This form is in addition to the standard Therapy Policy and Consent for Treatment Form and Notice of Privacy Practices for Protected Health Information commonly known as HIPAA. You must sign both in order to participate in Mental Telehealth sessions. Mental Telehealth involves one-on-one videoconference counseling. Prior to engaging in Mental Telehealth, an assessment/consultation will be done to assure that Mental Telehealth is an appropriate form of treatment. This is to inform you about what you can expect regarding your participation in Mental Telehealth.
Benefits to Mental Telehealth include but are not limited to:
-Ability to expand your choice of service provider.
-More convenient counseling options including location, time, no driving, etc.
-Reduction in overall cost and time of therapy due to elimination of physical transportation.
-Real time monitoring and reduction in wait time for scheduling office appointments.
-Increased availability of services to homebound clients, clients with limited mobility, and clients without convenient transportation options
It is important to note that there are limitations to Mental Telehealth that can affect the quality of the session(s). These limitations include but are not limited to:
-Limitations to perception of nonverbal communication cues (e.g., facial expression, body language).
-Auditory (sound) limitations requiring greater need for repetition and clarification.
-Technology failures before or during the Mental Telehealth session.
-Despite every effort made to reduce confidentiality breaches, such breaches could occur for various reasons.
-To reduce the effect of these limitations, I may ask you to describe how you are feeling, thinking, and/or acting in more detail than I would during a face-to-face session. You may likewise feel a need to describe your feelings, thoughts, and/or actions in more detail than you would during a face-to-face session.