Consent for Treatment and Limits of Liability
Limits of Services and Assumption of Risks:
Therapy sessions carry both benefits and risks. Engaging in therapy can significantly reduce distress, improve relationships, and resolve specific issues. However, these improvements cannot be guaranteed for any condition due to the many variables affecting therapy sessions. Experiencing uncomfortable feelings or discussing challenging aspects of your life are considered inherent risks of therapy sessions.
Limits of Confidentiality:
What you discuss during your therapy sessions remains confidential. No content from the therapy sessions, whether verbal or written, may be shared with another party without your written consent or the consent of your legal guardian. Please inform me in advance if anyone wishes to join your appointment or if anyone is present with you during a virtual session. This ensures I can protect your privacy and maintain confidentiality. The following are exceptions to confidentiality:
Duty to Warn and Protect:
If you disclose a plan or threaten to harm yourself, I am required to attempt notifying your family and/or the appropriate legal authorities. Additionally, if you disclose a plan to threaten or harm another person, I must warn the potential victim and notify legal authorities.
Abuse of Children and Vulnerable Adults:
If you disclose or there is suspicion of abuse or neglect of children or vulnerable adults (such as the elderly or disabled), I am obligated to report this information to the appropriate state agency and/or legal authorities.
Prenatal Exposure to Controlled Substances:
Therapists must report any admitted prenatal exposure to controlled substances that could be harmful to the mother or child.
Social Media:
Due to its public nature and to protect clients and their confidentiality, I do not communicate with clients via social media.
Cancellation Policy:
Counseling works best when clients are consistent and engaged in the process. However, if you cannot attend an appointment, please provide at least 48 hours' advanced notice via email, phone, or text. Since this time cannot be filled with another client, please note that clients will be billed for half the cost of the scheduled appointment if it is not canceled with at least 48 hours' notice, and the full cost if canceled within 24 hours, unless cancellation is due to illness or an emergency. For cancellations made with less than 48 hours' notice or for missed appointments, I will strive to rebook your session within the same Monday to Friday week if openings are available (though not guaranteed). Otherwise, the session will be billable. Excessive cancellations, even due to illness or emergencies, will require review as this can impact the therapeutic process. I appreciate your assistance in adhering to this cancellation policy to keep my schedule running smoothly.
EMDR Acknowledgement & Consent:
EMDR treatment is a simple and efficient form of therapy that utilizes Bilateral Stimulation (BLS)—usually through eye movements, tapping, or auditory tones—to accelerate the brain’s ability to process and heal troubling memories, thoughts, feelings, beliefs, or phobias.
Please note the following:
(1) Distressing, unresolved memories may surface during EMDR treatment. Some clients may experience reactions during sessions that neither they nor the clinician may have anticipated, including heightened emotions or physical sensations.
(2) Processing of incidents or material may continue after the treatment session, leading to other dreams, memories, flashbacks, or feelings surfacing. Typically, the brain can process these additional memories independently, but arrangements for assistance can be made if needed.
(3) Before commencing EMDR treatment, please consider all the above information and seek any necessary professional advice to make an informed decision regarding your participation in EMDR treatment.
(4) You are not obligated to utilize the EMDR protocol at any point and can opt for talk therapy instead.