Office Policy/Service Contract
Revised July 01, 2011
Welcome to Port Angeles and Arlington Psychological Services. For many people, consulting a psychologist can be a new, possibly anxiety-provoking experience. This policy statement is designed to answer the questions and clarify the most common issues that clients bring to us. Our goal is to develop a fair and clear understanding between professional and client. Please feel free to ask about any of these issues at any time.
“What are your qualifications?”
Paul C. Daley, Ph.D., is a Licensed Psychologist (#913). He received his undergraduate training in Psychology from the University of Washington, and received his graduate training in Counseling Psychology from Colorado State University, where his Ph.D. was granted in August of 1981. He interned at the Veterans Administration Medical Center in Milwaukee, Wisconsin. Before coming to Port Angeles, he served as the Staff Psychologist and then Program Director for a county mental health center in Eastern Oregon. He has been trained in diagnosis and assessment, individual therapy, marital therapy, family therapy, group therapy, and conflict mediation.
The licensure process in Washington is designed as a protection for the public. The process screens out people who lack minimal competencies. The licensure standards include a) approved doctoral level education; b) two years of supervision by a Licensed Psychologist; and c) written and oral examinations. It is unlawful for anyone to present him/herself as a psychologist, or as someone who provides psychological services, without a license. The Examining Board of Psychology can be reached at:
Department of Health
Examining Board of Psychology
1300 Quince Street SE
P.O. Box 47869
Olympia, WA 98504-7869
“What is your approach to treatment?”
Dr. Daley’s orientation to treatment varies with each client and presenting problem. However, in general, his approach might be described as “pragmatic.” That is, the type of approach he uses will depend on your motivation, the complexity and clarity of the problems with which you need help, your personal and financial resources, and your wishes. For some types of problems, you will need someone to help you work your way through very painful, complex, and confusing feelings and ideas, and a long-term, insight-oriented therapy would be appropriate, if that is what you (and/or your insurance carrier) want to buy. If finances are a major factor to consider, group therapy can be an ideal choice, providing both a powerful, insight-oriented, compassionate, and understanding therapy, and an inexpensive form of treatment. On the other hand, if you have a specific goal you want to accomplish (e.g., getting yourself over an irrational fear), these types of problems can often be treated quite briefly. In general, Dr. Daley’s approach would be considered “Cognitive-Behavioral,” meaning that most emotional problems are better approached by working on the thoughts and behaviors associated with the emotional distress.
“Is there ‘homework’ connected with therapy?”
Sometimes. Between-session work can speed the process of psychotherapy, although Dr. Daley’s homework assignments are “gifts,” but you are not required to complete homework assignments.
“What is a client-psychologist relationship like?”
A psychotherapy relationship is different than any other relationship. This relationship must develop into a very safe and trusting one where you can feel free to talk about even the most unacceptable thoughts, feelings, and actions. This is much easier said than done, especially as health care coverage for psychotherapy services gravitates ever more toward brief and rapid treatments! Learning to develop a level of trust that deep may not occur in brief therapy unless you make a conscious choice to take the risk of trusting your psychologist.
A note about Dr. Daley’s use of language. Becoming a person clients can trust easily and quickly is not an easy task. Dr. Daley has found that, the more “normal Joe” he is, the easier it is for clients to trust him. Sometimes this involves the use of swear words or the substitution of colloquial/politically-incorrect terms for professional language. If you are uncomfortable with this approach, say so. Dr. Daley is perfectly capable of communicating on a language continuum anywhere from “Common Joe” to erudite.
“What is my role as a client in this type of relationship?”
Your role in this process is to be as clear as you can (we know it is not easy sometimes) about the problems you want solved, as open and honest about your private behaviors, thoughts, and feelings as you can be (again, we know this can be difficult), and as active as possible in talking about, thinking about, and acting differently about your issues as you can be (again … we know it is not easy). Your role is also to keep your “eye on the ball,” so to speak. That is, if therapy is not working for you, tell Dr. Daley so adjustments can be made. Miscommunication is common in all relationships, and a normal part of a therapy relationship, so tell Dr. Daley if you do not understand what he meant, and actively work for clear communication. It is your responsibility to keep the pressure on yourself and your therapist to make sure your therapy works for you. Think of Dr. Daley as your employee, one with special expertise, but still working under your authority and direction.
Frequently, people come to a therapist expecting to tell the therapist about themselves, and expecting the therapist to say something profound that makes the problem go away. Unfortunately, this seldom happens. Effective therapy involves hard work on the part of both the client and the therapist.
“Are there risks to undertaking psychotherapy?”
Psychotherapy has both benefits and risks. The risks may include experiencing uncomfortable feelings (such as sadness, guilt, anxiety, anger and frustration, loneliness, helplessness, etc.), an initial worsening of your problem, becoming aware of undesirable aspects of your character, marriage, family, or life, and/or being faced with very difficult and undesirable conflicts (dilemmas). Rarely – very rarely – psychotherapy clients “break down” and require psychiatric hospitalization. (This has never happened in Dr. Daley’s practice, but it is theoretically possible.)
“What is ‘Trauma-focused” psychotherapy’?”
“Trauma-focused” psychotherapy is one of many approaches commonly used to treat Posttraumatic Stress Disorder (or similar conditions). It involves, basically, talking about, remembering, and thinking through traumatic experiences while feeling enough “upset-ness” to be of therapeutic value (the process only works if you become emotionally engaged in it), but not so upset as to become overwhelmed. Your therapist helps you to remember, talk about, and “work through” traumatic experiences, and helps you find a balance between being disengaged versus overwhelmed, with the goal of reducing the amount of “upset” that you experience when thinking about traumatic events.
“Does trauma-focused psychotherapy hurt?
Yes and no . . . Trauma-focused therapy is a therapy that brings you into direct confrontation with the very memories you might prefer to avoid, and yes, the process is initially somewhat painful. You may, in fact – at first – “get worse” and experience an increase in flashbacks, intrusive memories, intrusive thoughts, nightmares, interpersonal conflicts, etc. The positive “risk” is that you can – ideally – become desensitized to the traumatic event so that you come to be able to think about it with significant emotional separation, as something that is over and done with, as opposed to “re-living” the emotional distress you currently associate with it.
“How long does therapy usually take?”
How long you remain in therapy depends on two major points:
1) the nature of your problems. . .
If the problem you present to Dr. Daley is fairly specific and simple, the total number of sessions will be smaller (perhaps 1 to 10 sessions). If, on the other hand, you are seeking help in overcoming a depression that has troubled you most of your adult life, your treatment could take 20 to 200 or more sessions.
2) your effort and hard work. . .
Studies indicate that the more strongly motivated and firmly committed you are to change, the more rapidly therapy can progress.
Please feel free to discuss the likely length of treatment with your Dr. Daley.
“When are psychological tests administered?”
Occasionally, Dr. Daley may ask you to take one or more psychological tests. Some of these tests are simple forms that you fill out on your own. Others are tests administered by him. Some tests are computer scored. Typically, Dr. Daley will go over the results of the tests with you at your next session. There are additional fees for most psychological tests (see “What are your fees?” below).
“Do you regularly consult with other mental health professionals about your clients?”
Good therapy practices suggest that it is wise for psychologists to review their clinical work with a respected and knowledgeable colleague on occasion. Dr. Daley sometimes meets with (or consults by phone with) other therapists to discuss cases. In addition, depending on the special needs of each client, he may seek the consultation of other physicians, psychologists, or psychiatrists. All conferences with individuals outside of this agency will be made either with your permission, or without disclosing identifying information. You have a right to ask us not to consult with specific other professionals.
“Who decides when to stop therapy?”
Generally, the stopping of therapy is a topic for open discussion, and is mutually agreed upon by the therapist and the client. This is the best way to stop therapy.
Discussions of the termination of therapy should take a minimum of one full session. “By the way, I’m not coming anymore” robs you of the opportunity to confront and express tender and embarrassing feelings, disappointed or angry feelings, and all of the complex reactions associated with the loss of an important relationship. Clinical lore suggests that the memories of your therapy and therapist may remain with you for 10 or even 15 years after therapy ends. Having a discussion of your thoughts and feelings (positive and negative) associated with ending therapy can therefore significantly aid your transition out of a therapy relationship. If you wish to discontinue your therapy against the wishes of your therapist, please ask for a referral to another therapist.
Sometimes the stopping of therapy is not smooth. The process of talking over painful subjects can become very uncomfortable, and you may find yourself wanting to suddenly quit therapy. You may disagree with the direction of the therapy or feel impatient for faster or greater change. If these feelings happen to you, please talk with Dr. Daley before making any decisions. Please remember, though, that you have the right to stop treatment any time you want to, and the right to refuse some or all of the services provided at this office.
“What are your ethical and professional standards?”
Dr. Daley is bound by the code of ethics of the American Psychological Association, as well as by state laws regulating the practice of psychology and psychotherapy. If you believe his behavior may be unethical or below professional standards, you should follow a two- or three-step procedure. First, you will want to get a copy of the American Psychological Association’s “Ethical Standards” from our office or from the Washington State Psychological Association. After reading through these standards, you should either sit down with Dr. Daley and discuss your concerns, talk privately with a different psychologist, or file a formal complaint with the Department of Licensing. These options may put you on the “horns of a dilemma.” You may not want to directly confront Dr. Daley, and you may not be clear on the seriousness of the problem. We recommend that you consult an impartial Licensed Psychologist for advice.
Does your staff have access to clinical/private/privileged/“secret” information about me?
The support staff at this office DO have some access to some clinical information about you. When your therapist writes a letter, the support staff “processes”/types/edits it. Support/clerical staff also have access to your diagnoses and other billing information. If your managed care company requires us to fill out various forms, support staff often have access to the information in those forms because they sometimes have to fill out portions of the forms (e.g., the dates of all of your sessions). The support staff at this office are not only trained in the strictest understanding of the meaning of confidentiality, but, with the new HIPAA regulations, they are now required to sign a confidentiality agreement in order to maintain their employment in offices like this (in which confidentiality is so crucial). You may ask that confidential/clinical/private/“secret” information NOT be shared with support staff (although we ask that, except under special circumstances, you make this an all-or-nothing request [that is, it would be very difficult for us to keep track of requests to keep only certain bits of information away from the support staff, and much easier for us to keep everything away from support staff, although we cannot agree to keep the information needed to bill for services secret from the support staff who do our billing]).
“What are the office ‘rules’ about appointments?”
The first session is designed to acquaint you with Dr. Daley, answer your questions about how therapy works, and begin identifying treatment goals. The cost for this first session is higher than the cost for ongoing therapy sessions because of the work involved in setting up a new therapy. When you do begin your therapy, you may be seen weekly (sometimes twice weekly) in group, or anywhere from twice weekly to twice annually for individual, marital, or family therapy, depending on your needs and wishes.
If you desire “single session” treatment, we will want to schedule a two-hour session. Charges will be not be prorated if you do not need the entire two hours, but, in all likelihood, we will use all of the time. There are no reduced fees for single session therapies.
“How long is a therapy ‘hour’?”
A regular therapy appointment is 45–50 minutes in length. Please understand that if you arrive late, your appointment hour will not be extended (often another client is scheduled after you). However, you will still be charged for the full “hour,” since that is the amount of time reserved for your appointment.
“What if I need to cancel an appointment?”
As long as you provide 24 hours notice, there will be no charge. If you cancel with less than 24 hours notice, you will be charged as described in the following section.
“What if I simply do not show up for my appointment or cancel with less than 24 hour notice?”
Because your therapy “hour” is “reserved” for you, the first time you do not show up for your appointment or cancel with less than 24 hours notice due to illness or emergency, you will not be charged; if the cancelation-with-less-than-24-hours-notice is not due to illness or emergency – and for every emergency or illness cancellation after the first one – you will be charged $50.00 the first time, $75.00 the second time, $100.00 the third time, and $125.00 thereafter. Remember, your health insurance will not cover missed appointments; they are your responsibility.
“What are your fees?”
Initial Consultation $225.00 per hour
Individual, Marital, or Family therapy* $150.00 per hour
Group therapy $ 50.00 per hour
Divorce Mediation or Parenting Plan Mediation $150.00 per hour
Equine Facilitated Psychotherapy $250.00 per 2 hours
Court or Attorney referred evaluations $300.00 per hour
Courtroom testimony, preparation, and/or standby $300.00 per hour
Psychological Evaluations and Testing $190.00 per hour
Report preparation $190.00 per hour
Emergency services $190.00 per hour
Phone consultations $190.00 per hour
Computer scored tests $30.00 to $65.00 per test
“Who has final responsibility for the bill, me or the insurance company?”
Remember that you are responsible for your entire fee. If you have health insurance coverage, we will bill your insurance company for you, but any problems with the insurance coverage become your responsibility to resolve. (We will gladly help you in any way possible.) We are gladly willing to help you decipher your health care coverage/benefits/limitations, and we will call your insurance carrier on your behalf if you wish.
“When is payment for services due?”
Unless some prior arrangement has been made, you will be expected to pay your portion of the fee immediately before or after each session. To help you keep your own records straight, we will mail you a statement each month indicating how many sessions were billed to your account, how much you paid, and how much the insurance company paid.
“What happens when I fall behind on my payments?”
This is a rare event because our clients pay for their services at the time they are rendered. However, should you fall behind on your payments, we will not assess any finance charges as long as some payment is made each month. If a payment is not received for more than one month, a 1.5 percent per month finance charge will be assessed (computed on the outstanding balance each month). Delinquent accounts may be turned over to a collection agency, or we may initiate action against you in small claims court if we cannot work out a payment schedule with you. You will also be responsible for the cost of efforts to collect our fee from you.
“What if I disagree with my monthly statement or have a problem with payment?”
If you have any problem with your bill, please let us know at your earliest convenience. Most billing errors are the result of a simple oversight, and conflicts can be settled through discussion and negotiation.
Because the health care industry is changing so rapidly, you would be wise to make sure you have an accurate understanding of your health care coverage, benefits, and limitations. The escalation of the cost of health care has resulted in an increasing level of complexity about insurance benefits which sometimes makes it difficult to determine exactly how much mental health coverage is available. “Managed Health Care Plans” often require advance authorization before they will provide reimbursement for mental health services. These plans are often oriented toward a short term treatment approach designed to resolve specific problems that are interfering with one’s usual level of functioning. It may be necessary to seek additional approval after a certain number of sessions. In our experience, while quite a lot can be accomplished in short term therapy, many clients feel that more services are necessary after insurance benefits expire. Some managed care plans will not allow us to provide services to you once your benefits are no longer available. (If this is the case, Dr. Daley will do his best to find you another provider who will help you continue your psychotherapy.)
You should also be aware that most insurance agreements require you to authorize Dr. Daley to provide to the insurance company a clinical diagnosis, and sometimes additional clinical information such as a treatment plan or summary, or, in rare cases, a copy of the entire record. This information will become part of the insurance company files, and, in all probability, some of it will be computerized. All insurance companies claim to keep such information “confidential,” but once it is in their hands, this office has no control over what they do with it. In some cases they may share the information with a national medical information data bank. If you request it, we will provide you with a copy of any report we submit to your insurance company.
You should also be aware that you have the right to pay for professional services yourself, and thus avoid the insurance complexities described above.
“How can I reach you?”
Dr. Daley’s phones are answered 24 hours per day, either with “live reception” or an answering machine. His emergency phone number (360-809-3765) is also provided on the answering machine. If an emergency develops, and you cannot wait for Dr. Daley or the on-call mental health provider to call you, please call 911, call the Crisis Line at Peninsula Community Mental Health Center, contact your family doctor, or go to the Emergency Room at the local hospital.
“Do I have the right to see my records?”
This office keeps a record of the health care services Dr. Daley provides you (for example, summaries of your sessions, test results, and reports). You may ask to see and have a copy of that record (you will be charged for retrieval and copying of your records in accordance with the current acceptable fees for such practices; if the record contains references to others, it will require special review and preparation [in order to protect their privacy] at an additional fee). You may also ask to have your record corrected. We will not disclose your record to others unless you direct us to do so, or the law authorizes or compels us to do so. To review your record, please schedule an appointment with Dr. Daley.
“How confidential are the services I receive from Port Angeles and Arlington Psychological Services?”
The confidentiality of counseling information is extremely strict. This office will not tell anyone that you are coming here – let alone what is discussed – except under the following circumstances:
1. You may ask Dr. Daley to disclose confidential information to someone (for example, to your next therapist). If this happens he will ask you to sign a release form that specifically states what information can be released. HIPPA rules allow providers to disclose relevant information to other healthcare providers who are currently active in the client’s care WITHOUT signed authorization.
2. Dr. Daley may ask you for permission to disclose confidential information to another professional (for example, to consult with another therapist, psychologist, or psychiatrist). You do not have to agree to having any information disclosed about you. If you do agree, we will ask you to sign a release form that specifically states what information can be released. If you do not want information disclosed, except as specified below, we will honor your wishes.
- In cases of medical emergency, if Dr. Daley knows something that could save your life, he will disclose this information without your permission. Obviously, this rarely occurs.
4. As your therapist, Dr. Daley is a “mandated reporter.” This means that, in this state, he is required by law to inform the proper authorities – even if you do not give your permission – if he or she believes you are:
a) of immediate danger to yourself (for example, suicidal);
b) of immediate danger to others (for example, assaultive or homicidal);
c) of immediate danger to others’ property;
d) unable to meet your own basic needs (for example, for food and shelter);
e) physically, emotionally, or sexually abusing children, or a disabled person; or
f) physically, emotionally, or sexually abusing an elderly person,
Please note that some clients may think about suicide – even seriously – and Dr. Daley is NOT under any obligation to report these thoughts to anyone. Dr. Daley is only required to disclose this type of confidential information without your permission if he honestly believes you will kill yourself in the immediate future.
If you are abusing children or the elderly, Dr. Daley will always encourage you to make the report to the authorities yourself (in his presence). However, whether or not you make this report yourself, Dr. Daley is required by law to make such a report himself.
Please keep in mind that your therapist is here to help. He is not an officer of the law. If a report has to be made, every effort will be made to handle the report of such issues in a dignified and therapeutic manner.
5. A court of law may subpoena your records.
Generally, the confidentiality of your relationship with your therapist is protected by law, but Dr. Daley might be required to testify under the following circumstances:
a) if the court rules that other legal issues outweigh your right to the protection of your privacy;
b) if the court rules that you have already broken confidentiality by discussing your therapy with others; or
c) if the court sent you to us for psychological evaluation, and you agreed to participate.
6. Under recent revisions in Washington State Law, health care providers (including mental health providers) must or can disclose information about you under certain circumstances. Although Dr. Daley does not anticipate being asked to disclose any information about our clients under this law, you should know about the law and what it would require or allow us to do:
a) technically, we are allowed to disclose information – without your permission – to your physician or any other health care provider who works with you if we feel this is in your best interest;
b) technically, we are allowed to disclose information – without your permission – to immediate family members or to an individual known to have a close personal relationship with you if this is done according to the rules of good professional practice, and justified by the need to provide you with appropriate health care;
c) we are allowed to disclose some information – without your permission – if we are involved in a research project that has been approved by a human subjects review panel;
d) we are allowed to disclose information – without your permission – if we are subject to a financial audit;
e) we are allowed to disclose information about you – without your permission – to an official of a penal institution if you are imprisoned;
f) we are allowed to disclose information – without your permission – to federal, state, or local law enforcement authorities to the extent which the healthcare provider law requires it; and,
g) we can disclose certain portions of your records to appropriate authorities engaged in collecting data for legal, administrative, financial, or actuarial services provided to this office.
Please keep in mind that Dr. Daley’s own code of ethics is stricter than the state law. Therefore, his intent would be to not disclose any information about you under the provisions of this law unless he is legally required to do so and/or if he can be assured that the disclosures will then be kept confidential.
“What if I am not yet 18 years old?”
In the treatment of teenagers, there is a delicate “confidentiality balance” that cannot be fully resolved. On the one hand, establishing a trusting relationship with a teenager can be a very delicate and difficult task, and if the teen feels that his/her confidences will likely be disclosed/betrayed, s/he is unlikely to confide in the first place. On the other hand, teenagers can do a remarkable job of pointing themselves in frightening directions in life, and parents might rightfully feel betrayed to suddenly learn that their teen’s psychotherapist knew of their impending dysfunction, and never said a word.
Teens in therapy and their parents need to decide “which way to go” with this issue. As a parent, do you want to grant confidentiality and risk the double-edge blade of (a) your teen trusting me and making good progress v. (b) asking for regularly scheduled feedback and risking that, in the process, your teenager does not feel safe enough to talk about what is really happening with him/her?
If you are under 18 years of age, please be aware that the law may provide your parents with the right to examine your treatment records. It is Dr. Daley’s policy to request an agreement from your parents that they consent to give up access to your records. If they agree, we will provide them only with information about your therapy when we feel that there is a high and immediate risk that you, the client/teen, will seriously harm yourself or someone else, in which case Dr. Daley will notify your parents of our concern. Dr. Daley will also provide them with a summary of your treatment when it is complete, if you – and they – have made that agreement at the beginning of your therapy. Before giving your parents any information, Dr. Daley will discuss the matter with you, the client/teen, and he will do the best we can to resolve any objections you, the teen, have about what Dr. Daley is prepared to discuss.
Please be aware that there is an age (14?) when a teenager can engage a therapist for therapy – and pay for it him/herself – with telling his/her parents.
“What information do you give to the insurance company?”
Our office will tell your insurance company your diagnosis, dates of service, and the length of your sessions, if they are paying for services. If the insurance company wants additional information, Dr. Daley will complete the additional requested reports, and share/review them with you. You will then decide if you want this information disclosed to your insurance company. If you decide not to disclose the information required by the insurance company, and they then refuse to cover your sessions, you will be responsible for the entire fee.
Sometimes “Employee Assistance Program” (EAP) companies and other “managed care” entities ask for disclosure of your progress notes. If you have been referred by a managed care company or an EAP, it is your responsibility to make yourself aware of the rules, limitations, benefits, etc. of that company, and to provide us with clear (written) documentation of your wishes if you do not want us to comply with any of those requirements (typically, you will have already signed a document with those companies indicating your agreement to their program specifications, and we have no way of knowing that you do not wish us to comply with some aspect of their plan unless you tell us).
“Could there ever be a situation in which I want Dr. Daley to provide information to someone and he might refuse to do so?”
Legally, you have a right to your records except under very limited circumstance. If Dr. Daley thinks the disclosure will harm you, he can refuse to give you portions (but not all) of your record.
However, there could be circumstances wherein Dr. Daley might refuse to disclose your record despite your desire to have the record disclosed. Ethically, Dr. Daley has many obligations, one of which is to not hurt you. Imagine a scenario where you have disclosed something humiliating a long time ago, something you likely do not remember disclosing 10 years ago, let’s say, and now you want your records released to your new potential employer (who wants to make sure you are psychologically healthy). By law, if you say “disclose it,” Dr. Daley must do so. By human decency, and ethically, he might refuse.
Sometimes former clients or current clients want to subpoena our therapy records to support some legal action in which they are involved. You have the right to authorize that disclosure, but you must understand that Dr. Daley has an ethical obligation to make sure that the information disclosed is not misused, and, in general, therapy records are of minimal value to a legal proceeding.
If Dr. Daley is compelled by a court of law to testify, you will be required to pay his fee – in advance – for attendance and preparation at any legal proceeding even if his testimony harms your case.
“What if all I need is a Psychological Evaluation?”
If you have consulted us in order to obtain a psychological evaluation, and you are not seeking further services, we will continue to make every effort to maintain an open and direct relationship with you. This process can be complicated by circumstances surrounding your referral, however. For example, if you have been forced to seek an evaluation by a court of law, or if you are embroiled in some type of legal battle, you may not feel like you want to be completely open with Dr. Daley. You may be angry about having to submit to an evaluation. These issues should be discussed with Dr. Daley. If you have been forced by a court of law to undergo an evaluation, you have the right to question us in detail about the evaluation procedure, as well as the right to refuse to participate in the evaluation. If you choose to participate, though, the confidentiality of the evaluation will extend (within the limits outlined in this Office Policy) to everyone except the court or third party that ordered (and paid for) your evaluation. That is, the final report will be released to the person or agency that asked for and paid for the report, regardless of whether or not you want the report released to them.
It is also important for you to know that, if someone else is paying for your evaluation, then that third party – that agency – becomes the “client” of this office. Three factors often surface when an agency pays your fee. First, many clients are confused by the referral, and request an evaluation “because they told me I should come here.” Please recognize that psychological evaluations can have major impacts on your life and your benefits with these agencies, and you should be fully informed as to the nature of and reason for the evaluation. We will be glad to answer any questions that may arise in these cases. Secondly, when an agency is paying the fee for your evaluation, that agency earns the right to receive the written report of your evaluation, even if you are displeased with some or all of the report. If an agency (e.g., Division of Vocational Rehabilitation, Labor and Industries, Division of Disability Determination Services, Division of Child and Family Services, Department of Social and Health Services, etc.) is paying for your evaluation, you may refuse to begin the evaluation, but you cannot retrospectively revoke your permission to disclose confidential information to the referring agency unless you pay all of the fees involved. This means that, if you write to Dr. Daley and ask for a copy of “your” report – or authorize someone else to – Dr. Daley will refuse the request. Only the “client” (the paying agency) has the right to authorize such disclosures, not the evaluee.
Finally, as noted above, by your signature below, you are agreeing not to use an evaluation conducted at one agency’s request for subsequent legal or court issues, or for use by other agencies asking different evaluative questions. If you desire feedback about your evaluation, you may schedule an additional session to review the evaluation (the referring agency may or may not pay your fee for this “extra” session, and payment must be arranged in advance). Written reports will not be released until the fee for the evaluation has either been paid or guaranteed.
Agencies will often release a copy of the report about you to you if you request it, which is not a good idea. Dr. Daley should review the report with you first. Most of the time, the report is released in a manner that risks harming you (by just giving it to you without review/explanation), although almost always the risk is low.
Agreements
By your signature below, you are:
1) agreeing to pay your fee in full,
2) agreeing that you will not subpoena Dr. Daley or his records for any past, present, or future legal or administrative actions with which you become involved unless your initial referral was for a psychological evaluation, and you disclosed – in advance – that the records would be required for this particular legal action, and
3) agreeing to the terms set forth in this policy.
If you have questions, conflicts, or problems with any aspect of this policy, please negotiate a mutually agreeable resolution with Dr. Daley within 10 working days. Barring any discussion, this policy will take on the full force of a contractual agreement after 10 working days from your first session.
Summary
There is a fine line between providing people with information versus overwhelming them with information. This policy statement is intended to help you make informed choices about your therapy services. Indeed, it is very rare that serious problems ever arise. Please feel free to ask Dr. Daley any questions, or offer him feedback about any aspect of this practice.
Paul C. Daley, Ph.D.
Port Angeles and Arlington Psychological Services
Paul C. Daley, Ph.D., Licensed Psychologist (#913) 