Welcome and thank you for choosing Aurora Lake Mental Health for your mental health needs. Whether you were referred to us by your medical provider, urged to seek counseling by family or friends, or came because of problems and feelings only you know about, the decision to come here was yours. We congratulate you on taking this courageous step forward on your path to mental health recovery and are honored that you are considering one of our clinicians as your service provider.

During the first session, your therapist will explain policies and procedures, obtain a detailed intake and answer any questions that you may have regarding the counseling process. We realize that starting therapy is a major decision and you may have many concerns or questions. This document is intended to inform you of our policies, State and Federal Laws, and your rights and responsibilities as a client.

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CONFIDENTIALITY

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Confidentiality and Privilege: The information and content shared in therapy will remain confidential, except as noted in the next section. Your information will not be shared with anyone without your written consent. Your information is privileged, which means that your therapist is free from duty to speak in court about your counseling unless you waive that right or a judge orders it.

Exceptions to Confidentiality and Privilege: As a mandated reporter in the state of Minnesota, your therapist is legally obligated to violate confidentiality under the following circumstances:

• When the therapist has reason to suspect the client has been, or is currently, involved in the abuse or neglect of a child.

• When the therapist has reason to suspect that the client has been, or is currently, involved in the abuse or neglect of a vulnerable adult

• If a client is a serious danger to themselves (suicidal) or a danger to someone else (homicidal)

• If a client is pregnant and taking street drugs • If a client reports sexual misconduct by another medical provider

• A court order for specific information, signed by a judge in a pending legal case. Other circumstances when confidentiality is waived/limited:

• Information (diagnosis and dates of service) shared with your insurance company to process your claims.

• When you sign a release of information to have specific information shared.

• Minor clients: parents and guardians do have legal right to access a minor client’s records. Minor clients do have rights to complete confidentiality in obtaining counseling for pregnancies and associated conditions, sexually transmitted diseases, and information about alcohol or drug abuse.

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MEDICAL RECORDS Supporting Vendors: In the course of operating our mental health clinic, we contract with various external vendors such as an accountant, information technology (IT), claims clearinghouse, and an electronic health record (EHR) vendor. In all of these cases, we have a HIPAA business associate contract in place. This means they understand the federal HIPAA guidelines for confidentiality and agree to abide by those regulations set forth and maintain the same level of confidentiality that healthcare professionals are bound to in the event they should encounter patient information. Careful steps are taken with our accountant and IT vendors to ensure they rarely encounter any client information. Our claims clearinghouse and EHR are used to submit medical claims electronically and maintain client records. In each case, bank level security and encryption is used to protect client information.

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Maintaining Records: The laws and standards of our professions require that we keep treatment records. As a client, you have access to your records. If there is a belief that reviewing the record could be emotionally damaging, the therapist will send them to a mental health professional of your choice. We recommend that records be reviewed in your therapist’s presence so the contents can be discussed, as some of the records can be misinterpreted. You do have a right to contest material in your records and it will be duly noted in your record. You do not have a right to alter your records or dictate information be removed. All records include: a chronological listing of appointments and fees, a copy of signed releases, copies of any correspondence regarding your case, a copy of the consent form and a copy of all therapist’s progress notes. All records will be maintained by your therapist in a secured area for a period of 7-8 years (depending on therapist licensure) from the time of service termination or past the age of majority for minor clients. If your therapist leaves the agency or becomes incapacitated, you will be notified about how to access your records. Request for

Records/Letters: A therapist has 10 business days to respond to any request for records or correspondence.

A release of information must be completed fully, with the individual therapist’s name and the business or person you wish to have records released to. There may be a charge for medical records, depending on quantity of pages being sent and the professional that is requesting records. Rates for patient records are determined by MN Dept. of Health.

Records for Minors: If you are under the age of 18, the law provides your parents the right to review your treatment records as well as obtain information about your diagnosis, progress, and treatment. It is our policy to request an agreement from parents that they agree to avoid unnecessary review of records and involvement in your treatment. If they agree, we will only provide them general information about our work together. However, we will notify them of our concern if we feel there is a high risk that you will seriously harm yourself or someone else.

THE THERAPY PROCESS

Voluntary Participation: All clients voluntarily agree to treatment, and accordingly may terminate any time without penalty. Counseling involves a large commitment of time, money, and energy, so you should be thoughtful about the therapist you select. In the first few sessions, your therapist will ask a wide variety of questions designed to get to know you and learn about your personal history.

The therapeutic relationship is unique in that you are expected to talk freely and openly about yourself. The therapist’s job is to listen, select, sort, make observations and reflect your feelings so you may see yourself more clearly. In the first couple of sessions, you will decide whether your therapist is right for you. If you feel it is not a good match, your therapist will be happy to assist you in finding a different therapist.

Client Involvement: All clients are expected to arrive to appointments on time, prepared to focus and discuss therapy goals and issues, and not to be under the influence of mood altering chemicals. All clients are expected to be open and honest so your therapist can assist you with your goals.

Counseling is not like a medical doctor visit. Instead, it calls for very active effort on your part. In order for your therapist to be most successful, you are encouraged to work on things discussed both during sessions and at home. Inconsistent attendance can negatively affect your therapy progress. Violence (physical or verbal) is never acceptable. Your therapist reserves the right to discontinue a session at any time and call the proper authorities, if necessary. Recording during sessions by any method is strictly forbidden and results in automatic discharge.  

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The Therapeutic Relationship: An important aspect of the therapeutic process is the relationship that develops between the client and therapist. As with any new relationship, it may take time to trust and feel safe enough to share freely. If the relationship does not develop after a reasonable amount of time (3-4 sessions), at your request, the therapist would be happy to offer referrals to a few providers that may be a better fit for you.

If you were to encounter your therapist in any public place outside of therapy, your therapist will be careful not to acknowledge you or the relationship or engage in any conversation in order to protect your privacy and confidentiality. Exceptions to this would require the written permission for a very specific purpose discussed in advance, or in an emergency situation which may determine that confidentiality must be broken within the limits of the law to protect your personal safety, the possibility of you harming others, or to receive appropriate psychiatric care.

Dual Relationships: The therapeutic relationship is a professional relationship and as such, social or business relationships should be avoided. Your therapist cannot compromise the integrity of the therapeutic relationship in any way that would impair objectivity, clinical judgment, or the therapeutic effectiveness of treatment. In order to protect our therapeutic relationship, psychotherapy does not include physical contact. This means that we do not ordinarily touch one another as any part of therapy. Your therapist will limit contact to an occasional greeting, such as a handshake. 

We do not accept friend or contact requests from current or former clients on any social networking site (Facebook, Snapchat, Instagram, Twitter, Linkedln, etc.). We believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy and blur the boundaries of our therapeutic relationship. Confidential text reminders for sessions are available and can be signed up for on your client portal.

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Custody Issues and Therapy for Minors: It is our policy that for minor children, where legal custody is joint between parents or guardians who are no longer married or cohabitating, we need authorization and signatures from both parents on our Informed Consent and Confidentiality Notice prior to the child being seen.

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Telehealth services: When appropriate or necessary, your therapist may offer the option for telehealth psychotherapy. We utilize a secure, encrypted audio/video transmission software to deliver this service. All confidentiality laws remain in effect for telehealth services. You can improve your confidentiality by using headphones and a private space for your session. The risks and consequences of telehealth include the possibility that the transmission of services could be disrupted or distorted by technical failures and services and care may not be as complete as in-person services. All policies and procedures for in-person psychotherapy, as detailed in this document, also remain in effect for telehealth psychotherapy.

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Length of Therapy: Psychotherapy sessions are generally scheduled once per week or as needed, and may be adjusted to meet your current issues and treatment goals. Session length is typically 45 – 60 minutes, depending on insurance coverage. Please report any changes in your condition or behavior to your therapist throughout the course of therapy, as this may alter the scheduling of therapy sessions. If you feel the need to increase or decrease the frequency of sessions or to end counseling, please feel free to discuss this with your therapist at any time. On average, many people feel that they have obtained what they are looking for in 10-25 sessions.

Termination: As you approach your treatment goals, you should have the skills, strategies and encouragement to make the desired changes you have chosen for your life. Although your therapist can assist you through this process, ultimately only you can make the decision to change. (Please note: If the therapist determines that treatment is no longer effectively serving the needs or interests of the client, a decision to end therapy may be made.)

As the end of therapy approaches, you and your therapist will discuss discontinuing therapy with the understanding that you may choose to return to therapy as needed or be referred to other mental health providers. You have the right to end therapy at any time and for any reason. Please feel free to discuss this with your therapist so any necessary referrals can be provided.