The following is a detailed explanation of the policies and procedures of my practice. I am happy to answer any questions you might have.
Your appointment time is reserved for you. It is your responsibility to notify me at least 24 hours in advance if you are unable to attend. Cancellations of appointments less than 24 hours in advance and “no shows” are subject to full fee for the appointment time. If you arrive more than 15 minutes late for an appointment without notifying me, I will consider the appointment canceled and charge for the session.
Exceptions to this policy may occur in the case of unforeseen emergencies or serious illnesses/injuries that arise on the same day as the scheduled appointment. An emergency is defined as a major trauma that occurs to the you or an immediate family member (e.g.. Hospitalization, involvement in a car accident, victim of a crime.) Should one of these events occur on the same day as your appointment, please notify me as soon as reasonably possible, as you will be charged the full session fee if it appears that the cancellation is made at the “last minute” unnecessarily. As an additional exception, if you are aware in advance of an upcoming possible conflict with your appointment time, want me to hold the time for you, and will not know until less than 24 hours, I will make every effort to fill the appointment once you notify me and will waive the cancellation fee if I am able to fill the time.
I often have individuals waiting for a consistent weekly appointment slot. Therefore, should you have a weekly appointment slot and cancel twice in a month on more than one occasion for whatever reason, you will be asked to pay in full at the beginning of each month for the total hours for the month in order to hold that slot. In this circumstance, no refunds are available for unused session time regardless of cause. Should you prefer not to pay in advance each month, you will be offered session times as they become available due to cancellations.
Due to the nature of my work, there are times when unforeseen clinical crises or emergencies may arise with other clients, requiring that your appointment be canceled or delayed. When such situations are unavoidable, I will make every effort to inform you at the earliest possible time and reschedule the missed session time, in order to minimize the inconvenience to you.
Even the darkest night will end and the sun will rise.
– Victor Hugo
Payment & Fees
The standard fee for a 60-minute session is $200, and extended sessions are prorated accordingly. I generally provide treatment in weekly, two-hour sessions, unless there is clear, clinically-based rationale to provide shorter and/or less frequent sessions. I have found, as have many of the experts with whom I have trained, that longer, more intensive EMDR and CBT therapy sessions are often significantly more efficient and effective than shorter ones. Each session requires some attention to managing current life stressors, and longer sessions allow for this to be accomplished along with substantially more focused work toward resolving the primary symptoms of concern. My experience has shown me that far more can be accomplished in a briefer period of time through this approach.
Hourly prorated fees will be charged, should the time exceed 15 minutes and/or be necessary at frequent intervals during the course of treatment, for time spent communicating by phone, text, or email regarding treatment issues between sessions, as well as for time spent in consultation and coordination of care with other treatment providers. Hourly prorated fees will be charged should you require written reports of your assessment, treatment goals, or progress, with the minimum charge equal to the fee for a 60-minute session. I offer a limited number of sessions at a reduced rate for those experiencing financial hardship. Typically, reduced rates are only available to established clients and for a limited period of time. Please bring it to my attention should your financial situation hinder your ability to afford therapeutic services at the standard rate. Court testimony is charged at an hourly rate of twice the standard fee for a 60-minute session, including travel time and with a minimum charge of a full 8-hour day for each day on call for court appearance. No reduced fees are available for court testimony.
You are expected to pay for services at the time they are rendered, unless other arrangements are specifically discussed and agreed upon with me in advance. Invoices for payment are available at your request. An additional $10.00 per week will be charged for session fees not paid on the date of service, which will begin to accrue on the day directly following the date of service. Fees may be paid via cash, check, credit card, or transfer using Zelle. There is a $25.00 fee returned checks. My rates are reviewed each September and may be increased 5 – 10% annually.
I keep an authorization on file for each account that allows me to bill any accrued balance due. You are expected to ensure I have a current credit card on file, and you will be informed in advance of any amounts charged to your card. Credit card payments are processed using PayPal. However, it is not necessary for you to have a PayPal account. I can process the payment using the card authorization I keep on file, you can “swipe” your card in person at the time of session, or you can pay in advance using the website. When paying via the website, you may choose to use your personal PayPal account or sign in as a “guest” and enter your credit card information.
I treat my clients’ needs according to my clinical training and experience, and my rates are set in accordance with what is usual and customary for my level of expertise and specialization. I have found that the treatment protocols and authorization requirements of insurance companies are restrictive, burdensome, and often inadequate, and that they do not tend to promote my client’s receiving adequate and effective treatment. Therefore, as a rule, I do not contract with insurance companies as an In-Network Provider. As a service to you, I am willing to submit basic documentation of services to insurance and other third-party payers, but I cannot guarantee your benefit levels and am not responsible for their payment. In some cases, insurance or other third-party players may deem certain services as not “reasonable or necessary” or may determine that services will not be covered. You are responsible for payments regardless of any agency’s arbitrary determination of rates or coverage. Should your insurance company require written or verbal justification or pre-authorization for services and you wish for me to provide this information, hourly prorated fees will be charged for all time required to do so including chart review, hold times, and communication of clinical data, understanding that there is no guarantee it will result in subsequent approval by the insurance company.
Insurance billing and accounting is handled by Linda Griebel of Griebel Billing. You are welcome to contact her directly regarding any insurance related questions. Please contact her at the beginning of treatment or any time your insurance changes in order to verify the extent and specifications of your coverage. Insurance companies generally do not send this therapist the Explanation of Benefits for processed claims, so you are also encouraged to monitor the paperwork you receive from your insurance closely and contact Linda if anything appears amiss. Linda can be reached at (619) 224-6343 or email@example.com.
Telephone & Internet Communication
If there is a matter where you need a brief/crisis consultation with me, you may call to discuss the issue. I welcome text messages for practical matters but ask that clinical discussions be handled by phone or in session in order to ameliorate the risk of miscommunication inherent to texting. If anything communicated by text is confusing or troubling, I ask that you bring it to my attention so it can be addressed promptly. As it is challenging between scheduled sessions to insure in which I can provide adequate privacy and attention to meet your therapeutic needs, hourly pro-rated fees are charged for calls or texting that exceed 15 minutes or become frequent. If significant between-session communication is needed, I will typically recommend scheduling more frequent sessions or provide referrals for additional types of support.
You may text my office at 760-452-2776 to use an encrypted texting platform. By entering your cell phone number and initialing the Consent for Treatment, you are acknowledging that you are aware standard texting to my cell at 831-419-5271 may not be a secure form of communication and that your confidentiality and privacy may be at risk when engaging in text communication with this therapist.
You are welcome to send me correspondence related to your treatment using the email address: firstname.lastname@example.org. However, due to the inherent vulnerability of electronic communication, there is no guarantee that email correspondence is confidential. If you wish to communicate via encrypted message, please email me a brief note with this request. I will reply with message enabling encrypted communication via a secure, HIPAA-compliant platform. I will generally respond only briefly via email and will, rather, wait until you are face to face to address issues in any depth. Please use my voice mail to communicate any urgent information, as I cannot assure timeliness in reading or responding to email. In order to maintain the clarity of the therapeutic relationship, I will generally not use social networking sites (e.g. Facebook, Instagram, LinkedIn) to communicate with you about clinical issues.
Should the decision be made that treatment be conducted via the telephone or Internet (“telemedicine”), this decision will be made collaboratively based on the potential risks, consequences, and benefits of the unique situation involved. While telephone and Internet contact can overcome barriers of proximity and convenience, these methods can also inhibit some elements of communication, limit my use some types of treatment interventions, and possibly create difficulty for me to intervene in the case of a crisis. Due to varying quality of connection based on Internet speed, it is recommended that a cable connection or better is used for Internet video sessions, with a minimum of connection via DSL. Dial-Up connection is unable to maintain video streaming.
If using telemedicine, you agree to inform me of the address of your physical location for each session and your county’s Crisis Support phone number.
When obtaining treatment via the telephone or Internet, all existing laws protecting client confidentiality apply, all existing laws regarding access to medical information and copies of medical records apply, and dissemination of any client identifiable images or information from the telemedicine interaction to other entities shall not occur without consent of the client. However, the level of privacy involved in telephone and Internet contact can vary significantly, and you must be willing to allow for this risk.
Telemedicine may not be covered by your insurance, so it is your responsibility to obtain prior authorization and specific billing instructions prior to this therapist submitting claims to your insurance provider.
You have the option to withhold or withdraw consent for treatment via the telephone or Internet at any time without affecting your right to future treatment or risking any other potential consequences.
The material you disclose is confidential and cannot be released without your written consent. However, there are several important exceptions to confidentiality. These include:
- If there is reasonable belief or suspicion that child abuse has occurred
- If there is reasonable belief or suspicion that elder or dependent adult abuse has occurred
- If the client makes a serious threat of harm to another person
- If the client demonstrates danger to self or others
- If the client files an insurance claim to be reimbursed for some portion of the cost, this gives the insurance carrier the right to inquire regarding the client
- If the client enters into legal proceedings in which the client raises the issue of his/her mental health status, the court may order the applicable records
- If the client brings a lawsuit against this therapist
- If a judge orders the therapist to release client information
- If the therapist is disclosing medical information to a provider of health care, health care service plan, or contractor for the purposes of diagnosis or treatment of the client.
Should you give written permission to provide information to another party, there is limited confidentiality. In these cases and in most situations listed above, I can reveal information only to someone who has a “need to know”, and entire records or irrelevant information may not be disclosed. Whenever information will be shared with other persons, every effort will be made to ensure that the receiving person also maintains confidentiality.
In addition to the above, special circumstances apply to group, couple, parent-child, and family therapy and any time the client chooses to involve another person in treatment. Specifically, other individuals in the room are not bound by privilege and may possibly not hold all information confidential; I am not responsible for disclosure by these individuals.
Please note that my practice is clinically focused and not designed for legal proceedings or forensic purposes. I generally do not provide court testimony or documentation for the court cases unless legally required to do so. I am not trained as a child custody evaluator or mediator, am unable to make recommendations regarding custody arrangements, and customarily will not provide information to the court or its representatives beyond that which is legally mandated.
You may have access to your treatment records, although it may be best for me to discuss the items contained in the records with you or to provide you with a summary for a specific purpose. Financial records and insurance billing information are maintained in your chart and using the Quickbooks Online accounting program. These records may be managed by administrative personnel, who are under the same obligation to protection of your privacy and confidentiality as your therapist. My administrative personnel may contact you regarding accounting and scheduling issues.
It is important to me that I respect your right to privacy regarding your participation in therapy. Therefore, should you happen to encounter me in the community, I will allow you to initiate and determine the level of acknowledgment.
The Notice of Privacy Practices provides information about how I may use and disclose your protected health information. A copy of the Notice of Privacy Practices is generally made available to you at the time of intake but can be provided to you at any time upon your request. While the critical information is already contained in this Information form, I encourage you to read the Notice of Privacy Practices in full. The Notice of Privacy Practices is subject to change. If I change the Notice of Privacy Practices, you may obtain a copy of the revised notice from me.
When a minor is involved in therapy, I will clarify whether the client is the minor or the family. Minors will be informed that their parents will typically have access to information about their level of participation in treatment, treatment goals, and progress, in addition to any additional information the minor has provided consent to be shared. While a parent may have a right to information revealed by a minor for whom they have consented for treatment, I believe that it is therapeutically beneficial for the minor to be able to choose whether or not to share the disclosures they make in individual sessions with their parents. However, in cases where the safety of the minor or any other person is endangered, I maintain the right to reveal the secret information without the minor’s permission. I ask that parents do not provide me with information pertaining to their child or adolescent’s behavior that they do not want revealed to the child or adolescent, as my holding secret knowledge of this type has limited value in achieving therapeutic ends.
If more than one “set” of parents is involved in a minor’s treatment or the parents live in separate homes, specific guidelines and expectations will be discussed as to what types of information I will communicate between parental figures pertaining to the minor’s treatment.
When members of a couple come in for therapy, I will clarify whether the client is the individual or the couple. As a general rule, secrets are seen as harmful to the effectiveness of treatment for a couple. In situations when a couple is in therapy and secret information is revealed by one person, it is understood that I will not reveal the information to the other party without direct permission. However, in order to facilitate the success of the treatment, I will encourage full disclosure of information between participants. Should either member of the couple insist on maintaining a secret or if revealing the secret information would endanger one of the parties, I may determine that it is not workable to continue couple’s therapy at that time and that other options should be explored. Should such a situation arise, I will discuss it with you thoroughly.
She had not known the weight until she felt the freedom.
– Nathaniel Hawthorne
Crisis & Emergency Coverage
I generally respond to voice mail only during my normal business hours, Monday – Friday, from 10am-9pm. Under exceptional circumstances, I may return a call outside of my normal business hours if you are in an urgent, crisis situation. However, I may be unavailable at the time of your call, so there may be a reasonable delay in the ability to respond to your message. Therefore, should you be experiencing an emergency and require immediate assistance, please call 911 or go to the nearest emergency room.
I will assign another qualified therapist to be available and have access to treatment records should this be necessary under specific circumstances when I am not available, such as vacations or planned medical leave. The contact information for this therapist will be provided on my voice mail when appropriate. In the event of my unplanned absence from practice, whether due to injury, illness, death, or any other reason, I maintain a detailed Professional Will with instructions for a group of mental health professionals who will reach out to inform you of my status and ensure your continued care in accordance with your needs. By signing this document you are authorizing these professionals to access your treatment and financial records only in accordance with the terms of my Professional Will, and only in the event that I experience an event that has caused or is likely to cause a significant unplanned absence from practice.
Boundaries of the Therapeutic Relationship
The relationship with me, as your therapist, is solely professional, and it is at risk of becoming confusing, ineffective, or even harmful if clean boundaries around the nature of the relationship are not maintained. This means that I will not engage in close friendship, romantic relationship, sexual contact, or financial/business/employment arrangements simultaneous to acting as your therapist. It is often beneficial to maintain these boundaries even after the therapy has ended. As “crossing paths” is possible through the activities and workings of the community, I will take appropriate professional precautions to ensure that my therapeutic judgment is not impaired when such interactions are unavoidable.
You are welcome to like or follow my professional pages on Facebook and Instagram: @EMDRReadinessAcademy. You are under no obligation to like or follow these pages, nor are you under any obligation to like, comment, or share any posts. I will make every effort to maintain your privacy and confidentiality should you comment on any post by responding in a fashion intended to (1) cloak any indication that we have a therapist/client relationship and (2) to protect all content of your treatment. You, however, have the freedom to disclose the nature of our relationship should you so choose. While you may choose to send messages to me over these sites, I will seek to minimize clinically related discussions because of the vulnerability to your privacy and confidentiality on these platforms.
In order to maintain the clarity of the therapeutic relationship, I will generally not use social networking sites (e.g. Facebook, Instagram, LinkedIn) to communicate with you. I may choose to use cell phone, texting, and email communication with you during the course of treatment, and such communication is solely for professional purposes and does not constitute engagement in anything other than a therapeutic relationship. While not typical, there may be clinical reason for me to perform a home visit or conduct a session outside of the office setting, and again this does not constitute anything other than a professional relationship. Should you ever have confusion or concerns regarding the boundaries of your relationship with me, please bring these to my attention immediately.
Termination of Therapy
The length of time you remain in therapy is your decision. I will provide counsel to you on this matter, based on assessment of the presenting issues and the goals established during the course of treatment. Should you be concerned or dissatisfied at any time with the therapy provided, please discuss your concerns with me. It is a high priority for me to meet your therapeutic needs and your communication is essential in order to accomplish this. If it appears that you would attain greater benefit from work with a different therapist, I will provide you with referrals.
Potential Benefits & Risks of Treatment
The process of therapy can involve much comfort and growth, but it may also include difficult, challenging, and even painful emotions and relational experiences. Treatment benefits, while likely, cannot be guaranteed. Every client’s experience in therapy is different and the results of treatment can vary greatly. As the work of therapy is inherently a partnership, the outcome is dependent on what all participants contribute. My aim is to use my education and clinical experience to effectively work with you toward your treatment goals.
The Board of Behavioral Sciences receives and responds to complaints regarding services provided within the scope of practice of marriage and family therapists, licensed educational psychologists, clinical social workers, or professional clinical counselors. You may contact the Board online at www.bbs.ca.gov or by calling (916) 574-7830.
Statement Authorizing Consent for Self and/or Minor’s Treatment
I understand the above information regarding the nature and limitations of the professional counseling relationship. I understand that copies of any documents containing my signature are available upon my request and that I can access the most updated information regarding treatment policies online at www.susiemorganlmft.com.
I have asked any questions I need to ask in order to understand this document in its entirety, and I understand that I should not sign it until I have had all of my questions answered.
If signing for a minor, I assert that I hold legal custody or legal authorization to consent for the minor’s participation in therapy; the therapist has been informed of all other individuals holding legal custody or legal authorization to consent for the minor’s participation in therapy; and that the therapist must be provided with copies of any/all applicable legal documentation pertaining to custody/consent.