
In addition to abiding by the terms and provisions of your custody agreement, in treating your child, you understand and agree to the following:
1. The evaluation and/or treatment of your child is intended solely to provide treatment to address his or her psychological needs.
2. The usual exceptions to confidentiality apply as in noted IBC’s Notice of Privacy Practices, of which you have been provided a copy.
3. The clinician qualifies as a mandatory reporter under M.G.L. c. 51A, and that nothing in this agreement shall interfere with the clinician’s duty to report pursuant to that statute or any similar statute.
Importance of Confidentiality
IBC’s work with your child is for the benefit of the child as the child is the client. Subject to the provisions your custody agreement, IBC’s clinicians are available for independent meetings and consultations with both parents to discuss progress, treatment planning, and to provide clinical impressions, in accordance with IBC’s confidentiality policies, as outlined in IBC’s Notice of Privacy Practices. Also, a small portion of each counseling session is generally reserved for parents to communicate with their child’s clinician, again, in accordance with IBC’s Notice of Privacy Practices.
IBC’s Involvement in Legal Proceedings
In order to protect your child’s confidentiality and the effectiveness of the treatment, you acknowledge and agree to the following:
1. You agree that neither you nor your representative will call the child’s clinician as a witness in a separation, divorce or custody proceeding. In particular, the clinician needs your agreement that in any such proceedings, neither parent will ask us to testify in court, whether in person, or by affidavit. Each parent also agrees to instruct your attorneys not to subpoena your child’s clinician. If the clinician is subpoenaed in regard to custody or divorce disputes, they may not be able to continue as your child or family’s clinician.
2. Once treatment commences, clinicians will not notify or write letters about custody or visitation arrangements. Therefore, parents understand and agree that the treating clinician will not participate in any legal proceeding, in any manner, will not write a report or provide testimony, related to the child’s therapy, unless so ordered by a court of law.
3. Note that this agreement may not prevent a court from requiring the clinician’s testimony. If required to testify, the clinician is ethically bound not to give an opinion about either parent’s custody or visitation suitability. If the court appoints a custody evaluator, guardian ad litem, or parenting coordinator, the clinician will provide information as needed (if appropriate releases are signed or a court order is provided), but will not make any recommendation about the final decision. Furthermore, if the clinician is required to appear as a witness, the party responsible for our participation agrees to reimburse us at the rates noted in our Fee Schedule Agreement for time spent traveling, preparing reports, testifying, being in attendance, and any other case-related costs. If the party who subpoenaed the clinician was not a party to this contract, then the party or parties who signed the contract are obligated to reimburse the clinician costs for involvement on behalf of your family.
I agree with the policies outlined in this document.