Multiple Relationships. As is expected by professional standards, I will not conduct a Child Parenting Plan Evaluation or Social Investigation & Study for any current or former patient(s), or any person(s) with whom a previous professional or personal relationship exists. If I become aware of such a previous relationship during the course of the Investigation, I will inform the court and respective attorneys of my professional obligation to withdraw, if appropriate, and will refund any unused retainer to the appropriate parties.
Multiple Relationships. We make all attempts to avoid multiple relationships in regard to our patients engaged in counseling services. A multiple relationship occurs when a psychologist/counselor is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has a professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person. Although some multiple relationships are unavoidable, multiple relationships have the potential to impair our objectivity and effectiveness in our role as a therapist. Therefore, we usually refrain from providing individual services to more than one member of a family. If we are providing couples therapy, please understand that the union itself is the patient, and therefore, we will not keep secrets from either member of the couple. (PLEASE PROCEED TO THE NEXT PAGE OF THIS DOCUMENT TO PROVIDE SIGNATURES INDICATING UNDERSTANDING AND AGREEMENT WITH THE CONTENTS OF THIS DOCUMENT...) Thank you for choosing Birmingham Anxiety & Trauma Therapy! PLEASE INITIAL THE FOLLOWING STATEMENTS TO VERIFY YOUR UNDERSTANDING AND AGREEMENT: I (the patient/patient’s representative) understand that I am required to provide BATT a minimum of 48 hours advanced notice of any need to cancel or reschedule a session. Missed sessions without 48 hours’ notice will be charged a $100 no-show fee. I understand that I am responsible for any portion of the fees not covered by my insurance company. I understand that I am responsible for any professional fees associated with my care. I understand that BATT will only pursue rejected claims a maximum of three times and after that I am responsible for paying the entire xxxx. I understand that BATT provides eligibility and benefit information as a courtesy only, and that BATT cannot be held accountable for differences between what they tell me about my benefits (based on good faith of the insurance website information and phone call to the insurance company) and what the insurance companies actually pay on my behalf. I understand the limits to my confidentiality information as described in the CONFIDENTIALITY section above. I understand that if I should choose to contact my therapist via email or text, that these devices are not encrypted and thus pose a potential privacy...
Multiple Relationships. Multiple relationships, in which the Respondent assumes another role in addition to therapist, are prohibited when the relationship could reasonably be expected to impair the Respondent’s objectivity, competence, or effectiveness in performing the functions of a psychologist or otherwise risks exploitation or harm to the person with whom the professional relationship exists.
Multiple Relationships. Psychotherapy is a professional service I will provide to you. Because of the nature of therapy, your relationship with me must be different from most relationships. It may differ in how long it lasts, the objectives, or the topics discussed. It must also be limited to only the relationship of therapist and client. If you and I were to interact in any other ways (e.g., social, business, etc.) we would then have a “multiple relationship.” Multiple relationships may compromise our treatment and therefore, are discouraged in the mental health profession. To offer all my clients the best care, my judgment needs to be unselfish and purely focused on your needs. Therefore, your relationship with me must remain professional in nature. However, despite this popular perception, not all multiple relationships are unethical or avoidable. Therapy never involves sexual or any other dual relationship that impairs my objectivity, clinical judgment or can be exploitative in nature. I will assess carefully before entering non-sexual and non-exploitative dual relationships with clients. It is important to realize that in some communities, particularly small towns, small communities, military bases, university campuses, spiritual and rehabilitation communities, etc., multiple relationships are either unavoidable or expected. I will never acknowledge working with anyone without his/her written permission. Many clients have chosen me as their therapist because they knew me before they entered therapy with me, and/or are personally aware of my professional work and achievements. Nevertheless, I will discuss with you the often-existing complexities, potential benefits and difficulties that may be involved in dual or multiple relationships. Multiple relationships can enhance trust and therapeutic effectiveness but can also detract from it and often it is impossible to know which ahead of time. It is your responsibility to advise me if the dual or multiple relationships becomes uncomfortable for you in any way. I will always listen carefully and respond to your feedback and will discontinue the dual relationship if I find it interfering with the effectiveness of the therapy or your welfare and, of course, you can do the same at any time.
Multiple Relationships. From time to time it is possible that we may “bump” into each other in a setting outside of the therapy office. I do not acknowledge working with anyone without their permission. I do not discuss anyone without their permission and without a purpose that would be helpful in their case. I cannot anticipate when or where you might see or interact with me. It is my policy to not harm a patient, to not exploit a patient relationship and to insure that I can provide a reasonable standard of care. I do not have social or sexual relationships with current clients or former clients because to do so would not only be unethical and illegal, it would be an abuse of the power I have as a therapist. Time Parameters. Traditional mental health services offer 45 and 50 minute appointments one or two times a week for individual appointments. Family and group therapy are traditionally 1 ½ or 2 hour appointments. My work is designed to be short term, although more complicated problems may require services for a longer period of time. I provide intensive services to address problems. Crisis and severe problems may involve referral to in-patient facilities. I will make every reasonable effort to be available for existing patients who require emergency services. I may not be available due to illness or prior commitments. I will make a reasonable effort to notify patients in advance. If you require immediate emergency services or are encountering a medical emergency, you should contact your nearest emergency room, urgent care facility, or your family doctor. Cancellations. I request 24 hours’ notice of any cancellation. Failure to cancel an appointment may result in others not receiving the help they need or want. Your appointment times may be given to another patient if you fail to come to an appointment.
