Policies and Procedures

BUCKS COUNTY ANXIETY CENTER STATEMENT OF POLICIES

Please read through each policy.

Sign at the bottom of each policy to indicate you’ve read it and understand it.

If the patient is over the age of 18, only the patient needs to sign. If the patient is over the age of 18 but the parents are paying for services, or involved in any way, parent and patient need to sign.

1) Your therapist and their responsibilities

Your therapist is responsible for all aspects of your case and care.

Please speak directly with your therapist about any of your needs or concerns.

2) Pros and cons of psychotherapy services

Working with a psychotherapist can result in several benefits. The symptoms and issues that brought you to therapy can decrease. You can feel emotionally and physically better. Your thoughts, feelings, and choices can be healthier.

Psychotherapy requires active participation, honesty, and openness. During psychotherapy or consults, remembering or talking about unpleasant events, feelings or thoughts can result in uncomfortable feelings such as anger, sadness, worry, fear, etc. Your therapist may challenge your thoughts, behaviors, assumptions, and responses. As a result, you may feel angry, scared, sad, or disappointed.

Attempting to resolve issues that brought you into therapy may result in changes in your life that you were not planning on originally. For example, you may experience changes in feelings, behaviors, employment, substance use or abuse, schooling, housing, or relationships. Sometimes, a decision that is positive for one family member is viewed negatively by another family member. Change will sometimes be quick and easy, but it is usually slow and frustrating.

Sometimes, seeing an outpatient therapist once a week is not enough to really help you if you are experiencing a very high level of anxiety or depression. Your therapist will let you know as soon as possible if you need a higher level of care. They can help you get set up in a program or with another therapist.

If you are struggling with another mental health condition that is outside your therapist’s area of expertise, your therapist may refer you to another treatment program so that you can get a handle on that issue first. Examples include active eating disorders and addictions. Your therapist may also agree to treat you along with a therapist who specializes in treating your other mental health needs.

There is no guarantee that psychotherapy will lead to the result you want. There are many factors involved and your therapist will explain these as needed. If you have questions about the methods your therapist is using, ask your therapist and talk about it with them.

If your doubts continue, you can always get a second opinion. If you choose to see another therapist, every effort will be made to help transfer your case.

Your therapist will stop treatment and refer you to another practice if you do not comply with these policies or are disrespectful in any way. This applies to your family members as well. Your therapist reserves the right to refer you to another therapy practice if they feel they are not a good fit for you or your family.

3) Fees and payments

• Regular sessions are 45-50 minutes long. Fees are for this time period. Variations from this time (e.g., two sessions in one week, shorter or longer sessions) will be billed accordingly.
• You will be informed of your fee before your first session. You will be informed at least two weeks in advance of any fee increases.
• Consulting meetings may run longer than 45 minutes. You will receive specific information about the length of your meetings and the fees charged for those services.
• Payment is due at the beginning of each session and is payable by debit or credit card.
• You will be issued a superbill which has your name, contact information, diagnosis, fee, and the amount you paid. This is what insurance companies need you to submit to use your out of network benefits.
• You cannot carry a balance.
• If you are in crisis, your therapist will work with you to come up with an immediate plan to keep you safe.
• Future sessions will not be scheduled unless all balances are paid in full.
• If your account has not been paid for more than 60 days, your therapist has the option of using legal means to secure payment. This may involve a collection agency or going through small claims court. This means your therapist will have to disclose your confidential information.

4) Additional Fees and Services

• Your psychotherapist charges for other professional services you may need. They will let you know what the fee will be before providing the service.
• You will be charged for between-session phone calls lasting longer than 15 minutes on a pro-rated basis according to your fee.

Other services for which you will be charged include:

• Sending notes to an insurance company, attorney, or other service provider.
• Phone, virtual, or in-person consults with family members.
• Phone, virtual, or in-person consults with schools or other education programs.
• Case management and speaking with other providers to coordinate your care.
• Writing reports or letters for legal, academic, and/or professional reasons.
• Appearing in court on your behalf.
• There are additional fees related to all court matters.

5) Meeting times and cancellation policy

• Your therapist has a strict cancellation policy. Unlike other doctors or providers, your therapist does not double book a slot. Once an appointment has been scheduled, that time is reserved for you. This means your therapist cannot offer it to anyone else.
• You must provide 24 hours’ notice or you will be charged the cost of your therapist’s full out-of-pocket session fee.
• Often, appointments can be rescheduled for the same week. This is not always possible. If you cannot reschedule within the same week, you will be charged.

If you cancel twice with 24 hours notice within a period of 3 sessions, you will lose your regular slot. Your therapist will offer you appointment times based on what they have available. You will also have to pre pay for all of your sessions moving forward.

Phone or virtual sessions in place of in-person sessions are always available.

6) Psychotherapist availability and emergencies

• You may leave a voicemail message 24/7. You may also e-mail at any time.
• Calls and e-mails regarding scheduling issues will be returned during normal business hours, Monday-Friday 9-5pm.
• Urgent calls will be returned as soon as possible, and always within 24 hours.

7) Confidentiality of e-mail, cell phone, texts, and faxes:

With your permission, your psychotherapist will communicate with you via cell phone and e-mail. These means of communication are not 100% secure. If this is a concern to you, please be as brief as possible when sending an e-mail or leaving a voice mail.

8) Emergencies:

IN AN EMERGENCY (I.E., YOU NEED TO SPEAK WITH SOMEONE RIGHT AWAY BECAUSE YOU ARE EXPERIENCING SEVERE EMOTIONAL DISTRESS) YOU MUST GO TO THE EMERGENCY ROOM OR CALL 911.

If you are in the ER for observation and/or are admitted to a facility or program, please sign consent with the hospital or facility so that they can contact your therapist as soon as possible.

NEVER USE E-MAIL TO COMMUNICATE WITH YOUR THERAPIST DURING AN EMERGENCY.

9) Confidentiality and limits on confidentiality

The law protects the privacy of all communication between a client and a psychotherapist. In most situations, your therapist can only release information if you sign a consent form.

Your signature on this Agreement provides consent for these activities:

• Obtaining the appropriate kind and level of help if you threaten to harm yourself. This can involve contacting 911, a family member (including the emergency contact listed on this form), and/or others who can help provide protection.
• Consulting with other mental health or medical professionals regarding your situation. During these consults, every precaution is taken to protect your identity. The other professionals are also legally required to keep the information confidential. If you do not object, your psychotherapist will not inform you of these consults unless they feel it is important to your work together.
• E-mailing you regarding new services.
• Disclosing required information to a collection agency to collect overdue fees.
• Disclosing Personal Health Information to managed care companies regarding a claim you submitted.
• Disclosing Personal Health Information to managed care companies for the purpose of payment.

10) Duty to report and/or warn

In situations in which your therapist believes it is necessary to attempt to protect others from harm, they may need to reveal information about you and your treatment.

Your therapist does not need your consent or authorization to release information about you in the following situations:

• If there is reason to suspect child or elder abuse and/or neglect, a psychologist/social worker/therapist/counselor is mandated to file a report with the police and/or the necessary protective agencies. Once a report is filed, the mental health provider may be required to provide additional information.

• If a client communicates a threat of physical violence against an identifiable third person (or the community) and the client has the apparent intent and ability to carry out that threat in the near future, the psychologist/social worker/therapist/counselor has to take protective actions. These actions include notifying the potential victim (or, if the victim is a minor, his/her parents and the county Department of Social Services), contacting the police, and/or seeking psychiatric hospitalization for the client.

11) Client Consent to Treatment

I have read this document outlining information about psychotherapy as well as my therapist’s policies regarding services, payment, insurance, meeting times, cancellations, availability, and privacy.

I understand them and agree to comply with all the policies and procedures described in this document.

I consent for my therapist to treat me and/or my child.