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Policies

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My responsibility to you includes the promise to be transparent and consistent. Psychotherapy requires a commitment of time, energy and courage from both client and therapist. Psychotherapy is a significant financial investment for clients. In order to maintain clear mutual expectations around practical matters, and to support trust between us, I have developed the following office policies. I am happy to discuss them with you at any time.


Locations: Primarily I meet with clients at my home office in southeastern College Hill/northeastern Fox Point in Providence, RI 02906.


There may be times when you cannot meet in person due to extended travel or contagious illness. On these rare occasions we may decide together to meet via phone, Signal, or another secure service. Please be aware that your insurance may not reimburse for remote sessions and that you will be responsible for the full cost of your session at the time of our meeting.


There are sixteen stairs to gain entrance to my office which is on the second floor. If you are not able to safely walk up a flight of stairs, please let me know. Together we can make arrangements to meet in an accessible location in Providence, or, if you are farther away, to meet via secure internet connection. There are times when it may be best for therapy to happen over the phone/internet or in your home. I make a strong effort to continue seeing my clients with health conditions which may flare and limit their ability to leave home, or who have a worsening illness. The fees for office, home and telephone sessions are the same. Insurance may not reimburse phone/internet or in-home sessions.


Remote therapies: Therapy via video-conferencing and internet-based technologies has been repeatedly shown to be as effective as face-to-face therapy in reducing symptoms of anxiety and depression. However, there may be situations where I no longer believe it is beneficial or appropriate to continue meeting remotely. If I develop concerns about your stability and/or safety, I will initiate a dialogue with you about alternatives for local face-to-face therapy, additional supports, and safety planning.


Technological issues: Remote therapy offers the flexibility of engaging in services from home or when you are traveling. It also can demand flexibility when there are internet connection problems.


I make every effort to ensure a robust broadband connection on my end, however, there may times when technology distorts or disrupts a session, or interrupts communications during and outside of a session. If we agree that an internet or phone connection significantly reduced the quality of a session, we will make up that time at no additional fee during a future session.


Messages: You may leave voicemail at any time. I return phone calls within 24 hours during normal workdays (Monday through Friday). I return calls received on Friday evening through Sunday evening on Monday. You may contact me via email or text messaging concerning logistical questions such as a need to reschedule. I will return your email within 24 hours, Monday through Friday.


Appointment Scheduling and Cancellations: I request at least 24 hours notice, not including weekends, for cancelled appointments. Appointment slots are specific times I have reserved for you.


If you need to cancel or reschedule an appointment, I ask that you give me as much notice as possible via text or voicemail message at (401) 406-1223 or via email to therapy@seguinspear.com. If you cancel with less than twenty-four hours notice, I will request the full fee for your missed appointment. I ask clients provide a credit card number to be kept on file to be charged in the event of a cancellation with the less than twenty-four hours. I will not charge your card without your express permission.


The only exceptions to this cancellation policy are debilitating illnesses, illness of dependent child or severe illness of an immediate family member, car accidents, and extreme weather. Please understand that everyone has contingencies in their lives, from unexpected business meetings to exams to flight delays, and I am unable to absorb the lost clinical time resulting from such eventualities. Exception is made for severe weather: There is no late-cancellation fee in the event of unsafe travel conditions due to severe weather. Please text or call me (401) 406-1223 if you are concerned about travel safety. In the event Providence institutes a parking ban, I will contact you to discuss re-scheduling our appointment.


Email: I prefer to use email only for scheduling appointments. Please do not email me content related to your therapy sessions, as email is not completely secure or confidential. If you choose to communicate with me by email, be aware that email is retained in the logs of your and my Internet service providers. While it is unlikely that someone will be looking at these logs, they are, in theory, available to be read by the system administrator(s) of the Internet service provider.


Phone Check-ins: When needed, I offer one phone check-in per week in between appointments. These check-ins are free of charge, and last 10 minutes. If it is clear that more time is needed during the call, and my schedule allows us to continue, I will pro-rate a partial or full phone session. Please be aware that phone sessions are unlikely to be reimbursed by your insurer and I will ask for payment at the time of the phone session. If multiple check-ins per week are requested, we will discuss scheduling. I will charge for those calls at a pro-rated hourly fee ($150/hr). I may also suggest that we schedule a full 60-minute in-person session to meet your needs.


Insurance: I no longer contract with insurance companies. At your request, I can provide a monthly invoice, or "super-bill" which you may submit to your insurer. I am an out-of-network clinician. After you have met any out-of-network deductible, your insurer may pay a portion of the cost of your care. The full cost of your session is due at the time of your appointment.


If you wish to use your insurance to off-set the cost of therapy, please call your insurance company and learn about your out-of-network benefits. Also ask whether you have an out-of-network deductible, and if so, if you have met your deductible already this year.


Zencare provides a clear step-by-step guide to using insurance to meet with out-of-network therapists.


Payment & Balances: The fee is $150.00 US per sixty minute hour.


I accept cash, check or credit card for payments. If you wish to pay with a credit card, there is an additional $5.00 fee to offset the transaction cost. I ask clients provide a credit card number to be kept on file to be charged in the event of a remote sessions and cancellation with the less than twenty-four hours. I will not charge your card without your express permission. Checks will be cashed the same day as your appointment. Do not post-date checks. Please talk with me if money becomes a barrier to your accessing care in the course of our work together.


Fee re-assessment & changes: My current fee is $150.00 per sixty minute hour. Once a year on September 1st I reassess my fee schedules. In the event my fees increase, I will notify you two months in advance of fee increases.


I have a small number of lower fee appointments for uninsured and underinsured people who otherwise could not afford therapy. There is a waitlist for low fee hours. (Underinsured means you have insurance but cannot afford the costs of using your insurance.) In the course of our work together, please let me know if you have significant changes in your financial circumstances that impact your ability to pay for therapy. If you are paying a lower-fee please let me know if you become able to increase your fee, thereby allowing someone else to benefit.


Home Office: My office is sunny, quiet, comfortable and private. It is located in a second floor flat completely separate from the living quarters of my household. The office entrance is only used by clients and there is a private client-only restroom next to the therapy room. This is the most peaceful office I have ever had and I make great effort to prevent interruptions. That said, there may be rare occasions when clients are aware of activity in the flat below. At this time my office has a small waiting space appropriate for one person. Clients text me on their arrival. I space appointments with enough time between meetings that clients do not encounter each other – please do not come to your appointment more than five minutes early. I am happy to talk about any concerns you may have about my office.


Confidentiality & Privacy: All of our communications and interactions are confidential.


There are exceptions mandated by law, and ethical standards to which I must adhere. I will not reveal that you are receiving services from me or share any information about you unless any of the following circumstances apply. If there is ever a time when I am mandated to make a referral to an outside source I will share as little as possible while still meeting the intention of the law and NASW ethical standards. I will always make every effort possible to communicate with you before responding to any of these situations, unless I have reason to believe that my contacting you would compromise your, or anyone else's, safety.


--If I have reason to believe you are in imminent danger of killing yourself or seriously harming someone else.


--In the event I have reasonable suspicion of child, elder or dependent adult abuse or neglect


--In certain situations involving subpoenas


--You are an adult engaging with a minor in sexual activity.


Also know that if you submit super-bills or invoices to your insurer and/or are receiving reimbursements from your insurer, the insurance company or third-party payor may ask for information about you. Information that may be requested includes, but is not limited to: types of service, dates/times of service, diagnosis, treatment plan, description of impairment, progress of therapy, case notes, and summaries.
In order ensure a high quality of clinical care, and in accord with the ethical principles of my field, I participate in regular professional consultation with colleagues and specialists. In the event I consult regarding your case, your name and/or identifying information will not be disclosed unless you have provided written consent.

A word about social networking: To support clear understanding between us, to ensure confidentiality and allow you return to services in the future should you wish, I do not 'friend' or ‘follow’ current or former clients on any social networking sites. I will not respond to any invitations via social networking.


Endings: You may end psychotherapy at any time. All relationships come to an end and it is my practice to support our having a positive ending.



 






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Clear support for vibrant living.

 
Tassajara Photo by Shundo David Haye

401.406.1223


Near Intersection of
Hope & Power Streets
in College Hill
Providence, RI 02906