Policies and Procedures

Telephone Accessibility

When you call me at 617-855-9355 you will probably reach my confidential voice mail and need to leave a message. I will return your call as soon as possible, usually the same day. As I am not always available, if an urgent situation develops and you need help immediately, indicate that in your message, then call 911 or go to the nearest emergency room.

Email and Social Media

Email is not considered to be a confidential form of communication. Therefore, I prefer to communicate via email only around scheduling and billing issues. Please make your own decisions about what to communicate via email with the confidentiality limitations in mind. I do not interact with clients via social media such as Facebook, Twitter, LinkedIn, etc. My goal in keeping this distance is to maintain your privacy and confidentiality and to keep clear boundaries around the therapy relationship.

Cancellations

The times set aside for you are not easily filled when cancelled with short notice (less than 24 hours). Late cancellations and missed appointments will be charged at your agreed upon session fee. Please note that insurance will not pay for missed appointments. At my discretion, late cancellation and missed appointment fees may be waived on a case-by-case basis for circumstances beyond your control.

Fees

Fees or insurance co-payments are due at the beginning of each session; you may pay me by cash, check or credit card. Fees are based on your household income and range from $80 to $160 per session. Reduced fees may be negotiated at my discretion in exceptional circumstances.

There is no charge for telephone contact between sessions when needed. If such contact gets to be frequent and lengthy, I may need to negotiate a plan with you to pay for subsequent phone contact, but I have not usually found this to be necessary.

Insurance and Confidentiality

I am currently an in-network provider with Blue Cross/Blue Shield. Other insurance providers may allow you to see me out-of-network. You would pay me first and I would give you a detailed receipt with which you could seek (usually partial) reimbursement from your insurer. Please contact your insurer to find out if this is possible under your plan’s coverage.

If, for any reason, your insurance company declines to pay me for services provided, you will be responsible for the unpaid fees. I recommend talking with a representative from your insurance company to get details about the limits of your mental health benefits.

All insurance companies require information about you that includes, at minimum, a psychiatric diagnosis that becomes a permanent part of your medical record. Managed care companies often require considerably more information about your therapy. They may also require that we follow their prescribed form of treatment. If at any time in the future you apply for life insurance, disability insurance, or private health coverage, those companies will probably require you to sign a release to get a copy of your records. You could then be denied coverage, or have to pay more for it.

I cannot control the confidentiality of any information once it is disclosed to insurance companies or their agents. I will not be able to tell you whether employers have access to information about you or if such information is distributed to national data banks. The security of data on the web is compromised frequently, and even though health care companies usually protect data, there is no guarantee of confidentiality.

Confidentiality Policy and Exceptions

Professional ethics and legal standards require that our conversations, and my records (even the fact that you are a client) be kept strictly confidential unless you sign a release of information form. However, there are times when I am legally and ethically obligated to breach confidentiality, including:

  • If you present a serious, imminent danger to yourself or others;
  • In cases of apparent abuse or neglect of a child, an elderly person, or a disabled person;
  • When a judge orders the release of information;
  • If legal action is brought against me by a client and/or family;
  • When necessary to collect fees owed.

In the rare event that confidentiality must be breached, I will attempt to discuss it with you before taking any action, unless doing so would increase danger to you or someone else. In all cases, I will reveal only the minimum amount of information necessary.

For couples who are doing couples’ therapy with me, any individual communication with me that happens outside of a couples’ therapy session usually will be disclosed to the other partner, at my discretion.

Please refer to the Notice of Privacy Practices for more information about confidentiality.

Records

As required by law and professional ethics, I maintain written records of our sessions and any other contacts. These records are available to others only at your written request. You have the right to withdraw your permission in writing to prevent future disclosures. You are entitled to receive a copy of these records, unless there is reason to believe that releasing them might be harmful to you. In that case, I will provide them to an appropriate and legitimate licensed mental health professional of your choice.

Consultation

In order to serve you best, I will on occasion consult with other professionals about your therapy when appropriate. Your name and identifying details will not be disclosed.

The Treatment Process

The goals of therapy are arrived at by mutual agreement. Depending on the nature of these goals, the length of therapy can range from one or two sessions to several years.

Participation in therapy can result in a number of benefits, including reduction of the intensity of the distress or unease that brought you to therapy, improved interpersonal relationships, and insight. However, there are no guarantees that therapy will result in positive or intended results.

There are risks in undertaking therapy. Psychotherapy may sometimes involve recalling or reliving distressing aspects of your history. As a result, you may at times experience difficult emotions like sadness, guilt, anxiety, anger, loneliness, frustration, or helplessness. Occasionally, with your permission, I may challenge some of your long-held perceptions and propose different ways of looking at or handling situations, and these challenges may feel uncomfortable.

If at any time you have questions about the process of your therapy, I depend on you to bring them up for discussion. This may be difficult for you to do, but stretching yourself to try new ways of relating to me may be helpful in making positive changes in your relationships with others. I respond very positively to clients’ questioning my work, criticizing me, and identifying my mistakes and feel that such conversations are helpful for the therapy. It is also helpful for me to hear from you what you think is going well in therapy.

I am a trained Gestalt therapist and think of Gestalt therapy as my main orientation for therapy. I also draw from other psychological theories as well, including feminist, cognitive- behavioral, psychodynamic, systems, and Rogerian theories. Please feel free to ask me at any point if you are curious about the theory behind what I am doing in therapy sessions.

Ending Therapy

In the first couple of meetings we will assess if I can be of benefit to you. If we are not a good match, I will offer referrals to other clinicians or resources. If at any point during psychotherapy it becomes evident that our work together is not effective, I will discuss this with you, and if appropriate, terminate treatment and suggest alternatives.

I will do my best to support the concluding of our work together, whatever the reason. When you decide you are ready to leave, I would like to help you leave well. Please give at least one week’s notice so that we can review our work together, and plan for the future. Saying “goodbye” is important.