Policies and Procedures

Described here are our group-practice policies and procedures. This outlines key procedures and policies related to your rights and responsibilities as a client, ensuring that you have a clear understanding of your treatment experience. It covers your right to receive respectful and supportive care, the confidentiality of your treatment, and your ability to make informed decisions about your therapy. Additionally, it emphasizes your role in the counseling process, including providing accurate information and actively participating in your treatment. This also highlights important topics such as cancellation policies, emergencies, and the process of therapy termination, providing you with the tools to navigate your counseling journey effectively.

These procedures and policies are updated in January of each year. Please contact us if you have any questions or concerns regarding these.

Important Procedures and Policies

Client Rights and Responsibilities

As a client, you have a right to and deserve a respectful and supportive counseling experience. Your treatment is kept confidential, with exceptions as outlined below. You are encouraged to ask questions about your treatment and will be informed about your diagnosis, the methods and philosophy behind your treatment, your progress, and what to expect moving forward. You are also invited to participate in decisions about your care. If you undergo any assessments, the results will be explained to you in a way that makes sense. You have the right to decline any recommended treatments or methods, and you can choose to end counseling at any time—though we do ask that you talk it over with your counselor first. You can also request a second opinion, referral to another provider, or transfer to a different counselor if needed.

You also have some responsibilities in the counseling process. It’s important to prioritize your own health and safety and to actively engage in the process by sharing your thoughts, feelings, and concerns honestly. You play a key role in setting and working toward your therapeutic goals. We ask that you provide accurate information about your physical and mental health, including any past or current hospitalizations, medications, or treatments. If you decide to end counseling, please let us know before starting with another provider. Keeping appointments is important for
your progress, so if you need to cancel or reschedule, please contact your counselor in advance. If you notice any potential conflicts of interest with another patient or counselor, it’s important to let us know. Finally, if any issues come up that make it difficult for you to participate in counseling, we encourage you to talk to your counselor as soon as possible. We’re here to support you throughout the process.

Good Faith Estimates

In accordance with the No Surprises Act, you have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. We will provide you with an estimate of the expected charges for counseling services before your appointment or upon request. This estimate will outline the expected fees for your initial sessions and any planned follow-up sessions, including assessments, therapeutic services, or any additional treatment recommendations. Please note that this is only an estimate—actual charges may vary depending on the services you receive. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. For more information about your right to a Good Faith Estimate or to start a dispute, visit www.cms.gov/nosurprises.

Confidentiality

Our therapists recognize that confidentiality is essential to an effective counseling relationship. With a few exceptions (noted below), everything you share throughout your counseling treatment, including your identity, is confidential. Further, state and federal laws establish certain rights to confidentiality. If you would like us to disclose any of your information to someone else, you can sign a release of information form and identify the specific entities who are
allowed to release and receive your information, and identify the specific kinds of information that can be disclosed. Your counselor will only share information as authorized by you, ensuring that only the minimum necessary details are disclosed. Any further disclosures must be initiated
by you or specifically directed in writing on your release form.

Exceptions to patient confidentiality include, but are not limited to:

- Duty to Warn and Protect: When a client discloses intentions or a plan to harm another person, the mental health professional is required to warn the intended victim and report this information to legal authorities. In cases in which the client discloses or implies a plan for suicide, the health care professional is required to notify legal authorities and make reasonable attempts to notify the family of the client.
- Abuse of Children and Vulnerable Adults: If a client states or suggests that he or she is abusing a child (or vulnerable adult) or has recently abused a child (or vulnerable adult), or a child (or vulnerable adult) is in danger of abuse, the mental health professional is required to report this information to the appropriate social service and/or legal authorities.
- Prenatal Exposure to Controlled Substances: Mental Health care professionals are required to report admitted prenatal exposure to controlled substances that are potentially harmful.
- Insurance Providers (when applicable): Insurance companies and other third-party payers are given information that they request regarding services to clients. Information that may be requested includes, but is not limited to types of services, dates/times of
  service, diagnosis, treatment plan, description of impairment, progress of therapy, case notes, and summaries.
- Professional Consultation: To ensure quality care, your therapist may occasionally consult with other therapists in our practice about your treatment. If a conflict of interest arises, your counselor will limit or avoid such consultation. All therapists involved are ethically bound to maintain your confidentiality.

Personally Connected Patients

Clients who know each other outside of the counseling setting may seek services from the same counselor or different counselors within our practice. In such cases, counselors will carefully assess potential conflicts of interest, confidentiality risks, and ethical considerations. They will evaluate the situation to determine the best course of action, which may include discussing concerns with each client individually, without disclosing confidential information, and potentially transferring one or both clients to another counselor within the practice.

Cancellation Policy

If you need to cancel or reschedule an appointment, we appreciate as much notice as possible and charge a fee for cancellations with less than 24 hours’ notice. To cancel or reschedule an appointment, you must reach out to us directly by phone call or text (352-660-4142) or email (admin@gainesvillehealinghouse.com).

If you cancel your appointment less than 24 hours before its scheduled start time, we will charge your card on file $100. If you do not show up to your appointment within the first 20 minutes of its scheduled start time, we will charge your card on file the full session fee ($135 for individual and $145 for couples and families). Note that if you are more than 20 minutes late, it is at the counselor’s discretion whether you may keep the session or not. After 3 late cancellations, each additional late cancellation will incur the full session fee and the counselor may discuss options with you to improve attendance.

If you are in an active sliding scale fee agreement, we will charge your card the sliding scale rate for any late cancellation. If you receive counseling from an intern, we will charge your card on file $10 for the first 3 late cancellations and $30 for any following instances. You must pay a late cancellation fee in full before scheduling an additional appointment with a counselor.

Please note that Headway, our platform for billing insurance, may allow you to cancel your own appointments on their calendar, BUT THIS IS NOT REFLECTED ON OUR END SO YOU MUST STILL CONTACT US DIRECTLY TO CANCEL. Cancellation fees are never covered by insurance and must be paid via card, check, or cash.

Emergencies

In the event of an emergency or crisis, please call 911 or go to your nearest emergency room. If you are experiencing a mental health crisis outside of session hours, you may call or text the National Suicide Prevention Lifeline at 988. If you are in Alachua County, you can contact the Alachua County Crisis Center’s 24/7 helpline at (352) 264-6789, or UF Psychiatric Hospital at (352) 265-5481. Your counselor is not available for immediate emergency response, so it’s important to seek immediate help through these resources when needed.

Local Resources

Alachua County Crisis Center
24-hour helpline: (352) 264-6789
Address: 218 SE 24th St

UF Health Psychiatric Hospital
24-hour phone: (352) 265-5481
Address: 4101 NW 89 Blvd

Alachua County Victim Services and Rape Crisis Center
24-hour helpline: (352) 264-6760
Address: 218 SE 24th St

Informed Consent for Communication Outside of Therapy Sessions

Introduction:

This informed consent document outlines the boundaries and expectations for communication between you and your therapist outside of scheduled therapy sessions. Please read it carefully and feel free to ask any questions before signing.

Communication Methods

Therapists and office staff may communicate with clients, and clients may communicate with therapist and office staff, via the following methods outside of scheduled therapy sessions:

- Email
- Phone Calls
- Text Messages
- Messaging through the Therapy Appointment portal

Please let us know if you prefer we use only some of these methods.

Limitations of Communication

1. Response Time:
  - While your therapist will make efforts to read and respond to emails, phone calls, and text messages in a timely manner, there may be delays in response. Please do not expect an immediate reply.
  - Therapists typically respond during business hours (Monday-Thursday, 9:00 AM – 5:00 PM). Messages sent outside of business hours may not be read or responded to until the next business day.
2. Crisis Situations:
  - Therapists are typically not available to provide crisis support via email, phone, or text. If you are experiencing a mental health emergency or crisis, please call 911 , go to the nearest emergency room, or reach out to a local crisis hotline such as The Alachua County Crisis Center at 352-264-6789 or 988.
  - Therapists in this outpatient setting are not typically able to handle emergencies outside of scheduled therapy sessions and cannot provide the necessary support in these situations.
3. Confidentiality:
  - While communication through email, phone, and text is generally confidential, it is important to be aware that these methods may not be completely secure. Email and text messages, in particular, may be vulnerable to breaches in privacy.
  - By communicating outside of therapy sessions, you acknowledge that there are limits to confidentiality, especially in the event of a data breach or technical issues.
4. Scope of Communication:
  - Communication outside of sessions should be related to general inquiries, scheduling concerns, or clarifications about therapeutic goals. Extensive therapeutic discussions should take place during scheduled therapy sessions.
  - Emails, phone calls, or text messages that are lengthy or require substantial therapeutic work may be addressed briefly, but are not considered a substitute for in-depth counseling or therapy sessions.

Acknowledgment and Consent

By signing below, you acknowledge that you have read and understood the limitations and boundaries of communication outside of therapy sessions as outlined above. You also agree that:

- You will not use email, phone, or text for crisis intervention.
- You understand that your therapist may not be able to respond immediately and that responses may be delayed.
- You accept the limitations of confidentiality with regard to communications outside of scheduled therapy sessions.

If you have any questions about these boundaries or feel you may have unique or different needs, please feel free to discuss them with your therapist.

Informed Consent and Termination Policy for Therapy Services

Introduction:

This informed consent document outlines the conditions under which therapy may be terminated, the ethical principles guiding the termination process, and the general expectations for both clients and therapists throughout the process. It aims to ensure that clients are fully informed about their rights, responsibilities, and the professional ethical guidelines under which services are provided. Therapists in Florida abide by ethical codes, such as those from the NASW and ACA, to ensure that clients receive professional, respectful, and effective services. Termination is a natural part of the therapeutic process and is done with as much care possible in each unique circumstance.

Therapeutic Termination refers to the formal or informal process of ending the therapeutic relationship between a client and a mental health professional, such as a therapist, counselor, or social worker. Termination may be planned, with mutual agreement between the client and therapist, or it may occur unexpectedly due to various reasons.

Reasons for Therapy Termination:

Therapy may be terminated for various reasons, including but not limited to the following:

1. Client Request: A client may decide to terminate therapy at any time. Clients have the right to end the therapeutic relationship when they feel that their goals have been achieved, or they no longer wish to continue treatment.

2. Completion of Treatment Goals: Therapy may be terminated when the client and therapist agree that the original therapeutic goals have been met and there is no longer a need for ongoing therapy.

3. Lack of Progress or Client Non-Engagement: If there is insufficient progress toward treatment goals or the client consistently fails to engage in therapy (e.g., missed appointments or lack of participation), the therapist may suggest termination. In such cases, the therapist may discuss the reasons and, if appropriate, offer referrals to alternative services or professionals.

4. Inappropriate Fit or Therapeutic Relationship: If it becomes clear that the therapeutic relationship is not a good fit for the client (e.g., personality mismatch, differing treatment approaches), the therapist may recommend termination and facilitate a referral to a more suitable therapist.

5. Unethical or Illegal Behavior: If a client engages in behaviors that are unethical, illegal, or potentially harmful (such as threatening violence, harassment towards the therapist, verbal abuse towards the therapist or abusing substances during sessions), the therapist may ethically terminate the therapy and, when necessary, make a referral for alternative services or contact appropriate authorities.

6. Financial or Logistical Barriers: If a client is unable to continue therapy due to financial difficulties or other logistical barriers (e.g., relocation), the therapist will work with the client to explore alternatives, such as referrals to low-cost providers or community resources.

7. Need for Higher Level of Care: The Therapist may recommend termination and a transition to a higher level of care if client safety can not be maintained at the level of care offered at our outpatient office. The therapist will work collaboratively, if possible, with the client and provide support while navigating to a higher treatment care level.

Therapists are committed to ensuring that the termination process is done respectfully, ethically, and collaboratively. Every situation is different, however, the following steps are typically followed during the termination process:

1. Discussion of Termination: Termination will be discussed with the client with as much advance notice as possible given the unique situation, and if appropriate, the therapist and client will collaboratively determine when and how to conclude therapy. In cases of abrupt termination (e.g., client not attending or ending therapy without notice or in cases with inappropriate behavior towards the therapist that creates safety issues), the therapist will attempt to reach the client to discuss the situation and provide closure in the safest way possible for the therapist and the client.

2. Referral to Additional Services: If necessary, the therapist will provide appropriate referrals to other service providers or mental health professionals, ensuring that the client has access to continued care, if needed.

3. Review of Progress: The therapist and client will review the goals and progress made throughout therapy. This will allow the client to reflect on the work they’ve done and gain insight into their journey.

4. Final Session: The final session should focus on providing closure, summarizing the progress made, and addressing any last-minute concerns or feelings the client may have. The therapist may also explore any future needs the client might have and offer guidance on self-care and coping strategies moving forward.

5. Follow-Up: If appropriate, the therapist may schedule a follow-up session to check in with the client after termination, ensuring that the transition is smooth and that the client feels supported.

Client Rights and Responsibilities:

1. Right to Terminate: Clients have the right to terminate therapy at any time without fear of retaliation. It is encouraged, however, that they communicate their decision with the therapist to ensure a respectful closure.

2. Right to Confidentiality: Throughout the termination process, clients’ confidentiality will continue to be upheld as per ethical guidelines, including any information related to the reason for termination.

3. Responsibility to Communicate: Clients are encouraged to communicate openly with the therapist if they are experiencing any challenges with the therapy process or if they are considering termination, so that any issues can be addressed appropriately.

If you have any questions or concerns regarding termination of therapy, please speak to your provider.

References:

– National Association of Social Workers (NASW). (2021). *Code of Ethics*. NASW.

– American Counseling Association (ACA). (2014). *Code of Ethics*. ACA.