Notice of Privacy, Confidentiality, Telehealth, Forensic Services, and Termination

 Privacy and Confidentiality

Psychologists have an ethical and professional obligation to take reasonable precautions to protect confidential information obtained through their professional activities and stored or transmitted in any medium. The extent and limits of confidentiality may be established by applicable federal and state law, professional standards, court orders, institutional requirements, and the nature of the professional relationship.

At the beginning of services, clients will be informed about the foreseeable uses and disclosures of their information and the applicable limits of confidentiality. Information will generally be used and disclosed only as permitted or authorized by applicable law and professional standards.

Confidentiality may be limited when disclosure is required or permitted by law. Circumstances that may require or permit disclosure can include, but are not limited to:

  •  Situations involving an imminent or serious risk of harm to the client or another person
  •  Suspected abuse or neglect when reporting is required by applicable law
  •  Court orders, subpoenas, or other legal requirements
  •  Professional consultation or supervision when permitted and appropriate
  •  Situations involving a medical or psychiatric emergency
  •  Other circumstances in which disclosure is required or permitted by applicable federal or state law.

The specific requirements governing confidentiality, reporting, and disclosure may vary depending upon the client’s location, the nature of the service, and the circumstances involved. When legally and ethically appropriate, only information reasonably necessary for the particular purpose of disclosure will be shared.

Telehealth Services

Telehealth services may be provided through secure electronic communication technologies when clinically appropriate and permitted by applicable law and professional licensing requirements.

Telehealth involves additional considerations related to privacy, technology, communication, and emergency response. Reasonable measures will be taken to protect the privacy and security of information transmitted electronically. Telehealth services will be provided using technology and procedures designed to comply with applicable privacy and security requirements.

Clients are encouraged to participate in telehealth sessions from a private location and to use a private, password-protected device and secure internet connection whenever possible. Clients should also take reasonable steps to prevent others from overhearing or accessing their sessions or electronic communications.

At the beginning of telehealth services, the psychologist may verify the client’s identity, physical location, and contact information and may identify individuals who are present during the session. Clients are expected to provide accurate information regarding their physical location at the beginning of each telehealth session because applicable laws, licensing requirements, emergency procedures, and the psychologist’s authority to provide services may depend upon the client’s location.

Telehealth technology cannot eliminate all privacy or security risks. Although reasonable safeguards will be implemented, electronic communications may carry risks associated with unauthorized access, technical failures, connectivity problems, or other technology-related events.

Telehealth services may be interrupted, modified, or discontinued when the psychologist determines that telehealth is no longer clinically appropriate, cannot be provided safely, or cannot be provided in compliance with applicable laws or professional requirements.

In the event of an emergency during a telehealth session, the psychologist may use the client’s reported location and emergency contact information to facilitate an appropriate emergency response.

 Forensic Psychological Evaluations

Forensic psychological evaluations differ from psychotherapy and other clinical services. The psychologist’s role is to provide an objective professional opinion regarding a specific psycholegal referral question rather than to serve solely as the examinee’s treating psychologist or advocate.

Before beginning a forensic evaluation, the psychologist will explain the nature and purpose of the evaluation, the psychologist’s role, the intended use of the information, the anticipated recipients of the report or testimony, and the limits of confidentiality to the extent reasonably foreseeable.

Information obtained during a forensic evaluation may be included in the psychological report, discussed with the referral source or retaining party, or disclosed through testimony or other legal proceedings when authorized or required. Information may also be disclosed to other individuals or entities involved in the legal matter when disclosure is authorized or required by law, court order, or the terms of the forensic engagement.

Because forensic evaluations may involve legal proceedings, confidentiality protections applicable to psychotherapy do not necessarily apply in the same manner to forensic services. Examinees should understand that information disclosed during a forensic evaluation may not remain private.

The psychologist will seek to limit information included in reports and testimony to information relevant to the referral question and appropriate to the psychologist’s professional role, consistent with applicable law, ethical standards, and the requirements of the legal proceeding.

Forensic opinions and recommendations will be based upon information and methods sufficient to support the conclusions reached. Depending upon the referral question, an evaluation may include clinical interviews, psychological testing, records review, collateral information, and other relevant sources of information.

 Privately Retained Forensic Evaluations

When a forensic evaluation is privately retained, the nature and limits of confidentiality will be explained before the evaluation begins. The confidentiality expectations associated with a privately retained evaluation may differ from those associated with psychotherapy or a court-ordered evaluation.

The psychologist will identify, to the extent reasonably foreseeable, the retaining party, intended recipients of the evaluation, purpose of the evaluation, and anticipated use of the report or testimony.

The psychologist will not knowingly disclose confidential information outside the scope of the professional engagement unless authorized by the client or required or permitted by applicable law, court order, or professional obligations.

Clients should understand that requesting a forensic evaluation may result in information being disclosed to attorneys, courts, governmental agencies, opposing parties, or other authorized participants in a legal proceeding, depending upon the nature of the engagement and applicable law.

 Records and Electronic Information

Reasonable precautions will be taken to protect psychological records and information obtained, created, stored, or transmitted in connection with professional services. Records may be maintained electronically and may be transmitted electronically when necessary for treatment, assessment, consultation, billing, legal, or other legitimate professional purposes.

Clients should understand that electronic communication and storage carry inherent privacy and security risks despite the use of reasonable safeguards.

 Termination of Therapy

Therapy may be terminated when it becomes reasonably clear that the client no longer needs the service, is unlikely to benefit from continued treatment, or is being harmed by continued treatment. Therapy may also be terminated when the psychologist is threatened or otherwise endangered.

Services may also be discontinued when the psychologist determines that the client’s needs fall outside the psychologist’s scope of competence or when another level or type of care would be more appropriate.

Consistent with ethical and professional standards, reasonable efforts will be made to provide pre-termination counseling and, when appropriate, referrals or information regarding alternative providers.

Repeated missed appointments may result in termination of services in accordance with the practice’s attendance and cancellation policies. Three consecutive missed appointments may be considered grounds for termination; however, clinical circumstances and continuity-of-care considerations will be taken into account when determining whether termination is appropriate.

 Termination of Forensic Services

Forensic services are generally concluded when the agreed-upon evaluation, consultation, or other professional service has been completed, including completion of the evaluation, report, testimony, or other deliverable identified in the professional engagement.

Additional services may require a new agreement, referral, or authorization.

The completion or termination of a forensic evaluation does not create an ongoing therapeutic relationship. A forensic psychologist generally does not provide psychotherapy to an individual whom they have evaluated for a forensic purpose when doing so would create a conflict of interest, impair objectivity, or otherwise be inconsistent with applicable ethical or legal requirements.

 Fees and Outstanding Balances

Fees and payment arrangements will be discussed and agreed upon before or at the beginning of services whenever reasonably possible.

If a client fails to pay agreed-upon fees, the psychologist may provide notice of the outstanding balance and an opportunity to make prompt payment before pursuing additional collection measures, consistent with applicable law and professional standards.

If an account is referred to a third-party collection agency, only information reasonably necessary for the legitimate collection of the outstanding balance will be disclosed, consistent with applicable privacy laws and professional obligations.

Information or records will not be withheld when doing so would be prohibited by applicable law, including circumstances in which records are needed for emergency treatment.

 Jurisdiction and Telehealth Location

Psychological services are provided only when and where the psychologist is authorized to practice and when the service is clinically and legally appropriate.

The psychologist is licensed in Virginia, Washington, DC, Georgia, Illinois, Florida, and Missouri. Telehealth availability is subject to the psychologist’s current licensure, applicable state and federal laws, temporary practice provisions, client location, and other requirements that may apply at the time services are provided.

Clients are responsible for accurately reporting their physical location at each telehealth appointment and notifying the psychologist if their location changes.

Laws governing confidentiality, mandated reporting, emergency intervention, professional practice, and telehealth may vary by jurisdiction. The psychologist will comply with applicable legal and professional requirements based on the circumstances and jurisdiction involved.