What else should I know about therapy?

The Benefits and Risks of Therapy

As an informed consumer you should think about both the benefits and risks when making any treatment decisions.

In therapy, there is a risk that clients will, for a time, experience uncomfortable feelings such as sadness, guilt, anxiety, anger, or frustration. Clients may recall unpleasant memories which might be disturbing. Also, clients in therapy may experience stress with people important to them. Family secrets may be told and sometimes therapy may disrupt a marital relationship. Most of these risks are to be expected when people are making important positive changes in their lives.

In addition, in some cultures or communities there may be a social stigma against someone who seeks therapy which could cause distress to the client. Finally, even with our best efforts, there is a risk that therapy may not work for you the way that you want it to.

The benefits of therapy have been shown by scientists in hundreds of well-designed research studies. Therapy has been shown to lift depression and reduce feelings of anger, fear, and anxiety. In therapy, people have a chance to talk things out fully until their feelings are relieved or the problems are solved. Clients’ self-esteem, relationships, and coping skills may improve greatly often resulting in an increase of satisfaction with social and family relationships. Clients’ personal goals and values may become clearer and they may become more self- empowered. Clients’ usually grow in many ways… within their close relationships, in their work or schooling, and in the ability to enjoy their lives.

Limits to the Therapist/Client Relationship

As a professional, I will use my best knowledge and skills to help you. This includes following the standards of the American Association of Marriage and Family Therapists (AAMFT) and the American Psychological Association (APA). In your best interests, these regulatory entities put 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.

Psychotherapy is a professional service I can provide to you. Because of the nature of therapy, our relationship has to be different from most relationships and it must be limited to the relationship of therapist and client only. If we were to interact in any other ways, we would then have a “dual relationship,” which would not be right and may not be legal.

Because I am your therapist, dual relationships like these are improper:

• I cannot be your supervisor, teacher, or evaluator.
• I cannot be a therapist to my own relatives, friends (or the relatives of friends), people I know socially, or business contacts.
• I cannot provide therapy to people I used to know socially, or to former business contacts.
• I cannot have any other kind of business relationship with you besides the therapy itself. For example, I cannot employ you, lend to or borrow from you, or trade or barter your services (things like tutoring, repairing, child care, etc.) or goods for therapy.
• I cannot give legal, medical, financial, or any other type of professional advice.
• I cannot have any kind of romantic or sexual relationship with a former or current client, or any other people close to a client.
• Even though you might invite me, I may not attend your family gatherings, such as parties or weddings nor can I accept any gifts from you.
• If you ever become involved in a divorce or custody dispute, I will not provide evaluations or expert testimony in court as my statements would be considered biased in your favor because we have a therapy relationship. You should hire a different mental health professional for any evaluations or testimony you require.

Dual relationships can set up conflicts between my own (the therapist’s) interests and your (the client’s) best interests, and then your interests might not be put first. In order to offer all my clients the best care, my judgment needs to be unselfish and professional. Thank you for understanding.

About Confidentiality

It is your legal right that our sessions and my records about you be kept private. 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 make a serious threat to harm yourself or another person, the law requires that I try to protect you or that other person. In this case I would inform the necessary people to keep everyone safe.
• If I believe a child, elderly person, or disabled person has been or will be abused or neglected, I am legally required to report this to the authorities.
• If you are involved in a court case and my records are subpoenaed then I may be required to break our confidentiality agreement.

If you choose to use insurance as a method of payment then I will be required to provide the insurance company with basic 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 the minimum information that the insurance company requires. You can review your own records in my files at any time.

Please understand that there is one other situation in which I may speak about you. I sometimes consult other therapists or other professionals about my clients. This helps me to provide the highest- quality treatment and care. Your name will never be given to them and they are also required by law to keep our discussion private and confidential.

Cancelation Policy

An appointment is a commitment to our work. We agree to meet here and to be on time. 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. I will 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 24 hours notice.

Except for unpredictable emergencies and illness I will charge you 50% of the regular fee for any missed sessions. If the appointment is not kept or is cancelled with less than 24 hours’ advance notice, you can expect me to charge you for it.

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 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 rules of the American Association of Marriage and Family Therapists (AAMFT), the American Psychological Association (APA) and by those of my state license.

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. 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 inform me.

You can also contact the Washington State Department of Health or the AAMFT 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.

In 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.