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Office Policies

Fees, payments, scheduling, cancellations & more

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Options for participating in therapy

For individual therapy I have teletherapy openings Monday - Wednesday and in-person openings at my office Thursday - Friday. I encourage potential clients to think about group work and retreats. Both offer the possibility of intensive work supported by relational bonding and group energy. Retreats also provide the ability to focus without distractions while enjoying a beautiful natural setting. As Gabor Mate said, "traumatic injury occurs in relationships and is most effectively healed in relationships."

Fees

The charge for a one-hour therapy session is $150 for clients paying by check, Venmo or Zelle. Your initial session, known as an intake, will take 1.5 hours and will cost $225. The intake is longer than regular sessions because I will be exploring your issues of concern, desired outcome of therapy, current symptoms, trauma history, relationship history, risk of self-harm, prior treatment history, relevant biopsychosocial background, and cultural context.

Payment

Should you have any questions about fees please ask them during your free 15 minute consultation or during your initial visit. Should you need proof of billing for a third party I can provide you with a monthly statement called a Superbill. All fees must be paid before the session begins. This can be accomplished most easily by submitting a confidential credit card authorization before your first session. Consistent and timely payment of fees is required as a condition of therapy. Falling behind in your payment of counseling fees is grounds for termination of therapy. Should you have a temporary financial crisis please let me know and we can try to work out a mutually acceptable payment plan. If you are not able to commit or fail to adhere to a payment plan I will refer you to lower cost providers.  

Scheduling

For any scheduling issues please contact me by telephone or email. For all clinical questions or concerns, please contact me by phone. If I am not immediately available, please leave a voice message and I will return your call as soon as possible. If I will be absent from my practice and unavailable for certain days due to professional trainings, illness, family visits or vacation I will let you know ahead of time as much as possible. If my absence will be brief and I will only miss one of your usual appointments you have the option of missing it without charge and resuming the following week. If my absence will be for two or more weeks you have the right to be referred to a temporary therapist who covers for me and I will be happy to do this.

Cancellation

Please be aware that in order to make therapeutic progress, a commitment to attend and work on the issues that brought you into treatment is necessary. A weekly scheduled appointment is reserved for you, meaning you are responsible for holding to that appointment time. Cancellations require no less than 24 hours’ notice prior to your scheduled session time. If your appointment is not cancelled within the required time period, you will be charged the full fee for your session except in a genuine emergency situation. In the event of a medical emergency or an emergency involving a threat to your safety or the safety of others, please call 911 to request emergency assistance.

What to do in crisis

If you have made a suicide attempt, such as swallowing pills, call 911 immediately. If you having suicidal thoughts, please call me. If I am not available when you call, you should immediately call a suicide hotline. The national suicide hotline which is open 24/7 is 800-273-8255. Sacramento has a suicide hotline with restricted hours at 916-268-3111. If you are too distressed to make the call or you do not feel better after speaking to a suicide hotline case worker, you should call 911 for transport to the nearest psychiatric hospital.  When you get there let the admitting person know that I am your therapist and I want to be informed about your situation. 

Other emergency numbers when you are in crisis are:

      Sutter Center for Psychiatry: (916) 386-307

      Placer County Crisis Line: (888) 886-5401 

      Placer County Mental Health Services/Crisis Intervention: (916) 787-8860 

      Sacramento County Mental Health: (916) 732-3637 

      Nevada County Mental Health: (530) 265-5811 

      El Dorado County Mental Health: (530) 621-6210

      National Domestic Violence Hotline: 1- 800-799-7233

      National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

     National Domestic Violence Hotline: 1- 800-799-7233
     National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
     National Hopeline Network: 1-800-SUICIDE (800-784-2433)
     Crisis Text Line: Text "DESERVE" TO 741-741
     Lifeline Crisis Chat (Online live messaging): https://suicidepreventionlifeline.org/chat/
     Self-Harm Hotline: 1-800-DONT CUT (1-800-366-8288)
     Essential local and community services: 211, https://www.211.org/
     Planned Parenthood Hotline: 1-800-230-PLAN (7526) 
     American Association of Poison Control Centers: 1-800-222-1222
     National Council on Alcoholism & Drug Dependency Hope Line: 1-800-622-2255
     National Crisis Line - Anorexia and Bulimia: 1-800-233-4357
     GLBT Hotline: 1-888-843-4564
     TREVOR Crisis Hotline: 1-866-488-7386
     AIDS Crisis Line: 1-800-221-7044
     Veterans Crisis Line: https://www.veteranscrisisline.net
     TransLifeline: https://www.translifeline.org - 877-565-8860

 

Good Faith Estimate:

Under Section 2799B-6 of the Public Health Service Act (the “No Surprises Act”) psychotherapists are required to provide their clients a good faith estimate of expected charges when their clients are paying for therapy in cash because they have no mental health care insurance or have decided not to use it. A good faith estimate enumerates the expenses you can reasonably expect to pay for psychotherapy services provided by me.

A GFE must be furnished within 1 business day of scheduling an appointment. If you schedule an appointment at least 10 business days in advance, you are entitled to receive the GFE within 3 business days after scheduling.  A GFE must be provided within 3 business days upon request. A GFE shows the costs of non-emergency psychotherapy services that are reasonably expected for your mental health needs and the estimate is based upon information known at the time the estimate was created. A GFE does NOT include no-shows, late cancellations, or other services related to crisis care, which by definition are unexpected and cannot be predicted for the purpose of compiling a Good Faith Estimate in advance.


If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Please note that charges may be less than what the GFE predicted if therapist and client agree to reduce the number of client visits they originally predicted would be required. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises

 

Termination

 

Generally, termination of the psychotherapy relationship is agreed upon and scheduled in a phased manner after a thorough discussion between therapist and client. As a client you have the right to stop treatment with me at any time. Should you unilaterally decide to stop treatment, I would much prefer that you make one last appointment so we can discuss why you wish to terminate, whether I can rectify any concerns, in what ways you have benefitted from treatment, and which issues remain unresolved. At the last appointment I can prepare you for stopping therapy by means of referrals to other therapists, therapy groups, support groups, and community activities or organizations which could be of ongoing help to you. 

 

As your therapist I am required to bring up the subject of termination if I conclude that you have received the full benefit of therapy and there is nothing more I can do to benefit you; if it’s clear that you are not benefitting from therapy; or if it appears that continuance in therapy is more likely to harm you than help you. If I come to any of these conclusions, I will bring the matter of termination up for a full discussion between us.

Client referrals and testimonials

If you are highly satisfied with my services and you wish to refer someone else to me as a client, I would welcome that and I would speak with that individual to see if we are a good fit. By law I would not divulge our therapy relationship to that person or disclose any details of your therapy whatsoever. 

 

If you were highly satisfied with my services you can volunteer to provide me with a testimonial for my website. As a matter of professional ethics, I am not allowed to seek a testimonial from any existing client or former client. But this in no way prevents a client who has completed therapy with me from voluntarily offering to provide a testimonial.