Welcome to my practice. Below is important information about my professional services and business policies. Please read it carefully and jot down any questions you might have so that we can discuss them. If we decide that we will be working together, you will be asked to sign a document containing this information, which will act as a financial agreement between us, and function as consent to receive services. Potential clients are required to review and sign off on having read this information prior to engaging in our work together.
Telehealth Services
TeleHealth provision of care involves the use of audio, video or other electronic communications to interact with you. TeleHealth appointments with me, Dr. Lack, or “Exceptionally Wired” consultations are conducted by videoconferencing using a HIPPA compliant platform or by telephone conference. There are potential risks to this technology including interruptions, technical difficulties or possible unauthorized access. While there is increased convenience or access, it is still unclear if this form of intervention is any less or more effective than when the client/parent and provider are in the same room. Face-to-face services will resume in the near future.
The Process of Psychotherapy, Counseling, Coaching, or Consultation (P/C/C/C)
For individual Psychotherapy/Therapy, Counseling, or Coaching our initial contact is your inquiry e-mail, after which we chat for a 10-15 minute free consult to answer questions not answered by this policy page, and determine if you wish to book a first meeting which right now would be virtual and usually runs 1-1.5 clinical hours (clinical hour is 50 minutes). In this first meeting you fill me in on the reason you are seeking my services, any target you have in mind for our collaboration, we review the history of your concern/goal, what you have tried thus far, and what is going well. We also gather more information about facets of your life to help clarify the path forward, and supplement this with filling out some forms, questionnaires, or screening tools. We then define the focus of our work together and generate intervention options. Individual psychotherapy/counseling/coaching sessions are conducted weekly or bi-weekly in person, usually lasting between 50-60 minutes. For people with slower processing they may run longer. Consultation timing is similar or longer depending on the service (Family consult, In-service education can run longer).
Cancellation Policy
Given that a booked appointment is a time reserved for you, we require 48 business hours-notice if you need to change, cancel, or postpone a previously scheduled appointment without incurring the full charge for the appointment. Please note that most insurance companies do not reimburse for missed sessions. I will do my best to try to rebook you within the same week, free of charge, dependent upon my availability.
Payment in Full at Time of Service
Once services are rendered and paid for, I do not provide refunds, regardless of insurance company reimbursement decisions in the future. It is your responsibility to verify the specifics of your insurance coverage if relevant, and it is your responsibility to pay for services rendered by this practice.
Parent Authorization for Working with Minors
In order to authorize services for your child, you must have either sole or joint legal custody of your child. If you are, or become, separated or divorced from the other parent of your child, please notify us. You will be asked you to provide us a copy of the most recent custody decree that establishes custody rights or otherwise demonstrates that you have the right to authorize treatment for your child. While it is understood that not all parents agree with initiation of this work, that discrepancy can impact the situation and the work. It is important that parents have the right to know, unless there are extenuating circumstances, that their child is receiving evaluation or care, even if that is part of the initial conversations.
Engaging with minors, and young adults often involves parent coaching, psychoeducation or family meetings or consultation to ensure continuity and lasting support toward goals. Telehealth is not ideal for younger children or even some teens and so alternative options may be suggested.
Discussion of Intervention
I offer a free 10-15 minute phone consultation to get started. Visit the contact me page to send me an e-mail, and be sure to provide me your phone contact information and good times to reach you.
From the intake/evaluation/consultation will emerge a collaborative understanding of the nature of the services requested, the target of our work with possible directions, methods, and objectives, a sense of ‘goodness of fit.’ and identification of barriers, if any, to progress. If you have any unanswered questions about any of the procedures used in the course of our work, their possible risks, our expertise in employing them, or about the plan, please ask, and answers will be provided. If you or the child could benefit from any services that we do not provide, we have an ethical obligation to assist you in obtaining those services.
As a licensed psychologist in the state of Massachusetts, it is within the scope of my license, training, experience, and practice to provide counseling, psychotherapy, coaching, and consultation models of service. My style is active, collaborative, present and future oriented, yet I am trained to recognize the impact and complexities of the past, biology, neurology, social, and emotional dynamics, and to provide diagnoses and treatment when appropriate.
At the present time, ethics and laws prevent me from practicing “psychology” beyond the borders of the state of Massachusetts. As a nationally board certified, registered “art therapist” however, jurisdiction is not limited. I am authorized to provide clinical art therapy within and beyond the state of Massachusetts. Services rendered to clients outside the state of Massachusetts, therefore, must fall within the rubric of coaching, parent support, art therapy, education, training, supervision, or consultation, for which most insurance companies do not reimburse, and are offered via my coaching/education/consultation organization “Exceptionally WiredTM”.
Experience of Psychotherapy/Counseling/Coaching/Consultation
P/C/C/C can have benefits and risks. Since receiving services often involves discussing both positive and or unpleasant or difficult aspects of one’s life, one may experience uncomfortable feelings en route to one’s goals, or that are expected as healthy coping with challenging circumstances. Learning to be present and compassionate toward all facets of ourselves is an admirable aspirational goal. So too is expressing one’s intensity in a healthy manner and integrating various perspectives via self-reflection. P/C/C/C has also been shown by research to have benefits such as enhanced interrelationship between one’s mind, body, values, actions, behaviors, relationships and environment, and gaining a sense of clarity and direction to one’s life. Many of my clients say they ‘know what they need to do but can’t get themselves to do it”. Clients with challenges, or in need of healing, generally learn strategies and devise actionable solutions to grow and transform in a positive direction. But there are no guarantees of what you (or your child) may experience. Working together, whether using a psychotherapy/counseling or consultation/coaching model, calls for active effort on your part. Success usually involves your willingness to work on content in and outside of the appointments.
Termination
If at any point during receipt of services you are dissatisfied with the progress toward agreed upon goals, we are mutually responsible to discuss it, and may, if appropriate, revise or terminate services. If referral is the desired outcome, we will make every attempt to provide you at least one referral that may be of help to you or your child. If you request it and authorize it in writing, we will talk to the provider of your choice in order to help with the transition. If at any time you want another professional’s opinion or wish to consult with another practitioner, we will assist you in finding someone qualified. You have the right to terminate services at any time. If you choose to do so, we will offer to provide you with names of other qualified professionals whose services you might prefer.
Contacting Us
When I am in the office, I am usually seeing clients, so am likely not immediately available by telephone. When unavailable, my telephone is answered by voicemail. It is best to email me. I will make every effort to return your communication within a few days, with the exception of weekends, holidays and vacations. If you are unable to reach me and feel you cannot wait for a returned call, contact your family physician or the nearest emergency room and ask for the psychologist on call. If I will be unavailable for an extended time, we will provide you with the name of a colleague to contact, if necessary. Communication pertaining to last minute issues related to imminent appointments are best communicated via e-mail at HL@DrHeidiLack.com, and will be responded to when I am not in session. At this juncture, I do not text with clients, ‘friend’ or ‘follow’ clients on social media.
Minors
If you are under 18 years of age, please be aware that the law may provide your parents the right to examine your treatment records. It is our policy to request an agreement from your parents that they agree to give up access to your records. If they agree, we will provide them only with general information about our work together, unless we feel there is high risk that you will seriously harm yourself or someone else. In this case, we will notify them of our concern.
Research/Education
I may contribute to the scientific community by integrating research and education into my practice. I would like your permission to use your or your child’s data anonymously for research or educational purposes. All identifying information (e.g., names, birthdays, background information, etc.) will be removed. In addition, data will be aggregated so the individual client’s data will not be identifiable. There are no foreseeable risks or discomforts to the client for taking part in any study, and any data used will be will be handled in a highly confidential manner. Only I or any future staff who de-identify the files will know that you have decided to provide permission for the data to be used. Outside researchers will never have access to you or your child’s identity. Any reports or publications based on this research will use only group data and will not identify you or your child or any individual as being part of this project. The decision to participate in this research is up to you. Your permission would be requested to use case study information for teaching purposes. We will be happy to answer any questions you have about our ongoing studies or teaching. If you have further questions about research or teaching you may contact me directly.
Confidentiality
All information disclosed within sessions and the written records pertaining to those sessions, are confidential and may not be revealed to anyone without your (client’s) written permission, except where disclosure is required by law.
When Disclosure Is Required by Law
Some of the circumstances in which disclosure is required by the law are: when there is a reasonable suspicion of child, dependent, or elder abuse or neglect; when a client presents a danger to self, to others, to property, or is gravely disabled.
When Disclosure May be Required
Disclosure may be required pursuant to a legal proceeding. If you place your or your child’s mental status at issue in litigation initiated by you, the defendant may have the right to obtain mental health records and/or my testimony. In couples and family work, or when different family members are seen individually, confidentiality and privilege do not apply between the couple or among family members. I will use my clinical judgment when revealing such information. I will not release records to any outside party unless I am authorized to do so by all adult family members who were part of the services agreement.
Confidentiality of Email, Cellphone, Fax, Zoom, and Credit Card Communication
It is very important to be aware that e-mail, texts and cell phone (also cordless phones) communication can be relatively easily accessed by unauthorized people and hence, the privacy and confidentiality of such communication can be easily compromised. Emails, in particular, are vulnerable to such unauthorized access due to the fact that servers have unlimited and direct access to all emails that go through them. Faxes and emails can be sent erroneously to the wrong address. The form of videoconferencing and Credit Card processing utilized in this practice for TeleHealth is for professional paid use, encrypted, and HIPAA compliant, however, no practice can guarantee there will never be breaches to the databases of these companies. While Dr. Lack has made a good faith effort to ensure confidentiality of all technical aspects of this practice, neither the practice, “Exceptionally WiredTM“, nor Dr. Heidi Lack may be held responsible or liable for any repercussions arising from third party violations of confidentiality, anonymity, or breaches of private information. Please notify us at the beginning of services if you decide to avoid or limit in any way the use of any or all of the above-mentioned communication or processing systems. Please do not use email or faxes in emergency situations. Head to your local emergency room, or call 911.
Outside Consultation
On occasion I will seek professional consultation in order to provide the highest and most effective level of care, psychotherapy, counseling, coaching and consultation. Signing this agreement gives me, Dr. Heidi Lack and “Exceptionally WiredTM” permission to anonymously consult about my/my child’s needs when she determines it will be helpful to me/my child’s progress. Initial
E-Newsletter
I agree to receive email communications from Dr. Heidi Lack, including the monthly e-newsletter, and other updates on groups, workshops or event information. Initial
Emergencies
If you are in a medical or mental health crisis, please contact your local emergency room or call the local emergency number, in MA, 911. If there is an emergency during our work together, or in the future after termination, when I become concerned about you or your child’s personal safety, the possibility of you or your child injuring someone else, or about you or your child receiving proper psychiatric care, I will do whatever I can within the limits of the law, to prevent you or your child from injuring yourself or others, and to ensure that you or your child receive the proper medical care. This may include contacting an identified emergency contact or mandated reporter in your state. Excluded from this mandate are conversations pertaining to medical assisted end of life options.
Litigation Limitation
Due to the nature of any clinical, evaluative, therapeutic, growth process and the fact that it often involves making a disclosures or personal nature, about many matters which may be of a confidential nature, it is agreed that should there be legal proceedings (such as, but not limited to divorce and custody disputes, injuries, lawsuits, etc…), neither you (client’s) nor your attorneys, nor anyone else acting on your behalf will call on us to testify in court or at any other proceeding, nor will a disclosure of the psychotherapy/counseling/coaching/consultation records be requested. If you become involved in a legal proceeding that requires our participation, however, you will be expected to pay for our professional time, even if we are called to testify by another party. Due to the particularly demanding requirements of the legal system, we charge $500 per hour for these services, regardless of which “side” of a legal conflict calls on us to participate.