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Consumer Rights
and Office Policies

 

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Page Contents: Consumer Rights (What you should know before therapy starts; the Board of Psychology) / Office Policies (Confidentiality; Records; Professional training and experience; Length of services; Risk of services; Cost of treatment and payment procedures; Cancellation of a session; Telephone calls)

 

Consumer

Rights

As a voluntary psychotherapy client you are also a consumer, and you have consumer rights. This is a major point that many people do not understand. Your psychologist is paid to do a job, and to maintain a well-defined therapeutic neutrality, not to be a friend or confidant. I take my job very seriously and am very direct about it.

If you are thinking of beginning psychotherapy, you should first understand the process of choosing a psychologist. And, even as you are getting started, you should also understand how to encounter gracefully what all clients must ultimately face: the termination of psychotherapy.

As a consumer, you have the right to know the following:

The limits of psychology and whether you will be doing psychotherapy or counseling.

What kind of license your psychotherapist has; that is, whether he or she is really a psychologist or some other kind of psychotherapist (such as a social worker or MFT), or a counselor.

What kind of education your psychologist has. (In some states of the U.S. a person with a masters degree can be licensed as a psychologist, while other states require a doctoral degree.)

What kind of training and experience your psychologist has.

What sort of personal psychotherapy your psychologist has received. Was it just superficial cognitive-behavioral work to tick off the required number of sessions? Or was it serious psychodynamic psychotherapy or psychoanalysis?

The nature of therapeutic confidentiality and any exceptions.

Whether your psychologist is being supervised by anyone. (All psychologists in training must be under the clinical supervision of an experienced and licensed psychologist, and they must identify themselves as unlicensed interns or as licensed psychological assistants. Everything you tell an intern or psychological assistant under supervision will be repeated to the supervisor, and, if the supervision is conducted in a group setting, every other intern in the group will also hear all the intimate details of your life.)

What kind of treatment you will be receiving, the reasons why it will be used, and any other types of treatment that could be used instead.

How much your treatment will cost.

How much time your treatment might be expected to take.

What risks are involved in treatment.

What kinds of records will be kept, and who has access to them.

Whenever sessions are to be audiotaped or videotaped.

 
Feel free to ask any other questions that may occur to you. Remember that as a consumer you can ask any questions pertaining to treatment. If you were seeking someone for marital counseling, for example, it could be valuable to know that a potential “therapist” has been divorced five times. You might think twice about choosing her to help your marriage, right? In general, if questions are too personal, the psychologist should say so and politely refuse to answer. That’s the psychologist’s right. But if he or she gets defensive or evasive, watch out!

If you have any concerns about the above points, and if you cannot get a satisfactory answer from your psychologist, contact your state Board of Psychology for advice. (The Association of State and Provincial Psychology Boards provides a roster of all Boards of Psychology in the US and Canada.)

In CA, The Department of Consumer Affairs receives questions and complaints regarding the practice of psychology. If you have any questions or complaints, you may contact this department by calling (800) 633-2322 or (916) 263-2699 or by writing to the following address:
  
Board of Psychology
1422 Howe Avenue, Suite 22
Sacramento, CA 95825
 
Through the Internet: The California Board of Psychology

Before making a consumer complaint, however, you should realize that psychotherapy can, at times, provoke feelings of anger or frustration—or affection. Technically, these feelings are called a transference reaction. When this happens, you should be using psychotherapy itself to talk about such feelings. Also, your psychologist should be aware of your feelings and should be helping you verbalize them. A consumer complaint against your psychologist is warranted only if you cannot work out the problem within therapy—or if your psychologist does something blatantly illegal or fraudulent.

 


 

Office

Policies

Below is a nearly exact copy of the office policies (Treatment Consent Form) which I use in my practice. Review the various points to get a sense of how a psychological practice is conducted, and what a new client can expect of me.

Be advised, though, that not every practice employs exactly the same policies, and that my policies conform to California law.

If any mental health provider does not give you a written office policy statement, you have a right to ask that all policies be made clear to you before starting treatment.

 


 
Office Policy Form

Limits of Confidentiality: All information that you disclose to me within our sessions is confidential and will not be revealed to anyone without your written permission (or your parents’ permission if you are under 18 years old). Disclosure, however, may be authorized or required by law

where there is a reasonable suspicion of child abuse or elder adult physical abuse;

where there is a reasonable suspicion that you may present a danger of violence to others;

where there is a reasonable suspicion that you are likely to harm yourself unless protective measures are taken.

Disclosure may also be required pursuant to a legal proceeding.

Records: Your clinical file will consist of (a) legal forms such as this document, (b) a record of visits and payments, and (c) clinical progress notes. These progress notes will contain enough information about your treatment to justify it, should such justification ever become an issue.

Training and Experience: I have a Ph.D. in Clinical Psychology and have a valid license to practice as a Psychologist in the state of California (License # PSY 13274). Previous to my doctorate, I earned an M.A. in Religious Studies and an M.S.E. in Education in the field of counseling. During the course of my education I received training in Lacanian psychoanalysis, psychodynamic psychotherapy, and hypnosis. I completed a Post-doctoral Fellowship in Health Psychology at the Department of Veterans Affairs Medical Center, San Francisco. My experience encompasses crisis intervention, child & sexual abuse treatment, trauma & PTSD evaluation and treatment, and treatment of psychotic, mood, and anxiety disorders. I have extensively studied the field of aviation psychology and hold an FAA private pilot certificate. I am a current member of the Aerospace Medical Association and the International Society for Traumatic Stress Studies.

Probable Length of Services: Although many clients elect to pursue long-term, open-ended treatment, some issues can be resolved in about 25 to 30 sessions, some highly focused issues such as phobias can be resolved in about 12 sessions, and some hypnosis work may take only 1 or 2 sessions. The success of psychological treatment, however, depends on the motivation and aptitude of the person being treated. For this reason, I can make no guarantees about treatment length or success.

Risk of Services: You should be aware that, although I anticipate otherwise, despite treatment you may not improve at all, you may not improve as quickly as you might like, or you may start to improve only after treatment has ended. You should also be aware that treatment is intended to induce change in your life, and that when this change occurs it may disrupt your accustomed manner of living and your relationships with others. Treatment can also provoke feelings of affection or anger for the psychotherapist that must be discussed in the treatment. In short, treatment may be emotionally painful at times. Such is the nature of growth.

Your Rights: In a private practice such as this, treatment is entirely voluntary, and you have the right to terminate treatment at any time. If for any reason your treatment has been ordered by a third party, you will be fully informed of this.

In all cases, professional treatment never includes sexual contact with the treatment provider.

Payment for Service: My fee is $150 per 50-minute session. You will be expected to pay for services at the time they are rendered, unless other arrangements have been made. Payment can be in cash, by check, or with a credit card (Visa, MasterCard, Discover, or American Express).

Often, someone will say, “That’s too much. I can’t afford psychotherapy.”
 
But what this statement really means is this: I can’t afford psychotherapy on top of all my other expenses.
 
And when I look at all those “other expenses,” I often find a massive amount of frivolity. Cable TV. Movies. Personal cell phones. CDs. DVDs. Ball games and golf. Extravagant dining. Weekend vacations. Drinking and partying. Cigarettes. Manicurists, massage therapy and hair coloring—and on and on. And, apparently, to some people all these things have more importance than mental health. Come to think of it, maybe that’s why they lack mental health in the first place.

If you pay by a check that is ever returned for insufficient funds, I will expect you to make good on the check and to pay me for any service charges levied by my bank.

In general, large balances should not accrue, and we will work to prevent this from happening. As a last resort, I reserve the right to use a collection agency if you do not pay a large balance.

Managed Care: I do not accept managed care.

Insurance Reimbursement: If you carry insurance, please understand that my professional services are rendered and charged to you, not to the insurance company. If you request, I will provide you with a monthly statement which you can submit to your insurance company for reimbursement. This statement will include your diagnosis, the procedure code, the number of sessions, and the amount you have paid me. It will be your responsibility to contact your insurance company to determine if they will reimburse you under these terms, and, if so, what percentage of the fee they will cover.

Be advised, however, that your use of insurance severely jeopardizes the confidentiality of your treatment.

Cancellation: The scheduling of an appointment involves the reservation of time specifically for you, and I will wait the entire 50 minutes for you to arrive. If you are late, we will meet for whatever amount of your time remains. You will, of course, be required to pay for the full session. A minimum of 24 hours notice is required for rescheduling or cancellation of an appointment. A fee—equal to your regular session fee—will be charged for missed sessions without such notification.

Because insurance companies cannot be billed for missed sessions, please understand that if you are using insurance coverage you will always be personally responsible for paying the charges for late cancellations and missed sessions.

Telephone calls: You are welcome to leave messages at any time. If you need to speak with me, I will be happy to call you back and speak for a few minutes. Remember that, in general, telephone calls are not meant to take the place of an office visit; if you require extended time on the phone I may have to start billing you for my time. In special circumstances, I am agreeable to providing treatment over the phone at the same hourly rate as we have agreed upon for your office visits.

If you do request that I call you back, I will try to respond promptly, sometimes within a matter of minutes, although it may take several hours before I can return your call. If you call in the evening, on a weekend, or over a holiday, I may be unable to call back until the next business day. In case of an emergency, leave a message for me and then immediately contact your local crisis services.

E-mail: I discourage the use of e-mail with established clients because of the risk it poses to confidentiality.

 


 
Additional Resources
 
APA Ethical Principles of Psychologists
Association of State and Provincial Psychology Boards  —Roster for US and Canada.
The California Board of Psychology
Canadian Code of Ethics for Psychologists
   
Related pages within A Guide to Psychology and its Practice:
Choosing a Psychologist
Confidentiality
Legal Issues
The Limits of Psychology
Managed Care and Insurance Issues
Psychology: Clinical or Counseling or ...?
Questions and Answers about Psychotherapy
Reasons to Visit a Psychologist
Termination of Psychotherapy
Types of Psychological Treatment
   
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A Guide to Psychology and its Practice
www.GuideToPsychology.com
 
Copyright © 1997-2008 Raymond Lloyd Richmond, Ph.D. All rights reserved.
San Francisco, California USA

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