Counseling can carry both benefits and risks. Often, counseling can lead to a significant reduction in feelings of distress, improved relationships, and/or resolution of specific issues. However, there are no guarantees for a “cure” or improvement of any condition. Risks may involve experiencing uncomfortable feelings (i.e. sadness, guilt, or anxiety) or discussing unpleasant aspects of your life.
In accordance with ethical guidelines, what you discuss with a mental health professional is kept confidential. Your written permission will be required to release information to other parties (i.e. spouse, family members, or outside institutions).
There are circumstances where information can be released without your consent or authorization. These include:
- If you are at risk of being a threat or danger to yourself, a mental health professional is permitted to release information necessary for the purpose of your protection (such as contacting family members or seeking hospitalization)..
- If an immediate threat of physical violence against a readily identifiable victim is disclosed, your counselor may take action, which may include notifying the potential victim(s), notifying the police, or seeking hospitalization.
- If abuse or harmful neglect of children, the elderly, or disabled/incompetent is known or reasonably suspected, your counselor must file a report with the appropriate state agency.
- In the event a client decides to bring a malpractice suite against the counselor, the client’s record will be admitted as evidence in court.
- In court proceedings a judge may require the mental health professional’s testimony and client’s record if he/she determines this is necessary to resolve the issues before the court.
The laws concerning confidentiality can be quite complex. While your counselor is willing to discuss these matters with you, he/she is not an attorney. If you have specific legal questions, it is advised that you speak with an attorney.
Notice to Clients
If you have any complaints about my service, I invite you to discuss them with me at once. This process may enhance the counseling process as well as your progress. The Texas Behavioral Health Executive Council investigates and prosecutes professional misconduct committed by marriage and family therapists, professional counselors, psychologists, psychological associates, social workers, and licensed specialists in school psychology. Although not every complaint against or dispute with a licensee involves professional misconduct, the Executive Council will provide you with information about how to file a complaint.
Texas Behavioral Health Executive Council 333 Guadalupe St., Ste. 3-900 Austin, Texas 78701 Tel. (512) 305-7700 or1-800-821-3205 with a 24-hour, toll-free complaint system https://www.bhec.texas.gov/discipline-and-complaints/index.html
HIPPA Protected Health Information Policy
As of April 14, 2003, a Federal law (HIPAA) requires that this notice be posted on the website. It contains information about how your protected health information is handled. Please contact me if you have any questions or concerns.
Notice of Policies and Practices to Protect the Privacy of Your Health Information
THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. Uses and Disclosures for Treatment, Payment, and Health Care Operations
R.E.F. Counseling may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your general consent. To help clarify these terms, here are some definitions:
- “PHI” refers to information in your health record that could identify you.
- “Treatment, Payment and Health Care Operations” Treatment is when I provide, coordinate, or manage your health care and other services related to your health care. An example of treatment would be when I consult with another health care provider, such as your family physician or a colleague. Payment is when I obtain reimbursement for your health care or to determine eligibility or coverage. Health Care Operations are activities that relate to the performance and operation of my practice. Examples of health care services are quality assessment and improvement activities, business-related matters such as audits and administrative services, supervision, and case management and care coordination.
- “Use” applies only to activities within my practice such as utilizing information that identifies you.
- “Disclosure” applies to activities outside of my practice, such as releasing, transferring, or providing access to information about you to other parties.
II. Uses and Disclosures Requiring Authorization
I may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. An “authorization to release information” is written permission above and beyond the general consent that permits only specific disclosures. In those instances when we are asked for information for purposes outside of treatment, payment and health care operations, I will obtain authorization from you before releasing this information. I will also need to obtain an authorization before releasing your psychotherapy notes. “Psychotherapy notes” are notes I have made about our conversation regarding a private, group, joint, or family counseling session. These notes are given a greater degree of protection than PHI.
You may revoke all such authorizations (of PHI or psychotherapy notes) at any time, provided each revocation is in writing. You may revoke an authorization to the extent that (1) we have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy.
III. Uses and Disclosures with Neither Consent nor Authorization.
We may use or disclose PHI without your consent or authorization in the following circumstances:
- Child Abuse: If I have cause to believe that a child has been, or may be, abused, neglected, or sexually abused, I must make a report of such within 48 hours to the Texas Department of Protective and Regulatory Services, the Texas Youth Commission, or to any local or state law enforcement agency.
- Abuse of the Elderly and Disabled: If I have cause to believe an elderly or disabled person is in a state of abuse, neglect, or exploitation, I must immediately report such to the Texas Department of Protective and Regulatory Services, the Texas Youth Commission, or to any local or state law enforcement agency.
- Regulatory Oversight: If a complaint is filed against a therapist with regulatory authority, they have the authority to subpoena confidential mental health information relevant to that complaint.
- Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law, and I will not release information, without written authorization from you or your personal or legally appointed representative, or a court order. The privilege does not apply when you are being evaluated by a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.
- Serious Threat to Health or Safety: If I determine that there is a probability of imminent physical injury by you to yourself or others, or there is a probability of immediate mental or emotional injury to you, I may disclose relevant confidential mental health information to medical or law enforcement personnel.
- Worker’s Compensation: If you file a worker’s compensation claim, I may disclose records relating to your diagnosis and treatment to your employer’s insurance carrier.
IV. Client’s Rights and My Professional Duties
Client’s Rights:
- Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of protected health information about you. However, I am not required to agree to a restriction you request.
- Right to Receive Confidential Communications by Alternate Means and at Alternate Locations: You have the right to request and receive confidential communications of PHI by alternate means and at alternate locations. (For example, you may not want a family member to know that you are seeking services. Upon your request, we will send bills or other correspondence to another address.)
- Right to Inspect and Copy: You have the right to inspect or obtain a copy (or both) of PHI and psychotherapy notes in your mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. We may deny your access to PHI under certain circumstances, but in some cases, you may have this decision reviewed. On your request, I will discuss with you the details of the request and denial process.
- Right to Amend: You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. I may deny your request. At your request, we will discuss with you the details of the amendment process.
- Right to an Accounting: You generally have the right to receive an accounting of disclosures of PHI for which you have neither provided consent nor authorization (as described in Section III of this Notice). On your request, I will discuss with you the details of the accounting process.
- Right to a Paper Copy: You have the right to obtain a digital copy of the notice from R.E. F. Counseling upon request, even if you have agreed to receive the notice electronically.
My Professional Duties:
- I am required by law to maintain the privacy of PHI and to provide you with notice of my legal duties and privacy practices with respect to PHI.
- I reserve the right to change the privacy policies and practices described in this notice. Unless I notify you of such changes, however, I am required to abide by the terms currently in effect.
- If I revise my policies and procedures, you will be notified electronically.
- This notice has gone into effect on 2/1/2025.