THE THERAPY PROCESS
Therapy is not easily described in general statements. It varies depending on the personalities of the psychologist and patient, and the problems you hope to address. There are many different methods I may use to deal with those problems. Therapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. For the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home.
Psychotherapy can have benefits and risks. Because 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 benefits for people who go through it. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees as to what you will experience.
Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what our work will include and a treatment plan to follow if you decide to continue with therapy. You should evaluate this information along with your own opinions about whether you feel comfortable working with me. At the end of the evaluation, I will notify you if I believe that I am not the right therapist for you and, if so, I will give you referrals to other practitioners whom I believe are better suited to help you.
Therapy involves a large commitment of time, money, and energy, so you should be very careful about the therapist you select. If you have questions about my procedures, we should discuss them whenever they arise. If your doubts persist, I will be happy to help you set up a meeting with another mental health professional for a second opinion.
TELEHEALTH SERVICES
Tele-psychology refers to providing psychotherapy services remotely using telecommunications technologies, such as video conferencing or telephone. One of the benefits of tele-psychology is that the client and clinician can engage in services without being in the same physical location. This can be helpful in ensuring continuity of care if the client or clinician moves to a different location, takes an extended vacation, or is otherwise unable to continue to meet in person. It is also more convenient and takes less time. Tele-psychology, however, requires technical competence on both our parts to be helpful. Although there are benefits of tele-psychology, there are some differences between in-person psychotherapy and tele-psychology, as well as some risks. For example:
Risks to confidentiality. Because tele-psychology sessions take place outside of the therapist’s private office, there is potential for other people to overhear sessions if you are not in a private place during the session. On my end I will take reasonable steps to ensure your privacy. But it is important for you to make sure you find a private place for our session where you will not be interrupted. It is also important for you to protect the privacy of our session on your cell phone or other device. You should participate in therapy only while in a room or area where other people are not present and cannot overhear the conversation.
Issues related to technology. There are many ways that technology issues might impact tele-psychology. For example, technology may stop working during a session, other people might be able to get access to our private conversation, or stored data could be accessed by unauthorized people or companies. To use tele-health, you need an internet connection and a device with a camera for video. I can explain how to log in and use any features on the tele-health platform. Make sure to let me know if you are not in your usual location before starting any tele-health session.
Crisis management and intervention. Usually, I will not engage in tele-psychology with clients who are currently in a crisis, who require higher levels of support and intervention. Before engaging in tele-psychology, we will develop an emergency response plan to address potential crisis situations that may arise during our tele-psychology work.
Efficacy. Most research shows that tele-psychology is about as effective as in-person psychotherapy.
EMERGENCIES
Assessing and evaluating threats and other emergencies can be more difficult when conducting tele-psychology than in traditional in-person therapy. To address some of these difficulties, we will create an emergency plan regarding tele-psychology services. I will ask you to identify an emergency contact person who is near your location and who I will contact in the event of a crisis or emergency to assist in addressing the situation.
If the session is interrupted for any reason, such as the technological connection fails, and you are having an emergency, do not call me back; instead, call 911 or go to your nearest emergency room. Call me back after you have called or obtained emergency services. If the session is interrupted and you are not having an emergency, disconnect from the session and I will wait two (2) minutes and send you an invitation with a new meeting link. If you do not receive a call back within two (2) minutes, then call me on the phone number I provided you 914-475-7256.
CONFIDENTIALITY
I have a legal and ethical responsibility to make my best efforts to protect all communications that are a part of our tele-psychology. However, the nature of electronic communications technologies is such that I cannot guarantee that our communications will be kept confidential or that other people may not gain access to our communications. I will try to use updated encryption methods, firewalls, and back-up systems to help keep your information private, but there is a risk that our electronic communications may be compromised, unsecured, or accessed by others. You should also take reasonable steps to ensure the security of our communications (for example, only using secure networks for telepsychology sessions and having passwords to protect the device you use for tele-psychology).
I will not disclose your personal information without your permission unless required by law. If I must disclose your personal information without your permission, I will only disclose the minimum necessary to satisfy the obligation. However, there are a few exceptions.
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I may speak to other healthcare providers involved in your care.
• I may speak to emergency personnel. - If you report that another healthcare provider is engaging in inappropriate behavior, I may be required to report this information to the appropriate licensing board. I will discuss making this report with you first and will only share the minimum information needed while making a report. If I must share your personal information without getting your permission first, they will only share the minimum information needed.
There are a few times that I may not keep your personal information confidential.
- If I believe there is a specific, credible threat of harm to someone else, I may be required by law or may make my own decision about whether to warn the other person and notify law enforcement. The term specific, credible threat is defined by state law. I can explain more if you have questions.
• If I have reason to believe a minor or elderly individual is a victim of abuse or neglect, I am required by law to contact the appropriate authorities.
• If I believe that you are at imminent risk of harming yourself, I may contact law enforcement or other crisis services. However, before contacting emergency or crisis services, I will work with you to discuss other options to keep you safe.
Please let me know if you have any questions about exceptions to confidentiality.
RECORD KEEPING
I am required to keep records about your treatment. These records help ensure the quality and continuity of your care, as well as provide evidence that the services you receive meet the appropriate standards of care. Your records are maintained in an electronic health record provided by TherapyNotes. TherapyNotes has several safety features to protect your personal information, including advanced encryption techniques to make your personal information difficult to decode, firewalls to prevent unauthorized access, and a team of professionals monitoring the system for suspicious activity. TherapyNotes keeps records of all logins and actions within the system. The tele-psychology sessions shall not be recorded in any way unless agreed to in writing by mutual consent.
COMMUNICATION
For communication between sessions, I only use email communication and text messaging with your permission and only for administrative purposes unless we have made another agreement. This means that email exchanges and text messages with my office should be limited to administrative matters. This includes things like setting and changing appointments, billing matters, and other related issues. You should
be aware that I cannot guarantee the confidentiality of any information communicated by email or text. Therefore, I will not discuss any clinical information by email or text and prefer that you do not either. Also, I do not regularly check my email or texts, nor do I respond immediately, so these methods should not be used if there is an emergency.
Treatment is most effective when clinical discussions occur at your regularly scheduled sessions. But if an urgent issue arises, you should feel free to attempt to reach me by phone. I will try to return your call within 24 hours except on weekends and holidays. If you are unable to reach me and feel that you cannot wait for me to return your call, contact your family physician or the nearest emergency room and ask for the psychologist or psychiatrist on call. If I will be unavailable for an extended time, I will provide you with the name of a colleague to contact in my absence if necessary.
FEES AND PAYMENT FOR SERVICES
My hourly fee is $135.00 (without insurance). If we meet more than the usual time, I will charge accordingly. In addition to weekly appointments, I charge this same hourly rate for other professional services you may need, though I will prorate the hourly cost if I work for periods of less than one hour. Other professional services include report writing, telephone conversations lasting longer than 10 minutes, attendance at meetings with other professionals you have authorized, preparation of treatment summaries, and the time spent performing any other service you may request of me. MISSED/CANCELLED appointments: The cancellation fee for the 1st missed or cancelled appointment, without a 24 hour notice (including sickness) is $75. The cancellation fee for the 2nd missed appointment is $95. The cancellation fee for the 3rd missed appointment is $135. Also, if you miss 3 sessions in a few month period, we will need to re-evaluate the scheduling of any further sessions. I accept the following payment methods: Venmo, Paypal, and Zelle.
INSURANCE REIMBURSEMENT
Before starting therapy, if you plan on using insurance (and a participating provider on the panel), you should confirm with your insurance company if your benefits cover tele-health sessions and if you may be responsible for any portion of the payment, like co-pay. You need to also find out if you’ve covered your deductible for the year. Insurance will NOT pay for your sessions (you will be responsible) until you’ve covered your deductible. Also, keep in mind deductibles typically start over every years. I will fill out forms and provide you with whatever assistance I can in helping you receive the benefits to which you are entitled; however, you (not your insurance company) are responsible for full payment of my fees. It is very important that you find out exactly what mental health services your insurance policy covers. You should carefully read the section in your insurance coverage booklet that describes mental health services. If you have questions about the coverage, call your plan administrator.
Due to the rising costs of health care, insurance benefits have increasingly become more complex. It is sometimes difficult to determine exactly how much mental health coverage is available. “Managed Health Care” plans often require authorization before they provide reimbursement for mental health services. These plans are often limited to short-term treatment approaches designed to work out specific problems that interfere with a person’s usual level of functioning. It may be necessary to seek approval for more therapy after a certain number of sessions. Though a lot can be accomplished in short-term therapy, some patients feel that they need more services after insurance benefits end. [Some managed-care plans will not allow me to provide services to you once your benefits end. If this is the case, I will try to assist you in finding another provider who will help you continue your psychotherapy.]
You should also be aware that most insurance companies require that I provide them with your clinical diagnosis. Sometimes I must provide additional clinical information, such as treatment plans, progress notes or summaries, or copies of the entire record (in very rare cases). This information will become part of the insurance company files. Though all insurance companies claim to keep such information confidential, unless they must share to act on your behalf, comply with federal or state law, or complete administrative work, 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. Please understand that by using your insurance, you authorize me to release such information to your insurance company. I will try to keep that information limited to the minimum necessary.
Once we have all the information about your insurance coverage (if I’m a participating provider), we will discuss what we can expect to accomplish with the benefits that are available and what will happen if they run out before you feel ready to end our sessions. It is important to remember that you always have the right to pay for my services yourself to avoid the problems described above [unless prohibited by the insurance contract.