Common use of Therapy Clause in Contracts

Therapy. Psychotherapy, in general statements, varies depending on the personalities and skills of the counselor and patient. Each particular problem you are experiencing and hope to discuss may be addressed using different methods. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home. Frequency of visits will be addressed in the individual session. As you progress, the frequency of visits may change. If you want to decrease the frequency of appointments or feel ready to terminate therapy, we can discuss accordingly. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. Typically, the more invested you are in therapy, the better the outcome. This section contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a new federal law that provides new privacy protections and new patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which follows these Office Policies and is included as part of this Agreement, explains HIPAA and it application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of this session. Although these documents are long and sometimes complex, it is important that you read them carefully. We can discuss any questions you have about the procedures. When you sign the signature page of the intake form, your signature will represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred. LIMITS ON CONFIDENTIALITY Our sessions are confidential and in most cases, I can only release information about your treatment to others if you sign a written authorization form. There are other situations that require only written, advance consent. Your signature on this Agreement provides consent for those activities as follows: • I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The other professionals are 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. I will note all consultations in your Clinical Record (which is called Protected Health Information, PHI). • Disclosures by health insurers or to collect overdue fees are discussed elsewhere in this Agreement. • If a patient threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection. There are some situations where I am permitted or required to disclose information without either your consent or Authorization: • If a government agency is requesting the information for health oversight activities, I may be required to provide it for them. • If a patient files a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself. • If a patient files a worker’s compensation claim, and I am providing treatment related to the claim, I must, upon appropriate request, furnish copies of all medical reports and bills. There are some situations in which I am legally obligated to take actions and will release information without your written authorization or consent. These situations are unusual in my practice and are follows: • You tell me of a current situation involving the welfare of a child, disabled adult or a senior, in which I am required by law to report suspected abuse or neglect. Once a report has been filed, I may be required to provide additional information. • You report intentions to harm someone; • You report intentions of harming yourself; • I receive a court order from a judge to release information. I will take action to object but ultimately, I may be required to release information. If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary. The Privacy Policy which follows also outlines additional information regarding confidentiality of your protected health information. This information should be helpful in informing you, however if you have any questions about confidentiality, please ask.

Therapy. Psychotherapy, in general statements, varies depending on the personalities and skills of the counselor and patient. Each particular problem you are experiencing and hope to discuss may be addressed using different methods. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home. Frequency of visits will be addressed in the individual session. As you progress, the frequency of visits may change. If you want to decrease the frequency of appointments or feel ready to terminate therapy, we can discuss accordingly. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. Typically, the more invested you are in therapy, the better the outcome. This section contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a new federal law that provides new privacy protections and new patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which follows these Office Policies and is included as part of this Agreement, explains HIPAA and it application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of this session. Although these documents are long and sometimes complex, it is important that you read them carefully. We can discuss any questions you have about the procedures. When you sign the signature page of the intake form, your signature will represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred. LIMITS ON CONFIDENTIALITY Our sessions are confidential and in most cases, I can only release information about your treatment to others if you sign a written authorization form. There are other situations that require only written, advance consent. Your signature on this Agreement provides consent for those activities as follows: •  I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The other professionals are 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. I will note all consultations in your Clinical Record (which is called Protected Health Information, PHI). •  Disclosures by health insurers or to collect overdue fees are discussed elsewhere in this Agreement. •  If a patient threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection. There are some situations where I am permitted or required to disclose information without either your consent or Authorization: •  If you are involved in a court proceeding and a request is made for information concerning my services, I cannot provide information without your written authorization or a court order.  If a government agency is requesting the information for health oversight activities, I may be required to provide it for them. •  If a patient files a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself. •  If a patient files a worker’s compensation claim, and I am providing treatment related to the claim, I must, upon appropriate request, furnish copies of all medical reports and bills. There are some situations in which I am legally obligated to take actions actions, which I believe are necessary to attempt to protect you or others from harm and will release I may have to reveal some information without your written authorization or consentabout a client’s treatment. These situations are unusual in my practice and are follows: • practice.  You tell me of a current situation involving the welfare of a child, disabled adult child or a senior, in which I am required by law to report suspected abuse or neglect. Once a report has been filed, I may be required to provide additional information. •  You report intentions to harm someone; •  You report intentions of harming yourself; • I receive a court order from a judge to release information. I will take action to object but ultimately, I may be required to release information. If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary. The Privacy Policy which follows also outlines additional information regarding confidentiality of your protected health information. This information should be helpful in informing you, however if you have any questions about confidentiality, please ask.

Therapy. Psychotherapy, in general statements, varies depending on the personalities and skills of the counselor and patient. Each particular problem you are experiencing and hope to discuss may be addressed using different methods. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home. Frequency of visits will be addressed in the individual session. As you progress, the frequency of visits may change. If you want to decrease the frequency of appointments or feel ready to terminate therapy, we can discuss accordingly. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. Typically, the more invested you are in therapy, the better the outcome. This section contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a new federal law that provides new privacy protections and new patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which follows these Office Policies and is included as part of this Agreement, explains HIPAA and it application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of this session. Although these documents are long and sometimes complex, it is important that you read them carefully. We can discuss any questions you have about the procedures. When you sign the signature page of the intake form, your signature will represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred. LIMITS ON CONFIDENTIALITY Our sessions are confidential and in most cases, I can only release information about your treatment to others if you sign a written authorization form. There are other situations that require only written, advance consent. Your signature on this Agreement provides consent for those activities as follows: • I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The other professionals are 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. I will note all consultations in your Clinical Record (which is called Protected Health Information, PHI). • Disclosures by health insurers or to collect overdue fees are discussed elsewhere in this Agreement. • If a patient threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection. There are some situations where I am permitted or required to disclose information without either your consent or Authorization: • If you are involved in a court proceeding and a request is made for information concerning my services, I cannot provide information without your written authorization or a court order. • If a government agency is requesting the information for health oversight activities, I may be required to provide it for them. • If a patient files a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself. • If a patient files a worker’s compensation claim, and I am providing treatment related to the claim, I must, upon appropriate request, furnish copies of all medical reports and bills. There are some situations in which I am legally obligated to take actions actions, which I believe are necessary to attempt to protect you or others from harm and will release I may have to reveal some information without your written authorization or consentabout a client’s treatment. These situations are unusual in my practice and are follows: practice. • You tell me of a current situation involving the welfare of a child, disabled adult child or a senior, in which I am required by law to report suspected abuse or neglect. Once a report has been filed, I may be required to provide additional information. • You report intentions to harm someone; • You report intentions of harming yourself; • I receive a court order from a judge to release information. I will take action to object but ultimately, I may be required to release information. If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary. The Privacy Policy which follows also outlines additional information regarding confidentiality of your protected health information. This information should be helpful in informing you, however if you have any questions about confidentiality, please ask.

Therapy. Psychotherapy, in general statements, varies depending on the personalities and skills of the counselor and patient. Each particular problem you are experiencing and hope to discuss may be addressed using different methods. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home. Frequency of visits will be addressed in the individual session. As you progress, the frequency of visits may change. If you want to decrease the frequency of appointments or feel ready to terminate therapy, we can discuss accordingly. Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience. Typically, the more invested you are in therapy, the better the outcome. This section contains important information about my professional services and business policies. It also contains summary information about the Health Insurance Portability and Accountability Act (HIPAA), a new federal law that provides new privacy protections and new patient rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment and health care operations. The Notice, which follows these Office Policies and is included as part of this Agreement, explains HIPAA and it application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information at the end of this session. Although these documents are long and sometimes complex, it is important that you read them carefully. We can discuss any questions you have about the procedures. When you sign the signature page of the intake form, your signature will represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; if there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or if you have not satisfied any financial obligations you have incurred. LIMITS ON CONFIDENTIALITY Our sessions are confidential and in most cases, I can only release information about your treatment to others if you sign a written authorization form. There are other situations that require only written, advance consent. Your signature on this Agreement provides consent for those activities as follows: •  I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The other professionals are 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. I will note all consultations in your Clinical Record (which is called Protected Health Information, PHI). •  Disclosures by health insurers or to collect overdue fees are discussed elsewhere in this Agreement. •  If a patient threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection. There are some situations where I am permitted or required to disclose information without either your consent or Authorization: •  If a government agency is requesting the information for health oversight activities, I may be required to provide it for them. •  If a patient files a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself. •  If a patient files a worker’s compensation claim, and I am providing treatment related to the claim, I must, upon appropriate request, furnish copies of all medical reports and bills. There are some situations in which I am legally obligated to take actions and will release information without your written authorization or consent. These situations are unusual in my practice and are follows: •  You tell me of a current situation involving the welfare of a child, disabled adult or a senior, in which I am required by law to report suspected abuse or neglect. Once a report has been filed, I may be required to provide additional information. •  You report intentions to harm someone; •  You report intentions of harming yourself; •  I receive a court order from a judge to release information. I will take action to object but ultimately, I may be required to release information. If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary. The Privacy Policy which follows also outlines additional information regarding confidentiality of your protected health information. This information should be helpful in informing you, however if you have any questions about confidentiality, please ask.