Informed Consent

PSYCHOLOGICAL SERVICES

Psychotherapy is not easily described in general statements and varies depending on the personalities of the psychologist and patient, and the particular problems you hope to address.  There are many different methods I may use to deal with those problems.  Psychotherapy is not like a medical doctor visit, it instead calls for your active engagement.  For the therapy to be most successful, you will have to work on things we talk about both during our 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. 

Our first few sessions will involve an evaluation of your needs.  By the end of the evaluation, we will be able to offer you some first impressions of what our work will include and a treatment plan to follow.  You should evaluate this information along with your own opinions about whether you feel comfortable working with me. 

CONFIDENTIALITY

In general, the privacy of all communications between a patient and a psychologist is protected by law, and I can only release information about our work to others with your written permission.  But there are a few exceptions.

In most legal proceedings, you have the right to prevent me from providing any information about your treatment.  In some legal proceedings, a judge may order my testimony if he/she determines that the issues demand it, and I must comply with that court order. 

There are some situations in which I am legally obligated to take action to protect others from harm, even if I have to reveal some information about a patient’s treatment.  For example, if I believe that a child [elderly person or disabled person] is being abused or has been abused, I must [may be required to] make a report to the appropriate state agency.

If I believe that a patient is threatening serious bodily harm to another, I may be required to take protective actions.  These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the patient.  If the patient threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection.  If a similar situation occurs in the course of our work together, I will attempt to fully discuss it with you before taking any action.

I may occasionally find it helpful to consult other professionals about a case.  During a consultation, I make every effort to avoid revealing the identity of my patient.  The consultant is also legally bound to keep the information confidential.  Ordinarily, I will not tell you about these consultations unless I believe that it is important to our work together.

Although this written summary of exceptions to confidentiality is intended to inform you about potential issues that could arise, we must discuss any questions or concerns that you may have at our next meeting.  I will be happy to discuss these issues with you and provide clarification when possible.  However, if you need specific clarification or advice that I am unable to provide, formal legal advice may be needed, as the laws governing confidentiality are quite complex and I am not an attorney.  [If you request, I will provide you with relevant portions or summaries of the state laws regarding these issues.]

Your signature below indicates that you have read the information in this document and agree to abide by its terms during our professional relationship.

Last updated 2024