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Terms and Policy

Communications Policy
                                                                                    Caitlan Siegenthaler, MA, LPC NCC

                                                                                   +1-888-210-6424 LPC #0015722

                                                Secure contact information can be found at www.caitlansiegenthaler.com


                                                                                   Communications Policy 


Contacting Me:

Your confidentiality is very important in the work we do, both in my office (mostly virtual office) and out of it. Many modern methods of communication have poor privacy safeguards, and I strive to balance your confidentiality with our need to contact each other as easily and comfortably as possible.

If you need to contact me for any reason, the preferred method is by telephone via the secured, toll-free number:  +1-888-210-6424 or +41-78-26-2260 for Clients located in Switzerland. If for some reason I do not answer, please leave a voicemail message on this secure line. You may also text this secure number if you prefer.

Regular email is neither secure nor reliably confidential, so please be sure to utilize the secure client platform for any email like messaging we may need to do together. Due to their poor security, please refrain from making contact using social media messaging systems such as Facebook, Instagram or Twitter.

It is important that we be able to communicate and also keep the confidential space that is vital to therapy. Please speak with me about any concerns you have regarding preferred communication methods.


Response Time

While it is my intention to reply to communications from Clients immediately, due to the nature and volume of my practice, an immediate response is not always possible. For voicemails and other messages, I will get back to you within one business day (weekends are not included in this timeframe.) If I can anticipate that I will be unable to reply to your messages for an extended period of time, I will take reasonable steps to inform you beforehand.


Emergency Contact

If you are ever experiencing an emergency, including a mental health crisis, please call the Colorado Crisis Service Call: 1-844-493-8255 (TALK) or Text TALK to 38255. If you need to contact me about an emergency, please call the secure, toll-free number: +1-888-210-6424, and please note the eight hour time difference.

While communication via SMS text messages can be used to contact me in certain situations, please do not attempt to contact me via text message in an emergency. Your message may reach me later than would be desired or, in rare cases, not at all.


I will call your emergency contact in instances where I am concerned about your safety and/or would be required to break confidentiality. If you want to hurt yourself, someone else is hurting you, you want to hurt someone else. I would also reach out to your emergency contact if you did not show up for a session and I had concern about your well-being/ whereabouts based on the content of our last session. Therefore, with your permission, you are allowing me to reach out to your emergency contact in some instances. 


Disclosure Regarding Third-Party Access to Communications

Please know that when we use electronic communications methods, such as email, texting, online video, and others, there are various technicians and administrators who maintain these services and may have certain access to the content of those communications.

The platform that we will be using for most of our communication is CounSol, a HIPPA Secure platform, meaning your data and privacy is secure. This platform provides you a unique client login and allows us to securely do most of the communication we need to do, including video communication.

Of special consideration are work and school email addresses. If you use your work or school email to communicate with me, your employer or school officials may have access our email communications. There may be similar issues involved in email accounts associated with other organizations that you are affiliated with.

Additionally, people with access to your computer, mobile phone, and/or other devices may also have access to your email and/or text messages. This includes messages sent to my secure number. Please take a moment to contemplate the risks involved if any of these persons were to access the messages we exchange with each other.

If you have any questions regarding these communications policies, please don't hesitate to contact me directly, at the secure, toll-free number: +1-888-210-6424.


General Communication Notes:

If you do not show up for session, I will first email you to see if you're having trouble logging in, etc. I may also send you a text or give you a call when you do not show up for session. As a friendly reminder, you will be charged the full session amount if you do not show up for session and did not cancel 48 hours in advance. 


If I haven't heard from you or spoken with you in three weeks, I will reach out one more time via email to ensure you are okay and to check in to see if you still want to move forward with our agreement for our counseling work. If I do not receive a response, I will assume you are no longer interested and will no longer hold your space in my counseling practice. 


In the event of me having serious illness or in my death , you will hear from Remo Siegenthaler and he will tell you what has happened to me. At that time, he will also provide resources/referrals if necessary. 


Should I be out of the office for an extended period of time, I will make arrangements for a point of contact for you and will communicate who that is at that time. 

( Type Full Name )
( Full Name )
HIPPA Privacy Practices Notice

                                                                                Caitlan Siegenthaler, MA, LPC NCC

                                                                               +1-888-210-6424 LPC #0015722

                                               Secure contact information can be found at www.caitlansiegenthaler.com

                                                 Please refer to my Communications Policy for best contact methods


                                                                                  Notice of Privacy Practices

This Notice Describes How Medical Information About You May Be Used And Disclosed And How You Can Get Access To This Information. Please Review It Carefully.

I.               I Have A Legal Duty To Safeguard Your Protected Health Information ("PHI").

I am legally required to protect the privacy of your PHI, which includes information that can be used to identify you that I've created or received about your past, present, or future health or condition, the provision of health care to you, or the payment of this health care. I must provide you with this Notice about my privacy practices, and such Notice must explain how, when, and why I will "use" and "disclose" your PHI. "Use" of PHI occurs when I share, examine, utilize, apply, or analyze such information within my practice; PHI is "disclosed" when it is released, transferred, has been given to, or is otherwise divulged to a third party outside of my practice. With some exceptions, I may not use or disclose any more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made. And, I am legally required to follow the privacy practices described in this Notice of Privacy Practices ("Notice").

However, I reserve the right to change the terms of this Notice and my privacy policies at any time. Any changes will apply to PHI on file with me already. Before I make any important changes to my policies, I will promptly change this Notice and post a new copy of it in my office or at my website (if applicable). You can also request a copy of this Notice from me, or you can view a copy of it in my office or on my website.

II.             How I May Use And Disclose Your PHI.

I will use and disclose your PHI for many different reasons. For some of these uses or disclosures, I will need your prior authorization; for others, however, I do not. Listed below are the different categories of my uses and disclosures along with some examples of each category.

A. Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent. I can use and disclose your PHI without your consent for the following reasons:

1. For Treatment. I can disclose your PHI to physicians, psychiatrists,          psychologists, and other   licensed health care providers who provide you with             health care services or are involved in your care. For example, if you're being           treated by a psychiatrist, I can disclose your PHI to your psychiatrist in order to            coordinate your care.

 2. To Obtain Payment for Treatment. I can use and disclose your PHI to bill and     collect payment for the treatment and services provided by me to you. For     example, I might send your PHI to your insurance company or health plan to get      paid for the health care services that I have provided to you. I may also provide         your PHI to my business associates, such as billing companies, claims processing             companies, and others that process my health care claims.

3. For Health Care Operations. I can disclose your PHI to operate my practice. For example, I might use your PHI to evaluate the quality of healthcare services that you received or to evaluate the performance of the health care professionals  who provided such services to you. I may also provider your PHI to our accountants, attorneys, consultants, and others to make sure I'm complying with applicable laws.

4. Other Disclosures. I may also disclose your PHI to others without your consent in certain situations. For example, your consent isn't required if you need emergency treatment, as long as I try to get your consent after treatment is rendered, or if I try to get your consent after treatment is rendered, or if I try to get your consent but you are unable to communicate with me (for example, if you are unconscious or in severe pain) and I think that you would consent to such treatment if you were able to do so.

B. Certain uses and Disclosures Do Not Require Your Consent.

I can use and disclose your PHI without your consent or authorization for the following reasons:

1. When Disclosure is Required by the Federal, State or Local Law; Judicial or Administrative Proceedings; or, Law Enforcement. For example, I may make a disclosure to applicable officials when a law requires me to report information to government agencies and law enforcement personnel about victims of abuse or neglect; or when ordered in a judicial or administrative proceeding.

2. For Public Health Activities. For example, I may have to report information about you to the county coroner.

 3. For Health Oversight Activities. For example, I may have to provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.

4. For Research Purposes. In certain circumstances, I may provider PHI in order to conduct medical research.

5. To Avoid Harm. In order to avoid a serious threat to the health or safety of a person to the public, I may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.

 6. For specific government functions. I may disclose PHI of military personnel and veterans in certain situations. And I may disclose PHI for national security purposes, such as protecting the President of the United States or conducting intelligence operations.

7. For workers' compensation purposes. I may provide PHI in order to comply with workers' compensation laws.

 8. Appointment Reminders and Health-Related Benefits or Services. I may use PHI to provide appointment reminders or give you information about treatment alternatives, or other health care services or benefits I offer.

C. Certain Uses and Disclosures Require You to Have the Opportunity to Object. Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

D. Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in sections III A, B, and C above, I will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke such authorization in writing to stop any future uses and disclosures (to the extent that I haven't taken any action in reliance on such authorization) of your PHI by me.

 IV. Your Rights Regarding Your PHI

You have the following rights with respect to your PHI. To exercise any of these rights, please submit your request in writing to me, the Privacy Officer, at: Caitlan Siegenthaler, MA, LPC, NCC 1712 Peregrine Lane, Broomfield, CO 80020.

A.   Right of Access to Inspect and Copy.

You have the right, which may be restricted only in exceptional circumstances, to inspect and copy PHI that is maintained in a "designated record set". A designated record set contains mental health/medical and billing records and any other records that are used to make decisions about your care. Your right to inspect and copy PHI will be restricted only in those situations where there is compelling evidence that access would cause serious harm to you or if the information is contained in separately maintained psychotherapy notes. I may charge a reasonable, cost-based fee for copies. If your records are maintained electronically, you may also request an electronic copy of your PHI. You may also request that a copy of your PHI be provided to another person.

B.    Right to Amend.

If you feel that the PHI I have about you is incorrect or incomplete, you may ask us to amend the information although I am not required to agree to the amendment. If I deny your request for amendment, you have the right to file a statement of disagreement with me. I may prepare a rebuttal to your statement and will provide you with a copy. Please contact the Privacy Officer if you have any questions.

C.    Right to an Accounting of Disclosures.

You have the right to request an accounting of certain of the disclosures that I make of your PHI. I may charge you a reasonable fee if you request more than one accounting in any 12-month period.

D.   Right to Request Restrictions.

You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. I am not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a healthcare item or service that you paid for out of pocket. In that case, I am required to honor your request for a restriction.

E.    Right to Request Confidential Communication.

You have the right to request that I communicate with you about health matters in a certain way or at a certain location. I will accommodate reasonable requests. I may require information regarding how payment will be handled or specification of an alternative address or other method of contact as a condition for accommodating your request. I will not ask you for an explanation of why you are making the request.

F.    Breach Notification.

If there is a breach of unsecured PHI concerning you, I may be required to notify you of this breach, including what happened and what you can do to protect yourself.

G.   Right to a Copy of this Notice.

You have the right to a copy of this notice. If this notice was initially provided to you electronically, you have the right to obtain a paper copy and to take one home with you if you wish.

V.   Complaints.

If you believe your privacy rights with respect to confidential information in your health records have been violated and you wish to file a complaint with me, you may send your written complaint to:

Privacy Officer, Caitlan Siegenthaler, LPC, 1712 Peregrine Lane Broomfield, CO 80020

or

The Secretary of the Department of Health and Human Services, 200 Independence Avenue S.W., Washington, D.C. 2020, or by calling (202) 619-0257. I will take no retaliatory action against you if you file a complaint about my privacy practices.

The effective date of this Notice is March 1, 2020.

( Type Full Name )
( Full Name )
Informed Consent & Client Rights

                                                                 Caitlan Siegenthaler, MA, LPC NCC

                                                                +1-888-210-6424 LPC #0015722

                                        Secure contact information can be found at www.caitlansiegenthaler.com

                                             Please refer to my Communications Policy for best contact methods


                                                         Client Rights and Informed Consent for Treatment

Client Rights:

As a client you have the following rights:

-       To expect that your provider has the minimal qualifications of training and experience required;

-       To be informed of the cost of professional services before receiving those services; 

-       To be assured of privacy and confidentiality while receiving services as defined by rule and law, including the following exceptions:

o   Reporting suspected child abuse;

o   Reporting imminent danger to self or others;

o   Reporting information required in court proceedings;

o   Reporting suspected abuse of the elderly; 

-       To be free from being the object of discrimination on the basis of race, religion, gender, sexual orientation, disability or other unlawful category while receiving services. 

Notice of Privacy Practices

Your signature below indicates that you have received a Notice of Privacy Practices (HIPAA).

Informed Consent for Treatment:

By signing the form below, you understand and agree to the following: 

There is no guarantee any condition, limitation, or issue will improve or resolve through treatment. There is a possibility your condition, limitation, or issue could worsen;

The limits of confidentiality as outlined in the Notice of Privacy Practices;

Your responsibility to pay fees associated with counseling, and the policy regarding those fees, payment and cancellations as outlined in the Fee Agreement;

You will actively participate in your treatment and will follow through with the agreed upon weekly or bi-weekly session. 


I will be holding that space on my calendar for you in that time spot. If something changes with your plans of coming weekly or every other week please let me know.

Therapy takes commitment and if you feel you are unable to commit to showing up on a regular basis then this may not be the best area of support for you. 

I actively seek supervision and peer consultations. This means that I may discuss our work together with a licensed supervisor and/or colleagues. I will always protect your privacy and confidentiality if I do share pieces of our work.


( Type Full Name )
( Full Name )
Fee Agreement
                                                                          Caitlan Siegenthaler, MA, LPC NCC

                                                                            +1-888-210-6424 LPC #0015722


Secure contact information can be found at www.caitlansiegenthaler.com

Please refer to my Communications Policy for best contact methods


By signing the form below, you agree to the following information:

Client shall make all payments for services rendered by Caitlan Siegenthaler, MA LPC NCC, via private payment, including, but not limited to, cash payment, online payment, or electronic fund transfer. Client shall not bill or pay, or attempt to bill or pay, through any insurance provider. The payment of fees and charges associated with counseling are the responsibility of the Client. If the client does pay any accrued legal fees or charges associated to the rendering of services by Caitlan Siegenthaler, MA LPC NCC, Caitlan Siegenthaler, MA LPC NCC reserves the right to send any unpaid amounts to a collection agency for recovery.


Sessions are 222 CHF/USD for individuals. Sessions are 55-60 minutes in length. Fees for longer sessions are set at the same per-minute rate. Clients may provide payment for a scheduled session any time prior to the scheduled session. All session payments from Client are due no later than 24 hours after the Client's scheduled session. If session is not paid within 24 hours the card on file will automatically be charged. 


If Client is unable to make attend a scheduled session, notice must be provided at least 48 hours in advance to Caitlan Siegenthaler, MA LPC NCC. If 48-hour notice is not given, a full session fee charge will be assessed to the Client. If Client fails to appear for a scheduled session for any reason, a full session fee will be assessed. Cancellations less than 48 hours and no shows will be charged in full unless there is a life threatening emergency. No exceptions.


In the event Client is referred to another provider, the Client is responsible for the scheduling of an appointment with the provider so referred. 


I update my fee on a yearly basis starting on January 1st of the calendar year to account for inflation. If I should need to update my fee outside of that time frame, you will receive a 3-month notice of any fee changes.

Should your financial situation change, please notify me so that we may have conversations about the fee agreement.


Fee for Services as agreed by clinician and client: _____222 USD_______ per hour

I hereby certify that I have read this document, and understand the above terms. I expressly agree to the terms in this document:

( Type Full Name )
( Full Name )
Liability Waiver

                                                                   Caitlan Siegenthaler, MA, LPC NCC

                                                                     +1-888-210-6424 LPC #0015722

                                             Secure contact information can be found at www.caitlansiegenthaler.com

                                          Please refer to my Communications Policy for best contact methods

                                                               LIABILITY WAIVER AND AGREEMENT


I understand that the  coaching, counseling, therapy, telemental health, online counseling, and other activities ("Activities") offered by Caitlan Siegenthaler, MA, LPC, NCC ("Caitlan Siegenthaler") are designed to assist me in improving my mental health/ mental well-being (coaching) and creating positive emotional and psychological traits.


As is the case with any coaching, counseling or therapy activities, there may be a risk of emotional, psychological, and potentially physical harm that could come from the process. I acknowledge these risks. I acknowledge that I am participating in these Activities at my own risk.


I acknowledge that if I am living in a different country than my provider and then therefore I am acknowledging that the laws and rights of my home country do not apply.


I acknowledge that if I am living in Switzerland I am participating in counseling only. There will be no diagnosis and treatment of mental health disorders. 


I acknowledge the risk I am taking in selecting a provider outside my country of residence and absolve Caitlan Siegenthaler from any legal responsibilities. 


I acknowledge that if I am working with Caitlan Siegenthaler on career alignment, I'm working with her in a coaching capacity only and that should I need mental health care and support, I would need to seek an additional provider. 


I acknowledge it is my responsibility to understand the terms and conditions contained herein, and by signing, I affirm my understanding of the same. 


I understand that the Activities may occur online via the internet, and that I may attend sessions with Caitlan Siegenthaler from my home, work, public space, or even outdoors. I hereby represent that at all times I will obey any local rules or ordinances when attending these sessions.

I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assigns as follows: I (a) irrevocably WAIVE, RELEASE AND DISCHARGE FROM ANY AND ALL LIABILITY for my death, disability, personal injury, property damage, property theft or actions of any kind, Caitlan Siegenthaler, who is hosting the Activities, and each of its directors, officers, employees, volunteers, representatives, and agents ("Released Parties") even in the case of carelessness, negligence, or gross negligence; and (b) INDEMNIFY, HOLD HARMLESS AND AGREE NOT TO SUE the Released Parties as to any and all claims, demands, legal actions, disputes, or rights of action in law or in equity ("Claims").

I am aware and acknowledge there is no obligation for the Released Parties to provide medical care or treatment. I hereby represent that I will notify Caitlan Siegenthaler representatives of any physical pain or major discomfort felt during the Activities. If medical care or treatment is rendered to me, I consent to that care if I am unable to give my consent for any reason at the time the care or treatment is administered.

The Caitlan Siegenthaler Liability Waiver and Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. If any provision of this document shall be deemed unlawful, void, or unenforceable, then the provision shall be severable from the reaming provisions, which will be accorded their full weight and enforceability. 

I further understand that if any product or item is rented to me as part of the participation in the Activities, I will return the same in good working order. All payments are non-refundable or transferable for any reason, including, but not limited to vacation, illness, injury, or weather. The scheduling and content of the Activities may be cancelled or changed by Caitlan Siegenthaler without prior notice. I am responsible for possessing the proper technological and communication equipment to conduct the Activities (where applicable).

I hereby certify that I have read this document; and I understand its content.

I am aware that this is a release of liability as well as a contract and I sign it of my own free will.

I am aware that by signing this Liability Waiver and Agreement I am waiving certain legal rights.

( Type Full Name )
( Full Name )
Mandatory Disclosure Statement

                                                                         Caitlan Siegenthaler, MA, LPC NCC

                                                                            +1-888-210-6424 LPC #0015722

                                                Secure contact information can be found at www.caitlansiegenthaler.com

                                                Please refer to my Communications Policy for best contact methods


                                                                            Mandatory Disclosure Statement


Your signature on this document indicates that you have been informed of your protection as a client and my responsibility as a therapist, as described in Colorado House Bill 1026, effective July 1, 1988.


Credentials:

      Licensed Professional Counselor #0015722, Colorado

      National Certified Counselor

      Masters of Arts Counseling, University of Northern Colorado, Greeley, Colorado

      Bachelors of Arts Journalism and Technical Communication, Colorado State University, Fort Collins, Colorado


I.       Regulation of Psychotherapists:

The practice of licensed or registered persons in the field of psychotherapy is regulated by the Mental Health Licensing Section of the Division of Professions and Occupations. The Board of Licensed Professional Counselor Examiners can be reached at: Department of Regulatory Agencies Mental Health Licensing Section 1560 Broadway, Suite #880 (303) 894-7800. As to the regulatory requirements applicable to mental health professionals: The regulatory requirements for mental health professionals provide that a Licensed Clinical social worker, a Licensed Marriage and Family therapist, and a Licensed Professional Counselor must hold a masters degree in their profession and have a minimum of two years of post-masters supervision. A Licensed Psychologist must hold a doctorate degree in psychology and have one year of postdoctoral supervision. A Licensed Social Worker must hold a masters degree in social work. A Psychologist Candidate, a Marriage and Family Therapist Candidate, and a Licensed Professional Counselor Candidate must hold the necessary licensing degree and be in the process of completing the required supervision for licensure. A Certified Addiction Counselor I (CAC I) must be a high school graduate, and complete required training hours and 1000 hours of supervised experience. A CAC II must complete additional required training hours and 2,000 hours of supervised experience. A CAC III must have a bachelor's degree in behavioral health, and complete additional required training hours and 2,000 hours of supervised experience. A Licensed Addiction Counselor must have a clinical masters degree and meet the CAC III requirements. A Registered Psychotherapist is registered with the State Board of Registered Psychotherapists, is not licensed or certified, and no degree, training or experience is required.

II.   Client Rights and Important Information:

You are entitled to receive information from your therapist about the methods of therapy, the techniques used, the duration of your therapy (if known), and the fee structure.

You can seek a second opinion from another therapist or terminate therapy at any time.

In a professional relationship, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies the licensee, registrant or certificate holder.

Information given by minor children in therapy may be disclosed to parents/legal guardians if, in the judgment of the therapist, disclosure is in the best interest of the child.

Generally speaking, the information provided by and to a client during therapy sessions is communication and therefore legally confidential and cannot be released without the client's consent.

Exceptions to this confidentiality can be found in the Notice of Privacy Practices you were provided. For example, mental health professionals are required to report suspected child abuse to authorities. If a legal exception arises during therapy, if feasible, you will be informed accordingly. The Mental Health Practice Act (CRS 12-43-101, et seq.) is available at: http://www.dora.state.co.us/mental-health/statute.pdf.

Confidentiality is further discussed in my Practice Policies and Procedures.

I have read and agree to the preceding information and understand my rights and responsibilities as a client or as the client's responsible party. I also acknowledge that I have verbally been informed of the above information. I consent to the evaluation/treatment process with Caitlan Siegenthaler, LPC. I understand that I have the right to withdraw from treatment at any time.

( Type Full Name )
( Full Name )
Telemental Health Informed Consent

                                                                               Caitlan Siegenthaler, MA, LPC NCC

                                                                              +1-888-210-6424 LPC #0015722

                                                     Secure contact information can be found at www.caitlansiegenthaler.com

                                                     Please refer to my Communications Policy for best contact methods


The terms "Online Counseling" and "Telemental Health" are used herein interchangeably


Overview

❖     You will need access to the certain technological services and tools to engage in online counseling-based services with me

❖     Online counseling has both benefits and risks, which you and I will be monitoring as you proceed with your work

❖     It is possible that receiving services by online counseling will turn out to be inappropriate for you, and that you and I may have to cease work via online counseling

❖     You can stop work in online counseling at any time without prejudice

❖     You will need to participate in creating an appropriate space for your online counseling sessions

❖     You will need to participate in making a plan for managing technology failures, mental health crises, and medical emergencies

❖     I follow security best practices and legal standards in order to protect your health care information, but you will also need to participate in maintaining your own security and privacy


What is Telemental Health/Online Counseling?

"Telemental health"/ Online counseling means, in short, provision of mental health services with the provider and recipient of services being in separate locations, and the services being delivered over electronic media

*Please note online counseling services may not be reimbursed by insurance agencies

Services delivered via online counseling rely on a number of electronic, often Internet-based, technology tools. These tools can include videoconferencing software, email, text messaging, virtual environments, specialized mobile health ("mHealth") apps, and others.

Your provider typically provides online counseling services using the following tools:

CounSol Secure Client Portal

➢     You will need access to Internet service and technological tools needed to use the above-listed tools in order to engage in online counseling work with your provider.

➢     If you have any questions or concerns about the above tools, please address them directly to your provider so you can discuss their risks, benefits, and specific application to your treatment.


Benefits and Risks of Online Counseling


Receiving services via online counseling allows you to:

Receive services at times or in places where the service may not otherwise be available and/or are more conducive to stress reduction and support

Receive services in a fashion that may be more convenient and less prone to delays than in-person meetings.

Receive services when you are unable to travel to the service provider's office.

The unique characteristics of telemental health media may also help some people make improved progress on health goals that may not have been otherwise achievable without telemental health.


Receiving services via online counseling has the following risks:

Online counseling services can be impacted by technical failures, may introduce risks to your privacy, and may reduce my ability to directly intervene in crises or emergencies. Here is a non-exhaustive list of examples:

Internet connections and cloud services could cease working or become too unstable to use

Cloud-based service personnel, IT assistants, and malicious actors ("hackers") may have the ability to access your private information that is transmitted or stored in the process of online counseling-based service delivery.

Computer or smartphone hardware can have sudden failures or run out of power, or local power services can go out.

Interruptions may disrupt services at important moments, and I may be unable to reach you quickly or using the most effective tools. I may also be unable to help you in-person.

There may be additional benefits and risks to online counseling services that arise from the lack of in-person contact or presence, the distance between you and your provider at the time of service, and the technological tools used to deliver services. I will assess these potential benefits and risks, sometimes in collaboration with you, as your relationship progresses.


Assessing Online Counseling's Fit For You

Although it is well validated by research, service delivery via online counseling is not a good fit for every person. I will continuously assess if working via online counseling is appropriate for your case. If it is not appropriate, I will help you find in-person providers with whom to continue services.

Please talk to me if you find the online counseling media is so difficult to use that it distracts from the services being provided, if the medium causes trouble focusing on your services, or if there are any other reasons why the online counseling medium seems to be causing problems in receiving services. Raising your questions or concerns will not, by itself, result in termination of services. Bringing your concerns to me is often a part of the process.

You also have a right to stop receiving services by online counseling at any time without prejudice. If you can access my services in-person you will not be prevented from accessing those services if you choose to stop using online counseling.


Your Online Counseling Environment

You will be responsible for creating a safe and confidential space during sessions. You should use a space that is free of other people. It should also be difficult or impossible for people outside the space to see or hear your interactions with me during the session. If you are unsure of how to do this, please ask me for assistance.


Our Communication Plan

At our first session, we will develop a plan for backup communications in case of technology failures and a plan for responding to emergencies and mental health crises. In addition to those plans, I have the following policies regarding communications:

The best way to contact me between sessions is through a secure message on the client portal. Or you can reach me via telephone at: +1-888-210-6424

Your provider will respond to your messages within 24 business hours. Please note that I may not respond at all on weekends or holidays. I may also respond sooner than stated in this policy. That does not mean that I  will always respond that quickly.

Our work is done primarily during our appointed sessions, which will generally occur during 6:30 AM MST- 2PM MST of 10:00 AM- 8 PM Central European Time. Contact between sessions should be limited to:

Confirming or changing appointment times

Billing questions or issues

Questions about recommendations provided or given in the session (IE> meditation apps, book recommendations, etc).

Your provider is located in the Central European time zone. Please note the time difference from your own time zone. This is exactly 8 hours ahead of Colorado (Mountain Standard Time).

Please note that all textual messages you exchange with me r, e.g. emails and text messages, will become a part of your health record.

I may coordinate care with one or more of your other providers. I will use reasonable care to ensure that those communications are secure and that they safeguard your privacy.


Our Safety and Emergency Plan

As a recipient of online counseling-based services, you will need to participate in ensuring your safety during mental health crises, medical emergencies, and sessions that you have with me.

I will require you to designate an emergency contact. You will need to provide permission for me to communicate with this person about your care during emergencies.

I will also develop with you a plan for what to do during mental health crises and emergencies, and a plan for how to keep your space safe during sessions. It is important that you engage with me in the creation of these plans and that you follow them when you need to.


Your Security and Privacy

Except where otherwise noted, I employ software and hardware tools that adhere to security best practices and applicable legal standards for the purposes of protecting your privacy and ensuring that records of your health care services are not lost or damaged.

I use the CounSol software which is HIPPA secure. This is a client management software that we will utilize to communicate, conduct our video session, obtain payment, etc.

As with all things in online counseling, however, you also have a role to play in maintaining your security. Please use reasonable security protocols to protect the privacy of your own health care information. For example: when communicating with me, use devices and service accounts that are protected by unique passwords that only you know. Also, use the secure tools that I have supplied for communications.


Recordings

Please do not record video or audio sessions without my consent. Making recordings can quickly and easily compromise your privacy, and should be done so with great care. I will not record video or audio sessions. In the rare instance that I would need to record a session for peer to peer feedback or continued education growth I will ask your consent prior to and you will be notified as to the specific use for the video.

By signing the form below, you understand and agree to the above:

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