The session content and all relevant materials to the client’s treatment will be held confidential unless the client requests in writing to have all or portions of such content released to a specifically named person/persons. Limitations of such client held privilege of confidentiality exist and are itemized below:
- If a client threatens or attempts to commit suicide or otherwise conducts himself/herself in a manner in which there is a substantial risk of incurring serious bodily harm.
- If a client threatens grave bodily harm or death to another person.
- If the therapist has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional or sexual abuse of children under the age of 18 years.
- Suspicions as stated above in the case of an elderly person who may be subjected to these abuses.
- Suspected neglect of the parties named in items #3 and # 4.
- If a court of law issues a legitimate subpoena 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’s report to an attorney.
- For clients paying for services through an insurance company: certain medical information such as diagnosis must be disclosed for the purposes of receiving payment. In rare instances, insurance companies may also request additional information such as therapy session notes and the psychologist’s assessment of progress/response to treatment. Client’s consent authorizes the release of medical information necessary to process insurance claims and payment of medical benefits to Kunimatsu Psychology, LLC.
Occasionally I may need to consult with other professionals in their areas of expertise in order to provide the best treatment for clients. Client information may be shared in this context without using their name or other identifying information.
If I see a client accidentally outside of the therapy office, I will not acknowledge them first. Clients’ right to privacy and confidentiality is of the utmost importance to me, and I do not wish to jeopardize it. If they acknowledge me first, I will be more than happy to speak briefly, but feel it appropriate not to engage in any lengthy discussions in public or outside of the therapy office.
Appointments & Scheduling
In order to maintain optimal use of my time, I am only able to offer weekly or bi-weekly standing appointments to my clients. I cannot guarantee early rescheduling (i.e., a session before the next scheduled standing appointment) in the event of a cancellation, nor can I guarantee the possibility of multiple in-office sessions per week for any client. The meeting time for in-office psychotherapy sessions is 45 minutes. If a client is late to a session, the end time will not be extended to compensate for their tardiness. Requests to extend session duration beyond 45 minutes will not be granted.
Clients should use the Client Portal for all appointment schedule changes. Should clients request additional contacts with me in a single week they will be instructed to use the Client Portal to schedule a free phone consultation (15 minutes), availability permitting. I cannot guarantee availability for multiple contacts in a single week, nor can I guarantee availability via phone outside of my regular business hours. In a crisis or emergency situation, clients should contact 911 or any local emergency room.
If at all possible, clients should cancel or reschedule sessions in advance. For same-day cancellations, clients must provide notice within 15 minutes after the scheduled session start time in order to avoid fees. If a client cancels more than 15 minutes after start time (i.e., a “late cancel”) or fails to attend a scheduled session without any notice of cancellation (i.e. a “no-show”), they will be responsible for a missed session fee of $50.00. I cannot guarantee early rescheduling (i.e., a session before the next scheduled standing appointment) in the event of a cancellation. Multiple no-shows and/or repeated cancellations may result in termination of services.
I have set fees for in-office psychotherapy sessions and a per-session fee will be established during an initial phone consultation. The fee for a session no-show is $50, which will be charged to clients directly regardless of their regular payment type (i.e., self-pay or insurance). A $10.00 service charge will be charged for any checks returned for any reason for special handling.
I cannot guarantee availability via phone outside of scheduled phone consultations. All appointment cancellations/other schedule changes should be conducted through the Client Portal. If a client needs to contact me between sessions for a non-scheduling reason, I request that they either use the Client Portal to schedule a free phone consultation or leave a message on my voicemail. I am often not immediately available, but I will do my best to return calls within 24 hours. Please note that in-office psychotherapy sessions are highly preferable to these brief phone consultations. In a crisis or emergency situation, clients should contact 911 or any local emergency room.
Due to the importance of client confidentiality and the minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, Instagram, LinkedIn, etc.). I believe that adding clients as friends or contacts on these sites can compromise confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship.
I cannot ensure the confidentiality of any form of communication through electronic media, but if clients prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I try to return messages in a timely manner, I cannot guarantee immediate response and request that clients do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.
I welcome client inquiries of all backgrounds and aspire to respect cultural, individual, and role differences. My goal is to create a safe, supportive, and affirming therapeutic relationship for individuals of all races, ethnicities, national origins, genders, gender identities, sexual orientations, religions, ages, abilities, sizes, socioeconomic statuses, languages, and cultures.
If an emergency situation should arise, clients should seek help through hospital emergency room facilities or by calling 911.
Physical health can be an important factor in the emotional well-being of an individual. If a client has not had a physical examination in the last year, it is recommended that they do so, and that they report to me any medications they are now taking.
Ending relationships can be difficult, so it is important to have a termination process in order to achieve some closure. I may terminate treatment early, after appropriate discussion, if I determine that psychotherapy is not being effectively used, that presenting problems have changed in a way that requires a referral to a more specialized provider, or if clients are in default on payment. Multiple no-shows and/or repeated cancellations may also result in early termination of services. I will not terminate the therapeutic relationship without first attempting to discuss and explore the reasons and purpose of terminating. If therapy is terminated for any reason or a client requests another therapist, I will provide them with a list of qualified providers. Clients may also choose someone on their own or from another referral source.
Treating Other Family Members
In order to protect the therapeutic alliance between myself and my clients, I do not provide psychotherapy services to multiple members of the same nuclear family or family of origin. Should individual therapy clients request services for a partner, parent, sibling, child, etc., they will be provided with referral information for other qualified clinicians.
Emotional Support Animal (ESA) Letters
Due to a lack of standards and regulations regarding ESAs, an inability to confirm or monitor proper training and care of a potential ESA, as well as to minimize the risk of taking on a dual role in my relationship to clients, I do not write ESA letters. Any requests from clients regarding an ESA letter will be declined.
Forensic Services and Litigation
I am not a forensic psychologist; I do not provide forensic evaluations or offer any other kind of forensic services. My work with clients is exclusively psychotherapeutic in nature and should not be considered to reflect a psycholegal opinion of any kind. Should clients be interested in receiving forensic services, I will do my best to provide them with referral information to an appropriate provider.
In order to best protect the confidentiality of my clients in their work with me, I will always advise that my clients claim provider-patient privilege in the event of any kind of litigation. Ultimately the decision will be up to the client whether or not they would like their information released and rendered no longer confidential, but my policy is to always strongly recommend that clients invoke their privilege in order to best protect the privacy of therapy session content in the event of litigation. Should clients choose to not invoke their privilege, they will need to sign an additional Release of Information (ROI) document to signify their understanding that information used in legal proceedings will no longer be confidential.
The pressure to give or receive gifts can be a huge stressor to the therapeutic relationship and so it is not a part of my practice. Clients should be assured that their presence in our sessions is the greatest gift I can receive as a therapist.