Psychotherapeutic Services

A Consumer Guide

Prepared for clients of

Steele & Porret Psychologists Inc.

Thank you for choosing Steele & Porret Psychologists Inc. as the place you will receive professional services.

It is our hope that you obtain effective and respectful assistance for your personal or family concerns.

We are committed to providing you with ethical and competent services. This booklet has been prepared to help you to understand proper conduct by a professional therapist and to develop realistic expectations of the service you will receive here.

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YOUR RIGHTS IN SEEING A PROFESSIONAL THERAPIST

The right to privacy and confidentiality

What happens in our sessions will be kept confidential. If we feel it necessary to release information concerning our work with you to another professional, we will seek your permission. When we are working with more than one family member, we will do our utmost to ensure that we don’t violate trust of information shared with us and will work to open necessary lines of communication between family members.

There are specifically defined limitations to confidentiality in therapy. We have no choice but to break confidentiality in the interest of ensuring physical safety of you (i.e., imminent risk of suicide) or others (i.e., stated intention to do harm) or children (i.e., reason to believe that a child has been abused or are at risk of being abused). At times a crisis situation might mean we have to act outside of confidentiality decisively and immediately. Additionally, if subpoenaed to testify in court or to submit our records for examination by the court, we have no choice but to comply and provide the information requested.

You have the right to know

What rationale we have for the way we work with you.

Our qualifications.
If there are any discomforts or risks to be expected as a result of our professional assistance.
What alternative types of help you could pursue.

The right to withdraw from treatment

You have the right to withdraw from our treatment services at any time. You also have the right to withdraw consent you have given for release of information to others.

The right to freedom from dual relationships

The term dual relationship refers to a therapist having an additional relationship with you other than that of therapist/client – these are considered unethical by our professional association.

Dual relationships include: friendships, sexual, business, employment and collegial. Our avoidance of these additional types of relationships ensures that our professional services we provide do not become complicated.

The right to complain

You have the right to complain to us or about us to our regulatory bodies. If you register your complaint directly with us, we will do our best to ensure that it is dealt with in a straightforward manner.

If you make a complaint to our regulatory body, this may lead to an investigation into our work with you, our general policies, and to effect discipline if necessary. You may access the regulatory body as follows: The College of Alberta Psychologists, 2100 Sunlife Place, 10123 – 99 Street, Edmonton, AB T5J 3H1, 780 424-5070.

Finally, if you have a case manager, funding body or referral source that is sponsoring your work with us, you have the right to contact that organization if you feel you have not received competent or ethical service.

We hope that you will never need to complain. If we can talk about your concerns together, we will most likely be able to find a satisfactory solution. Knowing that you can take your complaint to an outside arbitrator if necessary is important so that you feel more secure in our relationship.

If you are unable to attend a scheduled appointment

Please plan to give 24-hour notice for cancelling your appointment. If you fail to cancel a scheduled appointment, we cannot use this time for another client and you will be billed for the cost of your missed appointment at our regular billing as per the recommended fees set out by the Psychologists’ Association of Alberta.

A full session will be charged for the missed appointment or a late cancellation (less than 24- hour notice) unless it is due to illness or an emergency. An Invoice will be emailed to all clients who do not show up or late cancel for an appointment.

Thank you for your understanding.

INDIVIDUAL PSYCHOTHERAPY

You come to us hoping that as a result of your contact with the therapist, the problems you are facing will be solved. We hope so too. Typically, individual psychotherapy can go a long way in resolving personal problems.

Therapists can assist clients to lessen extreme feelings (e.g. fear, depression, anger), reduce or eliminate disturbing behaviours (e.g. self-harm, addictions, abusive response to others), and to resolve relationship problems (e.g. marital tension, parenting problems).

The therapist is unlikely to have a quick solution to your problems – if there was one, you would have likely found it by now. The therapist will work with you to gradually uncover the solution that will be uniquely your own. This will take time. It will also take effort and willingness to change on your part.

Some problems cannot be completely eliminated, but can be managed and perspective can be gained on them. Your work with your therapist should help you to make decisions about important personal issues. You can expect to understand yourself and your situation better as a result of professional therapeutic help.

Potential risks

There are risks to individual therapy. Not everyone experiences these negative effects and you can work with your therapist to lessen them, if they do happen for you.

Often emotions emerge even more strongly when the exploration of them begins. You might be surprised by the intensity of feelings that you experience during therapy and in the hours and days before and after sessions. On a temporary basis you might experience worsened depression, anxiety, and nightmares. You might not be able to work efficiently in the hours after an appointment. Your therapist can assist you in managing these experiences and can work toward scheduling that is the least intrusive on the rest of your life.

As you share personal information with your therapist, there can be a strain on relationships with other important people in your life (e.g. an intimate partner). It is important to be open with your partner about your seeing a therapist, sharing with him/her what you are learning about yourself and how you are changing. Your intimate partner most likely will want to improve and will support your changes. Occasionally, however, what you learn about yourself and your relationships might put that other relationship in jeopardy. If your partner is suspicious, jealous, or abusive, you seeing a therapist may make those tendencies worse.

Occasionally, clients and therapists can develop strong emotional feelings between them. The proper identification and management of these feelings can actually contribute to your emotional growth and health. Ignoring these feelings, or their mismanagement, can create a severe crisis and further pain. Open discussion of those feelings can help a great deal. Remember, it is NEVER okay for there to be a sexual relationship between you and your therapist. Other additional roles between client and therapist (e.g. friendships, business relationships, employment relationships) can become problematic and need to be avoided if possible.

Be a wise consumer

You can lower your risks in therapy by being a wise consumer. Be choosey about who you allow to be your therapist – check credentials, ask who others have found to be trustworthy and helpful, ask other professionals about the therapist you are considering. If you don’t feel good about the assessment and guidance you are provided, be cautious. Talk to a close friend or family member about what is going on in your therapy.

Be open with your therapist about the risks identified in this booklet, talk about how your risks can be avoided and benefits maximized. If you have concerns about your therapy, get a second opinion. Your therapist should be willing to recommend other competent professionals for this purpose. You could also request your doctor to arrange one for you. If you arrange a second opinion, make it clear to the second professional what you are seeking.

Your therapist wants your therapy to succeed in accomplishing your personal goals. The risks mentioned here can be minimized or completely avoided, when both therapist and client are wise and careful.

Let’s work together to make therapy a good experience for you.

MARRIAGE AND FAMILY THERAPY

Most marriage and family therapists subscribe to a theoretical perspective called family systems theory. This theory states that there is not a simple cause and effect relationship between behaviours, feelings, and beliefs within a family, but that all parts of the family system contribute to the problems and to the solutions within that family. This perspective moves away from blame, to assist members of a family to develop an idea of how they each contribute to the problem. This perspective indicates that everyone has a responsibility to do their part in creating solutions.

The implications of this for therapy are clear. The perspective of every family member is important, so the therapist works hard to hear and understand everybody’s ideas. No one person is blamed. An understanding of how behaviours of different family members fit together is developed. Each person is expected to do their part in creating change.

Please note: “marriage therapy” is a poor term, but one that has been traditionally used. The same concepts and approaches that are effective for married persons are also applicable for non-married couples (e.g. common-law, engaged, and gay). Your therapist will make the necessary adjustments, if your relationship is not a traditional marriage.

Likely benefits

Marriage and family therapy will provide you with ideas and support on improving the important relationships of your life. We can help you to see your behaviour from the viewpoint of others and help you to act with more integrity and love toward others. As similar benefits come to other family members too, you will experience benefits from their changes.

Marriage and family therapy will assist in opening communication between family members. You will have an opportunity to listen to other family members speak from their perspective, free from having to defend yourself. In doing so you will become more understanding of those views.

Marriage and family therapy will provide you with an opportunity to envision healthier relationships and work cooperatively with other family members toward change.

Marriage and family therapy can burst the bubble of one’s own blame of other family members – it is not always comfortable to have to face personal responsibility for being part of a problem, one you thought belonged to the other. However, taking responsible action to participate in a solution to the problem, may allow you to feel better about yourself and others in your family.

Potential risks …

If there have been secrets in families (e.g. an affair), the opening of communication might reveal that distressing information. If there is a tendency toward violence between family members, family therapy can actually increase the risk of further violence. The information shared in session may be threatening those who are potentially violent. If family members are not committed toward change and strengthening of the family, therapy can lead to the discouraging awareness that not everyone is willing to work together. This can leave family members disappointed or frustrated that they cannot alone solve the problem.

Your family therapist is aware of these risks and will work in ways to minimize them. You can help by being honest and open in discussing potential risks with your therapist.

An additional consideration

No professional therapist should make major life decisions for you (e.g. to separate or stay together). No therapist should become another parent to your children. Therapists can provide perspective and ideas for you, but they do not do the work of those decisions or responsibilities on your behalf.

Marriage and family therapists devote time and resources to learning how to help. They are committed to assisting in the creation of healthy families. They want the best for you and your family and can work in interesting and innovative ways to support you in making desired change. Working with families is a complex job, one which creates strong feelings for everyone involved. Let’s work together; together we can sort things out.

Family therapy can assist in improving relationships through discussing shared problems and developing cooperative patterns of relating within the family. Parental counselling is directed at creating a positive atmosphere around the child, managing the problem behaviours in a constructive and straightforward fashion, ensuring the child’s emotional needs are met.

THE EFFECTIVENESS OF PSYCHOTHERAPY

It is a big step in your life to begin psychotherapeutic treatment. You may wonder if it will really help. Having appropriate expectations about what psychotherapy can do will help you use your therapy effectively and not be disappointed along the way.

Psychotherapy can help in understanding yourself better, making and following through on healthy decisions, and overcoming distressing emotions. Psychotherapy is unlikely to change your circumstances. The changes that people make in their own behaviour as a result of psychotherapy can help them cope with circumstances in new and better ways. Your psychotherapy cannot change another person who is distressing you. However, your different perspective and resolution of intense feelings can make a difference in how you act and others may respond to your changes by changing their own behaviour toward you.

Psychology, as a scientific discipline, has developed a body of knowledge regarding human behaviour and experience. Psychotherapy is an application of this knowledge to help individuals in distress or with life functioning difficulties. Psychotherapists provide assistance to their clients which is consistent with that basis of scientific knowledge, true to proven traditions of practice and up-to-date in the use of effective methodologies.

Your psychotherapist will provide assistance that is uniquely tailored to your needs. To do so, your psychotherapist will gather comprehensive information about your difficulties and consider a wide variety of treatment techniques. Effective treatment choice arises out of an honest and open collaboration between you and your psychotherapist.

Many factors contribute to a successful outcome for you. The most important of these is the relationship between you and your psychotherapist. Your psychotherapy will have the best outcome if there is a relationship of understanding, trust, respect, and hope. Feel free to ask questions so that you can be confident in the therapy that you are receiving.

Unlike other aspects of healthcare, a reliance on the newest methodologies of treatment is not critical for good outcomes. Current research is identifying methods which are most generally effective for particular types of problems and populations of clients. Much of accepted psychotherapeutic treatment is still outside the validation by scientific research. Your psychotherapist is trained in the traditions of good practice, with a variety of general treatment models and specific techniques. Your psychotherapist will bring the best she has to offer to your unique situation. If your psychotherapist believes that you could be better helped by a different psychotherapist using a different treatment approach this will be discussed with you and a referral will be made.

Staff of the practice may be involved with some clients in a different role, that of independent assessor. Assessments are completed to assist other professionals in understanding the needs of clients and making decisions within their own area of responsibility. Psychotherapists avoid the overlap of assessment and treatment roles in their work with individual clients.

Associates in this practice pledge to provide services that meet the highest standards of care. Your problems will be approached in ways that are unique to your needs and the specific training and skills of your psychotherapist. You can expect a relationship with your psychotherapist that provides you with the dignity and hope that will lead to a good outcome.

COLLECTED PERSONAL INFORMATION AND PRIVACY

The maintenance of privacy of your personal information is a cornerstone of professional counseling services. When you see a psychologist, you trust that your personal information will not be divulged except as professionally necessary. Psychologists are required to have policies protecting the privacy of information, advise their clients concerning the security of that private information, and obtain consent to collect and use private information as disclosed (The Personal Information Protection and Electronic Documents Act of the Federal Government). Steele & Porret Psychologists Inc. will collect the following types of information including name, address, phone numbers and date of birth date. If we are direct billing your insurance provider we will be collecting the necessary information from you. This information is for identification and contact purposes and billing.

Information obtained and generated as a result of professional assessment and treatment

We are also required to collect sufficient information concerning client’s presenting complaints, personal history and current living conditions as necessary to form a professional opinion regarding required care. In the course of professional services Psychologists also generate new information concerning you with respect to your attendance at sessions and professional opinions and observations regarding your specific problems.

Information concerning payment of fees and outstanding accounts

As part of our financial processes billing information will be maintained including your identifying information, your session dates, the fees that you are charged, and your payments. This information is retained to insure proper bookkeeping and accounting practices for the receiving and processing of payments. The may include third party payer information.

Secure storage of information

Information is stored in both electronic and paper files depending on the nature and use of the information. Our offices are kept locked except for times when they are occupied by responsible staff. There is an electronic alarm system in place for after hours. File cabinets are kept locked. Computers on which personal information is stored are password protected.

Information is stored for a period of 10 years following the final professional contact for services for adults and 10 years after a juvenile has reached the age of 18. File destruction of paper files is by shredding.

Staff access to your personal information

Your psychologist retains access to all your personal information. Additionally, an administrative assistant has access to information for administrative purposes only (e.g. billing, assistance in submitting reports, scheduling and booking appointments).

Other psychologists may have access to your professional information under extreme circumstances – e.g. if there is an audit of your psychologist’s professional practice due to ethical violations or if another psychologist must take over the role of your psychologist when your psychologist is unable to continue to serve you due to illness or death. Accountants may have access to information pertaining to fees and outstanding accounts for auditing purposes.

Your access to your information

You can access your own personal information or information concerning someone for who you are guardian at any time under the supervision of your psychologist. Your psychologist may restrict access if she has reason to believe that granting access would cause harm.

Disclosure of information

A psychologist is required to report to Child Protection Authorities if she has reason to believe, and does believe, that a child is at risk of abuse or neglect. A psychologist is required to take reasonable action to safeguard the life of an individual if the psychologist through her professional knowledge has reason to believe that a person’s life is at immediate risk. A psychologist will comply with a subpoena to testify in court, providing verbal testimony and records as specified in the subpoena.

Only with your consent can your psychologist divulge confidential information in addition to the provisions given above. Your psychologist will try to promote a reasonable coordination of care to you by being in contact with other professionals also assisting you.

Can I take my records with me when I have completed work with my psychotherapist?

Your psychotherapist will need to retain your record in case it needs to be produced in the future. If you wish a copy of your record, one can be prepared for you. Cautions as given in the section “Can I see my records?” also apply. There will likely be a cost to making a copy of your records.

FEES AND POLICIES REGARDING PAYMENT

Our fee for one-hour session is based on the Recommended Fee Schedule as determined by the Psychologists Association of Alberta. These fees are our compensation for years of training and professional development. They have been established at a level to provide an income similar to others of equivalent qualifications practicing in the human services field. Please understand that in addition to the hour we spend with you, we are also working for you at other times without additional charges (see below).

Is the fee covered by Alberta Health Care Insurance Plan?

No. We receive no fees or grants from any government health care plan.

Are there ever additional charges?

Only in exceptional circumstances. If your session goes over significantly over an hour, and we inform you as it is occurring that there will be additional charges. Your therapist will discuss the additional charges with you.

If we need to do a significant amount of paper work on your behalf outside of the session, the hourly rate applies. We will inform you before undertaking the additional service that there will be a separate charge.

If your therapy is provided in an alternate format (such as online or phone), charges will be established in consultation with you to ensure that the therapist’s time is compensated.

What services are offered without charge?

Generally, reasonable phone contact with clients is not charged (such arranging appointments). As our time for returning calls is limited, we will appreciate phone contact being brief unless specific arrangements are made for a longer call. We endeavor to return all calls within the day.

What if I cannot afford to pay?

Please discuss your financial difficulties with us as soon as you are aware of them. We will discuss other therapy options with you (e.g. government agencies), and help make a referral.

What about insurance?

Private insurance companies will likely assist with your fee, if you have appropriate coverage. It is up to you to determine from your company the process required by them to cover your fee. Generally, you will pay the full amount directly and submit your receipts to the insurer for reimbursement. Some insurers require a letter of referral to the therapist from a doctor. Obtaining that letter is your responsibility. We can direct bill Veterans Affairs, RCMP, Alberta School Employee Benefit Plan (ASEBP), Green Shield Canada, Medavie Blue Cross. If your insurer makes partial payments such as with ASEBP you are responsible to pay the balance at the time of each session.

Additional charges for assistance with legal matters

The preparation of letters or reports for lawyers will be charged or attendance at Court will be charged according to the Psychologists’ Association of Alberta fee guidelines.

These policies are intended to be fair and compassionate toward our clientele. We hope you will find them to be so. If you have any questions, comments or suggestions, please let us know.

RELEASE OF CONFIDENTIAL INFORMATION

As part of professional services to you, your therapist may need to be in communication with other professionals on your behalf. Such communication allows services to you to be coordinated and complementary. Please let your therapist know, if you are receiving help from other professionals concerning emotional or relationship problems. You and your psychologist may decide it is beneficial for this communication to take place.

Your therapist may communicate in several different ways. These will include letters of assessment and progress, letters of referral, telephone contact or participation in case conferences.

The release of information by your therapist can only occur with your permission or under extreme conditions (as given below).

Sometimes verbal consent will be obtained for verbal release of information (e.g. a telephone call to facilitate a referral). A written consent will be requested for the release of written information.

Please remember some basic rights that you have.

You have the right to take back any previous consent for release you have provided.
You have the right to know what is being said about you.
You have he right to always be treated with fairness and respect.

The conditions under which confidential information may be revealed without your knowledge or consent are very specific, as follows:

If you are of immediate danger to yourself or others.
If a child is being abused or at risk of being abused.
If records are subpoenaed for court purposes, or if your therapist is called to testify in court or under the provisions of a variety of Acts, including for example, the Worker’s Compensation Act, Mental Health Act, Child, Youth and Family Enhancement Act and Hospital Act.
If records are requested in investigative or disciplinary procedures regarding the therapist’s treatment of you.

Please direct any further questions to your therapist – we are here to serve you!

Where files contain information about several persons obtained in the context of a professional relationship (for example, in couples or family therapy), the psychologist must secure consent of all such persons before releasing the information. Your Psychologist Lisa Porret or Vivian Steele may enter into a Written Agreement with all parties whereby the parties would agree that the information may later be released to one of the parties without the expressed consent of the other parties.