There is a lot of information on this page, all of which will be provided to you via email prior to intake. I will be happy to answer any questions you have prior to our first session and during the intake session.
Psychotherapy is a collaborative process and that process can differ for each client depending on the particular issues you are choosing to work on at this time. The process of therapy is also not necessarily linear. In other words, changes are not always clear or in a straight line.
Psychotherapy has been shown to have many benefits for increasing positive outcomes in your life and reducing the effects of negative experiences. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness – it is your responsibility to discuss these openly, especially if they get worse or become concerning in session. Accepting and working through unpleasant feelings and thoughts is a primary goal of therapy so that you can more easily and skillfully reach the goals you have set for your life. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But, there are no guarantees of what you will experience. I do truly believe that therapy can be an effective tool for you.
There are many different methods I may suggest and you will have the choice whether to employ those suggestions. In order for the therapy to be most successful, you will likely work on things we talk about both during and between sessions.
The first session will involve discussion of the forms you completed, your history (personal history and the history of the issues that have led you to seek this particular treatment at this time). The first session will last about an hour and we will decide together if I am the best person to provide the services you need at this time in order to meet your treatment goals. We will evaluate your progress and how you feel about the sessions each time we meet. This is a collaborative process and your opinions about how you are feeling, the progress you are making, and your comfort with the therapeutic relationship are vital to this work.
I am open to discussing any questions you have about the treatment whenever they arise. At your request, or if progress is not evident to our satisfaction, I will provide you with referrals to another mental health professional who might have different options for you to work with. We will typically schedule one 50-minute session (one appointment hour of 50 minutes duration) per week at a time we agree on. I make every effort to start on time, but if I should be delayed with another client, I will try to compensate for that at the end of our session. At times, sessions may go beyond 50 minutes due to the matters we are discussing. If a session goes significantly over time, I will charge for the additional time. If possible, we will discuss meeting for extended sessions. Insurance companies do not cover additional time or charging for additional time. If you are using insurance, sessions will be necessarily kept to 50-55 minutes.
Once an appointment hour is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation. It is important to note that insurance companies do not provide reimbursement for cancelled sessions. If it is possible, I will try to find another time during the same week to reschedule the appointment, however inability to reschedule on either part does not take away your financial responsibility.
If you become involved in legal proceedings that require my participation, you will be expected to pay for all of my professional time, including preparation and transportation costs, even if I am called to testify by another party. Because of the difficulty of legal involvement, I charge a higher rate per hour for preparation and attendance at any legal proceeding. I also charge a minimum fee since I will have to cancel most appointments for that day. I ask that such fees be paid in advance on a retainer basis, just as your attorney would. If my preparation for such testimony requires that I obtain legal counsel myself, I will bill these charges against your retainer as well. My current charges for court work are: $250/hour (Minimum 4 hours). Transportation costs are calculated per standard rates.
Telephone and voicemail: My confidential phone number is (724) 602-9776 – this number does not accept texts. For emergencies please call 911, a crisis hotline, or go to the nearest emergency room and ask for the psychologist or psychiatrist on call. If I will be unavailable for an extended time, I will provide you with the name of a colleague to contact, if necessary.
National Suicide Prevention Lifeline: 1 (800) 273-8255
I do not answer the phone when I am with a patient. When I am unavailable, my telephone is answered by voice mail that I check when I am free. I will make every effort to return your call on the same day you make it, with the exception of weekends, and holidays and will call you back within 48 hours. I will only leave a message if you have agreed to that in advance. Please leave information regarding the best times to return the call and the best number to reach you at.
Facsimile, Email, and other electronic contacts: I can receive and send email but discourage this for routine use other than for transmission of forms and scheduling an appointment for confidentiality reasons. Information of a confidential, personal, and/or sensitive nature should be sent by regular mail or hand-delivered. If you email me, be sure I respond before assuming that I have received your email.
LIMITS ON CONFIDENTIALITY
The law protects the privacy of communication 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 pg 4 (Informed Consent) provides consent for those activities, as follows:
- I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The other professionals are also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. I will note all consultations in your Clinical Record (which is called “PHI” in my Notice of Psychologist’s Policies and Practices to Protect the Privacy of Your Health Information).
- I contract with collections agencies for the collection of past due accounts when necessary. As required by HIPAA, I will have a formal business associate contract with such businesses, in which they commit to maintaining the confidentiality of this data except as specifically allowed in the contract or otherwise required by law.
- Disclosures required by health insurers.
- If you threaten to harm yourself or another, I may be obligated to seek hospitalization, or to contact family members or others who can help provide protection.
- If you reveal suspected sexual abuse, physical abuse, or neglect of a child, I am a mandated reporter.
- I am mandated to report suspected elder abuse
- If you call Dr. Travia, please be aware that unless we are both on land line phones, the conversation is not confidential.
- Likewise, text messages are not confidential.
Confidentiality of E-mail and Chat, Cell Phone and Fax Communication:
If you choose to email me from your personal email account, please limit the contents to pragmatic issues such as cancellation or change in contact information. I cannot guarantee the confidentiality of such communications.
If you need to contact me via phone or choose to engage in psychotherapy over the phone (emergencies only), your confidentiality via these methods CANNOT be guaranteed. By signing this agreement, you are agreeing that you understand these limits.
If engaging in telephonic therapy, and we are unable to connect or are disconnected during a session due to a technological breakdown, please try to reconnect within 10 minutes. If re-connection is not possible, email to schedule a new session time.
There are some situations where I am permitted or required to disclose information without either your consent or Authorization:
- If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, such information is protected by the psychologist-patient privilege law. I cannot provide any information without your (or your legal representative’s) written authorization, unless I receive a court order or a subpoena is served to me with appropriate notices. If I receive a subpoena or court order, you and your attorney may move to block the subpoena or have the judge rule whether the materials are legally needed or admissible in the court proceedings. In that case, I may have to release information in a sealed envelope to the clerk of the court issuing the subpoena. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.
- If a government agency is requesting the information for health oversight activities, I may be required to provide it for them.
- If you file a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself.
- If you file a worker’s compensation claim, I must, upon appropriate request, provide a copy of any mental health report.
There are some situations in which I am legally obligated to take action that 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 that a child is abused or neglected, the law requires that I file a report with the appropriate governmental agency, usually the Department of Social Services. Once such a report is filed, I may be required to provide additional information.
- If I have reason to suspect that an adult is abused, neglected or exploited, the law requires that I report to the Department of Welfare or Social Services. Once such a report is filed, I may be required to provide additional information.
- If a patient communicates a specific threat of immediate serious physical harm to an identifiable victim, and I believe he/she has the intent and ability to carry out the threat, I am required to take protective actions. These actions may include notifying the potential victim or his/her guardian, contacting the police, or seeking hospitalization for the patient.
If such a situation arises, I will make every effort to discuss it with you before taking any action, and I will attempt to 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, and I am not an attorney. In situations where specific advice is required, formal legal advice may be needed.
HIPAA provides you with several new or expanded rights with regard to your Clinical Record and disclosures of protected health information. These rights include requesting that I amend your record; requesting restrictions on what information from your Clinical Record is disclosed to others; requesting an accounting of most disclosures of protected health information that you have neither consented to nor authorized; determining the location to which protected information disclosures are sent; having any complaints you make about my policies and procedures recorded in your records; and the right to a paper copy of this Agreement, the attached Notice form, and my privacy policies and procedures. I am happy to discuss any of these rights with you.
BILLING AND PAYMENTS
You will be expected to pay for each session at the time it is held, unless we agree otherwise. Payment schedules for other professional services will be agreed to when they are requested.
If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, I have the option of using legal means to secure the payment. This may involve referring your account to a collection agency or going through small claims court, which will require me to disclose otherwise confidential information. In most collection situations, 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 added to your unpaid balance. In addition, past due accounts are also subject to 12% APR interest on all outstanding amounts starting three months after the last session date.
MY PROFESSIONAL RELATIONSHIPS WITH OTHER PROVIDERS
If you have any questions about my relationships with other professionals, you should feel free to ask me. Unless I specifically tell you otherwise, I am not in a legal, professional association with any of the other professionals in the office settings where I practice. While I may refer you to others for additional services, I am also not in a legal, professional association with those providers either. I am presently working as an independent clinical psychologist. For tax and legal reasons, I operate as a professional corporation.