I was toodling around the Internet tonight when I stumbled across my colleague, David P. Diana’s website. Bless his heart for writing this post on providing mental health services online. In one little post he has listed 8 not-so-light-reading links on the ethical and legal implications of providing therapeutic services online.
Do you know of others? If so, please share them here as we all continue to learn about providing therapy online.
I received an email from J. Kipp Lanning, LIMHP of AdultSpan Counseling in Nebraska asking about peer consultation groups. He says:
A professional group of which I am a member is working on setting up a peer consultation group (APPT: Association of Private Practice Therapists). Do you have suggestions on how to make this most effective/beneficial regarding paperwork that demonstrates consultation with peers? Of particular concern to the group is a confidentiality agreement for the group and paperwork for the file demonstrating consultation with peers.
Thanks, Kipp
PS – love your blog!”
Thanks, Kipp, for being part of our online community here at Private Practice from the Inside Out and dropping in to chat!
I am not an attorney and not qualified to give legal advice. However, here is some of the information that I have been given related to this issue. According to mental health attorney, Denis K. Lane,
The generally accepted standard, established by ethical codes and practices nationwide, is that clinical supervision is a confidential process, the same as the counseling done by a supervisee with a client. Some states have exceptions to this rule, established by their state licensing board rules, but in general the supervision process is as confidential as mental health treatment itself . . . . Because consultations are a form of supervision according to the Licensing Boards’ Supervision Rule, they, too are confidential.” (The Legal Guide for Practicing Psychotherapy in Colorado, 2010 Edition, pp. 190-191)
I understand the mandated exceptions to confidentiality to be the same ones that pertain to counseling – those related to the potential for self-harm or the harm of others, court orders requiring disclosure, etc. Because Denis Lane is an attorney practicing in the state of Colorado, I would encourage you to take a moment to check with a mental health attorney in your own state to insure that you, your colleagues, and your clients are fully protected.
You will also want to remember that in order to discuss any client, you must first have that client’s written permission to do so. Former attorney and now counselor-in-training, Michelle Stevens of Introspection Counseling, offers this language to include in your consent to treatment and disclosure statement:
There may be times when I, as your psychotherapist, may need to consult with my supervisor or with a colleague or another professional, such as an attorney, concerning issues raised by you in therapy. Confidentiality is not waived during these consultations. By signing this disclosure statement, you give me permission, as your psychotherapist, to consult with other professionals as needed to provide professional services to you. This permission may be revoked at any time.”
Obviously, if you are not working under supervision, you do not need to include any reference to a supervisor in your statement
[Michelle is quick to note that the language above "is not intended as legal advice. I am not a practicing attorney and have never been licensed in or practiced in Colorado. When in doubt you should always consult an attorney with the expertise appropriate to your issue."]
The only other paperwork that comes to mind is the documentation that you need to include in your clinical note. I wrote about that here in The 5 W’s of Clinical Consultation.
Kipp, I hope you’ll drop back in and let us know how your new consultation group fares! We can all learn from your challenges and your successes! I look forward to hearing from you!
(This is the second of a two-part post on terminating your
relationship with insurance and managed care companies.
The first part begins here.)
On Monday, I talked to you about the importance of knowing what you have agreed to in your contracts with insurance and managed care companies before 
you begin termination of your professional relationships with them. Assuming that you have taken those legal commitments into consideration and you still want to terminate those professional relationships, here are the things that you need to do:
It’s that easy. And, once you’ve done it, drop back in here to let us know. I’ll be glad to celebrate with you!
The purpose of a professional disclosure statement is to inform clients about your professional background and the limitations of your professional relationship. It is sometimes referred to as a document of informed consent.
It is important to note that the state you practice in may dictate what must be included in your statement of disclosure.
The following items are often included:
Your professional disclosure statement is a living document. By that I mean that it will grow and change as your experience, training, and practice changes. It’s a good idea to review (and amend as needed) your disclosure statement at least annually.
When writing your disclosure statement, you may find it helpful to gather samples of other professionals statements. You will find a copy of my disclosure statement here at my counseling website.
Have you given any thought to your cancellation policy? If not, you should. Cancellation policies provide clarity for your clients and reinforce professional courtesy and boundaries for you.
It is common for mental health professionals to require a 24-48 hour notice for clients to cancel a scheduled appointment. Under such a policy, the client who fails to give appropriate notice for canceling an appointment typically pays the therapist’s usual and customary fee. Therapists who implement this type of policy often stipulate exceptions for emergencies and illness.
"Cancelled" by Paul G.
My cancellation policy reads as follows: “ A cancelled appointment delays our work. When you must cancel, please give me at least 24 hours notice. I am rarely able to fill a cancelled session unless I know at least 24 hours in advance. In you are unable to provide at least 24 hours notice when you cancel, you will be charged the full fee for your session unless I am able to fill it with another client. (You should note that insurance companies do not typically reimburse for missed appointments.) The only time I will waive this fee is in the event of serious or contagious illness or emergency.”
Should you decide to implement a cancellation policy in your practice, make sure that you include it in your written statement of disclosure.
Tamara G. Suttle, M.Ed., LPC has maintained a private clinical practice since 1991 and founded Private Practice from the Inside Out in 2003. She has spent almost 20 years consulting and teaching marketing strategies to health care professionals like you. You can learn more about her clinical practice at her website.
Email Tamara
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