Sometimes things come up — unexpected school cancellations, illness, car trouble. I've been there, life happens! Sometimes we can pivot to telehealth or reschedule the session within the same week, other times, that's just not possible.
If you cancel your appointment with less than 48 hours of advance notice, you will be charged 50% of your full session fee. If you miss your session without notifying me at all, you will be charged 100% of your session fee.
As much as you are able to, please communicate with me via phone call for all same-day cancellations and to notify me if you are running late to your session. If you cancel the night before your session or earlier, you may cancel through the client portal or via phone call.
The duration of your therapy session is an important part of your treatment. If you arrive more than 15 minutes late to a standard session or more than 45 minutes late to a 90-minute intake session, the session will be cancelled and you will be charged 100% of your session fee. Late starts due to clients' arrival time will end at the time initially agreed upon and will be charged the full fee indicated at the time of booking the session.
This standard works both ways! If I cancel on you with less than 48-hour notice or miss our session without notice, you will receive one credit to use to waive late-cancellation/no show fees in the future. And if I am more than 10 minutes late to your session, I will extend our time so that you receive the session time promised or I will discount that session's fee if our time cannot be extended.
In rare cases, we may arrange for alternative cancellation fees or a one-time waiver of the no-show fee without you using a credit as described above. Please ask for more information.
Therapy is mostly confidential, but not 100%. I am legally required to keep all of your Protected Health Information (PHI) confidential, which means I won't tell others what you say or do, and I'll securely store all of your files and communicate with you in a HIPAA-compliant way. Please be aware that the most secure way for us to communicate out of the office is via phone call or the client portal.
There are several exceptions in which I am required by law to break confidentiality. These are listed below:
Clients under 18 do not have a legal right to privacy. I do my best to respect the privacy of my adolescent clients, but I will tell caregivers/legal guardians about safety concerns and significant risks to health/wellbeing. I'll always try to talk with adolescents before I share any information, but sometimes this is not possible.
I learn or have reasonable suspicion that you or someone else is abusing or neglecting a child or a vulnerable adult. In this case, I am required to make a report to the Child Protection Hotline or the Adult Abuse & Neglect Hotline for the state in which the abuse occurred. This is legally required even if the abuse has already been reported by someone else.
I learn or have a compelling reason to believe that a client is an immediate physical danger to themself or others. For example, if you are having suicidal or homicidal thoughts and intend to act on them or if you have intent to harm others. In this case, I may need to: reach out to your emergency contacts to help keep you and others safe, take steps for you to be hospitalized or call the police to perform a wellness check or in order to fulfill my duty to warn in the case of harm to others.
If a judge requests a copy of your medical record, then I may be legally required to share this information. As part of my profession's code of ethics, I share only the minimum required information.
Additionally, if you have signed a Release of Information (ROI), I may exchange information related to your care with your psychiatrist, dietitian, primary care provider, school, concurrent specialty therapist, former therapist or any other individual/entity you approve. We will discuss the reason for the contact and what topics will/will not be shared before I respond to outreach from others or before I myself initiate contact. You may revoke an ROI at any time by filling out a Revocation of Authorization to Disclose Health Information Form.
I require 2 emergency contacts on file in order to ensure safety in cases of emergency. I will only share minimal information that is relevant to keeping you and others safe.
I will not require collaboration with your other providers unless I believe that the lack of this collaboration could negatively impact your treatment. Some examples include, but are not limited to: collaboration with your dietitian if you have an eating disorder; collaboration with your psychiatrist/PCP if your medication management needs are complex; collaboration with a concurrent therapist if you are in active therapy with another therapist (separate individual therapy, couples or family therapy).
For Couples and Family Therapy, I strive to balance individuals' privacy with the openness that is often necessary for effective interpersonal growth. We will discuss and set boundaries about confidentiality during our first session.
Lastly, therapists are encouraged to seek clinical supervision and consultation with colleagues, supervisors, instructors and specialists in order to improve their skills and enhance client outcomes. In these educational situations with other professionals, therapists must maintain legal confidentiality by protecting identifying information and only discussing de-identified material. For example, I wouldn't say, "my client is Jane Smith, a 46-year-old who works at Abbott Elementary," but rather, "my client is a woman in her forties who teaches school-aged children." This allows us therapists to keep learning from other professionals about how to better support you and your goals, without compromising your privacy.