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Here you will find an example of some current counseling policies. They are for informational purposes only and are not
intended to be a complete list of all policies. New clients will receive an Informed Consent packet which features a
complete listing of all policies prior to the first session.
Fees
30 minute consultation -- $60.00
50 minute in-office session -- $110.00
50 minute telephone session -- $110.00
80 minute session -- $170.00
Phone Consultation -- $22.00 per 10 minutes
I accept the following forms of payment: checks or credit cards are preferred, cash is accepted.
(Bartering for mental health services is not allowed by professional ethics codes.)
Please note: I will offer you my best effort, in accordance with my training. However, results are not guaranteed. Refunds will not be issued.
Insurance
As a fee-for service provider, I do not accept insurance and require payment for sessions at the time of service. It is the
individual’s responsibility to check with their insurance provider to verify out-of-network coverage prior to the start of therapy,
if expecting reimbursement. Your insurance may or may not cover the services of a Licensed Associate Marriage & Family
Therapist (LAMFT). You can be provided with a receipt to submit to your insurance with appropriate DSM diagnosis codes, if
requested. All charges incurred are the responsibility of the client.
Cancelled, Missed, or Late Appointments
I require a 24 hour cancellation notice for any scheduled appointment, except in the case of a verifiable emergency.
Appointments cancelled less than 24 hours prior to the appointment will be assessed a $60.00 cancellation fee, due before the
next appointment.
Missed appointments, or “no shows” for a scheduled appointment, will result in full-session session charge, due before the
next appointment.
Clients who are late to scheduled appointments will be charged the full-session fee.
Confidentiality
All applicable state and federal laws are followed with regard to the protection and release of confidential data. Any
information revealed by you during therapy will be kept strictly confidential and will not be revealed to any other person or
agency without your written permission, with certain limitations. Additionally, when more than one family member is being
seen in therapy, I may view the couple or family as a whole to be the client. Therefore, releases of information for couple or
family sessions require the written approval of every consenting member who was present at any time during the treatment.
Please be aware that when someone pays for the therapy services of another, the client’s information remains private and
confidential, with an exception for a minor child.
Limits to Confidentiality
You should know that there are certain situations I am required by law or other exceptions to reveal confidential information
obtained from you during therapy to other persons or agencies without your permission. Emergency contact names, persons
being threatened, law enforcement, designated government agencies, professional associations and/or other health care
professionals may be contacted to ensure appropriate steps have been taken in accordance with reporting responsibilities and
clinical judgment. Therapists are not required to inform you of any actions in this regard.
These situations include:
1. An immediate threat of harm to yourself, the threat of you harming others or if you require appropriate emergency
psychiatric care.
2. Any physical abuse, neglect, or sexual abuse of children or vulnerable adults in the past three years.
3. Use of an illegal drug for a non-medical purpose during a pregnancy.
4. Any sexual exploitation by health care professionals.
5. A court order for specific information, signed by a judge in a pending legal action.
6. Treatment results of court-ordered therapy
7. If State or Federal law authorizes the release of your records (e.g. SSI, Work Comp)
8. An investigation or disciplinary proceeding with a professional association, licensing board or law enforcement agency.
Note: All policies are outlined in detail in the Informed Consent packet provided to new clients upon commencement of
therapy.
intended to be a complete list of all policies. New clients will receive an Informed Consent packet which features a
complete listing of all policies prior to the first session.
Fees
30 minute consultation -- $60.00
50 minute in-office session -- $110.00
50 minute telephone session -- $110.00
80 minute session -- $170.00
Phone Consultation -- $22.00 per 10 minutes
I accept the following forms of payment: checks or credit cards are preferred, cash is accepted.
(Bartering for mental health services is not allowed by professional ethics codes.)
Please note: I will offer you my best effort, in accordance with my training. However, results are not guaranteed. Refunds will not be issued.
Insurance
As a fee-for service provider, I do not accept insurance and require payment for sessions at the time of service. It is the
individual’s responsibility to check with their insurance provider to verify out-of-network coverage prior to the start of therapy,
if expecting reimbursement. Your insurance may or may not cover the services of a Licensed Associate Marriage & Family
Therapist (LAMFT). You can be provided with a receipt to submit to your insurance with appropriate DSM diagnosis codes, if
requested. All charges incurred are the responsibility of the client.
Cancelled, Missed, or Late Appointments
I require a 24 hour cancellation notice for any scheduled appointment, except in the case of a verifiable emergency.
Appointments cancelled less than 24 hours prior to the appointment will be assessed a $60.00 cancellation fee, due before the
next appointment.
Missed appointments, or “no shows” for a scheduled appointment, will result in full-session session charge, due before the
next appointment.
Clients who are late to scheduled appointments will be charged the full-session fee.
Confidentiality
All applicable state and federal laws are followed with regard to the protection and release of confidential data. Any
information revealed by you during therapy will be kept strictly confidential and will not be revealed to any other person or
agency without your written permission, with certain limitations. Additionally, when more than one family member is being
seen in therapy, I may view the couple or family as a whole to be the client. Therefore, releases of information for couple or
family sessions require the written approval of every consenting member who was present at any time during the treatment.
Please be aware that when someone pays for the therapy services of another, the client’s information remains private and
confidential, with an exception for a minor child.
Limits to Confidentiality
You should know that there are certain situations I am required by law or other exceptions to reveal confidential information
obtained from you during therapy to other persons or agencies without your permission. Emergency contact names, persons
being threatened, law enforcement, designated government agencies, professional associations and/or other health care
professionals may be contacted to ensure appropriate steps have been taken in accordance with reporting responsibilities and
clinical judgment. Therapists are not required to inform you of any actions in this regard.
These situations include:
1. An immediate threat of harm to yourself, the threat of you harming others or if you require appropriate emergency
psychiatric care.
2. Any physical abuse, neglect, or sexual abuse of children or vulnerable adults in the past three years.
3. Use of an illegal drug for a non-medical purpose during a pregnancy.
4. Any sexual exploitation by health care professionals.
5. A court order for specific information, signed by a judge in a pending legal action.
6. Treatment results of court-ordered therapy
7. If State or Federal law authorizes the release of your records (e.g. SSI, Work Comp)
8. An investigation or disciplinary proceeding with a professional association, licensing board or law enforcement agency.
Note: All policies are outlined in detail in the Informed Consent packet provided to new clients upon commencement of
therapy.
| Fees & Policies |
Disclaimer: The contents of this site and all the pages herein are intended for informational purposes only and are subject to change without notice at any time. None of
the information in this site is intended to be taken as advice therapeutic, legal, or otherwise. At no time does use of this site nor communication through this site constitute a
therapeutic relationship between the user and therapist. Kari L.M. Silverberg, MA, LAMFT and Theraspire Counseling Services, PLLC assumes no liability for the
content of this site or damages that may result from use, reference to, reliance on, or decisions resulting from its use. Use of this site establishes your consent to the
provisions of this disclaimer. Copyright 2006. All rights reserved.
the information in this site is intended to be taken as advice therapeutic, legal, or otherwise. At no time does use of this site nor communication through this site constitute a
therapeutic relationship between the user and therapist. Kari L.M. Silverberg, MA, LAMFT and Theraspire Counseling Services, PLLC assumes no liability for the
content of this site or damages that may result from use, reference to, reliance on, or decisions resulting from its use. Use of this site establishes your consent to the
provisions of this disclaimer. Copyright 2006. All rights reserved.