scsnewclientinfopdf - silverado counseling · this document is the property of silverado counseling...

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This document is the property of Silverado Counseling Services and is confidential and proprietary in nature. Its contents, outline and/or format shall not be copied or reproduced without explicit permission.

New Client Informational Packet

Welcome,

When you start services with Silverado Counseling Services, you will be asked to read and sign a variety of consent forms. Some of these forms are required by professional ethics, may contain legal requirements, are for State licensing while others are informational. Before you attend your first appointment at Silverado Counseling, please take a few minutes to familiarize yourself with the content of this online informational packet. All of these documents will be explained to you when you attend your first appointment and any questions you might have will be addressed.

Our goal is to provide quality clinical services for our clients. Your cooperation is kindly requested to help

us ensure these goals are met. As you start your treatment with Silverado Counseling, we ask that you be advised of the following guidelines to enhance your overall experience in therapy with our agency. Expectations for attendance:

1. You have a responsibility to attend scheduled appointments on time. 2. Arriving late reduces the time of your session and “extra” time cannot generally be granted as this could

affect other appointments. -If you are more than 20 minutes late for an appointment, your therapist might complete the

session with the time remaining or opt to reschedule you. -If your therapist elects not to continue the session due to tardiness, the appointment will be

considered a “No Show”.

3. Appointments typically start at the top of the hour and last approximately 50 minutes. 4. Clients are expected to schedule and attend appointments at least twice a month unless otherwise

arranged with your Therapist. Clients receiving medication services in conjunction with therapy are expected to be active in treatment in order for medication services to continue. Appointment scheduling and reminders:

1. You are responsible for keeping track of your appointments and you should be prepared to attend appointments as scheduled. Although you might receive a courtesy call to remind you about your appointment, there is no guarantee that you will, so please keep track of your appointments. Staff can offer ways to help you remember your appointments, so please ask if you need assistance.

2. You should plan ahead for adverse weather, transportation delays and/or child care arrangements so

these factors do not interfere with attending appointments on time.

3. If your phone is shut off or out of service, it is your responsibility to make contact with your Therapist.

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Behavior Expectations while in the Office:

1. Please do not bring children or other people to your appointments unless they are scheduled to be a part of your session. If they are providing you with transportation, please ask them to come back to pick you up at the end of your scheduled session time.

2. Children MUST be monitored by an adult at all times while in our office or the building.

3. We ask that you help us maintain a calm and peaceful office environment by using soft voices, silencing

cell phones and other electronic devices. This is also to protect you from having your personal information shared outside of the offices.

4. Please respect the privacy of others and do not share personal information or ask personal information

from others in the office. Your effort will help avoid distracting your session or others in session. 5. Please do not to bring outside food or drinks to appointments. Water is available at the offices.

6. You should never come to therapy while under the influence of illegal substances or alcohol or if you are

overly impaired by use of prescription medications. If you are impaired, staff will exercise discretion to ensure your safety and the safety of others.

Cancellation and Rescheduling Policy:

1. If you must cancel or reschedule an appointment, it is standard professional courtesy to provide your therapist with at-least 24-hour notice.

2. Cancellations with less than 24-hour notice are considered a “No Show”. Certain contracts require that

we report all missed appointments, which may affect your standing with the referring agency. Missed appointments might also affect your status if you are applying for Social Security, if you are court involved or if you are required to participate as part of a benefits program.

3. Certain contracts do not allow us to bill clients for missed appointments, so unless you are exempt by contract guidelines, YOU will be billed for sessions not cancelled with 24-hour notification. Unpaid accounts will be sent to collections.

4. Silverado Counseling reserves the right to discontinue services if you fail to attend scheduled

appointments or cancel/reschedule without proper notice; if you have two “No-Shows” or two “Cancellations”; or if you fail to attend at least twice in a month. Smoking Policy The Salt Lake County Division of Substance Abuse and Mental Health (DSAMH) require that we maintain a smoke free facility and campus. This means that smoking is not allowed in the office, in the building and extends to the grounds surrounding the office. We appreciate your support in helping us adhere to this policy.

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CONSENT FOR MENTAL HEALTH TREATMENT

The consent for mental health treatment is a standard professional practice document, which outlines the understanding between client and professional about the services being provided and reveals alternatives as well as potential concerns.

1. You should understand the nature and intended purpose of your evaluation and/or treatment, including your responsibility to attend and participate actively.

2. You should be advised that when starting therapy, it is not unusual to experience some increase in symptom distress, such as increased anxiety. This may occur due to the process of gathering historical information, which may bring emotional issues to the forefront. It is expected that this distress will be short-lived and will resolve during the process of continued clinical support. If you experience emotional distress, please do not avoid treatment, but talk to your therapist so you can receive support.

3. You should understand that the practice of mental health is not an exact science. Therefore, no guarantees can be made about your outcomes in treatment. However, please be aware that your active and open participation in treatment can improve benefits and outcomes.

4. You should be aware that therapy is intended to promote emotional wellbeing and should never

cause you harm. However, there is potential for unforeseeable, unintended, or unpreventable situations that might result in a change of emotional state or abreaction. If this does occur, you should advise your therapist immediately.

5. Please be aware that information discussed in therapy sessions will be kept confidential according to the standards of quality care, State and Federal laws. However, there are certain situations when confidentiality CANNOT be protected; including cases of suspected child abuse or if there is a threat of harm to you or others. Also, personal information such as your name and contact information may be released for the purpose of billing and collecting fees for evaluation and treatment services. Some exceptions may include the following:

• If you are court involved there may be circumstances when the court will request updates and progress on your case. If

you do not attend therapy sessions, this will be so noted in the update and may be reported to the court.

• Contracts monitors audit our clinical files and thus your file might be audited. If you have any concerns about Monitors accessing your file during these audits please advise your therapist.

• Information about your case can/will be shared with certain persons or agencies only when agreed to by your signature

on a “Release of Information” form. • By law, we are obligated to make a report if there is any reason to believe that any disabled adult or any child has been

subjected to abuse, neglect or exploitation (Utah Code Sections 62A-4a-403 & 62A-3-305 or if there is any reason to believe that you present an eminent risk of harm to yourself or others (Tarasoff Doctrine).

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Client Rights and Grievance Protocol

All clients receiving services at Silverado Counseling Services have certain rights that are listed here asnd these should be explained to you when you start treatment. Persons having a specific grievance with this agency or any of the services provided have a right to express their concern and to have their concerns addressed satisfactorily.

• You have the right to receive professional services that meet Standards of Professional Care • You have the right to express yourself openly in treatment and to have your concerns addressed • You have the right to be treated with respect regardless of your circumstances • You have certain Civil Rights that include non-discrimination • You have the right to privacy and confidentiality within the guidelines of law and professional practice. • You have the right to feel safe when you come to treatment and to be free from harm or violence. • You have the right to be treated with dignity

How to handle concerns:

§ If you have any concerns about any of the services you are receiving or have been denied, § If you have a concern about inadequacies or inequities about this program or its staff, § If you have any concerns about the quality of service you received or if you feel for any reason that you have

been mistreated, § If you do feel you have a concern or if you feel that your rights as listed have been violated,

We ask that you first make an effort to discuss the concern with your therapist. If you still have concerns please contact:

Mark A. Weisbender, LCSW Founder/Owner Silverado Counseling Services P.O. Box 521207 Salt Lake City, UT 84152-1207 (801) 983-5540

You may also have other remedies such as your referring worker, insurance provider, case manager, court worker, or social worker.

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If you miss a scheduled appointment Please read carefully. If you miss an appointment, it is your responsibility to contact our office and/or your therapist to reschedule. Do not assume that you will be automatically scheduled at the same time the next week. If you are receiving medications as part of your treatment, you must remain active in therapy or have already made arrangements for treatment elsewhere. If you fail to remain active in treatment, we reserve the right to discontinue medication services with you. If you miss scheduled medication appointments, we reserve the right to discontinue medication services with you. If we suspend your medication services, we will attempt to provide you with a resource or referral for your medication needs. Please be aware that if you drop out of treatment, if you have excessive “No-Shows” or if you have an unpaid balance on your account;

We will not provide letters for court We will not respond to SSI information requests We will not provide file information to you or any other requesting agency.

You can avoid most problems by communicating your needs with your therapist or agency staff. Stay in contact with us and let us know how we can assist you better with your needs. Remember, we are here to help you but we cannot help you if we do not see you, hear from you or know what complications you may be experiencing.

scsnewclientinfopdf - silverado counseling · this document is the property of silverado counseling...

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