Welcome to my private practice. Your first visit to a new therapist is very important, and you may have some questions. This page allows me to introduce myself and provide you with information to help you decide if we are a good fit and can work well together. Please take the time to read it carefully and let me know if you have any questions or would like more information. When you sign the “Acknowledgement of Notifications” on the Forms page, it will acknowledge that you have read and understood these policies and will represent an agreement between us.
During our first few meetings, I will assess whether I feel I can be of benefit to you. I do not accept clients who I believe I cannot be helpful to, and if this is the case, I will refer you to others who work well with your particular issues. Within a reasonable amount of time after starting treatment, we will discuss my working understanding of your issues, my proposed treatment plan, and therapeutic objectives and possible outcomes of the therapy. If you have any questions or concerns about any of the procedures used in the course of your therapy, their possible risks, my expertise in employing them, or about the treatment plan in general, please ask me. You also have the right to ask about other possible treatments for your condition and their risks and benefits. If you could benefit from any treatments that I do not provide, I have an ethical obligation to assist you in obtaining those treatments.
Deciding when to stop our work together is meant to be a mutual process. Before we stop, we will discuss how you will know if or when to come back or whether a regularly scheduled "check-in" may be beneficial for you. If it is not to phase out of therapy, I recommend that we have closure on the therapy process with at least two termination sessions, but this can depend upon the length and intensity of the treatment. I also ask all clients to indicate on their intake form whether they consent to follow up emails to assess your satisfaction with my services, and a one-year follow-up to see if you have maintained your goals. You may opt out of both of these follow-up contacts.
I may terminate treatment with you after appropriate discussion and a termination process if I determine that the psychotherapy is not being effectively utilized or if you are in default on payment. I will look at your issues with you and exercise my educated judgment about what treatment will be in your best interest. Your responsibility is to make a good faith effort to fulfill the treatment recommendations to which you have agreed. If you have concerns or reservations about my treatment recommendations, I strongly encourage you to express them so that we can resolve any possible differences or misunderstandings.
If during our work together I assess that I am not effective in helping you reach your therapeutic goals, I am obligated to discuss this with you and, if appropriate, terminate treatment and give you referrals that may be of help to you. If you request it and authorize it in writing, I may talk to the psychotherapist of your choice (with your permission only) in order to help with the transition. If, at any time you want another professional's opinion or wish to consult with another therapist, I will assist you in finding someone qualified. You have the right to terminate treatment any time. If you choose to do so, I will offer to provide you with names of other qualified professionals whose services you might prefer.
If you commit violence to, verbally or physically threaten or harass me, the office, or my family, I reserve the right to terminate treatment unilaterally and immediately. Failure or refusal to pay for services after a reasonable time is another condition for termination of services. Please contact me to make arrangements any time your financial situation changes. I reserve the right to use a collections agency to recover unpaid fees after a reasonable amount of time, but will provide you with ample notice before doing so. I will provide the collections agency with the minimum amount of information (name, dates of service) in order to protect your confidentiality.
Therapy never involves sexual, business, or any other dual relationships that could impair my objectivity, clinical judgment or therapeutic effectiveness or could be exploitative in nature. It is possible that during the course of your treatment, I may become aware of other preexisting relationships that may affect our work together, and I will do my best to resolve those situations ethically, but this may entail our needing to stop working together, depending upon the type of conflict. Please discuss this with me if you have questions or concerns.
Due to the importance of your confidentiality as well as the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, Linkedin,etc.). I believe that interacting with former or current clients as friends or contacts on these sites may compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this policy, please bring them up when we meet and we can discuss it further.
Participation in therapy can result in a number of benefits to you, including improved interpersonal relationships and resolution of the specific concerns that led you to seek therapy. Working toward these benefits requires effort on your part. Psychotherapy requires your active involvement, honesty, and openness in order to change your thoughts, feelings , and/or behavior. I will ask for your feedback and views on your therapy and its progress. Sometimes more than one approach can be helpful.
During the initial evaluation or the course of therapy, remembering unpleasant events, feelings, or thoughts may result in your experiencing considerable discomfort, strong reactions, anxiety, depression, insomnia, or other responses. I may challenge some of your assumptions or perceptions, or propose different ways of thinking about or handling situations that may cause you to feel angry, upset, or disappointed. Attempting ti resolve issues that brought you to therapy may result in changes that were not originally anticipated. Psychotherapy may result in decisions to change behaviors, employment, substance use, schooling, housing, or relationships. Change can sometimes be quick and easy, but more often it can be gradual and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results.
Please refrain from using drugs and alcohol 24 hours prior to a session. If there is reasonable suspicion that you are under the influence when you arrive for session, the session will be terminated and full session fees will charged.
For small administrative matters such as checking appointment times or changing them, you are welcome to email me at DrJoHays@gmail.com. I generally receive and return emails within 24 hours, except on weekends.
If you need to contact me between sessions about a clinical matter, please leave a message for me at (818) 618-6053. I check my messages regularly and will try to return calls within 24 hours. On weekends and holidays, I will only return calls in the case of an emergency, otherwise, I will return calls on the next business day. If I am planning on being out of town, I will let you know in advance. I will additionally inform you who I have covering for me if I plan not to take or respond to phone messages during my absence.
Emergency phone consultations of ten minutes or less are generally free. However, if we spend more than ten minutes in a week on the phone, I will need to bill you on a prorated basis for that time.
If you feel the need for many phone calls and cannot wait for your next appointment, we may need to schedule more sessions in order to address your needs. If an emergency situation arises, please indicate it clearly in your message to me. If your situation is an acute emergency and you need to talk to someone right away, contact the closest 24-hour emergency psychiatric service: Dial 911 or go to your nearest Emergency Room. You may also contact the National Suicide Prevention Lifeline, open 24 hours a day 7 days a week, at 1-800-273-8255.
I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. Please understand that email and texts are not to be considered substitutes for therapy. If it becomes necessary, I may terminate treatment if email or text usage becomes inappropriate. While I try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.
Missed and cancelled appointments pose some issues for both of us. First, the work of psychotherapy is sometimes challenging and when we hit a difficult place together, it can feel easier to want to avoid coming in for treatment. I would prefer we speak about this directly and intentionally rather than you canceling sessions. Also, I hold your scheduled appointment time specifically for you and you alone. I also see a limited number of patients so that I can give you the focus and attention you deserve. It is extremely difficult for me to fill your last minute cancelled session on a short notice. Therefore, I charge for appointments cancelled with less than 24 hours notice unless we can find another time that week that works for both of us. If we are able to, I will allow you to reschedule within the same week at no extra cost.
If you are running late for your appointment, please phone or text me as soon as you are able to let me know you will be late. If I do not hear from you by 20 minutes into your session, I will call to check on you and may assume you do not plan to attend your session. If I am running late, I will extend the session if schedules permit, or reschedule at your convenience.
If you are late for your session, we will still end at our regular time so that I have time to prepare for my next appointment and I can be on time for them.
A $35.00 service charge will be charged for any checks returned for any reason.
My standard fee is for a 50 minute session. Fees will be discussed prior to starting therapy. The fee is to be paid at each session unless other arrangements have been made. If you are late, we will end on time and not run over into the nest person's session. Your session fee may be increased annually. In this event, you will be notified at least 30 days in advance.
Balances: I do not permit clients to carry a balance and if you are unable to pay fees, we will discuss whether it makes sense to pause your care or develop another strategy so that you can avoid incurring additional debt. Please let me know if any problem arises during the course of therapy regarding your ability to make timely payments. Failure to pay may result in cancellation of session and possible termination of services. Any remaining balances at that time may be handled by a collection agency or small claims court.
Insurance: I do not currently take insurance. I can provide you a monthly billing statement for reimbursement (Superbill) if you wish to submit it to your insurance company. This monthly statement is your receipt for tax or insurance purposes.
Some or all of your fees may be covered by your health insurance, if you have outpatient mental health coverage. However, your insurance companies do not reimburse all conditions that may be the focus of psychotherapy. It is your responsibility to verify the specifics of your coverage. Please remember that my services are provided and charged to you, not your insurance company, so you are responsible for payment. Fees you pay for therapy services that are not reimbursed by insurance may be deductible as medical expenses if you itemize deductions on your tax return. As described below in the section Health Insurance and Confidentiality of Records, be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk.
Other fees: If you become involved in legal proceedings that require my participation, you will be expected to pay for my professional time and services even if I have been called upon to testify by another party. Because of the difficulty of legal involvement and the interruption to my regular practice, I charge $375.00 per hour for preparation and attendance at any legal proceeding. I will provide bills/receipts at the end of each session and expect to be paid upon receipt unless otherwise agreed upon.
As a psychotherapy client, you have privileged communication. This means that your relationship with me as my client, all information disclosed in our sessions, as well as the written records of those sessions are confidential and may not be revealed to anyone without your written permission, except where law requires disclosure. Most of the provisions explaining when the law requires disclosure are described in the Notice of Privacy Practices.
When Disclosure Is Required by Law: Disclosure is required when there is a reasonable suspicion of child, dependent, or elder abuse or neglect and when a client presents a danger to self, to others, to property, or is gravely disabled.
When Disclosure May Be Required: Disclosure may be required in a legal proceeding. If you place your mental status at issue in litigation that you initiate, the defendant may have the right to obtain your psychotherapy records and/or my testimony. If you have not paid your bill for treatment for a long period of time, your name, payment record and last known address may be sent to a collection agency or small claims court.
In couple or relationship therapy, or when different family members are seen individually, confidentiality and privilege do not apply between the couple or among family members. I will use my clinical judgment when revealing such information.
Emergencies: If there is an emergency during our work together or after termination in which I become concerned about your personal safety, the possibility of you injuring someone else, or about you receiving psychiatric care, I will do whatever I can within the limits of the law to prevent you from injuring yourself or another, and to ensure that you receive appropriate medical care. For this purpose I may contact the person whose name you have provided on your General Information form.
Health Insurance and Confidentiality of Records: Your health insurance carrier may require disclosure of confidential information in order to process claims. Only the minimum necessary information will be communicated to your insurance carrier, including diagnosis, the date and length of sessions, and what services were provided. Often the billing statement and your company's claim form are sufficient. Sometimes treatment summaries or progress towards goals are also required. Unless explicitly authorized by you, psychotherapy notes will not be disclosed to your insurance carrier. While insurance companies claim to keep this information confidential, I have no control over the information once it leaves my office. Please be aware that submitting a mental health invoice for reimbursement carries with it some risk to confidentiality, privacy, or future eligibility to obtain health or life insurance.
Confidentiality of E-mail, Voicemail, Phone Texts and Fax Communications: Email, voicemail, phone texts and fax communications can be easily accessed by unauthorized people, compromising the privacy and confidentiality of such communications. Please notify me at the beginning of treatment if you would like to avoid or limit in any way the use of any or all of these communication devices and methods. Please do not contact me through email, text or fax for emergencies.
Consultation: I consult regularly with other professionals regarding my clients in order to provide you with the best possible services. Names or other identifying information are never mentioned; client identity remains completely anonymous and your confidentiality will be fully maintained. If, for some reason, I believe it is important to consult with another professional in-depth, and I believe identifying information about you may be shared, I will have you sign a release of information allowing me to share this information. Without such a release, I will not consult with another professional providing information that might lead another person to be able to identify you.
Release of Information: Considering all of the above exclusions, upon your request and with your written consent, I may release limited information to any person/agency you specify, unless I conclude that releasing such information might be harmful to you. If I reach that conclusion, I will explain the reason for denying your request.
If you have a concern or complaint about your treatment, please talk to me about it. I will take your criticism seriously and respond with care and respect. If you believe that I have been unwilling to listen and respond, or that I have behaves unethically, you can contact the Board of Behavioral Science Examiners which oversees licensing, and they will review the services I have provided.
Board of Psychology , 1625 Market Street, Suite N-215, Sacramento, CA 95834
Phone: 1-866-503-3221, Email: bopmail@dca.ca.gov
You are also free to discuss your complaints about me with anyone you wish and you do not have any responsibility to maintain confidentiality about what I do that you don't like since you are the person who has the right to decide what you want kept confidential. I hope this answers some of your questions. Please let me know if you have concerns or questions about any of these policies and procedures or this agreement for working together in psychotherapy.