General Psychological Services

Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychologist and client, as well as the particular issues that are presented. There are many different methods that can be used to deal with the changes that you hope to make. My approach is Cognitive Behavioral Therapy.

CBT

CBT is a very general term for a classification of therapies with similarities (i.e., Cognitive Therapy, Dialectical Behavior Therapy, Self-Instructional Training, Acceptance and Commitment Therapy, etc). Very different from other forms of psychotherapy (i.e., psychoanalytic, psychodynamic, etc.), CBT as a therapy emphasizes the important role of thinking in how we feel and what we do. For a more in-depth look at the characteristics of most cognitive-behavioral therapies, please refer to the CBT page of my website.

Benefits and Risks

As with other health interventions, CBT can have both benefits and risks. As psychotherapy often involves discussing unpleasant aspects of your life, you may experience painful feelings like sadness, guilt, anger, frustration, and helplessness. Such discomfort is generally temporary, short-term, and manageable. On the other hand, CBT has been shown to have benefits for people who actively engage in it. Therapy can lead to better relationships, solutions to specific problems, and significant reductions in feelings of distress and other symptoms. And while no guarantees can be made regarding treatment success, it has been my real privilege to have worked with people who have done a variety of difficult – and frankly amazing – things they thought to be all but impossible in order to pursue healthy, happy, productive lives. 

Client Rights

Three supporting documents, the Notice of Privacy Practices (HIPAA) and Behavioral Health Participant Rights and Responsibilities (CIGNA), and Good Faith Estimate for Health Care Items and Services Under the No Surprises Act, describe your rights as a psychotherapy client. These documents can also be found under the Practice Information tab on my website, in Treatment Contract and Forms (https://www.psychologist-nh.com/therapy-practice-information/nh-psychologist-my-contract-with-you/) and I am happy to discuss any of these rights with you.

Professional Records

The laws and standards of my profession require that I keep Protected Health Information (PHI) about you in your Clinical Record. Your Clinical Record is primarily stored in a laptop computer that is protected in a manner that is in keeping with the Ethical Principles of Psychologists and Code of Conduct. While I have exercised due diligence in protecting the confidentiality of your PHI/Clinical Record both on the laptop computer and paper records stored in my office, I cannot provide a complete guarantee against an unanticipated event (i.e., accident, theft). Given computer safeguards, I do not believe your PHI will be at any greater risk than if a paper copy of the information was stored in a file cabinet in my office. If you are uncomfortable with these arrangements, please discuss this with me at any point during our work together. Except in unusual circumstances, you may examine and/or receive a copy of your Clinical Record if you request it in writing.

Confidentiality

The law protects the privacy of all communications between a client and a psychologist. In most situations, I can only release information about your treatment to others if you sign a written authorization form that meets certain legal requirements imposed by HIPAA. There are other situations that require only that you provide written advance consent. Your signature on this Treatment Contract provides written advance consent for those activities, as follows.

• If I believe that a client presents an imminent danger to his/her health or safety, I am legally and ethically obligated to intervene appropriately to provide for the client’s protection. Such interventions may include dispatching police and/or emergency rescue services to his/her home, seeking hospitalization for him/her, or contacting family members or others who can help.
• Consultations/collaborations with other health and mental health professionals is helpful and professionally warranted. During such communications, I make every effort to avoid revealing client identity. Other health professionals are also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. I will note all consultations in your Clinical Record.
• Business contracts with corporate service firms, as required by HIPAA, require a formal business associate contract with these entities, in which they promise to maintain the confidentiality of data except as specifically allowed in the contract or otherwise required by law. If you wish, I can provide you with the name of these entities and/or a copy of these contracts.
• Disclosures required by health insurers or to collect overdue fees are outlined in my Financial Policy on pages 6-7 of this contract.

There are some situations where I am permitted or required to disclose information without either your consent or authorization, as follows.

• If you are involved in a court proceeding and a request is made for information concerning the professional services that I provided you, this is protected by the psychologist-client privilege law. However, I may be legally bound to provide requested information if I am presented with a court order. If you are involved in or contemplating litigation, you want to consult with your attorney to determine whether a court would be likely to order me to disclose information.
• If a government agency requests the information for health oversight activities, I may be required to provide it for them.
• If a client files a complaint or lawsuit against me, I can disclose relevant information in order to defend myself.
• If a client files a workers’ compensation claim, and my services are being compensated through workers’ compensation benefits, I must, upon request, provide a copy of the client’s record to his/her employer or the Industrial Commission.

There are some situations in which I am legally obligated to take actions which I believe are necessary to attempt to protect others from harm, and I may have to reveal some information about the client’s treatment. These situations are unusual in my practice.

• If I have cause to suspect that a child under 18 or a dependent elderly person is abused or neglected, or if I have reasonable cause to believe that a disabled adult is in need of protective services, I will file all necessary reports with the appropriate state agencies, as per my ethical and legal mandates in the State of New Hampshire. Once such a report is filed, I may be required to provide additional information.
• If I believe that a client presents an imminent danger to the health and safety of another, I may be required to disclose information in order to take protective actions, including warning the potential victim, if identifiable, initiating hospitalization, and/or calling the police.

If such situations arise, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to only what is absolutely necessary.