Practice Policies | Payments

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## Your Rights and Our Policies

### Children Ages 6–12

Children ages 6 through 12 must be accompanied by a parent or legal guardian to participate in telehealth therapy sessions.

Parental guidance sessions include the child and at least one parent or legal guardian. Where both parents or guardians share decision-making, we ask that both attend when possible.

Sessions in which a parent or guardian participates are billed as family therapy sessions.

### Adolescents

The remainder of this document is written for our adolescent patients and explains what you can expect from therapy and how confidentiality works.

## What to Expect

The purpose of meeting with a counselor or therapist is to get help with problems in your life that are bothering you or that are keeping you from being successful in important areas of your life. You may be here because you wanted to talk to a counselor or therapist about these problems. Or you may be here because your parent, guardian, doctor, or teacher had concerns about you.

When we meet, we will discuss these problems. I will ask questions, listen to you, and suggest a plan for improving these problems. It is important that you feel comfortable talking to me about the issues that are bothering you. Sometimes these issues will include things you do not want your parents or guardians to know about. For most people, knowing that what they say will be kept private helps them feel more comfortable and have more trust in their counselor or therapist. Privacy, also called confidentiality, is an important and necessary part of good counseling.

As a general rule, I will keep the information you share with me in our sessions confidential unless I have your written consent to disclose certain information. There are, however, important exceptions to this rule that you should understand before you share personal information with me in a therapy session. In some situations, I am required by law or by the guidelines of my profession to disclose information whether or not I have your permission. Some of those situations are listed below.

## Confidentiality Cannot Be Maintained When:

* You tell me you plan to cause serious harm or death to yourself, and I believe you have the intent and ability to carry out this threat in the very near future. I must take steps to inform a parent or guardian of what you have told me and how serious I believe this threat to be. I must make sure that you are protected from harming yourself.

* You tell me you plan to cause serious harm or death to someone else who can be identified, and I believe you have the intent and ability to carry out this threat in the very near future. In this situation, I must inform your parent or guardian, and I must inform the person you intend to harm.

* You are doing things that could cause serious harm to you or someone else, even if you do not intend to harm yourself or another person. In these situations, I will need to use my professional judgment to decide whether a parent or guardian should be informed.

* You tell me you are being abused — physically, sexually, or emotionally — or that you have been abused in the past. In this situation, I am required by law to report the abuse to the appropriate state child welfare agency. In Hawaii, this is the Department of Human Services, Child Welfare Services. In Oregon, this is the Department of Human Services, Child Welfare.

* You are involved in a court case and a request is made for information about your counseling or therapy. If this happens, I will not disclose information without your written agreement unless the court requires me to. I will do all I can within the law to protect your confidentiality, and if I am required to disclose information to the court, I will inform you that this is happening.

## Communicating With Your Parent(s) or Guardian(s)

Except for situations such as those mentioned above, I will not tell your parent or guardian specific things you share with me in our private therapy sessions. This includes activities and behavior that your parent or guardian would not approve of — or would be upset by — but that do not put you at risk of serious and immediate harm. However, if your risk-taking behavior becomes more serious, I will need to use my professional judgment to decide whether you are in serious and immediate danger of being harmed. If I believe that you are in such danger, I will communicate this information to your parent or guardian.

**Example:** If you tell me that you have tried alcohol at a few parties, I would keep this information confidential. If you tell me that you are drinking and driving, or that you are a passenger in a car with a driver who is drunk, I would not keep this information confidential from your parent or guardian. If you tell me, or if I come to believe based on things you have told me, that you are addicted to alcohol, I would not keep this information confidential.

**Example:** If you tell me that you are having protected sex with a boyfriend or girlfriend, I would keep this information confidential. If you tell me that, on several occasions, you have engaged in unprotected sex with people you do not know or in unsafe situations, I will not keep this information confidential.

You can always ask me questions about the types of information I would disclose. You can ask in the form of hypothetical situations — in other words: "If someone told you that they were doing ________, would you tell their parents?"

Even if I have agreed to keep information confidential and not tell your parent or guardian, I may believe that it is important for them to know what is going on in your life. In these situations, I will encourage you to tell your parent or guardian and will help you find the best way to tell them. Also, when meeting with your parents, I may sometimes describe problems in general terms, without using specifics, in order to help them know how to be more helpful to you.

You should also know that state law governs whether your parent or guardian has the right to see written records of our sessions, and that the rules differ depending on your age and the state where you receive care. Your provider will explain how this applies to you at the start of treatment. It is extremely rare that a parent or guardian would ever request to look at these records.

## Communicating With Other Adults

**School.** I will not share any information with your school unless I have your permission and permission from your parent or guardian. Sometimes I may request to speak to someone at your school to find out how things are going for you. It may also be helpful in some situations for me to give suggestions to your teacher or counselor at school. If I want to contact your school, or if someone at your school wants to contact me, I will discuss it with you and ask for your written permission. A very unlikely situation might come up in which I do not have your permission but both I and your parent or guardian believe that it is very important for me to share certain information with someone at your school. In that situation, I will use my professional judgment to decide whether to share any information.

**Doctors.** Sometimes your doctor and I may need to work together — for example, if you need to take medication in addition to seeing a counselor or therapist. I will get your written permission and permission from your parent or guardian in advance to share information with your doctor. The only time I will share information with your doctor without your permission is if you are doing something that puts you at risk for serious and immediate physical or medical harm.

Ready to get started? Contact us to schedule an appointment or to learn more about our services.