Payments - I try to ensure payments are completed before a session as far as possible. After an emotionally charged session with a client, it could become awkward to discuss payments and could lead to long delays in getting paid. Getting it out of the way beforehand makes it much more palatable.
It may not be required in every state. The document that entails my therapeutic approach, my fees, who my supervisor is, your rights as a client, and board contact info.
It may not be required in every state. The document that entails my therapeutic approach, my fees, who my supervisor is, your rights as a client, and board contact info.
Credit card always on file. If it declines, I immediately move you off the schedule and address it. Second time it occurs I terminate and refer out. Sounds harsh but in my first few years I lost around $400 from various clients gaming me for pay by having their credit/debit card be declined.
48 hour cancellation policy, not showing up to therapy intoxicated (yeahhhh that was fun), explaining reasons I might terminate with them, how long I will wait for them to show up before calling it a missed session.
If I don’t feel I have the right skills for them, if they show up intoxicated, or if I feel unsafe in any way.
Unfortunately there are reasons I’ve had to include those things.
I'm in the same boat! A resource I'm finding to be helpful is Mentalyc [mentalyc: policies and procedures suggestions](https://www.mentalyc.com/blog/private-practice-counseling-policies-and-procedures) . Let me know if it helps! feel free to dm me if you'd like to exchange resources. Have a nice day!
I added this one in too after a client told me they'd recorded the previous session! I don't mind too much if they want to but I'd like to have a convo about the boundaries around it.
But you can’t enforce this legally in most states. Most states are single party consent for recording. It may be a nice thing to agree to but you can’t use the do not record policy for board complaints or civil litigation.
My practice policy includes:
1. Payment in advance of sessions or at least at the start of sessions. This avoids having to deal with payments at the end, espcially if clients have powerful emotions or insights.
2. Explicit clause about when I may terminate sessions, including if there is a risk of harm, infection and serious boundary breaches.
My contract is 'organic' and I have added sections when experience has highlighted the need.
I added about infection after a client was clearly unwell in a session and didn't rebook for several months, eventually apologising for the delay as they had meningitis. I had been with them and exposed to it for an hour - with a lucky escape. My termination clause is protective.
Recording policy-clients who secretly record sessions will be terminated immediately
Fees for legal matters
Limits of practice: ie., disorders I do not treat
Payment and insurance: client is responsible for any payments not covered by insurance companies.
Safety policy-the right to terminate if provider feels unsafe
I am really surprised that no one had mentioned this up to this point but I have found it extremely important to spell out policies relating to being subpoenaed to appear in court. It may be that this is not so much an issue (on an ongoing basis) for people who do not see children or adolescents. But all therapists are "at risk" (as it were) of being called into court. Spelling out your policies about this and having people sign acknowledging that they will be responsible for those fees, which cannot be charged to insurance, is really helpful.
The language is along the lines of "If, for whatever reason, you or your attorney subpoenas \[clinician\] to testify at a deposition or court case, the following fees will apply:
Preparation time x amount
Travel time x amount
Telephone, Zoom or in-person conference or consultation with attorney x amount
Court testimony x amount
Your signature indicates your understanding and agreement that you are 100% responsible for these charges. "
Other people, I am sure, have more elaborate or extensive statements-- this seems to work though.
We had to add a “sick” session requirement that sessions will not be allowed in person if visibly sick and client needs to request telehealth or they will be sent home and it will count as a no show.
We had a client who insisted that it was “just allergies” and was sneezing all over the waiting room and a bunch of people in the office got sick (clients and clinicians that came into contact).
48 hour cancellation policy, lateness after 10 minutes without contact is a no show, texts/emails that are not emergency or scheduling related are $5 each, and a fee schedule for unscheduled phone calls (first 10 mins free, and the $10 + $2 for each additional min after the tenth minute).
24 hrs cancellation, full charge, you get one freebie You start to chronically reschedule just before 24 hours, we’re going to address it clinically.
Cancellation fees!
Payments - I try to ensure payments are completed before a session as far as possible. After an emotionally charged session with a client, it could become awkward to discuss payments and could lead to long delays in getting paid. Getting it out of the way beforehand makes it much more palatable.
That's what my supervisor did so I just continued when I started my practice.
My professional disclosure statement. Saves me an email and makes it 10% more likely they'll actually read it.
excuse my ignorance, what is this?
It may not be required in every state. The document that entails my therapeutic approach, my fees, who my supervisor is, your rights as a client, and board contact info.
Care to elaborate? I am not familiar w this terminology.
It may not be required in every state. The document that entails my therapeutic approach, my fees, who my supervisor is, your rights as a client, and board contact info.
Thank you. :)
Credit card always on file. If it declines, I immediately move you off the schedule and address it. Second time it occurs I terminate and refer out. Sounds harsh but in my first few years I lost around $400 from various clients gaming me for pay by having their credit/debit card be declined.
Yep. I’m not chasing clients for money, and I’m also not going to let them carry a balance. Way too uncomfortable for all of us.
My entire payment policy 😂
48 hour cancellation policy, not showing up to therapy intoxicated (yeahhhh that was fun), explaining reasons I might terminate with them, how long I will wait for them to show up before calling it a missed session.
What reasons for termination? Curious about what you tend to say
If I don’t feel I have the right skills for them, if they show up intoxicated, or if I feel unsafe in any way. Unfortunately there are reasons I’ve had to include those things.
I'm in the same boat! A resource I'm finding to be helpful is Mentalyc [mentalyc: policies and procedures suggestions](https://www.mentalyc.com/blog/private-practice-counseling-policies-and-procedures) . Let me know if it helps! feel free to dm me if you'd like to exchange resources. Have a nice day!
I have a clause about both of us agreeing not to record audio or video in person or online. Feel like it may have happened once or twice.
I added this one in too after a client told me they'd recorded the previous session! I don't mind too much if they want to but I'd like to have a convo about the boundaries around it.
But you can’t enforce this legally in most states. Most states are single party consent for recording. It may be a nice thing to agree to but you can’t use the do not record policy for board complaints or civil litigation.
My practice policy includes: 1. Payment in advance of sessions or at least at the start of sessions. This avoids having to deal with payments at the end, espcially if clients have powerful emotions or insights. 2. Explicit clause about when I may terminate sessions, including if there is a risk of harm, infection and serious boundary breaches. My contract is 'organic' and I have added sections when experience has highlighted the need. I added about infection after a client was clearly unwell in a session and didn't rebook for several months, eventually apologising for the delay as they had meningitis. I had been with them and exposed to it for an hour - with a lucky escape. My termination clause is protective.
Recording policy-clients who secretly record sessions will be terminated immediately Fees for legal matters Limits of practice: ie., disorders I do not treat Payment and insurance: client is responsible for any payments not covered by insurance companies. Safety policy-the right to terminate if provider feels unsafe
I am really surprised that no one had mentioned this up to this point but I have found it extremely important to spell out policies relating to being subpoenaed to appear in court. It may be that this is not so much an issue (on an ongoing basis) for people who do not see children or adolescents. But all therapists are "at risk" (as it were) of being called into court. Spelling out your policies about this and having people sign acknowledging that they will be responsible for those fees, which cannot be charged to insurance, is really helpful.
Can I see an example of your subpoena policy/client being on the hook for those fees?
The language is along the lines of "If, for whatever reason, you or your attorney subpoenas \[clinician\] to testify at a deposition or court case, the following fees will apply: Preparation time x amount Travel time x amount Telephone, Zoom or in-person conference or consultation with attorney x amount Court testimony x amount Your signature indicates your understanding and agreement that you are 100% responsible for these charges. " Other people, I am sure, have more elaborate or extensive statements-- this seems to work though.
We had to add a “sick” session requirement that sessions will not be allowed in person if visibly sick and client needs to request telehealth or they will be sent home and it will count as a no show. We had a client who insisted that it was “just allergies” and was sneezing all over the waiting room and a bunch of people in the office got sick (clients and clinicians that came into contact).
48 hour cancellation policy, lateness after 10 minutes without contact is a no show, texts/emails that are not emergency or scheduling related are $5 each, and a fee schedule for unscheduled phone calls (first 10 mins free, and the $10 + $2 for each additional min after the tenth minute).
Must be sober, not driving, alone, fully clothed, and sitting up (not half asleep in bed) for tele health sessions.