SCHEDULING AND APPOINTMENTS

Therapy Hours are Monday through Thursday between 8 am and 5 pm. Individual Psychotherapy sessions are 55 minutes.

As my client, you and I will discuss the frequency of your therapy sessions and adjust the frequency over time as deemed appropriate by both of us. Time slot frequencies are either weekly for newer clients, or bi-weekly for long-term clients (6+ months). Occasional check-ins are available for stable clients in maintenance therapy at my discretion and are scheduled on an as-needed basis. If there is disagreement about frequency of appointments, I will offer you referrals to other providers who have the appropriate availability.

Some clients request a regular appointment slot each week or every other week. I cannot guarantee this but I will work with you to try to offer you a regular day/time slot. However, in order to reserve a regularly scheduled appointment slot, clients must commit to the payment policy for missed or canceled appointments.  Missed or late-canceled appointments are charged the full session fee. The reason for this is that I only take on a limited number of clients on my caseload at any given time, to ensure that I can provide satisfactory care for my clients.  I do not reach out to waitlisted clients to fill open slots unless an existing client concludes therapy.  Therefore, all of my clients are expected to pay the full session fee for a canceled appointment, unless the appointment can be rescheduled in the same week or you have given 48 hours notice by email or voicemail.  If you cannot give 48 hours notice to cancel your appointment, I suggest you notify me as soon as you can before your scheduled time. Then, be flexible to accept another available time in the same week in order to avoid the cancelation fee. Insurance cannot be billed for missed or canceled appointments.

A repeated pattern of cancellations or rescheduling of appointments  interferes with effective treatment for you and impacts the financial sustainability of my practice. I will discuss this with you if it becomes an issue and possibly make a therapy referral or terminate therapy at my discretion. When you sign your treatment consent you are agreeing with this policy.

Session fees are never billed/charged if  I am unable to attend sessions.  Clients are never held responsible to pay for a cancelled appointment when the clinician/practitioner is unavailable to meet for any reason.

COMMUNICATION

PHONE

If you need to contact me between sessions, please leave a message on my direct voice mail or email me. I will attempt to return your call or email within 24 hours. If you have safety-threatening symptoms, please do not wait for me to return your call, rather, report to your nearest emergency department. In the event that you are out of town, sick or need brief and limited support, phone contact may be available provided that I am available. If a true life-threatening emergency situation arises, please call 911 or any local emergency department. Please do not use text messaging or email for anything aside from scheduling issues. They are not secure mediums nor appropriate means for clinically related communications.

SOCIAL MEDIA

Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, Twitter, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up with me and we can talk more about it. Additionally, you may find my provider or business profile on social media advertising sites (i.e. Yelp, Google Places, Healthgrades.com, Psychologytoday.com, etc.), and any reviews or posts you make on these sites are done at your own risk of disclosure that you have seen me as a client. I cannot stop you from any posts or public declarations you make, but I discourage you from compromising your privacy and confidentiality. Any feedback you have about my services (positive or negative) I absolutely welcome and hope to hear from you directly. Feedback is necessary for growth and can actually lead to changes that improve the therapy process.

COURT ORDERED WORK AND APPEARANCES

If I am subpoenaed to a court of law or other legal appointment on your behalf, I charge $440/hour of my time spent on these activities (including composition, production, organization, transmittal, and delivery of documentation, travel to and from courts or offices, time spent waiting for and in appointments and hearings, time spent in communication with attorneys or court officials, and any time demanded to be away from normal practice hours) which you will be responsible for entire payment of, and health insurance will not reimburse for. This is to account for the impact upon my practice for any such absence or activity required. In the event of couples or family therapy, I will not release records unless both partners agree in writing to such release to a specific individual for a specified reason unless otherwise ordered by a Court of Law, and I will provide a summary of services and progress to clearly specify the course of treatment. I am not a forensic evaluation specialty practice, nor a child custody evaluation specialist nor a parent coordinator, and therefore will not deliver opinions or judgments outside of the scope of my practice in these areas.

ELECTRONIC COMMUNICATION

I cannot ensure the confidentiality of any form of communication through electronic media, including email or text messages. I request that all communication be through email or phone. I also request that all scheduling changes be requested through email. Please do not send clinical information or information covered by HIPAA in your email unless I am able to first send you a secure file transfer form.

TELEHEALTH

Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine.
(1) All existing confidentiality protections are equally applicable to telemedicine.
(2) Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.
(3) There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs. Effective therapy is often facilitated when the therapist gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in therapy services, potential risks include, but are not limited to the therapist’s inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition including deformities, apparent height and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what he or she would consider important information, that you may not recognize as significant to present verbally the therapist.​

TERMINATION

Termination of the therapeutic relationship is the option of either therapist or client. Ending therapist-client relationships can be difficult, but can have therapeutic value. Saying goodbye is never easy, but can serve as a beginning.  I work hard to ensure that clients are prepared and ready for termination of therapy work. In fact, most clients suggest termination when they have met their goals. Termination often involves gradual reduction in frequency of sessions, followed by periodic check ins and then a final session. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment at any time if I feel the the therapy process is no longer effective for the client.  I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified psychotherapists who have openings to treat you. You may also choose someone on your own or from another referral source.

Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance or we have continued ongoing communications about your absence, for legal and ethical reasons, I must consider the professional relationship discontinued and your case inactive. I welcome return clients at my discretion.

If you have any questions or concerns about these policies, please email me at christina@ncdbt.com.