GOOD LIFE 

POSITIVE PSYCHOLOGY  

Good Life Positive Psychology Practice Policies

Good Life Positive Psychology., 

5680 King Centre Dr., Ste. 600, Alexandria, 

VA, 22315


Good Life Positive Psychology

CLIENT THERAPIST SERVICES AGREEMENT/INFORMED CONSENT

Welcome to the Good Life Positive Psychology. This document contains important information about our mental health professional services and business policies. Please read it carefully. When you sign this document, it will represent an agreement between us.

PSYCHOLOGICAL SERVICES

Psychotherapy is not easily described in general statements. It varies depending on the personalities of the therapist and patient, and the particular problems you hope to address. There are many different methods your therapist may use to deal with those problems. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for psychotherapy to be most successful, you will have to work on things you and your therapist talk about both during sessions and at home.

Psychotherapy can have benefits and risks. Because therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have benefits for people who go through it. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees as to what you will experience.

Your first few sessions will involve an evaluation of your needs. By the end of the evaluation, your therapist will discuss his or her first impressions and provide a plan for treatment, if you decide to continue with therapy. At the end of the evaluation, your therapist will notify you if he or she feels this is a good match for both parties. If your therapist concludes that he or she may not be the right therapist for you, referrals to other practitioners better suited to meet your needs will be provided.

It is the Good Life Positive Psychology policy to obtain relevant past treatment and concurrent information provided by other professionals and at mental health facilities, if applicable. Thus, you may be asked to sign authorizations that allow for these records to be released to us. While we respect your right to refuse access to records, Good Life Positive Psychology reserves the right not to enter into a therapeutic agreement if access to prior mental health records is denied.

Therapy involves a large commitment of time, money, and energy, so you should be careful about the therapist you select. If you have questions about your therapist’s modality of work, please discuss them openly with him or her. If your doubts persist, your therapist will assist you in securing consultation with another mental health professional for a second opinion.


CANCELLATIONS/NO SHOW POLICY

Once an appointment is scheduled, it is reserved for you and you will be expected to pay for the full scheduled session. If you do not attend a scheduled appointment or if you cancel less than 24 hours before the appointment time, not including weekends/holidays, you should expect to be billed for the entire amount of the session cost. If, in the unlikely event, your time slot is filled at the last minute, you will not be charged, even if you provided less than 24 hours notice. If you arrive late, you will be charged for the full scheduled session and it will end at the pre- scheduled time. If your therapist is late, additional time will be allocated to your session to ensure that you receive the full scheduled session.

PROFESSIONAL FEES

In order for you and your therapist to set realistic treatment goals and priorities, it is important to evaluate what resources you have available to pay for your treatment. The therapists in this practice are not participating providers in any insurance plans. Please note that you have complete financial responsibility for health care services provided by an out-of-network provider and you are responsible for full payment of fees. Out-of-network fees for your therapist are as follows:

Service Fee* 90 Minute Diagnostic Evaluation $360 45 Minute Individual/Family Psychotherapy $180 60 Minute Individual/Family Psychotherapy $240

In addition to weekly appointments, your therapist will charge his or her hourly rate for other professional services you may need, prorated in 15-minute increments. Other professional services include report writing, telephone conversations lasting longer than 15 minutes, attendance at meetings with other professionals you have authorized, preparation of treatment summaries, and the time spent performing any other service you may request. If you become involved in legal proceedings that require your therapist’s participation, you will be expected to pay for any professional time spend on your legal matter, even if the request comes from another party.

*The fees quoted in this agreement are subject to change. You will be notified at least one month in advance of any change in fees.


MEETINGS

Your initial evaluation will last from 2 to 4 hours. During this time, both you and your therapist will decide if he or she is the best person to meet your treatment goals. If you agree to begin psychotherapy, typically one 45-minute session (one appointment hour of 45 minutes duration) per week will be scheduled, at a time mutually agreed upon. Some sessions may be longer or more frequent. If you would like to schedule extended sessions, or more frequent sessions, this may greatly speed up your recovery. Double or triple sessions can be extremely effective.

BILLING AND PAYMENTS

You will be expected to pay for each session at the time it is held, unless otherwise agreed. Payment schedules for other professional services will be agreed to when such services are requested. In circumstances of unusual financial hardship, your therapist may be willing to negotiate a fee adjustment.


If your balance of fees total two sessions or more, your therapist reserves the right not to schedule additional appointments until you have had an opportunity to discuss a payment plan with your therapist.

If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, your therapist has the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court. If such legal action is necessary, its costs will be included in the claim. In most collection situations, the only information to be released regarding a patient’s treatment is his or her name, the dates, times, the nature of services provided, and the amount due.

INSURANCE REIMBURSEMENT

Your therapist is not a participating provider in any health insurance or managed care company plans. Upon request, your therapist will provide you with a receipt, which has all the information that your insurance company will require. You can then submit the receipt to your insurance company for the reimbursement they allow.

It is very important that you find out exactly what mental health services your insurance policy covers. You should carefully read the section in your insurance coverage booklet that describes mental health services. If you have questions about the coverage, call your plan administrator. If necessary, I am willing to call the insurance company on your behalf to obtain clarification.

Due to the rising costs of healthcare, insurance benefits have increasingly become more complex. It is sometimes difficult to determine exactly how much mental health coverage is available. “Managed Health Care” plans often require authorization before they provide reimbursement for mental health services. These plans are often limited to short-term treatment approaches designed to work on specific problems that interfere with a person’s usual level of functioning. It may be necessary to seek approval for more therapy after a certain number of sessions. Though a lot can be accomplished in short-term therapy, some patients feel that they need more services after insurance benefits end. Some managed-care plans will not provide reimbursement once your benefits end.

You should also be aware that most insurance companies require that therapists provide them with your clinical diagnosis. Sometimes therapists have to provide additional clinical information, such as treatment plans, progress notes or summaries, or copies of the entire record (in rare cases). This information will become part of the insurance company files. Though all insurance companies claim to keep such information confidential, Good Life Positive Psychology has no control over their handling of protected health information. In some cases, they may share the information with a national medical information databank. It is important to understand that, by using your insurance, you are authorizing Good Life Center for Mental Health, LLC to release such information to your insurance company. Good Life Positive Psychology will try to keep that information limited to the minimum necessary.

Once we have all of the information about your insurance coverage, your therapist will discuss with you what you can expect to accomplish with the benefits. If your insurance benefits run out before you feel ready to terminate treatment, you have the option to continue with your therapist, or your therapist will try to assist you in finding another provider who will help you continue


your psychotherapy. It is important to remember that you always have the right to pay for services yourself to avoid the problems described.

Please note that your therapist will only respond to a request for information pertaining to your case, on your behalf, once he or she receives written notification from you, the patient or insured.

TERMS

Email Communications

Email is typically not a secure way of communicating confidential information; therefore, Good Life Positive Psychology therapists will not typically use email to communicate with anyone in treatment. However, Good Life Positive Psychology offers secure one-way session reminders and portal notifications through email.

Text Messaging

Generally, text messaging is a very insecure and impersonal mode of communication, thus, your therapist will not typically text message you nor will he or she respond to text messages from you in treatment. However, Good Life Positive Psychology offers secure one-way session reminders and portal notifications.

Secure Messaging

Good Life Positive Psychology offers an opportunity for clients to communicate with their therapists for administrative purposes via secure messaging through their secure client portal. That means that secure messages should be limited to things like setting and changing appointments, billing matters and other related issues. Please do not message your therapist about clinical matters, unless this is agreed upon in advance. If you need to discuss a clinical matter, please feel free to call your therapist so you can discuss it on the phone or wait to discuss it during your therapy session. The telephone or face-to-face context simply is much more secure as a mode of communication.

Social Media

Your therapist will not communicate with, or contact, any clients through personal social media platforms like Twitter and Facebook. In addition, if your therapist discovers that he or she has accidentally established an online relationship with you, he or she will cancel that relationship. This is because these types of casual social contacts can create significant security risks for you.

Your therapist may participate on various social networks. If you have an online presence, there is a possibility that you may encounter your therapist by accident. If that occurs, please discuss it with your therapist during session. Communications with clients online have a high potential to compromise the professional relationship and are not ethical.

TERMS 2

Websites

Good Life Positive Psychology has a website www.good4life.org that you are free to access and review. If you have questions about any often information on it, you can discuss this with your therapist during your scheduled therapy sessions.

Web Searches

Your therapist will not use web searches to gather information about you without your permission. If you encounter any information about your therapist through web searches, or in any other fashion, please discuss this with him or her during your therapy appointment, so that its potential impact on your treatment can be addressed. Recently it has become fashionable for clients to review their health care provider on various websites. Unfortunately, mental health professionals cannot respond to such comments and related errors because doing so would jeopardize your confidentiality. If you encounter such reviews, please share it with your therapist so that the potential impact on your therapy can be discussed. We respectfully request that you do not rate our work while you are in treatment with us on any of these websites. This is because it has the potential to negatively impact your therapeutic work.

DISABILITY CLAIMS AND LITIGATION

Your therapist does not provide disability evaluations since this represents a conflict of interest. The reason for this is that if you recover and your therapists reports this fact to the disability officers reviewing your case, you could lose your benefits. This conflict of interest could prevent you and your therapist from working effectively together. If you wish to be evaluated for a disability, your therapist can suggest the names of evaluators who can provide that service for you.

Your therapist will not serve as an expert in forensic matters and does not provide custody evaluations. The rationale for this is that forensic involvement by a therapist can negatively impact the therapeutic relationship and compromise your recovery due to competing concerns about financial gains or losses. Please note that it is unethical for a therapist to provide treatment and simultaneously serve in a forensic role providing recommendations to the court on disputed issues or legal concerns.

PERSONAL AND BUSINESS RELATIONSHIPS

Your therapist has an ethical responsibility not to develop professional or business relationships with clients, their friends, or family members. Similarly, your therapist will not meet with clients or their associates outside of session for any reason. Your therapist will not accept gifts from clients or family members of clients because this is considered an ethics violation.