Depending on the issues you present at treatment, there are many different methods Dr. Stiritz may employ to assist with the problems that you wish to address. Psychotherapy differs from medical treatment, in that it requires active effort and responsibility on your part. In order for psychotherapy to be successful, you will be asked to work on things we talk about during our sessions, as well as at home. 

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The first few sessions will be evaluative in nature as Dr. Stiritz will determine your needs (or your child’s). With your consent, Dr. Stiritz may ask to speak with significant others in your life (spouse, family member) to best understand the nature of the issues and the impact of your difficulties in your life. With child/adolescent patients, Dr. Stiritz requests parents to meet to provide a detailed history of the child’s development and presenting issues. Following the evaluation process, Dr. Stiritz will offer you diagnostic impressions and a description of a treatment plan to follow if you decide to continue with therapy. 

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While research supports the efficacy of psychotherapy in having many benefits such as a reduction of symptoms and distress, helping one to find solutions to specific problems, and improved relationships, psychotherapy can also have risks. Those risks include at times experiencing uncomfortable feelings such as anger, guilt, grief, frustration, and loneliness. 

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In order for therapy to be effective, it must take place under circumstances in which participants feel that they can speak freely and openly without fear of disclosure. I have an ethical obligation to maintain the confidentiality of my patients, including statements made by the persons involved in the treatment and my own observations and impressions. 

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Additional Information Regarding Psychological Services for Children and Adolescents 

Parents are an integral part of a child’s treatment. In addition to providing you with education about your child’s development, parent guidance and coordination, it is Dr. Stiritz general practice to provide you with pertinent information about your child’s treatment and progress. If it is necessary for your child to see another mental health professional with specialized skills, or for your child to receive a higher level of care, such as a day treatment program, Dr. Stiritz will share that information with you and provide you referrals as needed.

 

At all times Dr. Stiritz will use her clinical discretion regarding what she shares with you as it pertains to what your child has disclosed to me. Therapy is most effective when a trusting relationship is established between the psychologist and the patient. Privacy is essential in securing and maintaining that trust, therefore it is necessary for children to feel free to discuss personal matters with freedom from concern of later disclosure. That said, one goal of treatment is to promote and support stronger relationships between children and their parents through improved communication. Whenever clinically indicated, Dr. Stiritz will work towards helping to open the channels of communication between a parent and child. When a child or adolescent reveals sensitive information regarding alcohol or drug use, sexual contact, or other potentially problematic behaviors, Dr. Stiritz will use clinical judgment to determine if these behaviors are within the range of normal adolescent experimentation or require parental intervention.

 

If Dr. Stiritz ever believes your child is at risk of harming herself/himself or another, she will immediately inform you. 

Although Dr. Stiritz responsibility to your child may require involvement in conflicts between parents, She will need your agreement that her involvement will be strictly limited to that which will benefit your child in therapy. As such, you will treat anything that is discussed in session as confidential. Specifically, neither parent will attempt to gain control in a divorce related legal proceeding from Dr. Stiritz involvement with the child.

 

Dr. Stiritz requires you agree in any such proceedings, neither parties will ask Dr. Stiritz to testify in court, request her presence in a deposition, or request copies of my files, either in person or by affidavit. You also agree to instruct your attorneys not to subpoena Dr. Stiritz. While such an agreement may not prevent a judge from requiring Dr. Stiritz testimony, she will attempt to prevent such an event. If by law Dr. Stiritz is required to testify, She is ethically bound not to give her opinion as to either parent’s custody or visitation suitability. If the court orders a custody evaluation, or appoints a guardian ad litem, or parenting coordinator, Dr. Stiritz will provide information as needed but will not make any recommendations about the final decision. 

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Professional Fees and Billing 

Fees are based on length of session and the type of services provided. Fees are pro-rated in 15 minute increments for telephone conversations, and for additional services that you have agreed to such as consulting with other professionals with your consent, attending school/professional meetings, preparation of records and treatment summaries. Payment for services are expected at the time services are rendered. 

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If you become involved in a legal proceeding that requires my participation, you will be expected to pay for all of my professional time including preparation, transportation costs, and deposition and court time at a rate of $400 per hour. Since it will be necessary to clear my calendar for the entire day in order to accommodate the unpredictability of the court’s schedule on the day of my testimony, I will require a retainer received not less than 7 days prior to the proceedings for the eight hours that is non-refundable and non-transferable (total $3200). 

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If your account has not been paid for more than 60 days and arrangements for payment has not been agreed upon, I may exercise the option of using legal means to secure payment. This may involve hiring a collection agency or going through small claims court which will require me to disclose otherwise confidential information. In most situations of this kind, the only information I release regarding a patient’s treatment is his/her name, the nature of services provided, and the amount due. If such legal action is necessary, its costs will be included in the claim. 

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Professional Records 

The laws and standards of my profession require that I keep Protected Health Information about you in your Clinical Record. Except in unusual circumstances that involve danger to yourself and others or where information has been confidentially supplied to me by others, you may examine and/or receive a copy of your Clinical Record, if you request it in writing. Because these are professional records, they can be misinterpreted to untrained readers. For this reason, I recommend that you initially review them in my presence, or have them forwarded to another mental health professional so you can discuss the contents. In most instances, I am allowed to charge a copying fee and mailing fee. If I refuse your request for access to your records, you have a right of review, which I will discuss with you upon request. 

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Limits on Confidentiality 

The law protects the privacy of all communications between a patient and a psychologist. 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 imposed 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, as follows: Disclosure required by health insurers or to collect overdue fees are discussed elsewhere in this Agreement; If you are involved in a court proceeding and a request is made by the court for information concerning your diagnosis and treatment; here are some situations in which I am permitted or required to disclose information without either your consent or Authorization: 

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• If a patient files a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself; 

• If a patient files a worker’s compensation claim, I must, upon appropriate request, furnish all treatment reports to the patient’s employer and to the patient or his/her attorney; 

• There are some situations in which I am legally obligated to take actions, which I believe are necessary to attempt to protect others from harm and I may have to reveal some information about a patient’s treatment; 

• If I have reason to suspect or believe that a child under 18 years of age (1) has been abused or neglect, (2) has had a non-accidental physical injury, or injury which is at variance with the history given of such injury, inflicted upon such child, or (3) is placed at imminent risk of serious harm, then I must report this suspicion or belief to the appropriate authority, usually the Department of Children and Families. Once such a report is filed, I may be required to provide additional information; 

• If I have reason to believe or suspect that an elderly or disabled or incompetent individual has been abused, I may have to report this to the appropriate authority. Once such a report is filed, I may be required to provide additional information; 

• If I believe that a patient presents an imminent risk of personal injury to another identifiable individual, I may be required to take protective actions. These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the patient. I may also have to take protective action if another’s property is endangered. 

• If a patient presents an imminent risk of personal injury to him/herself, I may be obliged to seek hospitalization for him/her, or to contact family members or others who can help provide protections; 

• If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary. 

• While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have now or in the future. The laws governing confidentiality can be quite complex, so in situations where specific advice is required, formal legal advice may be needed.