The Therapeutic Process

Deciding to seek therapy for your child is a great step in a positive direction. It is important that you understand the outcomes of therapy depend largely on your willingness to engage in this process. It may, at times, result in considerable discomfort. Remembering unpleasant events and becoming aware of feelings attached to those events can bring on strong feelings of anger, depression, anxiety, etc. In addition, creating change in parenting styles and relationships is challenging and threatens our confidence and sense of self as a parent.

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There are no miracle cures. We cannot promise that you or your child will change. Your therapist can promise to support you and do their best to understand you and your child, as well has to help you clarify what you and your child want and need, and determine a plan to achieve those things.

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Play therapy is not talk therapy.

Your child will not be expected to talk about their feelings or events going on in their daily life. If they wish to talk, they are encouraged to do so. However, it is important that you do not ask them to talk about something during their sessions. If the child brings up a specific situation or concern and you believe it may be helpful you are encouraged to suggest they talk to their therapist about it. But please do not ask them what they talked about each session or tell them they need to talk. You are also welcome to contact the therapist if there is a topic you are concerned about addressing.

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Play Therapy is evidence based.

Play therapy is an evidenced-based method of supporting children and teens in their personal growth, behavioral struggles, emotional regulation, and mental health. It focuses on using the body and imagination to express deep feelings and thoughts that the child may or may not be aware of. It also uses the body and the imagination to teach skills such as social skills, behavioral control, emotional regulation, problem solving, and decision making. The more a child talks, the more they use their language areas of the brain. These areas are not associated with significant improvement in behavioral emotional, or psychological well-being of a child. The body and imagination areas of the brain are associated with such improvement; thus, it is important the child continues to use these areas as much as possible. If you would like more information on some of the research supporting play therapy, The Association for Play Therapy has a fantastic Parent's Page and Research Page.

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Progress takes Time.

Because the struggles of children are typically subconscious and because the way they learn and express themselves best is through play. Progress can be slow, but when progress occurs through play therapy it is much more comprehensive and complete. It is also much longer lasting than progress through talk therapy for children. The typical length of time a child spends in play therapy is 12-24 months; however, treatment can be much shorter or longer depending on the specifics of each child’s needs.

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Ask Questions.

If you have any questions about play therapy, the research behind it, or how it works, please feel free to ask me about it. we am happy to answer any questions we can and provide you with resources to learn more about it on your own as well.

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Appropriate touch is essential to child development and play therapy.

It is unfortunate that the use of touch with children has been abused by many individuals making many adults afraid to allow touch or use touch with children. This is a particularly unfortunate, because touch is necessary for the healthy development of children. Because of this importance, touch will be used in play therapy when it is appropriate and necessary.

 

Touch helps build safety in a relationship, helps express empathy and understanding, and helps young children calm their bodies and emotions. Without touch, play therapy can be rendered entirely ineffective, because the relationship isn’t strong enough or safe enough for the child to process the thoughts and feelings that are causing their behavior. Please know that everyone in this office has had a thorough background check. Any touch that is concerning, such as a child performing inappropriate actions due to past trauma, will be discussed with parents and guardians as will the plans for treatment goals and boundaries around this behavior. If you have any questions or concerns about the use of therapeutic touch in therapy, please discuss them with me anytime.

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Our therapy office is a safe place.

Therapy brings up difficult topics for parents and kids alike. The stress of therapy and the discussions involved can cause tensions and emotions to rise. Please let us know if you are feeling overwhelmed at any time and we are happy to help you regulate or take a break from our work. Threatening aggression, abusive language, threats, and violence will not be tolerated. We are happy to help you work on expressing your concerns, and if you ever become aggressive, and we are happy to continue another time when you are more able to communicate calmly. We reserve the right to call security, the police, or terminate the therapy relationship should you choose to behave in a threatening manner despite my requests to end the session. This policy is to protect not only myself, but you, your children and other people in the office from frightening and potentially traumatizing experiences.

 

Please feel free to discuss this with us if you have concerns about your ability to follow this policy during difficult discussions.

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No intoxication or substances on the premises.

Good therapy requires your entire brain and a safe place. Alcohol, cigarettes or other substances are not permitted on the premises for safety reasons. In addition, coming in intoxicated is highly discouraged. If you are intoxicated to a point where it is disruptive to the office environment or unproductive for therapy, I will ask you to leave the premises for the safety of the other clients and to avoid wasting your time and money on ineffective sessions. We are happy to help you find a safe way home should this occur, and we are happy to work with you on substance use if you like. Similarly, please do not come to the office strongly smelling of smoke. Many of our child clients have asthma or allergies that can be very reactive to cigarette smoke, and it is important that the office is a safe place for them to visit. If your intoxication is a risk to the safety of yourself or others, we will contact police or CYFD to ensure everyone’s safety.

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CONFIDENTIALITY INFORMATION

You have the right to confidentiality of your sessions and documents related to your treatment.

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Calming Communities is concerned about confidentiality. It is the goal of Calming Communities to provide an environment in which our clients may place their trust and confidence. Under both federal and state law, confidentiality means communication with your therapist and any records pertaining to your identity, evaluation, or treatment will be held in confidence. Where federal and state laws differ, we comply with the stricter standard to ensure that your right to confidentiality is respected at all times.Also, beyond the law, we know that a sense of safety and security are necessary to the process of healing in which our clients are engaged Calming Communities will maintain confidentiality to the fullest extent personally and professionally. You have a right to confidentiality. We protect this right by ensuring that session content and all relevant materials to the cli ent’s treatment will be held confidential unless a parent or guardian with psychological record rights consent to release in writing. See limitations to confidentiality and requested records below.

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Minors and confidentiality:

Therapy services differ from other health services in that children do have a limited right to confidentiality. At 18, a teenager can consent to mental health treatment and to the release of information. This means, that you as a parent have no right to any information regarding their treatment unless they authorize me to release specific information, even if you or your insurance are paying for services. Please know that if your child discloses any situation that endangers their life, this constitutes an exception to confidentiality and a parent, guardian, or other authority will be informed in order to protect the child.

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Children under 18 also have limited confidentiality. This means that a parent will be informed of their child’s treatment and will be included in treatment planning sessions. In addition, parents are free to communicate openly with the therapist about any concerns and receive as much explanation as possible about what is occurring in session without breeching the child’s sense of safety and security.Parents will not be given a play by play of sessions or told everything that comes up, even if the language or behavior violate the parents’ rules for the child. This confidentiality is necessary for the child to be open and honest when exploring the issues going on and this allows for treatment to be successful. Without this protection, there is no possibility of effective treatment.'

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Similarly, any request for a release of the medical record will be reviewed and discussed with the child as well a the parent to ensure the safety and well being of the child. If the therapist determines it would do psychological harm to either the child or a guardian if the record is released, the therapist will explain this denial in writing in compliance with state and federal laws and offer a treatment summary addressing the information the requestor needs according to the minimum necessary rule and the wellbeing of the client and guardian.

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Exceptions:

Both legally and ethically, we are required to break confidentiality in three circumstances related to safety. This type of breech is done so in a limited way. I will only give information to those parties who are able and responsible for maintaining safety.

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• If you or your child inform me that someone is abusing or neglecting a child or elderly adult.

• If you or your child state that you may commit suicide or there is substantial risk of death involved in activities that you are engaging.

• If you or your child state, there is a risk to someone else’s life or safety.

• If a court of law issues a legitimate subpoena only for information stated on the subpoena.

• If a client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert report to an attorney.

• On occasion, your therapist may seek to consult with other professionals in their areas of expertise to provide the best treatment for you. Information about you may be disclosed in this context without using your name and with the minimal identifying features necessary.

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Release of information:

We are happy to honor your written wishes to release information to parties you choose but cannot be held liable for the distribution of that information once it has been sent. However, in order to protect your treatment and your child’s treatment, We do not release my documentation of sessions to outside parties. There are times when the technical jargon required by insurance and legal protection does not convey the meaning in away that is therapeutically appropriate. This could potentially be harmful to the therapeutic relationship and to your child’s mental health. Therefore, we are happy to provide treatment reviews in writing and consult verbally with anyone you wish that uses appropriate language for the audience.

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Separated Parents and Other Guardians:

Please be aware that right to information will be followed according to a custody agreement currently signed by the court. Parents are obligated to provide a copy of the custody agreement during the intake process and at any time the court updates the agreement. Any person(s) with the right to medical information have the right to all communications with the therapist. It is not my role to provide confidentiality from another guardian, but we are happy to provide referrals for your own therapist should you want to have a confidential space to discuss your concerns.

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In the case of high conflict co-parenting relationships or on-going custody cases, no communication outside of appointment reminders and changes, will occur without both parenting parties copied. This includes text messages, phone calls, and e-mails. Should one parent contact the therapist without the other copied, the therapist will reply with both parents copied and the original contact copied over for both parents to see.

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Billing insurance:

Insurance does require a limited release of information in order to be billed. If you are uncomfortable with this, you are welcome to deny me the ability to bill your insurance and choose to self-pay.Insurances are given the diagnosis code, appointment dates and times, the type of session, and limited information about what happened in session. This allows the insurance to pay your bill and make sure that we are not charging you for things that do not occur or are not therapy. If you have any questions about this please feel free to ask me or consult with your insurance company.

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Video/audio Recording is not permitted:

There is no video or audio recording allowed in the office or on telehealth and phone communications without prior consent in writing by every party involved in the session and/or phone call. A violation of this is a breech of safety and security for the parties involved and can result in termination of the therapeutic relationship. If you are interested in having a recording for some reason, please discuss this with me. There are times when it is helpful for learning to be able to review sessions and at these times I may request and/or approve a request to do so. I will not approve a request that is done to gather information on the child, the other parent, or be used as proof in a custody case.

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Calming Communities will not be responsible or accountable to the content of any audio or video recording done on the premises except with prior knowledge of client and therapist.

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Court Involvement and Custody Concerns:

Since it is rarely in the child’s best interest for a therapist to provide information to the court, we recommend you rely on a custody evaluator should you need court testimony. We are unable to make custody recommendations or evaluations. If we are subpoenaed, there is a fee that is based on the time the clinician must be away from the office. This fee must be paid 10 business days before the court date by cashier’s check.This fee will apply whether or not the court allows the clinician’s testimony, and additional fees apply for if the clinician is held over for multiple days.

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PAYMENT INFORMATION

The following information is provided to avoid any misunderstanding or disagreement concerning your payment for professional services. The fee for each service I provide is listed below. If it is listed as TBD, please consult with me before the event so we can discuss the fee for the specific circumstances of your requested service. Payments for all services are expected at the time of service.

• Therapy session: (45 minutes - family, couples, or individual)

  • Intern Clinician rate: $50

  • Associate Clinician rate: $100

  • Fully Licensed Clinician rate: $155

• Support Phone Call: Session rate (over 15 minutes).

• Treatment Review: Free. (short letter describing services provided).

• Court appearance: TBD - Minimum of $3000 paid by money order (the situation varies greatly, fee is based on time away from the office reserved for the appearance).

• Consultation: TBD (Usually, a session fee. Sometimes this is covered by insurance, but often it is not. Some consultations such as an IEP meeting may take longer or require travel that changes the fee by multiplying the provider’s session rate x the time spent in hours).

• Missed appointment: Session rate (less than 24-hours notice of absence).

• Records Requests: $25 for the first 20 page + $0.10 a page beyond that.

Insurance: As a courtesy, Calming Communities will file your insurance claims with your signed consent. However, we are not responsible for the accuracy of your insurance’s payments or verification. You are responsible for the full cost as described above, less the amount the insurance pays.

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Split Payments:

Calming Communities is unable to split payments each week or alternate payments across sessions. We require a card on file through our billing system. Parents may update this card as often as they like. We understand many custody agreements require medical bills be split 50/50. Our system is unable to host more than one card at a time, and attempting to regulate your financial relationship detracts from our ability to focus on your child's treatment. Parents must arrange with one another how they will work this out through reimbursement or otherwise.