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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. You pay your psychologist 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, it will be important to understand the process of choosing a psychologist. Furthermore, even as you are getting started, it will be important to 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 audio recorded or video recorded.

 
Feel free to ask any other questions that may occur to you. Remember that as a consumer you can ask any questions pertaining to your 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 916-574-7720 or toll free 866-503-3221 or by writing to the following address:
  
Board of Psychology
1625 North Market Blvd, Suite N-215
Sacramento, CA 95834
 
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 suggestion of an office policy (Treatment Consent) form. Review the various points to get a sense of how a psychological practice is conducted, and what a new client might expect of a psychological treatment provider.

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

If any mental health provider does not give you a written office policy statement (if the treatment will be conducted in person) or a website statement (if the treatment will be conducted remotely), 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 within your 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 may consist of a record of sessions and payments, clinician notes, testing reports, written communications, and any other documents related to treatment. 

Education, Training and Experience: The clinician should disclose his or her education, license, professional training, and any specialized clinical experience.

Length and Success of Services: The success of psychological treatment depends on the motivation and aptitude of the person being treated, and so guarantees about treatment success cannot be made. You have the right to decide when to terminate the treatment.

Risk of Services: You should be aware that 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 for the clinician or anger at the clinician, and these experiences should be considered normal aspects of the treatment to be discussed openly within the treatment.

Your Rights: You may ask about information that the clinician has about you from outside sources, such as other service providers. You have the right to terminate treatment at any time.

  

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

  

Payment for Service: The clinician’s fees should be specified before starting treatment. You may be expected to pay for services at the time they are rendered, unless other arrangements have been made.

If you pay by a check that is ever returned for insufficient funds, you may have to pay for any service charges levied by the clinician’s bank.

In general, large balances should not accrue, and this should be prevented from happening. As a last resort, the clinician has a right to use a collection agency if you do not pay a large balance.

Insurance Reimbursement: If you use insurance to pay for your treatment, your use of insurance will breach the confidentiality of your treatment because any employee of the insurance company can demand the details of your treatment. Furthermore, insurance companies require a psychiatric diagnosis (which becomes an indelible part of your world-wide medical record).

Cancellation: The scheduling of an appointment involves the reservation of time specifically for you, and if you are late, you will meet for whatever amount of your time remains, and you will 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 and late cancellations.

  

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.

  

You may leave messages on the clinician’s voice-mail at any time. If, in an extraordinary circumstance, you leave a message requesting that you be called back, it might take several hours before your call can be returned. If you call in the evening, on a weekend, or over a holiday, the clinician may be unable to call you back until the next business day. In case of an emergency, leave a message for and then immediately contact your local crisis services.

Remember that, in general, spontaneous telephone calls are not meant to be a form of free counseling. If you make repeated requests for telephone support, or if you require extended time on the phone, you may be billed at the same hourly rate as your regular sessions.

Text messages: Because of the danger of privacy breaches, the use of text messages should be short, information specific, and not refer to any psychological details.

E-mail: If you choose to contact your clinician through e-mail, keep in mind that e-mail is not secure and that someone, somewhere, could be reading anything you write by e-mail. Realize also that, if you are using a computer at your work site, your network administrator has the capability to read every piece of e-mail you send and receive through your company’s computer.

 


 

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Additional Resources
       
Ethics:
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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