WELCOME TO THE CENTER FOR RELATIONAL CARE (CRC)
Thank you for choosing to share a part of your life with us. We count it a privilege to work with you and will do our best to merit your trust. The relationship we have with you is an essential part of a successful counseling or consulting process. Therefore, we have prepared this information to inform you of our basic policies and procedures. If you have any questions about this information, please ask the receptionist or your counselor. Within the bounds of our expertise and ethical standards, we will help you to resolve the issues or problems that prompted you to seek our services.
WHO WE ARE
The purpose of the Center for Relational Care is to facilitate healing, growth, and reconciliation for marriages, families, and individuals. We also equip local churches to more effectively give care within their congregations and communities. In pursuit of this mission, our staff provides professional and pastoral counseling services to the general public and training and consulting for other counselors and church leaders. The CRC staff strives to help people develop themselves and their relationships with God and others so that their lives may be satisfying and productive. We work to help people address problems and experience freedom from obstacles to healthy, abundant living. In so doing, our staff facilitates the healing and transforming work of Jesus Christ in a confidential and compassionate manner. CRC counselors are gifted, caring, and committed Christians with advanced education and training. All CRC counselors hold master’s or doctorates in psychology, counseling, social work, theology and/or religious education. Though trained and willing to address spiritual issues, our staff will not impose their own beliefs on clients.
STANDARD SERVICES
Our counseling center provides marital, individual, child and family therapy for personal development and treatment of a variety of issues of an emotional, psychological, and spiritual nature. All CRC staff are trained in counseling approaches designed to bring about positive change in relationships and personal wholeness. Most CRC therapists have specialized training, certification and expertise in clinically respected therapeutic modalities such as play therapy for children and EMDR therapy for symptoms resulting from trauma and post- traumatic stress. We work with couples, children, adolescents, and single adults of all ages. If a need for medical treatment is indicated, CRC staff can help identify and refer you to other medical professionals for evaluation and medical care.
THE PROCESS OF THERAPEUTIC COUNSELING
Participation in therapy can result in a number of benefits to you, including improving interpersonal and spiritual relationships and resolution of specific concerns or symptoms that led you to seek therapy. Although there are no promises or guarantees of what you will experience or benefits you will receive, CRC's counseling has been shown to improve and deepen intimacy in relationships, provide solutions to specific problems and reduce feelings of distress.
A part of this experience can also be an increased awareness of feelings like hurt, sadness, frustration, guilt, and memories of unpleasant events. Your counselor will help you process your important experiences and emotions. Your counseling is most likely to be beneficial through your active involvement, sincere honesty and your commitment to working on the important relationships in your life. Working toward progress, growth and healing requires a collaborative effort on your part both within and outside of sessions.
CONFIDENTIALITY FOR COUNSELING
All counseling relationships and sessions are held in the strictest confidence. The staff of CRC will not knowingly acknowledge a counseling relationship and/or any communication concerning a client without the client's express written permission except in the following circumstances required by law:
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When there is reasonable suspicion that abuse or neglect of a child, elderly or disabled person has occurred, your Counselor is required to file a report with the proper authorities within 48 hours;
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When we reasonably believe that a client presents a danger to self or others, we may contact medical or law enforcement authorities. In addition, by your initials and signature, you further authorize your Counselor to disclose information deemed necessary to a spouse, parent or guardian, and/or to the intended victim.
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If our records are subpoenaed by any person or entity, the Counselor will contact the clients to make them aware of the subpoena and give them the chance to challenge it. By your signature below, you expressly authorize the Counselor to comply with any legally issued subpoena and provide records or testimony without the need for a separate authorization or release.
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When the Counselor is court ordered to testify or provide records to any person or entity.
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When the records are requested by any state or federal agency.
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Any other circumstance as outlined in the Notice of Privacy Practices.
If you and your Counselor see each other in a setting other than office, be it public, business or social, your Counselor will not speak to you or otherwise acknowledge that you know each other. If you decide to initiate a greeting, your Counselor will respond. If you do not, your Counselor will not signal verbally or non-verbally that you know each other. By your signature below, you indicate that you have been advised of this policy and you agree to abide by it.
As part of our counseling staff environment, CRC counselors anonymously staff cases in consultations for professional development in accordance with ethical principles of maintaining quality standard of care.
CONFIDENTIALITY ISSUES FOR MINORS
Our family and children’s therapists ask additional considerations on the part of the parents when a minor is the primary client. First, it is your responsibility as a parent to notify your therapist and anyone else so ordered if there is a court order influencing communication about counseling. Open communication among all parties, when possible, is the best philosophy. Secondly, we ask that parents respect their children’s privacy by allowing the therapist to take the lead on communicating relevant details from sessions. As a family-based model, we pursue treatment of familial relationships and will involve parents as soon as the therapist determines it is in your child’s best interest for parent involvement in the counseling work.
EMERGENCIES
Counselors at CRC do not provide 24-hour availability of services. If you have an emergency or crisis and are unable to reach your Counselor during or after regular business hours, you or someone you trust should call your local hospital emergency room, your medical doctor or 911. If during the course of your counseling experience your Counselor assesses that you are at risk for harming yourself or others, they may take steps to contact emergency personnel to advocate for your care and safety or the protection of others. Please do not use email, fax or text to communicate emergencies to your counselor.
LIMITATIONS OF THERAPY
Your Counselor will not offer a diagnosis for medical conditions, although he/she may recommend a medical exam to rule out possible physical issues/problems as a cause of any mental health symptoms. If you have a known medical condition, please let your Counselor know. With your permission, your Counselor will work closely with your physician to ensure the compatibility of your treatment. Your Counselor cannot prescribe medication. If it is determined that a medical evaluation is appropriate, your Counselor may refer you to a medical professional who can fully decide for medical help as a part of treatment. Your Counselor will not make recommendations regarding custody, visitation or parental access to children or any matters pertaining to the “best interest of the child” in Suits Affecting the Parent-Child Relationship (SAPCR), adoption or termination proceedings.
DURATION AND CHARGES FOR SERVICES RENDERED
The length of therapy is dependent on many factors, including the type and severity of the presented issues. At the beginning of therapy, your Counselor will perform an assessment and work with you to develop a plan for your therapeutic treatment.
CRC is a 501(c)(3) non-profit ministry that meets its expenses primarily through fees consistent with area norms for professional counseling. Standard fees, based upon session length and format of the session, follow:
Counselors
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Standard Fees
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Dr. Courtney Putnam, LPC, CPCS
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$150.00 / 50 minutes
$225.00 / 80 minutes
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Licensed Professional Counselors (LPCs) and Marriage and Family Therapists (MFTs) with Advanced Degrees or Specialization
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$125.00 / 50 minutes
$187.50 / 80 minutes
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Licensed Professional Counselors (LPCs) and Marriage and Family Therapists (MFTs)
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$110.00 / 50 minutes
$165.00 / 80 minutes
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Associate Professional Counselors (APCs) and Associate Marriage and Family Therapists (AMFTs)
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$ 90.00-$100.00 / 50 minutes
$135.00-$150.00 / 80 minutes
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Graduate Student Interns
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$ 40.00 / 50 minutes
$ 60.00 / 80 minutes
(Initial Free Assessment)
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Phone Consultation Fees
Telephone consultations are charged in 15-minute increments at the counselor's normal rate.
Mini Intensives
A Mini Intensive is an appointment scheduled for 4 or more hours of counseling for an individual, couple, or family that is not considered pre-work for an Intensive. All mini intensives require a deposit of 50% of the projected total fee (the number of scheduled hours at your Counselor’s normal hourly rate) with a maximum $500. The deposit is non-refundable. A deposit may be used for a rescheduled Mini Intensive as long as it is rescheduled at least 7 calendar days prior to the date of the original mini intensive. If the rescheduling is done inside of the 7-day window, the deferral of the deposit to a different date is at the discretion of CRC. Mini intensives canceled less than 24 hours in advance are subject to full charge. The deposit must be used within 180 days of the date the deposit is made; otherwise the deposit will be forfeited. The deposit may be transferred to another couple or individual at the discretion of the CRC.
The deposit payment will be applied to the total balance for the scheduled Mini Intensive. The final balance due is the actual number of hours spent in session at your Counselor’s rate, minus the deposit. Payment will be due upon the completion of Mini Intensives unless other arrangements have been made with CRC.
Fees for requests for client records
You have the right to review or receive a summary of your records at any time, except in limited legal circumstances or situations when such release might be harmful to you or others. All requests for records must be submitted in writing to the attention of your counselor by email to info@relationalcare.org or faxed to 512.492.6201. Fees for the copying of records provided will be charged at a minimum of $25.00 for the first 50 pages, and then $0.25 cents per page for each page thereafter. We are required by law to provide records to you within fifteen (15) days of receiving a written request in non-emergency situations.
Fees for depositions and court testimony
CRC counselors prefer to remain uninvolved in clients’ legal matters, including any interaction with a court system or an attorney, as it often compromises the therapeutic relationship. If your counselor is subpoenaed for depositions and court testimony, fees will be billed at the rate of $200 per hour. By your signature below, you agree to pay the rate of $200 per hour for the Counselor’s preparation time, point-to-point travel time, actual time on location by the counselor to attend a hearing, give a deposition or testify in court, and the costs of complying with a subpoena for records or testimony regardless of which party issued the subpoena, and you agree to pay the itemized charges upon receipt of an invoice.
TERMINATION OF THERAPY
You and your Counselor will determine when it is time for your therapy to end. While you are free to end your therapy at any time, it is more beneficial for you if the end of therapy is planned in advance. You will have a role in determining when you have accomplished the stated therapeutic goals. Your Counselor is ethically bound to terminate therapy if he/she determines that you are not benefitting from therapy, if he/she determines that your therapeutic needs are beyond the scope of his/her training, or if there is a conflict that makes further treatment inadvisable. Should any of these situations occur, your Counselor will refer you to other therapists who have specialized training or whose treatment might benefit you.
Additionally, due to the nature of the therapeutic process and the fact that it often involves making a full disclosure with regard to matters of a confidential nature, should there be legal proceedings (including but not limited to divorce and custody disputes, injuries, lawsuits, etc.), therapy may be terminated at the discretion of your Counselor.
By your signature below, you agree that your Counselor’s decision in these matters will be final.
APPOINTMENTS AND CANCELLATIONS
You may schedule your next appointment while you are in the office or by calling 678-653-3272 or toll free 877-567-5656 at your convenience. It is the responsibility of the client/s to remember appointments and allow for traffic delays, work demands and other personal conflicts. Arriving late, missing appointments or late appointment cancellations hinder our ability to provide proper care to you and other clients. We will make every reasonable effort to accommodate changes in your schedule as long as you notify us at least 24 hours in advance. Appointments canceled fewer than 24 hours in advance are subject to full charge. Monday appointments must be canceled by noon on the preceding Friday. Life-threatening emergencies or serious illnesses will be considered grounds for waiving such charges at the discretion of your counselor.
PAYMENT AND INSURANCE
Payment is due upon arrival for your session unless other arrangements have been made in advance. We accept checks, all major credit cards or cash (please bring correct change or the difference will be credited to your account). The client acknowledges being informed of the option to save a credit card on file and that by consenting to save their credit card on file they are permitting CRC to use the credit card for valid charges owed to CRC on the account under which that the credit card. It is the responsibility of the client to communicate any changes to a credit card that is saved on file prior to the session the new card is intended to be used. In addition to the amount due for a session, in the event a check is returned or a credit card charge is disputed for a valid charge made by CRC, a fee of $25 will be charged to the client.
Sometimes medical insurance may be applied to the cost of professional counseling. CRC is considered out-of- network for all insurance and does not file insurance claims for clients. Since our office doesn’t handle insurance, clients should call their own insurance company to see if they will pay reimbursement for out-of-network psychotherapy and what the procedure is for the client to file. Your health insurance carrier or HMO/PPO/MCO/EAP may require the disclosure of confidential information in order to process your claims. Only information required for billing and authorization will be disclosed by CRC. This does, however, require disclosure of diagnostic codes and CPT procedure codes. Counselors will provide the client with these necessary codes to assist them in filing insurance claims. Clients pay CRC in full and they receive a Statement of Services that includes all necessary information so that they can submit to their insurance company for reimbursement. CRC cannot guarantee insurance reimbursement and it is the responsibility of the client to call their insurance company prior to future counseling appointment.
POLICY ON SOCIAL NETWORKING AND ELECTRONIC COMMUNICATIONS
CRC is committed to following state and federal confidentiality guidelines for protection of the privacy of client sessions and records. To provide for protection of your privacy, a confidential voice mailbox is available for leaving messages for your counselor. Should you choose to send an email to your Counselor, CRC cannot guarantee the protection of the information in an email or text. By signing below, you are acknowledging that you have been informed that if you choose to send an email or text to your Counselor, CRC cannot guarantee the protection of the information in the email.
Your Counselor will not engage in social networking with clients on any social networking site such as Facebook, LinkedIn, Instagram, Twitter or any other social networking site. Please do not send “friend” requests to your Counselor or otherwise communicate with your Counselor through any interactive or social networking websites.
The Counselors at the Center for Relational Care would never post information about a client on a public website. We ask that you respect your Counselor’s privacy and refrain from posting any “reviews” or other information regarding this practice or your Counselor on any website such as Health Grades, Angie’s List, or other forum for posting public reviews of health care providers. By your signature below, you agree that you will not post any “review” or any other information on any such public website. If you refuse to abide by this stated professional boundary, your Counselor may terminate your professional relationship and refer you to other mental health professionals.
CONTACTS FOR COMPLAINTS OR CONCERNS
If you have any complaints or concerns about your Counselor, you may contact Courtney Putnam, Director for the Center for Relational Care Atlanta at 678-653-3237. You may also file a complaint with the Counselor’s licensing board. The Georgia Composite Board of Professional Counselors, Social Workers, and Marriage and Family Therapists regulates the practice of Licensed Professional Counselors (LPCs) and the practice of Marriage and Family Therapists (MFTs). You may call the complaint hot line (1-487-207-2440) to request a complaint form for both licenses or obtain more information. You can also send a complaint to the Georgia Composite Board of Professional Counselors, Social Workers, and Marriage and Family Therapists at 237 Coliseum Drive, Macon, GA 31217-3858. If you have a complaint concerning the HIPAA Privacy Regulations, you may contact Jim Walter at 512-492-6200, or the U. S. Department of Health and Human Services, Office for Civil Rights, at OCRMail@hhs.gov.
YOUR AGREEMENT
I have read this entire Agreement carefully. I understand the terms of this Agreement and I agree to comply with them. I agree that this Agreement will stay in effect until I revoke it in writing. I understand that any written revocation must be dated AFTER the date of this Agreement and must be provided to my Counselor at the Center for Relational Care. A copy of this Agreement has the same force and effect as the original.