Welcome to my practice. This document contains important information about my professional services and business policies. Please read it carefully and jot down any questions you might have so that we can discuss them at our next meeting. When you sign this document, it will represent an agreement between us.

Darren McCall, LPC

Contract for Services

Psychotherapy Services

Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychotherapist and client and the particular problems you bring forward. There are many different methods I may use to deal with the problems that you hope to address. Psychotherapy can have benefits and risks. Since therapy often involves discussing difficult aspects of your life, you might experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. Please know that any of these feelings can be normal parts of the process and we can use these feelings to help you reach your goals. 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. Of course, there are no guarantees of what you will experience, and I encourage you to address any concerns with me along the way. Our first session will involve a collaborative discussion of your needs and goals for therapy, your plan to take steps toward your goals, and the beginning of our therapeutic relationship. I advise that you evaluate this information along with your own opinions of whether you feel comfortable working with me in order to decide whether to continue. Therapy involves a commitment of time, money, and energy, and a good fit between you and your therapist is important. If you have questions about my procedures, please feel free to bring them up for discussion whenever they arise. I view our relationship as both a collaboration designed to meet your therapeutic goals and part of the means to reach those goals.

Meetings

Psychotherapy sessions are usually scheduled as one, 50-minute session (one appointment hour of 50 minutes duration) at a time we agree on, although some sessions may be longer. Once an appointment hour is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation (unless we both agree that you were unable to attend due to circumstances beyond your control). If it is possible, I will try to find another time to reschedule the appointment in the same week.

Professional Fees

My fees are listed in the Fee Schedule, which follows this paragraph. The primary service I will provide is meeting with you in my office for regularly scheduled sessions. In addition to these appointments, I charge other amounts for other professional services you may need (see the Fee Schedule below). Other services include report writing, telephone conversations lasting longer than 15 minutes, attendance at meetings with other professionals you have authorized, preparation of records or treatment summaries, and the time spent performing any other service you may request of me. If you ever happen to become involved in legal proceedings that require my participation, you will be expected to pay for my professional time even if I am called to testify by another party. (Because of the difficulty of legal involvement, I charge $200.00 per hour for preparation and attendance at any legal proceeding.) The following is a list of my fees for psychotherapy services*:

Individual Therapy, 50 minutes                                                                        $100.00

Individual Therapy, 75 minutes                                                                         $150.00

Couples Therapy, 50 minutes                                                                            $120.00

Couples Therapy, 75 minutes                                                                            $180.00

Group Therapy, 90 minutes                                                                                 $40.00

Reports, letters up to 20 minutes                                                                        $40.00

Reports, letters up to 45 minutes                                                                         $90.00

Telephone Contact, 15-30 minutes                                                                       $45.00

Telephone Contact, 30-45 minutes                                                                       $75.00

Telephone Contact, 45-60 minutes                                                                     $100.00

Court or Deposition Services (per hour)                                                            $200.00

No call/No Show w/out 24 hour notice                                                                $50.00

*These fees do not reflect any contracted discounts with managed care plans or individuals. The total fee, or the agreed upon co-payments, are due at the time of service unless alternative arrangements have been made.

Billing and Payments

You will be expected to pay for each session at the time it is held, unless we agree otherwise. Payment schedules for other professional services will be agreed to when they are requested. (In circumstances of unusual financial hardship, I am willing to negotiate a fee adjustment or payment installation plan.) If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, I have the option of using legal means to secure the payment. This might involve hiring a collection agency or going through small claims court. If such legal action is necessary, its costs will be included in the claim. In most collection situations, the only information I release regarding a client’s treatment is his/her name, the nature of services provided, and the amount due.

Insurance Reimbursements

In order for us to set realistic treatment goals and priorities, it is important to evaluate what resources you have available to pay for your treatment. If you have a health insurance policy, it will usually provide some coverage for mental health treatment. I will fill out forms and provide you with whatever assistance I can in helping you receive the benefits to which you are entitled; however, you (not your insurance company) are responsible for full payment of my fees. It is very important that you find out exactly what mental health services your insurance policy covers. I work with a third party service, Wellpay, Inc., to verify insurance coverage, to bill insurance companies or their representatives, and to negotiate with insurance companies or their representatives if a claim is disputed. I have a signed agreement with Wellpay whereby Wellpay agrees to abide by the same laws of confidentiality that apply to my services. I will provide representatives of Wellpay, Inc. only with the necessary information to submit and negotiate payments. You should carefully read the section in your insurance coverage booklet that describes mental health services. If you have questions about the coverage, call your plan administrator. I will relay questions about your insurance coverage to Wellpay, Inc. You should also be aware that most insurance companies require you to authorize me to provide them with a clinical diagnosis. Sometimes I have to provide additional clinical information such as treatment plans or summaries, or copies of the entire record (in rare cases). This information will become part of the insurance company files. I will provide you with a copy of any report I submit if you request it. Once we have all of the information about your insurance coverage, we will discuss what we can expect to accomplish with the benefits that are available and what will happen if they run out before you feel ready to end our sessions. It is important to remember that you always have the right to pay for my services yourself (unless prohibited by contract).

Contacting Me

My primary contact number is 512-789-6754. My email address is Darren@eightfoldcounseling.com. I am often not immediately available by telephone. When I am unavailable, my telephone is answered by my confidential voice mail, which I monitor frequently. I generally return phone messages by the end of the following business day. If you are difficult to reach, please inform me of times when you will be available. In the case of an emergency, you should contact your primary care physician, the nearest emergency room, 911, or the Austin Travis County Mental Health Hotline at 512-472-4357 (HELP). If I will be unavailable for an extended time, I will make arrangements with you in advance, if possible.

Professional Records

The laws and standards of my profession require that I keep treatment records. You are entitled to receive a copy of your records, or I can prepare a summary for you instead. Because these are professional records, they can be misinterpreted by and/or upsetting to untrained readers. If you wish to see your records, I recommend that you review them in my presence so that we can discuss the contents. (I am sometimes willing to conduct a review meeting without charge.) Clients will be charged an appropriate fee for any professional time spent in responding to information requests.

Confidentiality

In general, the law protects the privacy of all communications between a client and a therapist, and I can release information about our work to others only 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 proceedings involving child custody and those in which your emotional condition is an important issue, a judge may order my testimony if he or she determines that the issues demand it. 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 client’s treatment. For example, if I believe that a child, elderly person, or disabled person is being abused or neglected, I must file a report with the appropriate agency within 48 hours of learning of the abuse or neglect. If I believe the client is threatening serious bodily harm to another, I have the option but not the obligation to take protective actions. These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the client. If the client threatens to harm himself or herself, I may be obligated to seek hospitalization for him or her or to contact family members or others who can help provide protection. These situations are likely to occur rarely. If a similar situation occurs, I will make every effort to discuss it fully 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 client. The consultant is also legally bound to keep the information confidential. If you do not object, I will not tell you about these consultations unless I feel it is important to our work together. While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have at our next meeting.

Summary of your Rights and Responsibilities

As a client, you have the following rights and corresponding responsibilities:

Rights

  1. Refuse any counseling services.
  1. Receive counseling services as scheduled.
  1. Terminate counseling services at any time.
  1. Select a particular counselor.
  2. Have a private, uninterrupted conference with me, and that I am prompt, attentive, and willing to listen.
  3. Know how the counseling process works.
  1. Set goals for yourself within the counseling framework.
  2. Choose between individual and group counseling.
  1. Read your counseling records.
  1. Participate in the selection of questionnaires, inventories, assessments, activities, and assignments that facilitate the counseling process; and to see the results of any of these.
  1. Agree to divulge sensitive and confidential information to me that will facilitate the counseling process.
  2. Refuse to accept any of my professional recommendations.
  3. Evaluate the results of counseling.
  1. Seek consultation with another counselor or helping professional.

Responsibilities

  1. Inform me when you are refusing any counseling services.
  2. Cooperate and participate in counseling services.
  3. Inform me of your decision to terminate services and your reasons for terminating.
  4. Indicate to me the reasons for your preference.
  5. Arrive promptly and participate actively.
  1. Provide me with feedback about the efficacy of various techniques.
  2. Work actively toward your goals.
  1. Make the choice between individual and group counseling on the basis of sufficient information and, once the choice is made, remain in that mode for a reasonable and previously agreed on amount of time.
  2. Allow me the opportunity to review your counseling records with you so that I can help you understand any technical language or other pieces of information that might require clarification or context.
  3. Be informed about the factors involved in making selections by discussing the intent of the selection and doing any additional research on your own that you feel is helpful for participating in the selection process. Allow me the opportunity to review your questionnaires, inventories, assessments, activities, and assignments with you and discuss the implications of the results
  4. Understand the ethical and legal limits of confidentiality regarding privileged information.
  1. Accept responsibility for refusing any recommendations.
  2. Inform me of your criteria for and the results of your evaluation.
  3. Inform me of your decision to consult and your reasons for consulting