INFORMED CONSENT FOR PSYCHOTHERAPY
Risks and Benefits of Treatment: Psychotherapy and/or counseling involves a process in which you and I (and in group settings the other group members) will address a myriad of issues, events, experiences and memories for the purpose of you creating positive change in your life, self and relationships. The joint effort between us provides an opportunity to explore and understand yourself and any difficulties you are experiencing, more deeply. Success may vary depending on the issues being addressed and other factors such as motivation, frequency of sessions, etc.
Although there are no guarantees of results, many participants in therapy experience a number of benefits including, but not limited to: reduced stress, depression and anxiety; a decrease in self-sabotaging behaviors, improved interpersonal relationships, increased comfort in social, work and family settings, and greater capacity for intimacy and self-confidence. These benefits will require a substantial effort on your part to be active in the therapeutic process, be honest and willing to change feelings, thoughts, attitudes and behaviors.
There may be times when I will challenge your perceptions and assumptions and offer different perspectives. Participation in therapy may also involve some discomfort, including remembering and discussing unpleasant events, feelings and experiences. This process may evoke strong feelings of sadness, anger, fear, etc. There may be times when you may feel worse, rather than better and that your growth may feel slow or frustrating. Also, as you change, you may experience changes in your personal relationships. All of this is common, and I ask you to address any concerns you have with me when you experience them so that you can achieve your goals effectively and in the shortest time possible.
Confidentiality & Its Limits: What you share in therapy is confidential; however, this confidentiality is not without limits. For example: If you are a threat to yourself or others (showing suicidal or homicidal intent), your facilitator(s) may need to report your statements and/or behaviors to family, your therapist, or other appropriate mental health or law enforcement professionals in order to keep you and others safe. There is a broad range of events that are reportable under child protection statutes.
Physical or sexual abuse of a child will be reported to Child Protective Services. When the victim of child abuse is over age 18, reporting is not mandatory unless there are minors still living with the abuser, who may be in danger. Elder abuse is also required to be reported to the appropriate authorities. If a court of law orders a subpoena of case records or testimony, your facilitator(s) will first assert “privilege” (which is your right to deny the release of your records although this is not available in all states for group discussions). Your facilitator(s) will release records if a court denies the assertion of privilege and orders the release of records. Records may also be released with your written permission. Records will include only your personal progress.
Facilitators may consult with other professionals regarding a client’s therapy sessions and interactions. This allows a freedom to gain other perspectives and ideas concerning how best to help you reach your goals. No identifying information is shared in such consultations unless a release has been obtained from you. If your account with the psychotherapist becomes overdue and you do not work out a payment plan, the psychotherapist will have to reveal a limited amount of information about your treatment in taking legal measures to be paid.
Health Insurance Portability And Accountability Act (HIPAA) I am required by law to protect the privacy of your health information. Although your counseling record is my physical property, the information contained in your health record belongs to you. You have the right to:
- Request a restriction on certain uses and disclosures of your information
- Inspect and obtain a copy of your health record
- Amend your health record as provided by regulation
- Obtain an accounting of disclosures of your health information as provided by law
- Request communications of your health care information by alternative
- means or locations
- Revoke your authorization to use or disclose health information except to the extent that action has already been taken
No Secrets Policy for Participants in Couple, Family and/or Group Psychotherapy: When providing couple/marital/family or group therapy, I usually employ what is termed a “No Secrets Policy.” This means that information and actions in one modality can be used at my discretion in another modality in order to enhance your experience and augment your goals. For instance, I might bring up something that you said in group for further exploration in your individual session. Please ask me how this might apply to you if you are or will be in more than one modality.
Termination of Treatment: The ultimate aim of psychotherapy is termination of treatment. Usually termination is the natural conclusion to meeting your goals. Of course, either you or I have the right to terminate treatment at any time for other reasons. The most satisfying termination occurs when you and I review and assess the work you have done and the changes you have made. It is also useful for you to look at what personal growth you would like to achieve beyond the psychotherapeutic process. This review usually takes three sessions. For group psychotherapy participants, there are specific procedures that are employed that are unique to each group.