Frequently Asked Questions

Confidentiality  |  Fees/Billing  |  Therapist Availability  |  Risks and Benefits  |  Client Litigation  |  Termination of Therapy

Psychotherapy involves entering into a relationship with a licensed mental health professional. The following information about confidentiality, fees/billing, phone calls, and risks and benefits of treatment, are some of the "nuts and bolts" of the therapy relationship and are designed to help create a safe and professional atmosphere. It is included to give you basic information about what you might expect in psychotherapy.
 

Confidentiality

Confidentiality is essential to the development of the therapy relationship. The information you share with your therapist is held in the strictest confidence and may not be released to anyone without your written consent as prescribed by law. There are a few exceptions to this, which are also regulated by State law. For example, in cases of suspected child or elderly abuse, or if a person poses a serious and imminent danger to her/himself or someone else, your therapist is mandated by law to report this information to the proper authorities. Information subpoenaed by a valid court order is usually not protected by this limit on confidentiality. These situations rarely occur. In addition, some insurance companies require very brief and limited treatment information including diagnosis, and in some cases information about presenting symptoms and treatment planning. It is also appropriate for your therapist to discuss your care with professional colleagues for consultation, supervision, and coordination of care. These are the only exceptions to otherwise 100% confidentiality of what you talk about during therapy. If you do sign a consent to release information, you are encouraged to discuss the amount, type, and purpose of information to be discussed with your therapist. This allows you to maintain the highest level of confidentiality possible. Please discuss any questions you have about confidentiality with your therapist.

When parents and children, couples, or families participate in therapy, the parent-child, couple, or family is the treatment unit. Your therapist will maintain the confidentiality of each individual but cannot guarantee that all parties in the treatment unit will maintain confidentiality for the others. A therapist may sometimes meet with a smaller part of the treatment unit (e.g. meet with one partner of a couple individually) but uses her/his best clinical judgment to determine whether, when, and how to make disclosures of information learned in the separate session to the rest of the treatment unit, usually encouraging and facilitating the smaller unit to communicate the information to the rest of the treatment unit.

If you feel it necessary to talk about matters you do not want to share with the rest of the treatment unit, you might consider separate individual therapy. The addition of other parties to the treatment process will require each individual Client or Client representative to sign an Authorization for the Release of Protected Health Information or a renegotiation of the psychotherapy contract.

If your child is the client: your child has confidentiality. For psychotherapy with your child to be successful, there must be a trusting and confidential relationship between the therapist and your child. As a general rule, therapists will keep the information minors share with them in sessions confidential, unless they have written consent to disclose certain information.

There are, however, important exceptions to this rule that are important for children and teens to understand before they share personal information with therapists in a therapy session. In some situations, therapists are required by law or by the guidelines of our profession to disclose information whether or not we have your permission. Some of these situations include: The child/teen tells the therapist that she/he plans to cause serious harm or death to themself, and the therapist believes they have the intent and ability to carry out this threat in the very near future. The therapist must take steps to inform a parent or guardian of what the minor has told them and how serious they believe this threat to be. The therapist must make sure that the client is protected from harming themself.

Another exception to confidentiality is if the client tells the therapist they plan to cause serious harm or death to someone else who can be identified, and the therapist believes they have the intent and ability to carry out this threat in the very near future. In this situation, the therapist must inform the parent or guardian, and the police. If the child is doing things that could cause serious harm to themself or someone else, even if they do not intend to harm themselves or another person, the therapist must use their professional judgment to decide whether a parent or guardian should be informed.

If a child discloses to their therapist that they are being abused-physically, sexually or emotionally-or that they have been abused in the past, therapists are required by law to report the abuse to the Iowa Department of Human Services.

Finally, if the client is involved in a court case and a request is made for information about your counseling or therapy, there may be issues regarding confidentiality. If this happens, therapists will not disclose information without written agreement unless the court requires them to. Therapists will do all they can, within the law, to protect your confidentiality, and if required to disclose information to the court, you will be informed that this is happening.

Communicating with parent(s) or guardian(s): Except for situations such as those mentioned above, therapists will not tell parents or guardians specific things shared in private therapy sessions. This includes activities and behavior that parents/guardians may not approve of -- or would be upset by -- but that do not put the child at risk of serious and immediate harm. However, if their risk-taking behavior becomes more serious, then the therapist will need to use their professional judgment to decide whether the child/teen is in serious and immediate danger of being harmed. If the therapist feels that the client is in such danger, they will communicate this information to the parent or guardian.

Even if the therapist has agreed to keep information confidential - to not tell the parent or guardian - the therapist may believe that it is important for them to know what is going on in the child/teen's life. In these situations, the therapist will encourage the child/teen to tell their parent/guardian and will help find the best way to tell them. Also, when meeting with parents, the therapist may sometimes describe problems in general terms, without using specifics, in order to help them know how to be more helpful to their child/teen.

Children/teens/dependent adults with guardians should also know that, by law in Iowa, the parent/guardian has the right to see any written records kept about sessions. It is extremely rare that a parent/guardian would ever request to look at these records and we ask parents/guardians to respect their child's confidentiality to promote the goals of psychotherapy.

Professional Consultation: Professional consultation is an important component of a healthy psychotherapy practice. As such, therapists regularly participate in clinical, ethical, and legal consultation with appropriate professionals. During such consultations, therapists will not reveal any personally identifying information regarding clients.

Consent for treatment: Before the initiation of services you as the client or as the guardian/representative of the client will be asked to read and sign the informed consent statement that explains much of the information included on this page. To initiate psychotherapy services, you must be at least 18 years old or an emancipated adolescent. If you are a minor client or a dependent adult, your guardian/representative will need to consent for treatment and you will be provided with the information included in the informed consent materials and asked for assent. Adult clients or the guardians/representatives of clients will be asked to sign and date the informed consent document stating that you/they have read, understand, and agree to the conditions stated within before therapy will commence. There is also a Patient Bill of Rights you will be asked to read and sign. If you have any questions about these documents, please discuss them with your therapist.

Consent for the Treatment of a Minor Child: Therapists generally expect both parents to be aware of their child's participation in therapy. Therapists will make reasonable efforts to ensure that both parents are notified and have reasonable access to provide information and consent to the therapist. If any question exists regarding the authority of a parent/guardian to give consent for psychotherapy, therapists will require that the parent/guardian submit supporting legal documentation, such as a custody order, prior to the commencement of services.

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Fees/Billing

Each client is responsible for managing the finances of the psychotherapy relationship. Fees are standardized throughout the group. Your health insurance may cover all or part of the fees. We will work with you to facilitate the exchange of information with your insurance company for payment and we will usually directly submit your claims electronically to your insurance carrier. You should contact your health insurance company or consult with your therapist for additional information. Each client is responsible for payment for services rendered on the day of the appointment.

Initial Appointment = $230.00
53-60 minute psychotherapy session = $220
38-52 minute psychotherapy session = $170 
30-37 minute psychotherapy session = $110
Psychological Testing = $200.00 per hour (Your insurance may cover)

Most insurance companies do NOT cover the following:
School staffing attendance = $50.00
Late (less than 24 hour) notice to Cancel or No-Show = $100.00

Since we reserve your appointment time for you, there will be a charge for any appointments missed or not canceled within 24 hours of your appointment time.

Insurance does not cover the Late Cancel/ No Show fee, which means that it is essential for you to cancel your appointment at least 24 hours in advance to avoid this charge.

 

Therapist Availability

Sessions are scheduled by appointment only. Scheduling and canceling of appointments are handled through the West Des Moines office at 515-222-1999 and through the Ames office at 515-233-1122. You may leave a message on the answering machine to cancel appointments. Please include your name, your therapist's name, the appointment time, and a contact phone number.

Our offices are equipped with office staff to answer phone calls during regular business hours Monday through Friday and an answering machine that allows clients to leave a message at any time. Therapists will make every effort to return calls within 24 hours (or by the next business day), but cannot guarantee the calls will be returned immediately.

In the event that a client is feeling unsafe or requires immediate medical or psychiatric assistance, he/she should call 911, Crisis Hotline at 232-5811 in Ames, or in Des Moines call 211 or 244-1010, or go to the nearest emergency room. Your local emergency room or law enforcement agency can provide emergency help if the crisis is acute. Therapists are unable to provide 24-hour crisis service so instructions for emergency calls are given on the outgoing message for Central Iowa Psychological Services (515) 222-1999 and (515) 233- 1122.

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Risks and Benefits

Psychotherapy is considered to be a safe and effective treatment for a wide range of mental health concerns. Some of the benefits include reduction of symptoms, development of coping and problem solving skills, providing support during intense emotional times, and facilitating the creation of healthier relationships. Risks can include initial and temporary increases in emotional tension or discomfort. Changes during therapy may occur that affect relationships. If these become too distressing; please discuss them with your therapist.

Alternatives to psychotherapy include no treatment or medication therapy. Medication may be an option for assistance with managing the physiological/medical problems associated with mental health concerns and used in conjunction with therapy. The therapist you work with can assist you with a referral for a medical or psychiatric consultation if needed.

 

Client Litigation

Therapists will not voluntarily participate in any litigation, or custody dispute in which a Client or their Representative/Guardian and another individual, or entity, are parties. Each therapist has a policy of not communicating with Representative's attorney and will generally not write or sign letters, reports, declarations, or affidavits to be used in Client's, or Representative's legal matters unless clients complete a written release of information form or the information is court ordered by a judge. Therapists will generally not provide records or testimony unless compelled to do so. Should therapists be subpoenaed, or ordered by a court of law, to appear as a witness in an action involving a client, the client will be contacted immediately. Clients agree to reimburse the therapist for any time spent for preparation, travel, or other time in which therapist has made herself/himself available for such an appearance at therapist's usual and customary hourly rate. In addition, the therapist will not make any recommendation as to custody or visitation regarding clients.

 

Termination of Therapy

Clients and therapists may mutually agree to termination of therapy when treatment goals are met. The therapist reserves the right to terminate therapy at her/his discretion. Reasons for termination include, but are not limited to; successful completion of therapy goals, non-attended sessions, untimely payment of fees, failure to comply with treatment recommendations, conflicts of interest, failure to participate in therapy, if client needs are outside of the therapist's scope of competence or practice, or if the client is not making adequate progress in therapy. The client or her/his representative/guardian has the right to terminate therapy at her/his discretion. Upon either party's decision to terminate therapy, the therapist will generally recommend that client participate in at least one, or possibly more, termination sessions. These sessions are intended to facilitate a positive termination experience and give both parties an opportunity to reflect on the work that has been done and make appropriate recommendations if needed. Therapists will also attempt to ensure a smooth transition to another therapist by offering referrals to the client or their guardian(s) and offer consultation.

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