Practice Policies
Consent for Treatment
Therapeutic Relationship
I encourage you to obtain knowledge of the procedures, goals, and possible side effects of psychotherapy. I expect to make our professional contact one where you receive the maximum benefit. Psychotherapy may be tremendously beneficial for some people, however, at the same time there are some risks. These risks may include the experience of unwanted or unexpected feelings, such as sadness, anger, guilt, or anxiety. It is important to remember that these feelings are normal and are an important part of the therapy process, which often entails becoming familiar with your emotional life in order to cope adaptively with life circumstances. Other risks of therapy might include recalling unpleasant life events, facing unpleasant thoughts and beliefs, and changes in beliefs concerning interpersonal relationships.
In therapy, major life decisions are sometimes made, including separations within families, changing employment settings, and changing lifestyles. These decisions are often the legitimate outcome of the therapy experience as a result of the person examining beliefs, values, and feelings and developing greater self-awareness. As your therapist, I will be available to discuss any of your assumptions, problems, or possible side effects of our work together.
Clinical Services
Our first several appointments offer a period of time in which to discuss your concerns from your point of view. The focus is primarily on gathering historical information and other background data, in order to get to know you and tailor our work to your specific needs. If it is necessary for insurance purposes, a diagnosis can be reached during this time and can be discussed with you if you desire. We will also discuss various treatment recommendations and goals. Certainly, evaluation is a process that occurs over the course of our work together and after the initial sessions, we will discuss progress periodically and modify therapy goals and interventions accordingly. In the case of crises, the initial sessions must be used to bring relief to the immediate crisis.
I prefer to meet with clients on a weekly basis. This allows for the process of therapy to progress and prevents the “catch-up” needed when sessions are held less frequently. When a person is really struggling with a specific issue or feeling increasingly depressed or upset, meetings more than once per week are often recommended. I am certainly willing to adjust the frequency of sessions to what makes sense in each individual circumstance and we will discuss this as needed.
Written Communication
Confidentiality will be respected in all cases, except those noted below. If a client requests that I disclose information to another person or professional, I must have your written permission to do so. We will also discuss the possible risks and benefits of a requested release of information to a third party. In such cases, I have release of information forms that can be signed by a client requesting that information be disclosed.
I do consult with and seek supervision from other professionals as a way to ensure the highest quality service possible. Unless you have signed a release of information form allowing me to do so, or except in cases of emergency involving imminent danger to yourself or others, I will not share any identifying information about you or your situation.
Termination
Termination may occur at any time and may be initiated by either the client or the therapist. I request that if a decision to end treatment is reached that you would give a minimum of two weeks notice so that we would have adequate time to discuss and explore the reasons for termination. Termination itself can be a very constructive and useful part of the therapy process. It can be a time when treatment gains can be meaningfully consolidated and integrated into one’s daily life. If any referral or plan for further treatment is warranted, these will be made during the termination process.
Payment
Some people prefer not to use their insurance for therapy for a variety of reasons. If you prefer to use your insurance, I am an Out of Network provider with insurance companies which means that I do not bill insurance companies directly. Your counseling services may be eligible for reimbursement through out-of-network benefits, medical spending or health care savings accounts. I am happy to provide the necessary documentation needed (known as a superbill) for reimbursement. Health insurance plans and out-of-network benefits vary. Tesfa-House, however, does not bear responsibility for the success or otherwise of such insurance claims. To ensure efficiency of services, please contact your health insurance directly for concrete information regarding your out-of-network benefits. Please be aware that some insurance options do not cover telephone or video sessions. Contact your insurance for more information if you are interested in these forms of counseling.
I prefer to not work with insurance companies because I strive to provide the most effective and comprehensive client care possible. I have found that the session limits, confidentiality issues, and pathology “labels” associated with taking insurance can pose more of a hindrance to good client care than it does a benefit. While session frequency and the number of sessions should be a collaborative decision between the client and the therapist, insurance companies frequently impose a session limit or require a specific treatment. This can undercut the effectiveness of the overall therapy process as well as remove the freedom of choice and control a client has over his or her mental health care.
In addition, insurance companies require a diagnosis code, and many times, a treatment plan for each client. This can result in what feels like an invasion of privacy as well as a feeling of being “labeled” or “pathologized.” Because my goal is to work in a holistic and non-stigmatizing manner, the requirements of insurance can pose a conflict of interest.
Fees
Phone or video sessions are possible, when necessary, and the fee for such sessions is the same as office appointments. Any phone call over 15 minutes in length is considered to be a phone session and a full fee charge will apply. These fees are based on the usual and customary charge of other clinicians in this area. The fee also includes time spent on your behalf, including record-keeping and preparation for sessions. I encourage you to discuss fees and any problems with payment at any time. I request that payment be made on a weekly basis as you attend each session unless other arrangements are needed and agreed upon. It is preferable that you make the payment out in advance so that the entire session can be spent attending to your concerns. Fees are subject to change with a four-week notice, and on some occasions, sliding scale is possible. Please refer to the Counseling Fees section for current fee charges.
Cancellation Policy
Sessions canceled without 48 hours advance notice or missed without notification will be billed at the agreed upon session fee.
Patient Privacy
Confidentiality
At any time, my clients may question and/or refuse therapeutic or diagnostic procedures or methods, or gain whatever information they wish to know about the process or course of therapy. Clients are assured confidentiality, which is protected by ethical practice and Pennsylvania law. There are several important exceptions to confidentiality that are legally mandated. In general terms, these exceptions include: 1) I must notify relevant others if I believe the client has an intention to harm another person, 2) I must report child abuse, neglect, or molestation as required by law, 3) in legal proceedings, I and/or my records may be subpoenaed by the court; and 4) I may need to notify relevant others if I believe that a client is at risk of harming him/herself.
Minors
If you are under eighteen years of age, please be aware that the law may provide your parents or legal guardians the right to examine your treatment records. I will initially request an agreement from parents or legal guardians 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 these instances, I will notify them of my concerns. However, before sharing any information, I will attempt to discuss this with you first, and if possible, do my best to handle any objections you may have with what I am prepared to discuss.
Request for Psychotherapy notes
The client may request to see a copy of their psychotherapy notes held by Tesfa-House. Notes will be shared unless a provider determines that it would be emotionally damaging to the client. In this case, the clinician may provide a summary of the information that can be discussed at the client’s request. The client also may request a correction to any information that they believe is incorrect.
Complaints
If the client feels that their rights to privacy may have been violated by Tesfa-House, they may contact the practice to seek remedy. Clients may also file a complaint with the Pennsylvania Department of Health and Human Services, in which case the practice will respect due process and not retaliate against the client.