Practice Policies
Please discuss any questions or concerns regarding the following policies with Kindle Counseling.
IN AN EMERGENCY, CALL 911.
EMERGENCIES:
IN AN EMERGENCY, CALL 911. While Kindle Counseling, PLLC therapists care greatly about their clients, they are often not immediately available and cannot guarantee a timely response in emergency situations; therefore, if an emergency arises, PLEASE CALL 9-1-1.
TELEPHONE ACCESSIBILITY:
If you need to contact your therapist in non-emergency situations between sessions, please leave a telephone voice message or send a message through your client portal. Your therapist is often not immediately available; however, your therapist will attempt to return your call or message within 24 normal operating business hours. Face-to-face or telemental health sessions are highly preferable to phone sessions; however, in the event that you are out of town, sick or need additional support, phone sessions are available. Scheduling and inquiry phone calls are typically no charge; however, if phone calls become more frequent and lengthy, emulating a therapy appointment, fees for future phone appointments will be discussed and utilized following the guidelines for and provision of a Good Faith Estimate (GFE). (Please note that rates may apply and note the Jurisdiction Requirements Policy.)
APPOINTMENTS & FEES:
Kindle Counseling does not accept insurance for many reasons; however, a “superbill” can be given to a client upon request. Clients may submit a superbill to their insurance company and request partial reimbursement; however, Kindle Counseling does not communicate with insurance companies and makes no claim that any insurance company will reimburse a client. It is up to clients to communicate with their insurance companies about their insurance plans and any possible insurance reimbursement.
Kindle Counseling’s private-pay rates reflect the therapist’s extensive past and ongoing education, training, licensure, certification, and experience as well as the dedicated time commitment, during and outside of appointments, allotted for clients. Outside of client appointment time, Kindle Counseling therapists plan and prepare for each appointment as well as maintain the required secure documentation and treatment plan for each client. These rates are set to ensure that high-quality services, which meet the unique needs of every individual, are provided. Due to the high quality pre and post appointment preparation as well as appointment services provided, Kindle Counseling, PLLC requires a credit card to be on file for each client with consent signed to authorize payment for services provided as well as for fees as designated in the Cancellations policy. Payments are due on the same date of service. Late fees may be assessed for late payments. In order to maintain mutual respect and a healthy therapeutic working relationship, Kindle Counseling reserves the right to provide referrals and discontinue services if a client is default on payment.
Please refer to Kindle Counseling’s website for current session lengths and rates or discuss any questions/concerns regarding session lengths and/or rates with your therapist prior to appointments:
https://www.kindlecounseling.com/rates
A $25.00 service charge will be charged for any checks returned for any reason for special handling.
CANCELLATIONS:
Kindle Counseling has a 24-hour cancellation policy. If you need to reschedule or cancel your appointment, we request that you notify Kindle Counseling via phone at 346-527-8911 or the client portal scheduling or messaging system at least 24 hours in advance. This allows time to offer the session time to another client and fosters a therapeutic relationship built on trust and mutual respect. You will be responsible for the entire fee if cancellation is less than 24 hours. This is necessary because a time commitment is made to you and is held exclusively for you. Psychotherapy sessions have standard meeting lengths. If you are late for a session, you will lose some of that session time. Kindle Counseling understands that life can be unpredictable and sometimes circumstances change; therefore, please consider contacting Kindle Counseling and requesting your in-office appointment be changed at no additional charge to a telemental health session for your office appointment time if you unexpectedly find you are unable to attend your Kindle Counseling office location session. Kindle Counseling cannot guarantee this arrangement due to possible time constraints and receipt of such requests; however, every attempt will be made to comply with a request.
CONFIDENTIALITY:
In general, discussions between a therapist and a client are confidential. No information will be released without the client's written permission unless mandated or permitted by law. Possible exceptions to confidentiality include but are not limited to the following situations: abuse or sexual exploitation; court orders or subpoenas; situations where the therapist has a duty to disclose or where, in the therapist's judgment, it is necessary to warn, protect, notify or disclose; related to payment or authorization for health services; to employees or agents of Kindle Counseling, PLLC for operational purposes; to regulatory authorities in connection with compliance responsibilities; for treatment consultations with other mental health professionals when deemed necessary; to your primary care provider or other mental health provider for the purposes of continuity of care; and for fee disputes, licensing board complaints, or lawsuits between the client and the therapist. Please also refer to the Confidentiality section of the “Informed Consent for Psychotherapy” as well as the “Notice of Privacy Practices”, which explains confidentiality policies further and will be provided to clients.
JURISDICTION REQUIREMENTS:
Due to the current complexity and changing nature of laws related to a therapist’s ability to provide mental health services to clients when one or both parties are outside of Texas jurisdictions, the legality of providing those services will need to be explored for all states in which the services are to be provided prior to conducting interstate mental health services. When state law and licensing boards are silent on this issue, therapists have not been expressly granted the authority to provide mental health services in that jurisdiction. It is Kindle Counseling’s policy to treat Texas residents within Texas jurisdiction, unless previously arranged with clients and laws permitting the interstate mental health services are verified.
SOCIAL MEDIA AND TELECOMMUNICATION:
Due to the importance of client confidentiality and the importance of minimizing dual relationships, Kindle Counseling therapists do not intentionally accept friend or contact requests from current or former clients on any *social networking site (*Facebook, Instagram, LinkedIn, etc.). Adding clients as friends or contacts on these sites can compromise your confidentiality and privacy. It may also blur the boundaries of the therapeutic relationship. If you have questions about this, please bring them up with your therapist.
Please Note: Kindle Counseling’s social media pages are public and viewable to others and provide information and news about Kindle Counseling. If you choose to visit, “like”, and/or comment on any Kindle Counseling social media page, your identity, as you have arranged with social media, may be visible to others. Your choice to visit, like, and/or follow Kindle Counseling social media pages is independent of your care at Kindle Counseling and is outside of Kindle Counseling’s privacy policies and protections. Do not consider any information on Kindle Counseling’s social medica pages as therapeutic advice, and please discuss with your therapist any questions and/or concerns about any material you may read on those sites.
TREATMENT PLAN:
Kindle Counseling therapists will discuss the goals, objectives, and techniques of therapy with clients. Clients should communicate any questions or concerns regarding their treatment plan with their therapist
AUDIO or VIDEO RECORDINGS:
Neither a client nor a therapist will record (audio or video) any sessions without the prior mutual written consent of the therapist and client.
ELECTRONIC COMMUNICATION:
Kindle Counseling, PLLC uses HIPAA compliant Simple Practice software designed for health professionals and includes the following services: electronic health records, appointment scheduling, telehealth, client portal, paperless forms, and appointment reminders as well as a secure messaging system and a convenient app. You may use the following link for more information about downloading the Simple Practice app or request more information from Kindle Counseling.
Kindle Counseling cannot ensure the confidentiality of any form of communication through electronic media, including email and text messages. If you prefer to communicate via email or text messaging, Kindle Counseling may comply. Your therapist is often not immediately available; however, your therapist will attempt to return your message within 24 normal operating business hours. Please do not use these methods of communication to discuss therapeutic content and do not use these methods to request assistance for emergencies. Call 9-1-1 in an emergency. (Please also see Kindle Counseling’s “Notice of Privacy Practices”)
While usual Kindle Counseling electronic communication does not typically involve a fee, if frequent and/or lengthy communication requires repeated therapist time to address and respond, fees for future non-typical electronic communication will be discussed and utilized following the guidelines for and provision of a Good Faith Estimate (GFE)
MINORS:
If you are a minor, your parents may be legally entitled to some information about your therapy. I will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential.
TERMINATION:
Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. Some instances where a therapist may terminate treatment are: if it is determined that psychotherapy services are not being effectively used and/or a lack of adequate progress is made; if a conflict of interest becomes apparent; if it becomes apparent that mental health needs are beyond a therapist’s area of expertise; or if a client is in default on payment. If therapy is terminated for any reason or you request another therapist, your therapist will provide you with a list of psychotherapists upon request. You may also choose someone on your own or from another referral source. Should you fail to schedule an appointment for four consecutive weeks without other arrangements having been made in advance, for legal and ethical reasons, the professional relationship must be considered discontinued.
COURT RELATED SERVICES:
Kindle Counseling, PLLC does not provide or perform evaluations for custody, visitation or other forensic matters. Therefore, it is understood and agreed that Kindle Counseling cannot and will not provide any testimony or reports regarding issues of custody, visitation or fitness of a parent in any legal matters or administrative proceedings. If Kindle Counseling is contacted by an attorney regarding your treatment, either at your behest or related to a legal matter you are involved in, you agree to and acknowledge the following:
Kindle Counseling charges a retainer prior to any preparation or attendance of legal proceedings.
Kindle Counseling charges to prepare for and/or attend any legal proceeding and for all court related services.
Charges for court related services are not covered by insurance.
Court related services include: talking with attorneys, preparing documents, traveling to/from court, depositions and court appearances.
If the court or attorneys do not pay one or more of Kindle Counseling’s fees, you will be charged for those fees and for the time your therapist spends responding to legal matters
You will also be charged for any costs Kindle Counseling incurs responding to attorneys in your case, including but not limited to fees Kindle Counseling pays for legal consultation and representation by attorneys and fees related to research time spent by Kindle Counseling.
TELEMENTAL HEALTH*:
*PLEASE REFER TO THE KINDLE COUNSELING, PLLC - TELEMENTAL HEALTH INFORMED CONSENT (below)
MARITAL or JOINT THERAPY*:
*PLEASE REFER TO THE KINDLE COUNSELING, PLLC - COUPLE COUNSEING, RELEASE OF INFORMATION, & LIMITED SECRETS POLICY which will be sent separately from this document if you will be participating in Marital or Joint Therapy.
TELEMENTAL HEALTH INFORMED CONSENT:
When appropriate, therapy can be conducted via Kindle Counseling’s HIPAA compliant telemental health service for Texas residents. Some clients prefer to use telehealth services for their therapy appointments while others prefer to meet together at Kindle Counseling’s office for appointments. Either way, telehealth provides on option for the unexpected events in life and allows sessions to take place when otherwise might not be possible. (Example: A client has to unexpectedly be home with a sick child or forgets about a scheduled session.) By signing this document, you are not committing to participating in telemental health services; however, signing allows telemental health to be a part of your therapeutic services offered by Kindle Counseling, PLLC and acknowledges your receipt of important details about telemental health services.
I hereby consent to participate in telemental health with Kindle Counseling, PLLC as part of my psychotherapy when appropriate and agreed on by all participants. I understand that telemental health is the practice of delivering clinical health care services via technology assisted media or other electronic means between a practitioner and a client who are located in two different locations.
I understand the following with respect to telemental health:
I understand that it is my duty to ensure the privacy of my location so as to maintain confidentiality and agree to do so and to immediately notify other participants if a non-designated participant either on or off the camera is able to hear and/or see any part of a telehealth session.
I understand that while telehealth allows for sessions to take place outside of Kindle Counseling’s physical office location, it is expected that all participants during telehealth sessions shall: refrain from driving; attend sessions wearing appropriate attire; refrain from using substances; and refrain from being under the influence of substances as if attending in-office sessions together and agree to do so.
I understand that I have the right to withdraw consent at any time without affecting my right to future care, outside of telehealth services, or program benefits to which I would otherwise be entitled.
The general rule regarding the provision of telemental health services is that providers must meet any licensure requirements of the jurisdiction where they are licensed and any licensure requirements of the jurisdiction where the client is physically located. If state law and licensing boards are silent on this issue, then therapists have not been expressly granted the authority to provide telemental health services in that jurisdiction. Due to the current complexity and changing nature of laws related to a therapist’s ability to provide telemental health services to clients when one or both parties are outside of Texas jurisdictions, the legality of providing telemental health services will need to be explored for both states in which the services are to be provided prior to conducting interstate telemental health services. It is Kindle Counseling’s policy to treat Texas residents within Texas jurisdiction, unless previously arranged with clients and laws permitting the interstate mental services are verified.
I understand that there are risks, benefits, and consequences associated with telemental health, including but not limited to, disruption of transmission by technology failures, interruption and/or breaches of confidentiality by unauthorized persons, and/or limited ability to respond to emergencies. I understand that Kindle Counseling, PLLC cannot guarantee the absence of technological breaches of confidentiality nor guarantee that technology will be available or work as expected.
I understand that Telehealth by Simple Practice is the technology service used by Kindle Counseling, PLLC to conduct telehealth videoconferencing appointments and there are no passwords required to log in. To maintain confidentiality, I will not share my telehealth appointment link with anyone unauthorized to attend the appointment.
I agree that there will be no screenshot or recording of any of the online sessions by either party.
I understand that the privacy laws that protect the confidentiality of my protected health information (PHI) also apply to telemental health unless an exception to confidentiality applies (i.e. mandatory reporting of child, elder, or vulnerable adult abuse; danger to self or others; I raise mental/emotional health as an issue in a legal proceeding).
I understand that if I am having suicidal or homicidal thoughts, actively experiencing psychotic symptoms or experiencing a mental health crisis that cannot be resolved remotely, it may be determined that telemental health services are not appropriate and a higher level of care is required.
I understand that during a telemental health session, technical difficulties could be encountered resulting in service interruptions. If this occurs, I will end and restart the session. I agree to keep my contact phone number in my portal up to date and understand this is the number my therapist will use to contact me if technical difficulties occur. I also agree to notify my therapist at the start of a telehealth session if an alternate number should be used. If I’m unable to reconnect within ten minutes and I have not received a call from my therapist, I agree to call Kindle Counseling, PLLC at 346-527-8911 to discuss and possibly re-schedule my appointment.
I understand that my therapist may need to contact my emergency contact and/or appropriate authorities in case of an emergency.
Emergency Protocols:
I agree to call 9-1-1 in the event of an emergency. I understand that if I am having suicidal or homicidal thoughts, experiencing psychotic symptoms, or in a crisis that cannot be solved remotely, my therapist may determine that I need a higher level of care and telehealth services are not appropriate. Since my location needs to be known in case of an emergency, I agree to inform my therapist at the beginning of each telemental health session if my address is one different than the address provided below. I also agree to notify my therapist ASAP if I will be outside of Texas jurisdiction during a scheduled telemental health appointment and understand appointments may need to be rescheduled due to state laws limiting interstate telemental health practice.
* In case of an emergency, my location is: ___________________________________
I agree to be knowledgeable of nearby emergency care wherever I receive telemental health services and to contact 9-1-1 in an emergency.
I understand that I need to designate a contact person who my therapist may contact on my behalf in a life-threatening emergency. I agree to update this information any time this person cannot serve as my emergency contact person. This person may be contacted to go to my location and/or take me to the hospital in the event of an emergency.
* My local emergency contact person’s name, relation to me, address, and phone number: ___________________________________
COUPLE COUNSEING, RELEASE OF INFORMATION, & LIMITED SECRETS:
The “COUPLE COUNSELING, RELEASE OF INFORMATION, & LIMITED SECRETS” form is in addition to the “KINDLE COUNSELING - INTAKE DOCUMENT” policies and consents.
THE COUPLE IS THE CLIENT:
When you attend couple therapy sessions you as a couple are considered to be “the client’ and your mental health records therefore belong to both of you. This means that except in the circumstances below, written consent from both of you is required in order to disclose information from your record to a third party.
CONFIDENTIALITY:
Information you share is protected by confidentiality laws. Without your written consent and permission, Kindle Counseling cannot reveal whether or not you are a client nor discuss any information from sessions with a third party outside of the client couple and therapist. The following are some exceptions to this rule:
· If one of you pose an imminent danger to yourself, your partner, or someone else, information may be released to emergency services, law enforcement personnel, and/or hospital staff.
· If you talk about events that indicating that a child under the age of 18 or an elderly or disabled person is at risk of emotional, physical, or sexual abuse, neglect, or exploration, a report to Protective Services is required by law.
· If a judge in a court of law orders the release of information or if a subpoena is lawfully issued, information may need to be released after attempts are made to verify the legal requirement to do so.
COURT PROCEEDINGS/SUBPOENA OF RECORDS:
It is understood that the purpose of marital/couple therapy is for the amelioration of distress within a relationship. Therefore, if both partners request Kindle Counseling services, they are expected not to use information provided during the therapy process against the other party in a judicial setting of any kind, be it civil, criminal, or circuit. Likewise, neither party shall for any reason attempt to subpoena a Kindle Counseling therapist’s testimony or records to be presented in a deposition or court hearing of any kind for any reason, such as a divorce case.
LIMITED SECRETS POLICY:
When a couple enters into counseling, the couple is considered to be one unit. This means that therapist allegiance is to the couple “unit,” and not to either partner as an individual. This process is important in creating a space for open and honest communication and allowing therapists to work diligently to support the goals of the couple unit.
It is important to note that couples are entrusting Kindle Counseling therapists to use their professional judgement as a whole and as it relates to individual confidences; therefore, Kindle Counseling has a “Limited Secrets Policy”. By signing this form, you are acknowledging that anything you communicate individually to your couple therapist by individual session, phone, message, email, or any other means may be important to bring up and work on in a couple therapy session, and your therapist reserves the right, but not the obligation, to do so. For example, on occasion during the counseling process, individual partners may be seen for an individual counseling session. In this case, the individual session is still considered as part of the couple counseling relationship. Information disclosed during individual sessions may be relevant or even essential to the proper treatment of the couple. If an individual chooses to share relevant or essential information with the therapist, the therapist will offer the individual every opportunity to disclose the relevant information and will provide guidance in this process. If the individual refuses to disclose this information within a couple session, it may become necessary to discontinue the counseling relationship with the couple. If there is information that an individual desires to address within a context of individual therapy confidentiality, the therapist will be happy to provide referrals to therapists who can provide concurrent individual therapy. This Limited Secrets Policy is intended to maintain the integrity of the couple/marital counseling relationship.
BOUNDARIES:
Because the relationship is the main focus of couple therapy, both partners of a couple must be present for the couple session to start. It is often not in the best interest of the couple to distribute time unevenly between partners or to have unplanned meetings with only one partner present. If one partner is late in arriving or does not show for the appointment, Kindle Counseling therapists reserve the right to delay the start of the session or to cancel the session if necessary.
LENGTH OF COUPLE THERAPY:
A completed couple therapy varies greatly among couples. Length of time depends on severity level of problems, history of past trauma/ infidelity/ or betrayals, and the presence of co-occurring emotional or psychological issues, such as mood disorders, depressive symptoms, substance use problems, or personality disorder traits. It is advisable (but optional) for each partner to schedule at least one individual session with the couple therapist as part of the couple therapy process.
LIMITATIONS OF COUPLE THERAPY:
Couple therapy will only be effective in cases where both partners put in a good faith effort to work on their problems and their relationship. Deliberate dishonesty or deceit, unwillingness to introspect and take responsibility for one’s actions or lack of interest to engage in the couple therapy process by one or both partners will undermine the therapy. The continued participation by each person is voluntary. Either participant may suspend or terminate the therapy at her or his individual request. Kindle Counseling, PLLC is unable to accept clients in a relationship with a history of domestic violence.
FEES/24-HOUR CANCELLATION POLICY:
Couple therapy begins with a 60-minute initial intake session or “psychiatric evaluation” ($225) where a thorough assessment of presenting issues and history is conducted and a treatment plan initiated. In addition to the 60-minute appointment, this rate includes the clinician’s pre/post intake appointment: initial documents completion; client HIPAA-compliant confidential online record and portal formation; treatment plan completion after the intake appointment; and preparation for the next appointment. Following the intake appointment, Couple therapy sessions are 45-minutes each ($185/session) with occasional 45-minute individual partner sessions ($175/session).
If I am prevented from attending a scheduled session and do not cancel the appointment at least 24-hours in advance, I understand that I will be charged the full session fee. This practice for no-shows or late cancellations is standard practice in the field, and takes into account that you are not just paying for services rendered, but reserving a time slot which will not be possible to offer to others on short notice.
