PRIVACY, CONFIDENTIALITY, AND INFORMED CONSENT

Privacy/Confidentiality Policy
Your privacy is very important to me. Accordingly, I have developed this Policy in order for you to understand how I collect, use, communicate and disclose and make use of personal information. The following outlines our privacy policy.
  • Before or at the time of collecting personal information, we will identify the purposes for which information is being collected.

  • I will collect and use personal information solely with the objective of fulfilling those purposes specified by us and for other compatible purposes, unless we obtain the consent of the individual concerned or as required by law.*I am required by law to report any suspicions of abuse.

  • I will only retain personal information as long as necessary for the fulfillment of those purposes.

  • I will collect personal information by lawful and fair means and, where appropriate, with the knowledge or consent of the individual concerned.

  • Personal data should be relevant to the purposes for which it is to be used, and, to the extent necessary for those purposes, should be accurate, complete, and up-to-date.

  • I will protect personal information by reasonable security safeguards against loss or theft, as well as unauthorized access, disclosure, copying, use or modification.

  • I  will make readily available to customers information about our policies and practices relating to the management of personal information.




I am committed to conducting our business in accordance with these principles in order to ensure that the confidentiality of personal information is protected and maintained.

Informed Consent for Treatment




 This section contains important information about my profession online services and business policies. Please read it carefully and take down any questions you might have that I can address. By agreeing to enter into a online therapeutic counseling with me, you are giving your consent for this mode of treatment and you understand the limitations of this mode of therapy.

Virtual Therapeutic Services
  • Virtual therapy can include psychotherapy via telephone talking and/or video meetings. The subjects of the therapy depend on the personality and diagnosis of the client and the the particular problems that a client brings forward.  There are many different methods I may use to deal with your problems you hope to address.  Virtual therapy is not like a medical or therapist in-the-office visit.  Virtual therapy calls for complete active effort on the part of the client which will entail homework or other behavioral type assignments. In order for therapy to be most successful, the client will have to work on things we discuss virtual as well as when the client is not online.
  • Virtual  has its benefits and risks.  Unpleasant thoughts and feelings can arise from therapy like sadness, guilt, anger, frustration, loneliness, and helplessness; however, therapy has shown to help people work through these type of issues. Although online therapy can help lead to improved insight into an illness, improve a person's ability to cope better, improve communication in relationships and help in other areas, the outcome is not solely on the therapist and there is no guarantee of what a client will experience from participating in this method of therapy.
  • The first few sessions will involve an evaluation of a clients needs. I will obtain basic demographic information: name, physical address, email, emergency contact information.  By the end of the evaluation, I will offer to the client some first impressions of what our work will include and I with the input from the client will develop a *S.M.A.R.T treatment plan to follow, if they decide to continue with therapy. *S.M.A.R.T treatment plan: Specific, Measurable, Realistic, and Time-Limited. Online therapy is not for those individuals with life long chronic illness. Online therapy is not expected to last for years.  It is a short term, solution focused therapy to help individuals stabilize and be able to manage their problem on their own.
  • You should evaluate this information along with your opinions of whether you feel comfortable working with me.  Virtual therapy involves some commitment of time, money and energy.  If you have any questions about my procedures, we should discuss them whenever they arise.  
  • The primary therapeutic methods I will use are Bible Based Theology, Cognitive Behavioral, Rational Emotive Behavior, Emotions Focused Individual Therapy, and Solution-Focused Brief Therapy.
  • If you feel like this therapy is not working for you, I will be happy to help you with referrals to another mental health or substance abuse professional.
Virtual Meetings.-Time/Client expectations/Cancellation policy/No-Show Policy
  • I normally conduct an evaluation that can take up to 2 to 4 sessions. Clients are given a written assessment and are expected to fully complete the assessment to the best of their ability. During this assessment phase, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals.  If online therapy is begun, Therapy sessions can be in 5, 10, 15, 20, 30, 45 and 50 minute increments as we agree on what is needed. Clients can ask questions (emails or calls) in between scheduled sessions at no cost, however, if the questions become frequent, then the client would be expected to save the questions for an actual scheduled session.  You are expected to pay for your scheduled sessions within 24 hours of your scheduled session. This is to insure client's willing participation in therapy. If a client needs to cancel a scheduled session, they should do so within 48 hours before the scheduled session (unless we both agree that you were unable to attend due to circumstances beyond your control. If possible, I will try to find another time to reschedule the session). If client does not cancel within 48 hours, and they have pre-paid for the session, the payment will not be refunded.
  • On day of a scheduled appointment, I will wait for 5 minutes, if client does not show after 5 minutes, the appointment will be canceled and I will send client a message about the cancellation and offer to reschedule. After 3 no call/no shows, client will be discharged with no refunds for any previous services. 
Virtual  Therapy Fees
  • The session fee schedule is  :  5 minutes  $9.00    10 minutes $ 18.00 15 minutes $26.00   20 minutes $35.00   30 minutes $53.00  45 minutes $65  50 minutes $100.00 Couples Counseling 60 minutes $150
  • The fees listed for the basic online counseling sessions. There may be times that other time blocks may be needed, or sessions longer than 50 minutes. Other services could include report writing, talking with other professions you have authorized like your psychiatrist or medical doctor, preparation of records of treatment summaries, and time spent performing any other service you may request of me.  If you become involved in legal proceedings that require my participation, we will discuss any extra charges that would have to be paid in order for me to participate/prepare for any legal proceedings. 
  • **Clients with certain insurance plans can see me through Headway or Sondermind see below the insurance currently accepting through these programs.
Virtual  Life Coaching
  • Online life coaching follows the pricing and time slots of the therapy sessions but the coaching interventions/sessions are not mental health therapy. The fees for online coaching are the same as therapy sessions but clients need to be sure to select the coaching options on the payment page. Clients are offered 1 free 30 minutes initial consultation to introduce the client to the program.
​
Limits of Confidentiality
  • Although I use HIPPA compliant tele-health platforms that have the highest security protections, there is still no guarantee that my or client's account could not be hacked or some other unwanted intrusions.
  • At times I may need to consult with a colleague about client cases, only minimal information will be shared for the purpose of consultation. 
Billing and Payments
  • Clients with insurance who will not being using insurance will receive a Good Faith Health Estimate. Self-pay through this website. Sliding-scale fee clients will pay through Zelle. 
  • I currently accept these insurance plans through
Claim Doc (For the states I'm licensed in only)

  Headway:
 Blue Essentials HMO, Blue High Performance Network, Horizon BCBS Of New Jersey for clients located in Texas) ), Aetna, Oxford, Oscar Health, United Health Care   
        www.sondermind.com/
Texas: Aetna
Aetna Allied Benefit System
Aetna Boon-Chapman
Aetna GEHA
Aetna Medicare Advantage
Aetna Meritain
Aetna WebTPA
Apostrophe
Ascension
Bright Health Plan
Bright Health Plan Medicare Advantage
Centivo (Only for Employees of Ellwood Group, Inc.)
Decent Health
Friday Health Plans (TX)
Medicare
Medicare Supplemental Plan
​Moda Health 
Optum - Carveout
Optum/United-EAP (TX)
Oscar Health Plan
Optum Medicare Advantage
SonderMind - Self-pay by Credit Card
TriWest
United All Savers
United BIND
United GEHA/Shared Services
United HealthScope Benefits
United Healthcare (TX)
United Healthcare Golden Rule
United Healthcare Medicare Advantage
United Oxford (TX)
United Student Resources (TX)
United UMR
​Unity
 Colorado: 
Anthem
Centivo (Only for Employees of Ellwood Group, Inc.)
​Decent Health
Foster Source
Justice Reskill
Triwest
​Lucent Health
​SBA
Arizona
Medicare
Humana Medicare Advantage
​Devoted Medicare Advantage
Decent Health
Teladoc
Texas, Arizona, Colorado, Aransas, Alabama
  • Amerigroup
  • BCBS
  • BCBS SC Core
  • Blue Card Network
  • SEIU 1199
  • Teladoc Core Network
  • Teladoc W
 
  • If not using insurance through one of the online programs, you are expected to pay for each session before it is held, unless we agree otherwise.  
  • Payments are made through Stripe which uses checking accounts and debit/credit cards. I currently do not take any insurance via my personal business. Most insurance plans have a mental health benefit; however, You would need to talk with your insurance carrier on how to get reimbursed through your out-of-network benefits and even if they would reimburse these type of services. It is important for you to find out exactly what mental health services your insurance policy covers. If your insurance plan will cover these sessions, you should be aware most insurance companies require that you allow me to provide them with clinical information and other information like treatment plan or summaries, copies of entire record (in rare cases).  This information will become part of the insurance company files and probably stored on a computer.  Though all insurance companies claim to keep such information confidential,
Contacting Me/Social Media Policy
  • I am not available immediately by telephone or email.  I usually scan my emails at least 4 times a day.  I normally respond to emails/phone calls between the hours of 5;00 pm CST and 8:30 pm CST Monday through Friday. I do not take any calls on weekends and holidays, so if I get a message at 8:31 pm on a Friday, I will not respond until the following Monday.  I will try to return messages within 24 hours of receipt during the week. Messages left/emailed over the weekend may not get responded to until within 48 to 72 hours.  When I am unavailable, my telephone is answered by an answering machine. If you are having technical difficulties, please try to reach me by phone or someone else's computer/phone if you feel comfortable doing that.  I will notify you if I will be unavailable for an extended amount of time and coordinate alternative options for while I am gone.
  • No contact or communication via social media sites such as Facebook, Twitter, Instagram, Snapchat, Linked In, TikTok, etc. Clients are not permitted to publish any information from sessions on any social media site.
  • Text-messages is only for making appointment changes-request date/change date/cancel appointment, NO PERSONAL OR PROFESSION COMMENTS!
Professional Records (CLIENT IS NOT PERMITTED TO RECORD VIDEO OR TELEPHONIC RECORDS OF SESSIONS!) THE THERAPIST MAY RECORD SESSIONS WITH CLIENT'S CONSENT FOR CONSULTATION, TRAINING PURPOSES.)
  • The laws and standards of my profession require that I keep treatment records.  You are entitled a copy of your records, or I can prepare a summary for you instead.  Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. If you wish to see your records, I recommend that you review them and we can discuss the contents free of charge.
Minors * I am not seeing clients under the age of 18 at this time
  • If you are under the age of eighteen years of age, please be aware that the law may provide your parents the right to examine your treatment records.  It is my policy to request an agreement from parents that they understand that I will only provide them with general information about what we discuss, unless I feel there is a high risk you will seriously harm yourself or someone else.  In this case, I will notify them of my concern.  I will also provide a summary of treatment after discussing it with you. 
Other
Emergencies
  • In the event of an emergency, i.e. if client voices thoughts of harm to self or others, or client appears to be in a threatening situation, from the beginning of therapy services, client will need to provide their actual location address, phone number, and email address, and an emergency contact person and the emergency contact person's phone number and or email. In the event an emergency occurs during a session, I will contact the previously identified emergency contact or local emergency services such as 911.
  • I am a Licensed Clinical Social Worker, I am licensed within the States of: Texas, Colorado, Arizona, Arkansas, and Alabama to perform therapy and other social work type of activities.  I am not a medical doctor or psychiatrist and will not be making a decisions about medications.  At times, if I believe that a client could be helped by being on some medication, I will recommend that client make an appointment with a Board Certified Psychiatrist. 
Technical Problems
  • It is not unusual to have technical problems, in the event of a technical problem during a session, I will end the session and try to reconnect, if unable to reconnect, I will try to reschedule the session in agreement with client.
  • Clients are fully responsible for their own equipment i.e. phones, computers, internet access/providers, making sure physical or virtual settings for sessions are private and secure i.e. not signing in from public hotspot areas or having sessions where other people/family/friends can listen in on the sessions.


Texas State Board of Social Worker Examiners 
Texas Behavioral Health Executive Council
George H.W. Bush State Office Bldg.
1801 Congress Ave., Ste. 7.300
Austin, Texas 78701
Telephone: (512) 305-1700 or the complaint line (800) 821-3205
Email: To make an online complaint email: [email protected]
General questions email [email protected]
Website: https://www.bhec.texas.gov/texas-state-board-of-social-worker-examiners/index.html



Alabama State Board of Social Work Examiners
Physical Address: Alabama State Board of Social Work Examiners
100 North Union Street Suite 736
Montgomery, AL 36104
Mailing Address:
AL State Board of Social Work Examiners
Post Office Box 301620
Montgomery AL 36130-1620Phone: 334-242-5860 / 888-879-3672
Fax: 334-242-0280
Complaints Against Social Workers
Complaint forms must be signed and witnessed. Please understand the Board can not accept anonymous complaints
https://www.socialwork.alabama.gov/PDF/Complaint%20Form(1page).pdf
Alabama Social Work Standards of Professional Conduct and Ethics
https://www.socialwork.alabama.gov/default.aspx
Physical Address:
Alabama State Board of Social Work Examiners
100 North Union Street Suite 736
Montgomery, AL 36104
Mailing Address:
AL State Board of Social Work Examiners
Post Office Box 301620
Montgomery AL 36130-1620Phone: 334-242-5860 / 888-879-3672
Fax: 334-242-0280


ARKANSAS SOCIAL WORK LICENSING BOARD
5800 West 10th St, Suite 100, Little Rock, AR
Main:   501.372.5071  Fax: 501.372.6301
Mailing: P.O. Box 251965, Arkansas 72225
Email: [email protected]
To file a Complaint: The Board is authorized to receive complaints against licensees or applicants from any person. A complaint form may be obtained from the board office or this website. The Board may in its own motion, in the absence of a written complaint, initiate its own complaint and conduct an investigation of a suspected violation if reasonable cause exists to believe a violation has occurred.
https://www.healthy.arkansas.gov/programs-services/topics/arkansas-social-work-licensing-board

ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS
1740 W. Adams Street, Suite 3600, Phoenix, AZ  85007
Main:   602-542-1882 Fax: 602-364-0890
This form is used for an individual or agency to file a complaint against a licensed practitioner or applicant for licensure:
Complaint form
https://azbbhe.us/

Colorado Division of Professions and Occupations
 P: 303.894.7800 | F: 303.894.7693
1560 Broadway, Suite 1350, Denver, CO 80202
[email protected] | dpo.colorado.gov
To file a complaint: click here