Terms and Conditions

You, or a member of your family, are about to become involved in counseling or psychotherapy with a trained therapist. I want to take this opportunity to welcome you and also to state some basic principles I believe essential in establishing a good counseling relationship between us. Please read through this information and sign this Consent before you start therapy. If you have any questions, contact me at johankim1001@gmail.com

THE THERAPY PROCESS

Therapy is a collaborative process where you and your therapist will work together on equal footing to achieve goals that you define. This means that you will follow a defined process supported by scientific evidence, where you and your therapist have specific rights and responsibilities. Therapy generally shows positive outcomes for individuals who follow the process. Better outcomes are often associated with a good relationship between a client and their therapist. To foster the best possible relationship, it is important you understand as much about the process before deciding to commit.

INITIAL INTERVIEW

Your first visit is considered a diagnostic or evaluation interview. At the time of this appointment, the following decisions will be made with you:
a) Type of therapy needed (individual, group, medication referral, etc.)
b) Frequency of therapy sessions (weekly, biweekly, etc.)
c) Goals of therapy (what you hope to gain from this process.)
d) The risks and benefits of therapy

First, you will review your therapist's policies and procedures, talk about fees, identify emergency contacts, and decide if you want health insurance to pay your fees depending on your plan's benefits.

Second, you will discuss what to expect during therapy, including the type of therapy, the length of treatment, and, if your therapist is practicing under the supervision of another professional, your therapist will tell you about their supervision and the name of the supervising professional.

Third, you will form a treatment plan, including the type of therapy, how often you will attend therapy, your short- and long-term goals, and the steps you will take to achieve them. Over time, you and your therapist may edit your treatment plan to be sure it describes your goals and steps you need to take. After intake, you will attend regular therapy sessions at your therapist's office or through video, called telehealth. Participation in therapy is voluntary, meaning you can stop at any time. At some point, you will achieve your goals. At this time, you will review your progress, identify supports that will help you maintain your progress, and discuss how to return to therapy if you need it in the future.

TELEHEALTH SERVICES

To use telehealth, you need an internet connection and a device with a camera for video. Your Provider can explain how to log in and use any features on the telehealth platform. If telehealth is not a good fit for you, your therapist will recommend a different option. There are some risks and benefits to using telehealth:

Risks

Privacy and Confidentiality. You may be asked to share personal information with the telehealth platform to create an account, such as your name, date of birth, location, and contact information. Your therapist carefully vets any telehealth platform to ensure your information is secured to the appropriate standards.
Technology. At times, you could have problems with your internet, video, or sound. If you have issues during a session, your therapist will follow the backup plan that you agree to prior to sessions.

Crisis Management. It may be difficult for your therapist to provide immediate support during an emergency or crisis. You and your therapist will develop a plan for emergencies or crises, such as choosing a local emergency contact, creating a communication plan, and making a list of local support, emergency, and crisis services.

Benefits

Flexibility. You can attend therapy wherever is convenient for you.
Ease of Access. You can attend telehealth sessions without worrying about traveling, meaning you can schedule less time per session and can attend therapy during inclement weather or illness.

Recommendations

Make sure that other people cannot hear your conversation or see your screen during sessions.
Do not use video or audio to record your session unless you ask your therapist for their permission in advance.
Make sure to let your therapist know if you are not in your usual location before starting any telehealth session.

CONFIDENTIALITY

All information regarding the specific nature of your counseling or psychotherapy is maintained at Johan Kim, LMHC and is considered confidential within the office unless specified by you in writing. However, each therapist at this office reserves the right to use specialty consultation with other therapists at the office as deemed necessary. I follow HIPAA and maintain strict confidentiality. I are bound to report suspected child abuse/neglect, harm to self/others, or follow a court-issued subpoena. Your therapist may speak to emergency personnel. Your therapist will not disclose your personal information without your permission unless required by law.

If your therapist must disclose your personal information without your permission, your therapist will only disclose the minimum necessary to satisfy the obligation. However, there are a few exceptions.
If your therapist believes that you are at imminent risk of harming yourself, they may contact law enforcement or other crisis services. However, before contacting emergency or crisis services, your therapist will work with you to discuss other options to keep you safe.

If your therapist believes there is a specific, credible threat of harm to someone else, they may be required by law or may make their own decision about whether to warn the other person and notify law enforcement. The term specific, credible threat is defined by state law. Your therapist can explain more if you have questions.

RECORD KEEPING

Your therapist is required to keep records about your treatment. These records help ensure the quality and continuity of your care, as well as provide evidence that the services you receive meet the appropriate standards of care. Your records are maintained in an electronic health record provided by TherapyNotes. TherapyNotes has several safety features to protect your personal information, including advanced encryption techniques to make your personal information difficult to decode, firewalls to prevent unauthorized access, and a team of professionals monitoring the system for suspicious activity. TherapyNotes keeps records of all log-ins and actions within the system.

COMMUNICATION

You decide how to communicate with your therapist outside of your sessions. You have several options:
Texting/Email. Texting and email are not secure methods of communication and should not be used to communicate personal information. You may choose to receive appointment reminders via text message or email. You should carefully consider who may have access to your text messages or emails before choosing to communicate via either method.

Secure Communication. Secure communications are the best way to communicate personal information, though no method is entirely without risk. Your therapist will discuss options available to you. If you decide to be contacted via non-secure methods, your therapist will document this in your record.
Social Media/Review Websites. If you try to communicate with your therapist via these methods, they will not respond. This includes any form of friend or contact request, @mention, direct message, wall post, and so on. This is to protect your confidentiality and ensure appropriate boundaries in therapy. Your therapist may publish content on various social media websites or blogs. There is no expectation that you will follow, comment on, or otherwise engage with any content. If you do choose to follow your therapist on any platform, they will not follow you back.

If you see your therapist on any form of review website, it is not a solicitation for a review. Many such sites scrape business listings and may automatically include your therapist. If you choose to leave a review of your therapist on any website, they will not respond. While you are always free to express yourself in the manner you choose, please be aware of the potential impact on your confidentiality prior to leaving a review. It is often impossible to remove reviews later, and some sites aggregate reviews from several platforms leading to your review appearing other places without your knowledge.

COMPLAINTS

If you feel your therapist has engaged in improper or unethical behavior, you can talk to them, or you may contact the Massachusetts Board of Registration of Allied Mental Health and Human Services Professions (https://www.mass.gov/orgs/board-of-registration-of-allied-mental-health-and-human-services-professions), your insurance company (if applicable), or the US Department of Health and Human Services.

INSURANCE

Before starting therapy, you should confirm with your insurance company if:

• Your benefits cover the type of therapy you will receive,

• Your benefits cover in-person and telehealth sessions,

• You may be responsible for any portion of the payment, and

• Your therapist is in-network or out-of-network.

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Sharing Information with Insurance Companies. If you choose to use insurance benefits to pay for services, you will be required to share personal information with your insurance company. Insurance companies keep personal information confidential unless they must share to act on your behalf, comply with federal or state law, or complete administrative work.

Covered and Non-Covered Services. When your therapist is in-network, they have a contract with your insurance company. Your insurance plan may cover all or part of the cost of therapy. You are responsible for any part of this cost not covered by insurance, such as deductibles, copays, or coinsurance. You may also be responsible for any services not covered by your insurance. When your therapist is out-of-network, they do not have a contract with your insurance company. You can still choose to see your therapist; however, all fees will be due at the time of your session to your therapist. Your therapist will tell you if they can help you file for reimbursement from your insurance company. If your insurance company decides that they will not reimburse you, you are still responsible for the full amount.

Payment Methods. The practice requires that you keep a valid credit or debit card on file. This card will be charged for the amount due at the time of service and for any fees you may accrue unless other arrangements have been made with the practice ahead of time. It is your responsibility to keep this information up to date, including providing new information if the card information changes or the account has insufficient funds to cover these charges.

FEES AND PAYMENT FOR SERVICES

You may be required to pay for services and other fees. You will be provided with these costs prior to beginning therapy, and should confirm with your insurance if part or all of these fees may be covered. You should also know about the following:

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No-Show and Late Cancellation Fees. If you are unable to attend therapy, you must contact your therapist at least 24 hours before your session. Exceptions may be made in cases of emergencies. Otherwise, you may subject to fees outlined in your fee agreement. Insurance does not cover these fees.
Balance Accrual. Full payment is due at the time of your session. If you are unable to pay, tell your therapist. Your therapist may offer payment plans or a sliding scale. If not, your therapist may refer you to other low- or no-cost services. Any balance due will continue to be due until paid in full. If necessary, your balance may be sent to a collections service.

Administrative Fees. Your therapist may charge administrative fees for writing a letter or report at your request; consulting with another healthcare therapist or other professional outside of normal case management practices; or for preparation, travel, and attendance at a court appearance. These fees are listed in the fee agreement. Payment is due in advance.