As a counselor, there are some rules that I legally have to follow and I don't get any sort of say on. That includes rules about confidentiality, consent for services, and only offering services that I am trained in.
You will receive a bunch of documents when beginning services with me. They will be sent to you to be signed and returned for my records (don't worry, I have an easy way to make that happen).
While it is always very important to actually review any legal documents you receive, I have supplied a TL;DR summary here (so you can know some of the rules beforehand)...
Laws & Ethics
Notice of Privacy Practices
Therapy is a medical service, and is protected by HIPAA laws. The shortest explanation is that I cannot and do not share your personal health information with anyone you have not signed a release for. Your information is yours. You can request it, but others cannot without your permission. There are some exceptions which I list in this doc.
If I need to share your information, I share the minimal amount of information necessary for the situation.
If there is a breach of my records system and someone who shouldn't have had access to your information, I will inform you as required by law.
Informed Consent for Psychotherapy
A lot of this information is about what you can expect from counseling services with me and information about me. It touches on confidentiality again and discusses diagnosis. Diagnosis is not required if you are not using insurance, but there are pros and cons to having or not having a diagnosis. If you are planning on using your insurance, you will have to meet the qualifications for a mental health diagnosis. We can talk about your preferences or concerns in our initial session.
I also give information on how I make ethical decisions and how to file a formal complaint against me to the Department of Health.
Consent for Telehealth Consultation / Telehealth Safety Plan
Telehealth comes with its own safety challenges and legal rules. As much as I will always do my part to ensure that everything is confidential on my side, and I recommend doing what you can to ensure the same on your end. If needed, we will end the session to keep your information confidential.
As fantastic as the internet can be, it also has a habit of crapping out at the worst time. We will create a plan for how we continue or wrap up if our call drops.
Telehealth also means that I'm not in the room with you to help if you're feeling overwhelmed or physically unsafe. This means you can do therapy from the comfort of your personal space, but it also means that you're stuck with the spaces you have. I will require some extra information to make sure I can help keep you safe in the event you need some extra help.
Safety Concerns & Contracts
Mental health can be messy when it comes to safety. Suicidal feelings, self-harm, and wanting to hurt or kill others are common issues that come up. Not to mention some of those things we do that aren't necessarily immediately unsafe, like drinking way too much, but can have big impacts. I ethically and legally can't let you do things that could cause imminent harm.
You wanting to be dead doesn't scare me. I get it. I've been in that spot. And. I can't just let you kill yourself
As a single therapist business, I can't be available 24-7. If it's appropriate, we will work together to make a safety plan. However. If we find that your suicidal feelings are beyond what's appropriate for the level of care I can provide, I will help you find another provider or setting that can better serve you.
These are the policies specific to Heavy Boots Counseling PLLC. These include my expectations and rules about attendance, telehealth, records, billing, and stuff like that. These will probably change in the future, especially as Heavy Boots moves forward to bigger and better things. I will always let my clients know at least 30 days in advance (unless due to safety concerns that cannot wait) if these policies are changing.
Good Faith Estimate for Health Care Items and Services
In 2022, a federal law went into effect called the No Surprises Act. This means that I don't get to change how much I charge you for services without notice or throw on surprise fees. I provide you the Good Faith Estimate after your intake with an estimate of the total cost of services. This estimate is good for 12 months. It is NOT a bill, so when it shows $3,000 or something ridiculous, you do NOT owe that number at that time.
Obviously, things change, and I may realize you need different services, insurance copays may change, or the prices I'm charging need to change. Those changes will never happen without me speaking with you in advance.
All my prices are based on current price trends and what I need to pay my bills for both my business and my personal life. I didn't go into mental health for the money, but I can't help you if I'm not able to take care of myself. That said, if you hit a rough patch financially, please talk to me so we can figure out how to make services happen if at all possible.
I do not decide what insurance co-pays are. These are based on my session prices, what insurance covers, and the difference between the two prices. If you have any questions or concerns, again, please talk to me.
Outside Resources on Laws and Ethics
- HIPAA Laws
Washington State Laws: Abuse and Neglect
Washington State Laws: Mental Health Counselors
Washington State Laws: Behavioral Health Disorders
Washington State Laws: Behavioral Health Services for Minors
Washington State Laws: Telehealth
Washington State Department of Health: Filing an official grievance
Info on Emotional Support Animals
Info on Gender-Affirming Care
Finding another therapist: Psychology Today