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Policies

 

It is my joy and privilege to collaborate with my clients in a joint effort to improve their life experiences.  There are occasions, however, where I may be limited in my ability to helpful for clients.  If I find myself in a place where I am failing to help you, I will honestly inform you and try my best to direct you to an appropriate treatment resource.

 

 

This document is intended to outline the boundaries and expectations that will enable our relationship to be helpful for you and safe and enjoyable for the both of us.  Failure to observe these boundaries may damage our relationship, interfere with my ability to be helpful you and others, and require me to discharge you from treatment.

 

 

  • Evaluation period: The first 3 months of meeting with me are considered an evaluation period for us to assess whether our relationship can be helpful for you.  If not, my goal would be to refer you to an appropriate resource.

  • Honesty: Be honest, forthright and respectful with me at all times.  This includes not withholding important information relevant to your health and safety.  I will do the same for you.

  • Respect: Please conduct yourself with respect in my waiting room and with all individuals at either of my practice locations.

  • Consistency: Please attend your scheduled appointments with me consistently.  Cancelling or failure to attend 3 out of any 10 scheduled visits may render me unable to be helpful for you.

  • Frequency: Please allow for sufficient visit frequency to treat your condition.  I am unable to be helpful if visits are too infrequent.

  • Diligence: Please engage fully in the work requested of you both in our sessions and between our sessions.

  • Therapy Requirement for Medication: Limiting treatment to medication-only critically limits my ability to be helpful for you.  To recieve medication treatment from me, you must be engaged in therapy with myself or a trusted collaborating colleage.  

  • Phone Calls, Emails: I am unable to practice psychiatry by phone or email.  If you do need to schedule an urgent appointment please inform me and we will try to arrange one.

  • Work outside of appointment time: I am limited in my time outside of our appointments, as I have other clinical and personal obligations.  Outside of life threatening emergencies, please do your best to limit any help you request of me to our scheduled appointment time.  This includes forms and paperwork, prescription renewals and phone calls you need me to make on your behalf.  If you request that I do work for you outside of our appointment time, please be willing to reimburse me for the time and energy I spend on your behalf.

  • Continual Improvement: It is our joint responsibility to ensure you are making progress in therapy.  Lack of progress or regression in functioning is a sign that this therapy is not effective for you, and the treatment should be changed or ended.

  • Higher levels of care: If it becomes evident that you need more help than I am able to provide, I will recommend a higher level of care (partial hospitalization, group treatment, inpatient hospitalization, detox admission, emergency room evaluation, etc.).  Refusal or failure to get more help when you need it will leave me in a position where I am unable to help you.  It is my ethical responsibility to make clients aware when I can no longer be helpful for them (so as not to waste the resources of the client or myself) and conclude treatment accordingly.

  • Safety: Maintain a lifestyle and life situation that is safe enough to address the symptoms for which you want help.  I would expect any unsafe situations to be reported to me immediately so that they can be addressed first and foremost.  Waiting until the end of a visit to raise an emergent safety issue will render me unable to evaluate your situation myself, and may require me to refer you to an emergency room for an evaluation.  The following are examples of situations that threaten your safety and therefore would need to be addressed and changed before any other condition could be successfully addressed or medicated:

    • Ongoing abusive relationships and/or domestic violence.

    • Active drug abuse and/or heavy drinking.

    • Ongoing risky behavior such as drunk driving.

    • Ongoing self-mutilatory behavior.

    • Ongoing binging, purging, restricting behavior of eating disorders.

    • Ongoing suicidal thinking, plans, stockpiling of medications, etc.

    • Other risky behaviors or situations that can be seen as a threat to your physical health.

  • Suicidality: It is my duty to hospitalize clients who, to the best of my clinical judgement, are actively suicidal, homicidal or unable care for themselves, for their own safety.  If you would never consider hospitalization at my recommendation, even if you had an active, life-threatening suicidality, please seek treatment elsewhere.

  • Appropriate medication use: Please use medications in the manner that we have agreed upon in our appointments.  Please consult with me regarding your medication changes, especially medication increases.  I cannot ethically prescribe for persons who may harm themselves by overusing or misusing medication.

  • Controlled substances: Please keep track of your controlled substance prescriptions and medications, and use them in no other way but as prescribed.  

    • Early refill requests for controlled substances will generally not be honored.

    • Overuse or failure to keep medication safe (out of the hands of others) may ethically require me to discontinue a medication.

  • Drug Seeking: Clients who consistently struggle with me over prescriptions, dose increases and early refills of abusable substances will be promptly discharged from my clinic.

  • Collateral communication: Allow for communication between me and other members of your healthcare team (current and former), and in certain circumstances, key members of your support network.

    • I often cannot be helpful for you without communication with other providers.

    • These other persons are only involved to provide me with information to help with your care.  I assume a responsibility only to you as the patient and not to any family member or other person I may speak with for information purposes.

  • Payment: I consider financial reimbursement to every bit as important to the treatment relationship as the time and energy that I dedicate to you.  Just as payment would not expected without time being provided for you, my time and energy will not reserved for you without payment being provided. 

    • Payment is due at the time of the visit unless we have arranged otherwise.

    • 48 hour Cancellation Policy- By agreeing to an appointment with me, you accept financial responsibility for anything that arises on your end that interferes with you making that appointment.  Otherwise, I would be baring that responsibility by losing income.  You will be billed out-of-pocket for appointments cancelled with less than 48 hours of notice (note that insurance will not pay for missed appointments).

    • You are responsible for all visits not covered by your insurance.

    • You are responsible for keeping your health insurance active, and/or maintaining a financial situation that can provide for my service.

    • Please be aware that I cannot assume financial responsibility for my clients by waving fees, reducing fees etc.

 

Standard Treatment Contract (Samadhi Integral)

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