Privacy Policy

A copy of HIPAA privacy laws and the following policies is available upon request.

Subject to Late Cancellation/No Show fee

Before session leave credit card on file

 

What to Expect from Therapy: Our therapists work from a variety of therapeutic modalities to assist you and your family in addressing life’s problems.  Goals for therapy are always established through collaboration with the client(s).  They assist couples and families in organizing their relationships so that resources can be brought to bear on the problems being presented.  Techniques that are often employed are psycho-education, modeling and role playing more positive and effective communication skills, along with between session assignments and goals created by the client(s) and their therapist.  The completion of homework and client efforts to reach their goals set between sessions is necessary to get the most from the therapeutic experience. 

 

What We Expect from Clients:  Clients must make their own decisions regarding such things as educational changes, changes in marital status such as separation, divorce, reconciliation, parenting and co-parenting, custody and visitation.  Our therapists are here to help you think through the possibilities and consequences of decisions, but the therapist is not going to make a specific decision for you.

 

Privileged Communication:  Licensed therapists make every effort to comply with HIPAA privacy laws and are required to abide by the professional practice standards for a licensee in the State of Texas and Texas

 

State laws such as:  

  • Licensed therapists do not disclose client confidences and information to any third party, except for materials shared during supervision, without a client’s written consent or waiver except when mandated or permitted by law.  Verbal authorization will not be sufficient except in emergency situations.  

  • Licensed therapists report to the proper authorities suspected cases of child abuse/neglect, elder abuse/neglect, or disabled adult abuse/neglect and instances of danger to self or others when reasonably necessary to protect the client or other parties from a clear and imminent threat of serious physical harm. 

  • Certain types of litigation (such as child custody suits) may lead to court-ordered release of information without your consent.

  • If a complaint is made against the therapist license, that therapist may use case information to defend this complaint.  

  • When working with couples, families, and/or groups, Licensed therapists cannot disclose any information outside of the treatment context without a written authorization from all individuals competent to sign such authorization.  For example, your therapist will not release any information about either or both spouses that have been seen for marital therapy to an attorney without signed authorizations from both spouses.

 

After-Hours Emergencies:  You may contact your therapist directly via email or phone. Please talk with your therapist directly about contacting them outside of your scheduled sessions.  You may also leave a confidential voicemail for your therapist at (832) 598-6373 that will be forwarded to them.  In an emergency when an immediate response is necessary, please call 911 or go to your nearest emergency room.   

 

Records and Court: Records can be obtained from All Things Therapy (appropriate fees apply).  Client files and records will be maintained in accordance with current State and Federal laws and will consider the end date of a treatment episode as the basis for file destruction.  Licensed therapists do not provide Custody Evaluations or Expert Witness court testimony.  If we are asked to produce a copy of client records, there is a minimum charge of $50.00 for up to 50 pages and a cost of $1.00 per page thereafter.  Copy fees are due prior to release of the record.  If a Licensed Therapist is subpoenaed to testify in court, the minimum charge is $750.00, due prior to the court date, for any time up to three hours (this includes preparation time, travel, and testifying), additional time is charged at $250.00 per hour.

 

Potential Risks and Benefits of Therapy 
 

  • Making changes through the therapy process may produce other unforeseen changes in a person's life.

 

  • A risk in the therapy process could be feeling worse before feeling better. 

 

  • Changes in relationship patterns that may result from therapy may produce unpredicted and/or possibly adverse responses from other people in the client’s social system. 

 

  • A result of therapy may be a realization on the part of the client that there are issues that may not have surfaced prior to the onset of the therapeutic relationship. 

 

  • Couple or family conflicts may initially intensify as feelings are expressed. Individuals in couple or family therapy may find that partners or family members are not willing to change. 



 

Financial Responsibility: Private Pay (*subject to Late Cancellation/No Show fee):

Please read following statements carefully 

 

  • I understand that my rate for therapeutic services offered by the Licensed Therapists is: Virtual or phone call: $105.00/session (individual therapy), $115.00/session (couples); $125.00 (family therapy), that I am opting to pay for services with cash, credit, check, or flexible spending/health savings account. 

 

  • I understand I will not require my Licensed Therapist to verify my insurance benefits or file accordingly.  

 

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  • I understand I am financially responsible should I request any of the following additional fees from my therapist:

 

LETTERS: $35.00/letter (72 hrs. notice required/does not include school/work excuse)COPY OF RECORDS: $50.00 for the first 25 pages, $1.00/page thereafter

 

 

Appointment Reservations:  

 

  • I understand that, if applicable, I will be charged a fee of $20.00 (virtual); $30 ( in person) if I do not show up for my appointment or make a same day cancellation for my appointment or if I am more than 15 minutes late & my therapist has already left the office.

 

  • I understand that it is acceptable to leave a voicemail or send an email for a cancellation notice in order to avoid a no-show fee.  If I am running late, I can make a courtesy call to my therapist or leave a voicemail with the practice main phone number.  Acceptable phone numbers and email addresses are:

Private Practice E-Mail: Allthingstherapy21@gmail.com

Private Practice Office voicemail – Ph: (832-598-6373) 

 

  • I understand that if I reschedule, cancel, or no show my appointment 3 times in a row that I must pre-pay at the rate listed above prior to making any future appointments.  No refunds will be given if pre-pay appointments are cancelled or missed.  

 

  • I understand that all fees due are to be paid at the time services are rendered.  Advanced payments are to be used within 2 weeks of payment date. No refunds on services or advanced payments, including clients on a prepay plan.  

 

  • I understand that a $25.00 fee will be charged at or before the next session for returned checks or declined/invalid credit cards in addition to session fees due.  If fee is unable to be charged, an invoice will be mailed to the address listed on page 1 of this form. I also understand that I am responsible for any additional fees incurred by the practice for any disputed credit card charges.  Prior to disputing credit card charges from me, please discuss the charges with your therapist to avoid these fees.

 

  • I understand that my client file will be closed after a 30-day lapse in services.  When I return, I understand my fee will be at the current, standard rate or private pay discount rate. 

 

  • I understand that Licensed Therapists and Private Practice owners shall not be liable for any injuries or damages incurred by the undersigned for active or passive negligence caused by a clinician, the undersigned hereby indemnifies and holds harmless Licensed Therapists and Private Practice owners or its location affiliates from all claims, damages, injuries of whatever nature that may be caused by a clinician, the facility or facility staff of any program or location.

Telehealth Policy

 

Because of recent advances in communication technology, the field of tele-therapy has evolved. It has allowed individuals who may not have local access to a mental health professional to use electronic means to receive services. Because it is relatively new, there is not a lot of research indicating that it is an effective means of receiving therapy. An important part of therapy is sitting face to face with an individual, where non-verbal communication (body signals) are readily available to both therapist and client. Without this information, tele-therapy may be slower to progress or less effective. With the telephone, the client’s tone of voice, pauses and choice of words become especially important and therefore an important focus of the sessions. With therapy via email, the written word is the exclusive focus. What is important here is that you are aware that tele-therapy may or may not be as effective as in-person therapy and therefore we must pay close attention to your progress and periodically evaluate the effectiveness of this form of therapy. Because I may not have met you in person, I may request that you be interviewed by a professional in your area and allow me to talk to that individual before proceeding with therapy. With tele-therapy, there is the question of where is the therapy occurring –at the therapist’s office or the location of the client The law has not yet clarified this issue; therefore, it is my policy to inform clients that they are receiving services from my office and therefore are bound by the laws of the State of Texas. 

 

In addition, clients must reside within the State of Texas. These laws are primarily related to confidentiality as outlined in this form and my disclosure form. I understand that I have the following rights with respect to telehealth:

1) I have the right to withhold or withdraw consent at any time without affecting my right to future care or treatment nor risking the loss or withdrawal of any program benefits to which I would otherwise be entitled. 

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2) The laws that protect the confidentiality of my medical information also apply to telehealth. As such, I understand that the information disclosed by me during my therapy is generally confidential. However, there are both mandatory and permissive exceptions to confidentiality, including, but not limited to reporting child, elder, and dependent adult abuse; expressed threats of violence towards an ascertainable victim; and where I make my mental or emotional state an issue in a legal proceeding. I also understand that the dissemination of any personally

identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without my written consent. 

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3) I understand that there are risks and consequences from telehealth, including, but not limited to, the possibility, despite reasonable efforts on the part of my psychotherapist, that: the transmission of my medical information could be disrupted or distorted by technical failures; the transmission of my medical information could be interrupted by unauthorized persons; and/or the electronic storage of my medical information could be accessed by unauthorized persons. In addition, I understand that telehealth-based services and care may not be as complete as face-to-face services. I also understand that if my psychotherapist believes I would be better served by another form of psychotherapeutic services (e.g. face-to-face services) I will be referred to a psychotherapist who can provide such services in my area. Finally, I understand that there are potential risks and benefits associated with any form of psychotherapy, and that despite my efforts and the efforts of my psychotherapist, my condition may not be improve, and in some cases may even get worse. 

 

Please be advised that you may benefit from telehealth, but that results cannot be guaranteed or assured.