Disclosure Statement

Welcome to my practice! This document is intended to give you some important information about our work together, and also includes a lot of other information considered necessary by attorneys, legislators and professional organizations. I will put in bold type the items I think you will most want to know about, but I’ll ask you to sign a copy of this by our second session to acknowledge that you have had a chance to read it all as carefully as you wish.

Psychotherapy Services

I employ a variety of psychotherapy approaches and techniques flexibly tailored to the goals and difficulties that you bring to my office. With couples I work mainly from the Gottman Method Couples Therapy model. With individual clients I pull strongly from mindfulness-based behavioral therapies such as DBT and ACT, but I am likely to also include other methods I’ve learned over 35 years of practice. The Gottman Institute wants me to inform you that while I have taken training in the Gottman Method of couples therapy, I am completely independent in providing you with clinical services, and I alone am fully responsible for those services.  The Gottman Institute or its agents have no responsibility for the services you receive.

I’m supposed to tell you that any psychotherapy can have risks as well as benefits.

Since you’ve presumably come to therapy to deal with some unpleasant aspects of your life, discussing and dealing with these parts may involve uncomfortable feelings such as sadness, guilt, anger, frustration, loneliness and helplessness. I will be teaching you powerful techniques for managing and tolerating these emotions, and support you to use them when feelings get too intense to bear or start to interfere with our efforts to improve your life.  To maximize the benefits of psychotherapy, I am employing state-of-the-art methods that clinical research has demonstrated to be the most effective available at this point in time.

Meetings and Professional Fees

Our first meeting should be considered an evaluation and goal setting session, and an opportunity to see if we are a good match for working together. With couples, our first session will usually be 90 minutes in length. With individual clients the session is usually 60 minutes, though sometimes it is useful to go longer. The length of subsequent sessions would be negotiated on the basis of what seems most useful. For sessions over an hour in length, we calculate the fee based on my hourly rate. I provide phone coaching as a regular part of my practice – ten minutes a week are free (coaching calls are quite focused) and beyond that I would charge my regular rate pro-rated to the amount of time needed.

I offer a sliding scale based on the client’s financial situation—I am happy for clients to decide where they belong within the range of the scale. My full fee is $180 per hour, and I slide down to $120 per hour. In the extremely rare event (hasn’t happened in 35 years of private practice) that you become involved in legal proceedings that require my participation, you would be expected to pay for my professional time even if I were called to testify by another party. Because of the difficulty of legal involvement, I charge $250 per hour for preparation and attendance at any legal proceeding.

Once an appointment is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation, unless we both agree that you were unable to attend due to circumstances beyond your control. I am usually pretty forgiving around circumstances of physical illness, childcare issues, etc.

Insurance Reimbursement

How I usually work with clients who have insurance is to ask them to pay me the agreed upon fee at each session, and I provide billing statements and telephone support for them to seek reimbursement from their insurance provider. It is important that you check with your insurance company and see how much they will reimburse you for an out-of-network provider, as I am not a member of any insurance panels.

You should also be aware that most insurance companies require you to authorize me to provide them with a clinical diagnosis. Sometimes I have to provide additional clinical information such as treatment plans or summaries, or copies of the entire record (in rare cases). This information will become part of the insurance company files and will probably be stored in a computer. Though all insurance companies state that they keep such information confidential, I have no control over what they do with it once it is in their hands. In some cases, they may share the information with a national medical information databank. I will provide you with a copy of any report I submit, if you request it.

Contacting Me

As a DBT Therapist who works with a number of potentially suicidal clients, I am much more available by phone than most therapists. Providing short coaching calls is an integral part of the DBT model. My cell phone charges by my bed at night, so you could potentially reach me 24/7 if really necessary, except when I am seeing clients. Please don’t call in the middle of the night unless you really need immediate help. To help prevent self-harm behaviors, I would gladly do coaching calls at any hour.

Professional Records

The laws and standards of my profession require that I keep treatment records, including a diagnosis and treatment plan. You are entitled to receive a copy of your records, or I can prepare a summary of them instead (I would recommend getting a summary, as my handwriting and abbreviations are hard to read). I would charge my hourly rate for providing these records. I want you to know that in addition to what is required by professional standards the contents of my notes are merely facts that I need to keep track of.  There are no secret judgements about you to be found in the files – I write them as if you were looking over my shoulder while I write, and in any event, I’m not a judgmental kind of person. My sense is that everyone is doing the very best they can, based on the life experiences that have shaped them.

Minors

If you are under eighteen years of age, please be aware that the law may provide your parents the right to examine your treatment records. It is my policy to request an agreement from parents that they agree to give up access to your records. If they agree, I will provide them only with general information about our work together, unless I feel there is a high risk that you will seriously harm yourself or someone else. In this case, I will notify them of my concern. Before giving them any information, I will discuss the matter with you, if possible, and do my best to handle any objections you may have with what I am prepared to discuss.

Confidentiality

In general, the privacy of all communications between a client and a psychotherapist is protected by law, and I can only release information about our work to others with your written permission. But there are a few exceptions. In most legal proceedings, you have the right to prevent me from providing any information about your treatment. In some proceedings involving child custody and those in which your emotional condition is an important issue, a judge may order my testimony if he or she determines that the issues demand it.

There are some situations in which I am legally obligated to take action to protect others from harm, even if I have to reveal some information about a client’s treatment.

For example, if I believe that a child, an elderly person, or a disabled person is being abused, I must file a report with the appropriate state agency.

If I believe that a client is threatening serious bodily harm to another, I am required to take protective actions. These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the patient.

If a client threatens to harm himself or herself, I may be obligated to seek hospitalization for him or her or to contact family members or others who can help provide protection.

These situations have rarely occurred in my practice. If a similar situation occurs, I will make every effort to fully discuss it with you before taking any action.

I may occasionally find it helpful to consult other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my client. The consultant is also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together.

While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have at our next meeting. I will be happy to discuss these issues with you if you need specific advice, but formal legal advice may be needed because the laws governing confidentiality are quite complex, and I am not an attorney (what I do in actual clinical situations is contact one).