Informed Consent for Psychology Services

Welcome to Genuine Center. Your psychotherapy experience depends upon trust and understanding between you and your therapist. This document has been prepared to inform you about what to expect from your therapist, James Shaw, PsyD.

James Shaw, PsyD
In 2009, Dr. James Shaw earned his doctoral degree in Clinical Psychology from Argosy University Dallas in Dallas, TX. In 2011, he obtained his license as a Clinical Psychologist, and worked practicing in private practice.  In 2012, he began work at The Ohio State University where he practiced therapy, supervised up to six PhD students, and taught family physician residents. During this time, Dr. Shaw worked with family physicians and residents to integrate care.  Dr. Shaw has written three bibliotherapy books.  Dr. Shaw has taught psychology course at five universities. He has treated a wide range of psychological issues. His professional interests include providing individual and couples therapy with an emphasis on treating anger, anxiety, stress, careers and communications.

Understanding Psychotherapy
Psychotherapy is a process of understanding your concerns more clearly and working towards accomplishing your desired goals. The benefit to participating in psychotherapy is the ability to enhance personal growth, such as gaining insight into your concerns, clarifying your personal goals and values and improving your coping skills. Often times, change involves an extensive process and can trigger intense feelings, such as frustration. However, your effort, in and out of session, has a significant impact on your progress. Thus, you are encouraged to have open discussions about your progress within your sessions.

Treatment Approach
Dr. James Shaw’s treatment approach is primarily cognitive-behavioral therapy (CBT) with an incorporation of person-centered therapy, Gottman couple’s therapy, and many others. A person centered approach focuses on being an active listener and allowing the client to go at their own pace. The person centered approach provides a safe/nonjudgmental environment, which can allow the client to feel comfortable sharing his or her personal information. CBT is a structured approach that focuses on identifying and changing negative thoughts to more positive/realistic thoughts, which in turn changes the individual’s feelings and behaviors. The CBT approach also focuses on enhancing coping skills by collaboratively developing short and long term goals. CBT may assist you in becoming more emotionally healthy, more resistant to life stressors and less prone to anxiety, depression, or other future problem areas. The therapy session is time-limited, 53 minutes per session. Thus, most of the work takes place outside of therapy by practicing the skills in between sessions, and then discussing your barriers, progress and success in session. As a result, at times, you may be recommended to complete tasks between sessions, such as reading handouts and maintaining logs, in order to work towards the established short and long-term goals.

What to Expect in Your Therapy Sessions
Your first visit, and possibly the second visit, will involve an evaluation, which is an opportunity to gain an understanding of your concerns, symptoms and desired areas for improvement. Following the evaluation, you will have the opportunity to collaboratively develop a treatment plan with your therapist. From that point, your psychotherapy sessions will mainly consist of having open discussions on the following topics: 1) Progress pertaining to your personal growth and treatment goals; 2) Identifying and changing your negative thoughts to positive/realistic thoughts, which in turn changes your feelings and behaviors and 3) Increasing and improving your coping skills in order to manage your daily concerns.

Setting Aside Time for Therapy
While illness, unexpected events, or vacations may occasionally interrupt your therapy, consistent attendance and participation during your therapy sessions play a significant role in your treatment progress. It is recommended that you arrive a few minutes ahead of your appointment time, so that you will have the opportunity to set aside the concerns of the day and to prepare for your session. Additionally, you may find it helpful to take notes on the skills that are reviewed during your therapy session. It is very important that you participate fully and consistently in therapy sessions.

Duration of therapy
The length of treatment and the frequency of therapy sessions depends on the individual’s number of concerns, severity of symptoms, treatment goals and their effort put forth in and out of session. Initially, clients often begin with weekly 53 minute sessions in order to build a rapport and to increase their knowledge of various skills. Once these goals are completed, then the client usually schedules more time in between appointments, such as biweekly or every 3 weeks, depending on their treatment progress. At this time, the treatment goals are for the client to be able to maintain their progress and to continue their progress on their own, without the therapist. Once this is accomplished, then the client typically stops attending therapy. The process of ending therapy, termination, can be a very valuable part of your treatment. Terminating therapy should not be done casually, although either you or your therapist may decide to end therapy if it is in your best interest. It is recommended that you agree now to meet for at least one additional session to review your treatment progress and to allow for closure if you wish to terminate or to take a break from therapy.

The Therapeutic Relationship
The relationship between you and your therapist is very unique. In therapy, the focus is mainly on you. This is a luxury that everyday life does not typically provide, so at first, this luxury may seem a little awkward. After awhile, you may find yourself enjoying the time that is devoted solely to you. You are encouraged to be open and honest with your therapist about your thoughts and feelings in order to cultivate an effective working relationship. The therapy process requires the client to share personal information and the therapist to not make judgments or give advice, but instead, for the therapist to assist the client in finding the best course of action.

There are some limitations on the professional relationship in order to protect the client’s confidentiality and to maintain professionalism. One of these being, there are restrictions on therapists and clients socializing outside of therapy. For example, if a therapist happens to meet you on the street or socially, they may not say hello or talk to you very much. Also, all communication outside of therapy should be for the purposed of setting up therapy sessions. Also, even though you might invite a therapist, they will not attend your family gatherings, such as parties or weddings. Your therapist will not celebrate holidays with you or give you gifts, and they may not eagerly receive any of your gifts. In addition, therapists and clients are restricted from dating or engaging in a sexual relationship. While talking about sexual thoughts or feelings are a part of therapy for many clients, sexual relations between a therapist and client are never okay.

If you become involved in a divorce or custody dispute, it is important that you understand and agree that your therapist will not provide evaluations or expert testimony in court. It is recommended that you hire another mental health professional for any evaluations or testimony you require. This position is based on two reasons: (1) Your therapist’s statements will be seen as biased, in your favor, because they have a therapeutic relationship with you; and (2) the testimony may affect your therapeutic relationship with your therapist.

Children and pets
No children under the age of 18 years or pets are allowed in the therapy session or in the waiting room for individual or couples therapy.  It is your responsibility to make sure you have made arrangements for child care ahead of time.

Contact with Your Primary Care Physician
It may be beneficial for your therapist to consult with your primary care physician, psychiatrist or other doctors in regards to your psychological treatment or to discuss any medical conditions for which you are receiving treatment. If you are interested in having your therapist consult with one of your doctors or providers, please complete the Authorized to Release Confidential Information form.

Alternative Treatments and Medications
Psychologists are not physicians, and they do not prescribe medication or perform medical procedures. You are encouraged to consult with your primary care physician to rule out any medical conditions that may affect your mental health. At times, a combination of services, individual therapy and additional services, may be beneficial to your treatment progress.

In addition, there are many different levels of care and specialties that psychologists can provide. Thus, in some circumstances, the level of care the therapist offers may not be the best match for a client’s needs or various concerns may be outside of the therapist’s scope of competence. If this were to become a concern, your therapist would consult with you in regards to the clinical necessity to refer you to another provider. Also, you have the right to end therapy at any time; your therapist will provide you with a referral upon request.

Confidentiality
In accordance with the professional ethic codes, the information revealed in therapy is confidential, and it will not be revealed to anyone without your written permission, except as required by law. Some of the circumstances where disclosure is required by law are: 1) Where there is a reasonable suspicion of child, dependent or elder abuse or neglect. 2) When a client presents a danger to self, to others or is gravely disabled. It is our policy to request your consent to allow your therapist to consult with another therapist about your case in the following circumstances: 1) When your therapist is away from the office, fellow therapists, who are also required to maintain confidentiality, may be informed of your personal information in order to provide assistance to you in emergency situations. 2) Your therapist may consult with other professionals, who are also required to maintain confidentiality, to assist with providing high-quality treatment. During these consultations, your name will not be provided and the provided information will be limited to the necessary information in order to consult on the issues of concern. You have the right to request a copy of your records or a treatment summary. However, since these are professional records, they can be misinterpreted by an untrained reader. Thus, it is recommended that you review your records in your therapist’s presence so you can discuss the content. Please refer to the Financial Policy regarding these professional fees.

Health Insurance and Confidentiality of Records
Disclosure of confidential information may be required by your health insurance carrier in order to process claims. The minimum necessary information needed to submit a mental health invoice for reimbursement of the services rendered will be provided to your insurance company. This carries a certain amount of risk to confidentiality, privacy or future capacity to obtain health or life insurance, or even a job. The risk stems from the fact that mental health information is likely to be entered into insurance companies’ computers and to be reported to the National Medical Data Bank. Accessibility to companies’ computers or to the National Medical Data Bank is always in question as computers are inherently vulnerable to unauthorized access. Medical data has also reportedly been legally accessed by enforcement and other agencies, which could put you in a vulnerable position.

Emergencies
In case of an emergency, you may contact us via telephone (512) 800-0222. Please note that staff may not be available immediately to handle emergency situations. In emergencey situations, please call 911 or go to the closest hospital emergency room for a psychological evaluation. Please do not contact us via e-mail in an emergency situation.

Financial Policy
If your health insurance is in-network, in which your therapist is an approved provider under your insurance plan, we will bill your insurance as a courtesy. Please visit our website at www.genuinepsych.com to inquire on in and out-of-network benefits. However, you are required to pay your co-payment, co-insurance and any uncovered services at the beginning of each visit. You are encouraged to contact your insurance company if you are unsure of your coverage. If Genuine Psychology Center does not receive your insurance payment within 60 days of billing your insurance, you are responsible for the full account balance. In case of separation or divorce, the parent bringing their child for treatment is responsible to pay for the services provided. If you have an out-of-network health insurance plan, in which our providers are not approved providers under your insurance, we will provide you with a billing receipt that includes the information you will need to submit for an out-of-network provider claim on your own. However, if you have an out-of-network insurance plan or are a self-pay patient, not using an insurance plan, then you are required to pay for the session in full at the start of each visit.
Initial Evaluation $150.00
Individual or Couples Psychotherapy (60 minutes) $150.00

Please note, any of the services described under this section (Other Professional Fees) and any other professional fees not included in the Payment Responsibility section, are not covered under your insurance policy. Thus, it is your responsibility to pay the fee in full. If you become involved in a legal proceeding that requires Genuine Psychology Center participation, you will be required to pay for their preparation, travel time and attendance at a rate of $350.00 per hour with a minimum of 4 hours. Please note, any phone calls longer than 10 minutes, will be charged at a rate of $200.00 per 50 minutes, which is a rate of $4.00 per minute. Other services for which our provides, such as writing, attendance of meetings with other professionals, preparation of documents or any other services requested by you, would require payment at a rate of $200 per hour.

No Show / Cancelation
It is your responsibility to attend all scheduled appointments and to arrive to your appointments on-time. If you need to cancel your appointment, please do so 24 hours prior to your scheduled appointments in order to avoid being charged. Any late cancellations (not canceling within the 24 hour policy), no-shows or late arrivals  may be subject to dismissal from the practice.

Acknowledgement

I acknowledge that I have read, understand and agree to the information provided in the Informed Consent for Psychotherapy, and that I have had my questions answered thoroughly. I do hereby seek and consent to take part in psychotherapy with a therapist at Psychological Services of Chicago, Ltd. I am aware that I may terminate psychotherapy at any time.