Therapy is a collaborative process. You are always welcome to ask questions, give feedback, request changes, take a break, or stop therapy at any time. If it would feel helpful, you may invite a support person to join a session.

At the start of treatment, the clinician may ask how you learned about these services in order to identify any potential conflicts of interest, prior relationships, or other factors that could affect care.

Client privacy is very important. Information shared in therapy is protected under HIPAA and kept confidential.

Confidentiality may be limited in certain situations, including:

• Risk of harm to yourself or another person

• Suspected abuse or neglect of a child, elder, or vulnerable individual

• Court orders or other legal requirements

• When a client signs a release of information (ROI) giving permission for the clinician to communicate with another provider, family member, or other designated person

If confidentiality must be broken for safety or legal reasons, only the minimum necessary information will be shared, as required by law.

To support quality care, the clinician may consult with a supervisor or trusted colleague for clinical guidance. In those situations, identifying information is not shared and nothing discussed can be traced back to the client.

The client messaging portal is the preferred method of communication as it a secure and HIPPA compliant platform.

Text messaging may be used for scheduling purposes only. Text is not HIPAA-secure, and clients should not send personal or clinical information by text.

Communication between sessions is not a replacement for therapy sessions. Any clinical or therapy-related content sent through the portal will be discussed at the next scheduled appointment. If longer messages or documents are shared, the therapist cannot guarantee they will be reviewed prior to the session, but will make their best effort when time allows.

Messages are typically answered during business hours, often the same day, but responses may take up to 24 hours depending on availability and session schedule, and up to 48 hours or longer on weekends or holidays.

These communication methods should not be used for urgent or emergency situations. If you are in crisis, please call 911, go to the nearest emergency room, or call/text 988 for immediate mental health support.

Appointment times are reserved in advance, and this policy helps maintain consistent scheduling and the sustainability of the practice.

Weekly or biweekly sessions are scheduled as recurring appointments and hold a reserved time. Monthly or as-needed sessions (no less frequent than once every three months) are scheduled individually and do not hold a recurring appointment slot.

Please provide at least 24 hours notice if you need to cancel or reschedule. Late cancellations (less than 24 hours notice) will be charged a fee of $75. Missed appointments without notice will be charged the full session fee of $150.

If you arrive late, your session will still end at the scheduled time. If you arrive 15 minutes or more late, the session will be considered a missed appointment and the full session fee will apply.

Missed session fees are not covered by insurance and must be paid out of pocket. Some insurance plans may require different fees for late cancellations or missed appointments, and those requirements will apply when necessary.

Regular attendance supports therapeutic progress, continuity of care, and fairness in scheduling for all clients.

Three missed sessions in a row:
If three sessions are missed consecutively, the reserved appointment time will be removed from the schedule. Services can resume when availability and scheduling allows.

Repeated missed sessions:
If three sessions are missed within two months, or eight sessions within twelve months, the standing appointment time may be removed. At that point, scheduling, frequency of sessions, or readiness for ongoing treatment may be reassessed. Referrals may be provided if a different level of care or structure would be more appropriate.

No sessions for 90 days:
If there has been no contact or no sessions for 90 days, the case may be closed. Clients are welcome to return in the future and will be scheduled based on availability at that time.

All sessions are conducted through secure video telehealth.

Clients must be located in Massachusetts at the time of the session and should attend from a private, quiet, and safe location whenever possible. Sessions cannot be conducted while driving or while the client is in a situation that may interfere with privacy, safety, or the ability to fully participate.

Technology problems can occasionally occur. If a session is interrupted, reasonable efforts will be made to reconnect or reschedule.

Telehealth services are not appropriate for emergencies or crisis situations. If you are experiencing a mental health emergency, call 911, go to the nearest emergency room, or contact a crisis service such as 988. This practice may not be appropriate for all concerns or levels of need. If a higher level of care, in-person services, or a different type of treatment is recommended, referrals will be provided when possible.

Insurance billing is handled through Grow Therapy or Headway, depending on insurance coverage and availability.

Clients are responsible for any copays, deductibles, or balances required by their insurance.

Self-pay sessions are $150 per session.

Missed session fees are not covered by insurance and must be paid out of pocket.

Questions about coverage, deductibles, or benefits should be directed to your insurance company.

Clients who are not using insurance have the right to receive a Good Faith Estimate of expected charges under the No Surprises Act.

This estimate explains the expected cost of therapy services and can be requested at any time.

To protect client privacy and maintain professional boundaries, the clinician does not accept friend or follow requests and does not interact with clients on social media.

If you see the clinician in public, you are welcome to approach and say hello. Brief conversation is fine, but clinical topics cannot be discussed outside of session. To protect confidentiality, the clinician will not initiate contact or acknowledge the therapeutic relationship unless you do so first, and will not introduce you to others in a way that identifies you as a client.

This practice does not provide emergency or crisis services, and messages may not be seen immediately.

If immediate support is needed, please contact:

• 911

• Your nearest emergency room

• 988 (call or text) for 24/7 crisis support

Clients are required to provide an emergency contact for services. This information will only be used if there are concerns about safety or if the clinician is unable to reach you during an urgent situation. If an emergency contact is not available or cannot be reached, emergency services (911) may be contacted if needed to ensure safety.

Clients may choose to stop therapy at any time. If therapy needs to end, it can be helpful to discuss this in session so the work can be reviewed and next steps can be considered.

In some situations, the clinician may recommend reducing frequency, taking a break, or ending treatment if therapy is no longer helpful, attendance is inconsistent, or a different level of care is needed.

Referrals can be provided when appropriate.