GENERAL INFORMATION
The therapeutic relationship is unique in that it is both highly personal and contractual. It is important that we have a clear understanding of how our relationship will work and what each of us can expect. This informed consent provides a framework for our work together. Please feel free to ask questions or discuss any part of this document with me. By signing this document, you acknowledge that you have read, understood, and agree to the policies described below.
THE THERAPEUTIC PROCESS
You have taken a positive step by deciding to seek therapy. The outcome of treatment depends largely on your willingness to engage in the therapeutic process, which may, at times, result in emotional discomfort. Recalling unpleasant experiences and becoming aware of the feelings associated with those experiences may bring about strong emotions such as sadness, anxiety, anger, or frustration.
There are no miracle cures, and I cannot guarantee that your behaviors or circumstances will change. I can, however, promise to support you, do my best to understand you and your recurring patterns, and help you clarify your goals and move toward the changes you desire.
CONFIDENTIALITY
The content of your therapy sessions and all records related to your treatment will remain confidential except when you provide written authorization for the release of information or when disclosure is required or permitted by law.
Limits to confidentiality include the following:
If you threaten or attempt suicide or otherwise engage in behavior that places you at substantial risk of serious bodily harm.
If you threaten serious bodily harm or death to another person.
If I have reasonable suspicion that a child under the age of 18 has been physically, emotionally, or sexually abused or neglected.
If I have reasonable suspicion that an at-risk elder or dependent adult has been abused or neglected.
If a court issues a valid subpoena or court order requiring the release of information.
If therapy is court ordered or information is obtained for the purpose of preparing a report for the court or an attorney.
As otherwise required or permitted under Colorado law.
At times, I may consult with other licensed professionals regarding your treatment to ensure you receive the highest quality of care. During these consultations, identifying information will be omitted whenever possible.
If we happen to see each other outside of the therapy office, I will not acknowledge you first in order to protect your privacy. If you choose to greet me first, I will gladly respond but will avoid engaging in lengthy conversations in public. Mixing personal and professional relationships can create ethical concerns and compromise confidentiality. In accordance with the American Counseling Association (ACA) Code of Ethics, I also do not attend clients' personal events.
PRACTICE POLICIES: APPOINTMENTS AND CANCELLATIONS
Please cancel or reschedule appointments at least 48 hours in advance.
If you cancel with less than 48 hours' notice or do not attend your scheduled appointment, you may be charged the full session fee. Your appointment time is reserved exclusively for you.
If you arrive late, your session will still end at the scheduled time. Woven Counseling allows a 15-minute grace period. If you are more than 15 minutes late without communication, your appointment will be considered a no-show and the full session fee will be charged.
Cancellation fees may be waived in cases of illness or emergencies that prevent attendance. Fees will not be waived for work obligations or other last-minute scheduling conflicts.
The standard psychotherapy session is 50 minutes. Extended 80-minute sessions may be available and must be discussed and scheduled in advance.
TELEPHONE ACCESSIBILITY
If you need to contact me between sessions, you may call, text, or email. I may not be immediately available, but I will make every effort to respond within one business day.
Whenever possible, video sessions are preferred over telephone sessions because they allow for a more complete clinical assessment. Phone sessions are available when clinically appropriate.
If you are experiencing a mental health emergency, call 911, go to your nearest emergency room, or contact the Colorado Crisis Hotline at (844) 493-8255.
SOCIAL MEDIA
To protect your confidentiality and avoid dual relationships, I do not accept friend or contact requests from current or former clients on any social networking platform, including Facebook, Instagram, LinkedIn, or similar sites.
ELECTRONIC COMMUNICATION
While I make every effort to protect your privacy, I cannot guarantee the confidentiality of electronic communications such as text messages or email. Please use your secure client portal whenever possible to communicate sensitive information.
Electronic communication should not be used for discussing therapeutic issues requiring immediate attention or for emergencies. I cannot guarantee an immediate response.
Telehealth services have limitations compared to in-person services. Clinical assessments are typically informed not only by verbal communication but also by visual and environmental observations. During telehealth sessions, there may be limitations in my ability to observe clinically relevant information, including aspects of your physical appearance, hygiene, body language, movement, facial expressions, eye contact, or other nonverbal behaviors. These limitations may affect my clinical assessment and treatment recommendations.
TERMINATION OF THERAPY
Ending therapy is an important part of the therapeutic process and, whenever possible, should involve a planned termination discussion.
Treatment may be terminated when therapeutic goals have been met, if therapy is no longer clinically appropriate or effective, if financial obligations remain unpaid, or by mutual agreement.
I will make every reasonable effort to discuss termination with you before ending services. If you request a referral, Woven Counseling will provide referrals to other qualified mental health professionals. You are also free to seek services from another provider of your choice.
If you have four consecutive weeks without a scheduled appointment, unless other arrangements have been made, your professional relationship with Woven Counseling may be considered inactive for legal and ethical reasons.
If you miss three consecutive scheduled sessions, we will discuss whether continuing therapy is appropriate. If it appears that you no longer wish to participate in treatment, you will receive written notice. If I do not receive a response within seven (7) days, your file will be closed, and the therapeutic relationship will be considered terminated.
You are welcome to return for services in the future. Resuming treatment may require completing a new intake appointment.
FEES AND PAYMENT
The fee for a standard individual 50-minute psychotherapy session is $125. The fee for a standard couples 50-minute psychotherapy session is $150.
Payment is due within 15 days of receiving your invoice.
If payment is not received by the due date, future appointments may be suspended until the balance is paid in full. A $50 late fee may be added to overdue balances.
Superbills are available upon request for clients who wish to seek reimbursement from their insurance provider.
Professional Supervision
Heather Gilbert, LPCC, is supervised by Michelle Payne, LPC.