Stephanie McIntyre, M.A.
Licensed Professional Counselor
(512) 914-1446
Client Services Agreement
The purpose of this document is to introduce you to the services, agreements, definitions and limitations of my professional practice. Should you decide to work with me, this document will provide you with information you may find helpful in optimizing your experience. It also includes information about the Health Insurance Portability and Accountability Act (HIPAA), a federal law that provides privacy protections and client’s rights with regard to the use and disclosure of your Protected Health Information (PHI), used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices for use and disclosure of PHI for treatment, payment, and health care operations. This Notice which will also be provided for you explains HIPAA in greater detail. The law requires that I obtain your signature verifying that I have provided you with this information at the end of this intake session. It is important that you review these documents before our next session. Any questions you may have will be addressed at that time.
Introduction:
In order to assist in making a decision to work with me, you may want to know some things about my professional history, experience and theoretical perspectives. I hold a Bachelor of Science degree in Industrial Psychology from Fairmont State University and a Master of Science degree in Industrial Relations from West Virginia University. I also hold a Master of Arts in counseling from St. Edward’s University in Austin, Tx.
I have lived in Austin since 1989. I was employed in the high-tech industry for over a decade. I have multiple hobbies and interests and am an active member in my church. I feel my personal experiences and education have qualified me to connect and empathize with my clients in order to help them examine and redefine multiple aspects of their lives within a therapeutic setting.
My practice embraces an all-encompassing approach toward making changes in multiple areas of your life based on Albert Ellis’s theory of Rational Emotive Behavior Therapy (REBT). REBT is an action-directed therapy in which emotional and behavioral problems are addressed through exploration of your beliefs. Ellis believed that if you change your thinking you can change your life. Based on his premise, I believe it is important to explore multiple areas of your life and the beliefs you act upon in order to discover opportunities where you can implement empowering changes.
I don’t want to just help you feel better….I want to help you change your life!
My therapeutic style is didactic and motivational. I work closely with the client to facilitate exploration of various areas of the client’s life. This collaborative effort leads to a customized approach to therapy based on the needs of each individual and involves a whole-life application which includes the mind, body and spirit. I believe it is important for the client to feel empowered, encouraged and educated during the counseling process. Most, if not all, of my clients know what problems they have and even how these problems originated. What they are looking for are TOOLS they can use in order to move forward with a more productive and fulfilling life.
The Process of Psychotherapy:
Psychotherapy is difficult to define. It can be as variable and unique as the range of clientele seeking a psychotherapeutic experience. It can require a few sessions over a few weeks; over a number of months; and sometimes over several years to accomplish the change desired. It can assist in addressing a specific and limited issue; or it can be a life changing, redemptive, or even a life saving experience. Usually, in order for therapy to be effective, the individual, or couple, or family has to be motivated to address the issue or issues sufficiently to invest the time, energy, and resources necessary for real change to occur. The process can be uncomfortable, even painful when difficult issues are faced. However, when clients are willing to reflect upon the challenging aspects of their lives, examine the patterns, roles, and dynamics they discover, and take the risks real change requires, the results can not only be gratifying but transformative as well.
Intake:
The intake session is not really therapy. It is an opportunity to determine if the goals of the client and the expertise of the therapist are a match. I believe that the process of selecting a therapist is very important and should be made with care. I attempt to create an atmosphere wherein the client(s) can feel free to ask the questions needed to make that decision. I, too, need to be able to ask questions to determine if my expertise falls within the area of client concerns. Normally, the first few sessions are devoted to this exploratory process. Even though therapy begins after the first session, both you and I may decide that your needs may be better served by someone else. In this case, I will attempt to assist with a referral. There are also situations for which I may recommend adjunctive services; body work, group psychotherapy, medical or psychological evaluation, art therapy, to name a few. You are always free to pursue these additions and alternatives or not. Psychotherapy is a voluntary process which you have the right to discontinue at any time. It can be an important part of the therapeutic process to discuss when you believe that your needs have been met and you are ready to discontinue the process. Many times, clients discover they want to come back occasionally for a tune up or to address new circumstances in their lives. Once a client has successfully worked with me, they are always welcomed back to work on subsequent issues.
Appointment scheduling:
Appointments are usually 50 minutes in length. I attempt to start appointments on the hour. If an appointment begins a few minutes late, I will attempt to be sure the client receives a fifty minute session without encroaching on the next client’s time. Normally sessions are weekly; however, dependent upon the need of the client, sessions can be scheduled more or less frequently. After initial assessments, many people prefer having a session once per week. For some clients in the later stages of therapy, sessions can be scheduled once every month or on an as-needed basis.
Cancellations:
I require notice of cancellation 24 hours in advance. A 24 hour notification is the standard procedure in the profession. Cancellations and no-shows with less than 24 hour notice do not allow me time to book another appointment. A no-show / late-cancelation fee will be charged to your account. Late cancellations and no-show fees cannot be billed to your insurance company and must be private pay.
Fees:
My fee is $110 per 50-minutes. I offer a few sliding scale openings if clients are unable to afford my regular fee. The sliding scale I use to determine the hourly fee is based on the client’s household size and income level. I ask my clients to pay what they feel is appropriate for them within that fee scale. I want my clients to be able to afford their counseling sessions so it is important for us to agree upon a fee that will be fair to the both of us. Report writing, inpatient services or any involvement in legal proceedings is billed at the higher rate because of the inherent complexity of these involvements. Phone sessions over 10 minutes may also be prorated at the selected client fee.
Payment:
Payment can be made by cash, check, Venmo, debit, credit or HSA card at the beginning of each session. Please bring exact change if you plan to pay with cash. Clients are expected to reimburse any returned check fees. Upon request, I can provide you with a receipt for your personal records.
Insurance:
I accept several insurance policies. If using insurance, your session fee will be based upon your insurance deductible or co-pay, if applicable. If I am not a provider for your specific insurance, I can provide you with a receipt for counseling services that you may submit to your insurance company for possible reimbursement. Concerned about using your insurance? See my website Fees page to learn more about issues you should consider when using your insurance:
Telephone and After-Hours Procedures:
My voicemail is private and no one else will have access to hear your messages. If you do leave a message, I will attempt to return your call as soon as possible. Messages left on weekends and holidays will be responded to when I return to the office. Video, telephone and long-distance sessions may be held under certain circumstances. Tele-health sessions will be billed at the client’s agreed-upon per-session fee including any telephone conversation lasting more than 10 minutes. If you need immediate assistance and are unable to reach me, please contact your family physician, nearest emergency room or one of the following:
24-hour crisis hotline (512) 472-HELP
Shoal Creek Psychiatric Hospital (512) 324-2000
Safeplace (512) 267-SAFE (7233)
Safeplace Text (737) 888-7233
General Emergency 911
Ethics:
As a Licensed Professional Counselor, I abide by the professional standards of my profession. You can discuss those standards with me, or contact the Licensing Board of Licensed Professional Counselors through the Texas Health Department to obtain a copy of those standards.
Records:
As required by law, I keep a record of your sessions. Your Clinical Record may contain your goals for therapy, your diagnosis, treatment progress, social history, past treatment records received from other providers, reports, letters, payment records, and insurance documentation. It is my practice to keep minimal records containing only basic information pertinent to my understanding of the goals of your therapy. If you use insurance to cover the cost of your session, insurance companies can request copies of your therapy records.
Confidentiality:
The law protects the privacy of communication between a licensed therapist and a client(s). In most situations, I can only release information about your treatment to others if you sign a written authorization form that meets certain legal requirements required by HIPAA. There are other situations that require only that you provide written, advance consent. Your signature on this agreement provides consent for those activities which include:
1. I may occasionally find it helpful to consult or communicate with other mental health professionals including my supervisor about a case. I always make every effort to protect the identity of my client(s). The other professionals are legally bound to keep the information confidential as well.
2. If a client seriously threatens to inflict imminent physical, mental, or emotional harm on him or herself or others, I may be obligated to seek hospitalization for that client, or to contact law enforcement officials, family members, or other interested parties to assist in providing protection.
There are some situations where I am permitted or required to disclose information without either your consent or authorization. They are as follows:
1. If I have cause to believe that a child under 18 has been or may be abused or neglected (physical injury, substantial threat of harm, mental or emotional injury, any kind of sexual contact or conduct), or that an elderly or disabled person is in a state of abuse, neglect or exploitation, the law requires that I make a report to the appropriate governmental agency. Once such a report is filed, additional information may be required.
2. If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, I cannot provide any information without your or your legal representative’s written authorization, or a court order. If you are contemplating litigation or are involved in litigation, it would be in your best interest to determine the likelihood of whether a court would order me to disclose information.
3. If you disclose information regarding a sexual involvement with a mental health professional who was involved in your care, I am required to report this to the appropriate state board.
4. If a government agency is requesting information for health oversight activities, I may be required to provide information to them.
5. If a patient files a complaint or lawsuit against me, I may disclose relevant information in order to defend myself.
6. If a patient files a workman’s compensation claim, I am required, upon appropriate request to provide records pertaining to treatment or hospitalization for which compensation is being sought.
If any of the above situations arise, I will make every effort to discuss the situation with you prior to disclosure and will disclose only what is necessary.
Confidentiality with Minors, Couples and Groups:
1. When I work with minors, I ask parents to respect the confidentiality of their child. Therapy is not possible without trust. The law gives parents and guardians the right to see records if the child is under 18. I will ask the child’s permission to discuss his/her therapy with parents or guardians in response to parent’s questions as the child and I feel would be helpful. Even then I will only offer general information unless the child and I agree otherwise. Exceptions would include imminent harm or child abuse or neglect as indicated above.
2. Couples and family therapy can be very complex. Confidentiality issues will be discussed as needed.
3. Members of psychotherapy groups are required to maintain confidentiality regarding the identity of group members and the personal information shared during sessions.