ABOUT PSYCHOTHERAPY

I strongly believe you should feel comfortable with the therapist you choose and hopeful about the therapy. When you feel this way, therapy is more likely to be helpful to you. Let me describe how I see therapy.

I call my approach to psychotherapy an integrated, pragmatic approach.  I tend to think about the issues that bring individuals, couples, or families into my office in cognitive and interpersonal terms.  That is, many, if not most, of the problems in living that my patients experience are the result of faulty thinking and cyclical maladaptive interpersonal patterns.  Specifically, the psychological theories to which I most closely adhere are Cognitive Behavior Therapy (CBT) and Time-Limited Dynamic Psychotherapy (TLDP).  In brief, the TLDP approach to psychotherapy holds that we perceive ourselves in certain ways and engage in certain behaviors which leads us to expect specific reactions from other people, that others respond to us in ways that either confirm or disconfirm our expectations, and that as a result of this process, we develop ideas about who we are and how we should act in the world that then feeds back into the cycle I have just described.  For instance, if Harry meets Sally and he expects Sally to reject him, Harry may be overly protective of himself and fail to demonstrate his interest in Sally.  Sally may perceive Harry as aloof and misinterpret his fear of rejection as lack of interest.  As a result, Sally doesn’t show her interest in Harry.  In the end, both Harry and Sally feel rejected (thus, confirming Harry’s expectation of being rejected) because both Harry and Sally misinterpreted the others behavior.

An essential assumption of TLDP is that the same interpersonal patterns that have become problematic in a client’s life will also occur in the relationship with the therapist.  A crucial part of the therapeutic process is to explore these patterns as they are occurring in the therapeutic relationship.  It is absolutely critical that anyone engaging in this type of therapy be able and willing to manage any possible discomfort that may arise from examining these patterns in the “here and now” with the therapist.

While TLDP provides my clients with a useful framework for understanding and changing their interpersonal relationships, and thus their emotional states, I draw from a wide range of therapeutic interventions.  In other words, I have systematically drawn from a broad range of therapeutic interventions and integrated these techniques in a pragmatic fashion into my overall therapeutic framework to assist patients in achieving their therapeutic goals.  For instance, I draw on the cognitive behavioral therapy (CBT) approaches of Aaron and Judith Beck (particularly in addressing anxiety) and family systems therapy (in working with couples and families).  I also draw heavily from what has become known as positive psychology.  Positive psychology is not a therapeutic approach but rather a set of strengths and virtues that have been shown in research to improve the well-being of those who practice them.

I usually take notes during our meetings. You may find it useful to take your own notes, and also to take notes outside the session. You could also record our meetings to review at your leisure at home.

By the end of our first or second session, I will tell you how I see your case and how I think we should proceed. I view therapy as a partnership between us. You define the problem areas to be worked on; I use my knowledge to help you make the changes you want to make. Psychotherapy is not like visiting a medical doctor. It requires your very active involvement. It requires your best efforts to change thoughts, feelings, and behaviors. For example, I want you to tell me about important experiences, what they mean to you, and what strong feelings are involved. This is one of the ways you are an active partner in therapy.

I expect us to plan our work together. In our treatment plan we will list the areas to work on, our goals, the methods we will use, the time and money commitments we will make, and so on. I expect us to agree on a plan that we will both work hard to follow. From time to time, we will look together at our progress and goals. If we think we need to, we can then change our treatment plan, its goals, or its methods. 

An important part of your therapy will be practicing new skills that you will learn in our sessions. I will ask you to practice outside our meetings, and we will work together to set up homework assignments for you. I might ask you to do exercises, keep records, and read to deepen your learning. You will probably have to work on relationships in your life and make long-term efforts to get the best results. These are important parts of personal change. Change will sometimes be easy and quick, but more often it will be slow and frustrating, and you will need to keep trying. There are no instant, painless cures and no “magic pills.” However, you can learn new ways of looking at your problems that will be very helpful for changing your feelings and reactions.

Most of my clients see me once a week for 3 to 4 months. After that, we meet less often for several more months. Therapy then usually comes to an end. The process of ending therapy, called “termination,” can be a very valuable part of our work. Stopping therapy should not be done casually, although either of us may decide to end it if we believe it is in your best interest. If you wish to stop therapy at any time, I ask that you agree now to meet then for at least one more session to review our work together. We will review our goals, the work we have done, any future work that needs to be done, and our choices. If you would like to take a “time out” from therapy to try it on your own, we should discuss this. We can often make such a “time out” more helpful.

I may send you a brief set of questions about 6 months after our last session. These questions will ask you to look back at our work together, and sending them to you is part of my duty as a therapist. I ask that you agree, as part of entering therapy with me, to return this follow-up form and to be very honest about what you tell me.

BENEFITS AND RISKS OF THERAPY

As with any powerful treatment, there are some risks as well as many benefits with therapy. You should think about both the benefits and risks when making any treatment decisions. For example, in therapy, there is a risk that clients will, for a time, have uncomfortable levels of sadness, guilt, anxiety, anger, frustration, loneliness, helplessness, or other negative feelings. Clients may recall unpleasant memories. These feelings or memories may bother a client at work or in school. In addition, some people in the community may mistakenly view anyone in therapy as weak, or perhaps as seriously disturbed or even dangerous. Also, clients in therapy may have problems with people important to them. Family secrets may be told. Therapy may disrupt a marital relationship and sometimes may even lead to a divorce. Sometimes, too, a client’s problems may temporarily worsen after the beginning of treatment. Most of these risks are to be expected when people are making important changes in their lives. Finally, even with our best efforts, there is a risk that therapy may not work out well for you.

While you consider these risks, you should also know that the benefits of therapy have been shown by scientists in hundreds of well-designed research studies. People who are depressed may find their mood lifting. Others may no longer feel afraid, angry, or anxious. In therapy, people have a chance to talk things out fully until their feelings are relieved or the problems are solved. Clients’ relationships and coping skills may improve greatly. They may get more satisfaction out of social and family relationships. Their personal goals and values may become clearer. They may grow in many directions—as persons, in their close relationships, in their work or schooling, and in the ability to enjoy their lives. I do not take on clients I do not think I can help. Therefore, I will enter our relationship with optimism about our progress.

CONSULTATIONS

If you could benefit from a treatment I cannot provide, I will help you to get it. You have a right to ask me about such other treatments, their risks, and their benefits. Based on what I learn about your problems, I may recommend a medical exam or use of medication. If I do this, I will fully discuss my reasons with you, so that you can decide what is best. If you are treated by another professional, I will coordinate my services with them and with your own medical doctor.

If for some reason treatment is not going well, I might suggest you see another therapist or another professional for an evaluation. As a responsible person and ethical therapist, I cannot continue to treat you if my treatment is not working for you. If you wish for another professional’s opinion at any time, or wish to talk with another therapist, I will help you find a qualified person and will provide him or her with the information needed.

WHAT TO EXPECT FROM OUR RELATIONSHIP

As a professional, I will use my best knowledge and skills to help you. This includes following the standards of the American Psychological Association, or APA. In your best interests, the APA puts limits on the relationship between a therapist and a client, and I will abide by these. Let me explain these limits, so you will not think they are personal responses to you.

First, I am licensed and trained to practice psychology—not law, medicine, finance, or any other profession. I am not able to give you good advice from these other professional viewpoints.

Second, state laws and the rules of the APA require me to keep what you tell me confidential (that is, just between us). You can trust me not to tell anyone else what you tell me, except in certain limited situations. I explain what those are in the “About Confidentiality” section of this brochure.

This is part of my effort to maintain your privacy. If we meet on the street or socially, I may not say hello or talk to you very much. My behavior will not be a personal reaction to you, but a way to maintain the confidentiality of our relationship.

Third, in your best interest, and following the APA’s standards, I can only be your therapist. I cannot have any other role in your life. I cannot, now or ever, be a close friend to or socialize with any of my clients. I cannot be a therapist to someone who is already a friend. I can never have a sexual or romantic relationship with any client during, or after, the course of therapy. I cannot have a business relationship with any of my clients, other than the therapy relationship.

If you ever become involved in a divorce or custody dispute, I want you to understand and agree that I will not provide evaluations or expert testimony in court. You should hire a different mental health professional for any evaluations or testimony you require. This position is based on two reasons: (1) My statements will be seen as biased in your favor because we have a therapy relationship; and (2) the testimony might affect our therapy relationship, and I must put this relationship first.

Even though you might invite me, I will not attend your family gatherings, such as parties or weddings.

As your therapist, I will not celebrate holidays or give you gifts; I may not notice or recall your birthday and may not receive your gifts eagerly.

ABOUT CONFIDENTIALITY

(There is a separate document you will be required to sign acknowledging that you understand confidentiality.)

will treat with great care all the information you share with me. It is your legal right that our sessions and my records about you be kept private. That is why I ask you to sign a “release-of-records” form before I can talk about you or send my records about you to anyone else. In general, I will tell no one what you tell me. I will not even reveal that you are receiving treatment from me. In all but a few rare situations, your confidentiality (that is, our privacy) is protected by federal and state laws and by the rules of my profession.

Here are the most common cases in which confidentiality is not protected:

• If you were sent to me by a court or an employer for evaluation or treatment, the court or employer expects a report from me. If this is your situation, please talk with me before you tell me anything you do not want the court or your employer to know. You have a right to tell me only what you are comfortable with telling.

• Are you suing someone or being sued? Are you being charged with a crime? If so, and you tell the court that you are seeing me, I may then be ordered to show the court my records. Please consult your lawyer about these issues.

• If you make a serious threat to harm yourself or another person, the law requires me to try to protect you or that other person. This usually means telling others about the threat. I cannot promise never to tell others about threats you make.

• If I believe a child, an elder, or dependent adult has been or will be abused or neglected, I am legally required to report this to the authorities.

There are some times I might talk about part of your case with another therapist. I ask now for your understanding and agreement to let me do so in these two situations. This helps me in giving high-quality treatment. These persons are also required to keep your information private. Your name will never be given to them, some information will be changed or omitted, and they will be told only as much as they need to know to understand your situation.

It may be beneficial for me to confer with your primary care physician with regard to your psychological treatment or to discuss any medical problems for which you are receiving treatment. In addition, Medicare requires that I notify your physician by telephone or in writing, concerning services that are being provided by me unless you request that notification not be made.  Please complete the form Physician Contact Information if making this request.

For the purpose of these consultations, I may want to make audio or video recordings of our sessions. I will review the recordings with my consultant to assist with your treatment. I will ask your permission to make any recording. I promise to destroy each recording as soon as I no longer need it, or, at the latest, when I destroy your case records. You can refuse to allow this recording, or can insist that the recording be edited.

If your records need to be seen by another professional, or anyone else, I will discuss it with you. If you agree to share these records, you will need to sign an authorization form. This form states exactly what information is to be shared, with whom, and why, and it also sets time limits. You may read this form at any time. If you have questions, please ask me.

It is my office policy to maintain clients’ records for the state required number of years after the end of our therapy, which is currently seven years. Until then, I will keep your case records in a safe place.

If I must discontinue our relationship because of illness, disability, or other presently unforeseen circumstances, I ask you to agree to my transferring your records to another therapist who will assure their confidentiality, preservation, and appropriate access.

As part of cost control efforts, an insurance company will sometimes ask for more information on symptoms, diagnoses, and my treatment methods. It will become part of your permanent medical record. I will let you know if this should occur and what the company has asked for. Please understand that I have no control over how these records are handled at the insurance company. My policy is to provide only as much information as the insurance company will need to pay your benefits.

You can review your own records in my files at any time. You may add to them or correct them, and you can have copies of them. I ask you to understand and agree that you may not examine records created by anyone else and then sent to me.

In some very rare situations, I may temporarily remove parts of your records before you see them. This would happen if I believe that the information will be harmful to you, but I will discuss this with you.

You have the right to ask that your information not be shared with family members or others, and I can agree to that limitation. You can also tell me if you want me to send mail or phone you at a more private address or number than, say, your home or workplace. If this is of concern to you, please tell me so that we can make arrangements.

ABOUT OUR APPOINTMENTS

The very first time I meet with you, we will need to give each other much basic information. For this reason, I usually schedule 1–2 hours for this first meeting. Following this, we will usually meet for a 45-minute session once or twice a week, then less often. We can schedule meetings for both your and my convenience. I will tell you at least a month in advance of my vacations or any other times we cannot meet. Please ask about my schedule in making your own plans.

All our appointments will take place online through Google Meet. I have a Business Associate's Agreement with Google which makes our video appointments secure in the Google Workspace environment. I will send a link to the meeting to you prior to our meeting time. An appointment is a commitment to our work. We agree to meet here and to be on time. If I am ever unable to start on time, I ask your understanding. I also assure you that you will receive the full time agreed to. If you are late, we will probably be unable to meet for the full time, because it is likely that I will have another appointment after yours. A canceled appointment delays our work. I consider our meetings very important and ask you to do the same. Please try not to miss sessions if you can possibly help it. When you must cancel, please give me at least a week’s notice. Your session time is reserved for you. I am rarely able to fill a canceled session unless I know a week in advance. If you cancel a session with less than 48-hour notice, I will have to charge you for the lost time unless I am able to fill it.

I will reserve a regular appointment time for you into the foreseeable future. I also do this for my other patients. Therefore, I am rarely able to fill a canceled session unless I have several weeks notice. You will be charged the full fee for sessions canceled with less than 48 hours’ notice, for other than the most serious reasons.

If the appointment is not kept or is canceled with less than 48 hours advance notice, you can expect me to charge you the full fee for that session.

Cancellations for a Monday appointment should be made no later than Saturday morning.

Please make arrangements for childcare so that you can be entirely focused on our work together during our session.

FEES, PAYMENTS, & BILLING

Payment for services is an important part of any professional relationship. This is even more true in therapy; one treatment goal is to make relationships and the duties and obligations they involve clear. You are responsible for seeing that my services are paid for. Meeting this responsibility shows your commitment and maturity.

My current regular fees are as follows. Alternate fees are determined on a case-by-case basis. You will be given advance notice if my fees should change.

Regular Individual Therapy services: $100 for a 45-minute session

Regular Couples Therapy Services: $150 for a 45-minute session, and $200 for a 75 minutes session

Through my online portal, you will automatically be charged on the day of your appointment. I have found that this arrangement helps us stay focused on our goals. It also allows me to keep my fees as low as possible because it cuts down on my bookkeeping costs. Other payment or fee arrangements must be worked out before the end of our first meeting. I highly recommend that you enroll in automatic payments if possible.

Telephone consultations: I believe that telephone consultations may be suitable or even needed at times in our therapy. If so, I will charge you our regular fee, prorated over the time needed. If I need to have long telephone conferences with other professionals as part of your treatment, you will be billed for these at the same rate as for regular therapy services. If you are concerned about this arrangement, please be sure to discuss it with me in advance so we can set a policy that is comfortable for both of us. Of course, there is no charge for calls about appointments or similar business.

Extended sessions: Occasionally it may be better to go on with a session, rather than stop or postpone work on a particular issue. When this extension is more than 10 minutes, I will tell you, because sessions that are extended beyond 10 minutes will be charged on a prorated basis.

I realize that my fees involve a substantial amount of money, although they are well in line with similar professionals’ charges. For you to get the best value for your money, we must work hard and well.

I will assume that our agreed-upon fee-paying relationship will continue as long as I provide services to you. I will assume this until you tell me in person, by telephone, or by certified mail that you wish to end it. You have a responsibility to pay for any services you receive before you end the relationship.

Because I expect all payment prior to the time of our meetings, I usually do not send bills. However, if we have agreed that I will bill you, I ask that the bill be paid within 5 days of when you receive it.

If requested, at the end of each month, I will send you a statement. The statement can be used for health insurance claims, as described in the next section. It will show all of our meetings, the charges for each, how much has been paid, and how much (if any) is still owed. At the end of treatment, and when you have paid for all sessions, I will send you a final statement for your tax records.

Depending on your financial circumstances and total medical costs for any year, psychotherapy may be a deductible expense; consult your tax advisor. 

If you think you may have trouble paying your bills on time, please discuss this with me. I will also raise the matter with you so we can arrive at a solution. If your unpaid balance reaches $300, I will notify you by email. If it then remains unpaid, I must stop therapy with you. Fees that continue unpaid after this will be turned over to small-claims court or a collection service.

Patients who owe money and fail to make arrangements to pay may be referred to a collection agency.

A late payment fee of $25 will be charged each month that a balance remains unpaid.

If there is any problem with my charges, my billing, your insurance, or any other money-related point, please bring it to my attention. I will do the same with you. Such problems can interfere greatly with our work. They must be worked out openly and quickly.

IF YOU NEED TO CONTACT ME

The best way to contact me is through email. I respond to emails on a daily basis. Because I work online only, I cannot offer emergency services.

You may also call me at the number listed at the top of this form. 

If you are experiencing an emergency, do not call me. Call 911.

CLIENT BILL OF RIGHTS

You have the right to:

• Get respectful treatment that will be helpful to you.

• Have a safe treatment setting, free from sexual, physical, and emotional abuse.

• Report immoral and illegal behavior by a therapist.

• Ask for and get information about the therapist’s qualifications, including his or her license, education, training, experience, membership in professional groups, special areas of practice, and limits on practice.

• Have written information, before entering therapy, about fees, method of payment, insurance coverage, number of sessions the therapist thinks will be needed, substitute therapists (in cases of vacation and emergencies), and cancellation policies.

• Refuse audio or video recording of sessions (but you may ask for it if you wish).

• Refuse to answer any question or give any information you choose not to answer or give.

• Know if your therapist will discuss your case with others (for instance, supervisors, consultants, or students).

• Ask that the therapist inform you of your progress.

STATEMENT OF PRINCIPLES AND COMPLAINT PROCEDURES

It is my intention to fully abide by all the ethics code of the American Psychological Association (APA) and by laws and regulations of the State of Florida.

Problems can arise in our relationship, just as in any other relationship. If you are not satisfied with any area of our work, please raise your concerns with me at once. Our work together will be slower and harder if your concerns with me are not worked out. I will make every effort to hear any complaints you have and to seek solutions to them. If you feel that I (or any other therapist) have treated you unfairly or have even broken a professional rule, please tell me. You can also contact the state or local psychological association and speak to the chairperson of the ethics committee. He or she can help clarify your concerns or tell you how to file a complaint. You may also contact the Florida Board of Psychology, the organization that licenses those of us in the independent practice of psychology.

n my practice as a therapist, I do not discriminate against clients because of any of these factors: age, sex, marital/family status, race, color, religious beliefs, ethnic origin, place of residence, veteran status, physical disability, health status, sexual orientation, or criminal record unrelated to present dangerousness. This is a personal commitment, as well as being required by federal, state, and local laws and regulations. I will always take steps to advance and support the values of equal opportunity, human dignity, and racial/ethnic/ cultural diversity. If you believe you have been discriminated against, please bring this matter to my attention immediately.

If you have read this document all the way to the end, you are a trooper. This kind of persistence bodes well for your commitment to your therapeutic success. If you have any questions, please do not hesitate to bring them up in our next meeting. I look forward to seeing you soon.

To keep a copy of this document for your records, right click on the page, choose to print as a PDF, save to the location of your choice on your PC.

MY BACKGROUND

I am a licensed clinical psychologist with 15 years of experience. I am trained and experienced in doing individual, couples, and group therapy with adults (18 years and over).

I hold these qualifications: 

• I have a doctoral degree in Counseling Psychology from the University of Florida, whose program is approved by the American Psychological Association (APA).

• I completed an internship and postdoctoral residency at the University of Central Florida.

• I am a licensed psychologist in the State of Florida (license PY 8422)

• I earned a master of divinity degree from George W. Truett Theological Seminary at Baylor University.