Welcome to The Center for Living Balance. We are pleased that you selected our facility for your therapy, and we are sincerely looking forward to assisting you. This document is designed to inform you about what you can expect from your therapist or group leader, policies regarding confidentiality and emergencies, and other details regarding your treatment at The Center for Living Balance. Although providing this document is part of an ethical obligation to our profession, more importantly, it is part of our commitment to you to keep you fully informed of every part of your therapeutic experience. Please know that your relationship with your therapist or group leader is a collaborative one, and we welcome any questions, comments, or suggestions regarding your course of therapy at any time.

Amy Jaynes is the CEO and founder of The Center for Living Balance and currently serves as the Clinical Co-Director. She is a Licensed Professional Counselor (LPC) in the State of Georgia, Nationally Certified Counselor, and Certified Rehabilitation Counselor. She received her undergraduate degree in Psychology from The University of Georgia and her master’s degree in Rehabilitation Counseling from Georgia State University. In addition to the above credentials, Amy has advanced training in Emotionally Focused Therapy for Couples (EFT), Affiar and Betrayal Recovery, Emotionally Focused Family Therapy (EFFT), Emotionally Focused Individual Therapy (EFIT), Divorce Discernment Counseling, Eating Disorder Treatment, Chronic Illness and Disability Adjustment, and Motivational Interviewing (MI). While all of Amy's work is infomred by John Bowlby's Attachment Theory, the majority of her current works is focused on relationships—including marriage and couple counseling, attachment injury repair, the impact on illness/disability on romanitic relationships, and women’s relationships with their bodies and food. Additional information regarding Amy’s educational background and experience may be found on our website under her name. Please feel free to view that information at www.centerforlivingbalance.com.

It is our belief that as people become more aware of and accepting of themselves and their partner(s), they are more capable of finding a sense of peace and contentment in their lives. However, self-awareness and self-acceptance are goals that may take a long time to achieve. Some clients need only a few sessions to achieve these goals, whereas others may require months or even years of therapy. As a client, you are in complete control, and you may end your relationship with your therapist/group leader at any point.

In order for therapy to be most successful, it is important for you to take an active role. This means working on the things you and your therapist talk about both during and between sessions. This also means avoiding any mind-altering substances like alcohol or non-prescription drugs for at least eight hours prior to your therapy sessions. Generally, the more of yourself you are willing to invest, the greater the return.

Furthermore, it is our policy to only see clients who we believe have the capacity to resolve their own problems with our assistance. It is our intention to empower you in your growth process to the degree that you are capable of facing life’s challenges in the future without your therapist. We also don’t believe in creating dependency or prolonging therapy if the therapeutic intervention does not seem to be helping. If this is the case, your therapist will direct you to other resources that will be of assistance to you. Your personal development is our number one priority. We encourage you to let us know if you feel that transferring to another facility or another therapist is necessary at any time. Our goal is to facilitate healing and growth, and we are very committed to helping you in whatever way seems to produce maximum benefit. If at any point you are unable to keep your appointments or we don't hear from you for one month, we will need to close your chart. However, reopening your chart and resuming treatment is always an option.

Your communications with your therapist will become part of a clinical record of treatment, and it is referred to as Protected Health Information (PHI). Your PHI will be kept in a file stored in a locked filing cabinet in our locked office. Additionally, our practice uses HIPAA Compliant electronic medical records software, called My Clients Plus and their scheduling software Jituzu. Our phone systems are a HIPAA compliant software called Spruce. Our office also has  Business Service Agreements with Google and JotForm to provide wordprocessing, spreadsheet, and form submission services to our office in compliance with HIPAA. We use Square to process credit card transactions.

Your therapist will always keep everything you say to him or her completely confidential, with the following exceptions: (1) you direct your therapist to tell someone else and you sign a “Release of Information” form; (2) your therapist determines that you are a danger to yourself or to others; (3) you report information about the abuse of a child, an elderly person, or a disabled individual who may require protection; or (4) your therapist is ordered by a judge to disclose information. In the latter case, your therapist’s license does provide him or her with the ability to uphold what is legally termed “privileged communication.” Privileged communication is your right as a client to have a confidential relationship with a counselor. This state has a very good track record in respecting this legal right. If for some unusual reason a judge were to order the disclosure of your private information, this order can be appealed. We cannot guarantee that the appeal will be sustained, but we will do everything in our power to keep what you say confidential.

Please note that in relationship (couples or family) counseling, your therapist does not agree to keep secrets. Information revealed in any context may be discussed with any party involved in treatment. Additionally, these records are treated differently that individual counseling records. The relationship holds the confidentiality in these cases and all adult parties must sign consent to release information or records request form in the case of the need to consult or report data.

At your intake appointment, your therapist will work with you to assess your needs, level of care, symptoms, and goals. You will work together to develop a treatment plan based on your clinical needs.

If you are seeking services for your minor child, you and the other parent/guardians will meet with your therapist for an initial intake appointment without the minor child. This allows the therapist to collect necessary information and get a clear understanding of your goals of the therapeutic process. Please bring any custody documents, divorce decrees, or other formalized parenting plans to the intake session. In cases of divorce and legal separation, we cannot provide treatment services without these legal documents.

In general, your therapist agrees to provide psychotherapy at the fee schedule below:

50 min individual counseling session - $200.00

50 min couples counseling session - $200.00

100 min discernment counseling session - $400.00

Phone consultations between sessions - $8.00/min

Form completion (per 5 pages)

Letter writing - $75.00

Returned check fee - $50.00

Doing psychotherapy by telephone is not ideal and needing to talk to your therapist between sessions may indicate that you need extra support. If this is the case, you and your therapist will need to explore adding sessions or developing other resources you have available to help you.

The fee for each session will be due at the beginning of the session. Cash, personal checks, Visa, MasterCard, Discover, or American Express are acceptable for payment, and your therapist will provide you with a receipt of payment. The receipt of payment may also be used as a statement for insurance if applicable to you. Fees for missed or late-canceled appointments must be paid prior to scheduling future appointments.

Insurance companies have many rules and requirements specific to certain plans. Unless otherwise negotiated, it is your responsibility to find out your insurance company’s policies and to file for insurance reimbursement. Your therapist will be glad to provide you with a statement for your insurance company and to assist you with any questions you may have in this area.

In the event that you are unable to keep an appointment, you must notify your therapist at least 24 hours in advance. If such advance notice is not received, you will be financially responsible for the session you missed. You will be billed the full session fee for any missed session without 24 hour notification. 24 hour notice for an 8:00am appointment would be 8:00am the previous business day. Monday appointments need to be canceled or changed by the scheduled appointment time on Friday. One exception to this policy per client is granted once per calendar year. All additional missed or late-canceled sessions will be billed at the full rate, regardless of circumstances.

The Center for Living Balance is considered to be an outpatient facility, and we are set up to accommodate individuals, couples, and families who are reasonably safe and resourceful. We do not carry beepers nor are we available at all times. If at any time this does not feel like sufficient support, please inform your therapist, and he or she can discuss additional resources or transfer your case to a therapist or clinic with 24-hour availability. Generally, your therapist will return phone calls within 24-48 hours. If you have a mental health emergency, we encourage you not to wait for a call back, but to do one or more of the following:

• Call Behavioral Health Li nk/G CAL: 800 - 715 - 4225
• Call Ridgevi ew Institute at 770.434.4567 or Piedmont Hospit al Fayet teville at 770 - 719 - 7000
• Call Peachford Hospital at 770.454.5589
• Call Lifeline at (800) 273 - 8255 (National Crisis Line)
• Call 911.
• Go to the emergency room of your cho ice .

Psychotherapy is a professional service we will provide to you. Because of the nature of therapy, your relationship with your therapist has to be different from most relationships. It may differ in how long it lasts, the objectives, or the topics discussed. It must also be limited to only the relationship of therapist and client. If you and your therapist were to interact in any other ways, you would then have a "dual relationship," which could prove to be harmful to you in the long run and is, therefore, unethical in the mental health profession. Dual relationships can set up conflicts between the therapist's interests and the client’s interests, and then the client’s (your) interests might not be put first. In order to offer all of our clients the best care, your therapist’s judgment needs to be unselfish and purely focused on your needs. This is why your relationship with your therapist must remain professional in nature.

Additionally, there are important differences between therapy and friendship. Friends may see your position only from their personal viewpoints and experiences. Friends may want to find quick and easy solutions to your problems so that they can feel helpful. These short-term solutions may not be in your long-term best interest. Friends do not usually follow up on their advice to see whether it was useful. They may need to have you do what they advise. A therapist offers you choices and helps you choose what is best for you. A therapist helps you learn how to solve problems better and make better decisions. A therapist's responses to your situation are based on tested theories and methods of change.

You should also know that therapists are required to keep the identity of their clients confidential. As much as your therapist would like to, for your confidentiality he or she will not address you in public unless you speak to him or her first. Your therapist also must decline any invitation to attend gatherings with your family or friends. Lastly, when your therapy is completed, your therapist will not be able to be a friend to you like your other friends. In sum, it is the duty of your therapist to always maintain a professional role. Please note that these guidelines are not meant to be discourteous in any way, they are strictly for your long-term protection.

The Center for Living Balance assures you that our services will be rendered in a professional manner consistent with the ethical standards of the American Counseling Association. If at any time you feel that your therapist is not performing in an ethical or professional manner, we ask that you please let him or her know immediately. If the two of you are unable to resolve your concern, please contact one of the Clinical Co Directors (Amy Jaynes, LPC and Deana Riley, LPC) at 770-451-0404.

Due to the very nature of psychotherapy, as much as we would like to guarantee specific results regarding your therapeutic goals, we are unable to do so. However, your therapist, with your participation, will work to achieve the best possible results for you. Please also be aware that changes made in therapy may affect other people in your life. For example, an increase in your assertiveness may not always be welcomed by others. It is our intention to help you manage changes in your interpersonal relationships as they arise, but it is important for you to be aware of this possibility nonetheless.

Additionally, at times people find that they feel somewhat worse when they first start therapy before they begin to feel better. This may occur as you begin discussing certain sensitive areas of your life. However, a topic usually isn’t sensitive unless it needs attention. Therefore, discovering the discomfort is actually a success. Once you and your therapist are able to target your specific treatment needs and the particular modalities that work the best for you, help is generally on the way.

In our ever-changing technological society, there are several ways we could potentially communicate and/or follow each other electronically. It is of utmost importance to us that we maintain your confidentiality, respect your boundaries, and ascertain that your relationship with your therapist remains therapeutic and professional. Therefore, we’ve developed the following policies:

Cell phones: It is important for you to know that cell phones may not be completely secure and confidential.

However, we realize that most people have and utilize a cell phone. Your therapist may also use a cell phone to contact you. If this is a problem, please feel free to discuss this with your therapist.

Text Messaging and Email: Both text messaging and emailing are not secure means of communication and may compromise your confidentiality. However, we realize that many people prefer to text and/or email because it is a quick way to convey information. If you choose to utilize texting or email, please discuss this with your therapist. However, please know that it is our policy to utilize these means of communication strictly for appointment confirmations (nothing that anyone could infer as therapy). Please do not bring up any therapeutic content via text or email to prevent compromising your confidentiality. If you do, please know that your therapist will not respond.

You also need to know that we are required to keep a summary or a copy of all emails and texts as part of your clinical record that address anything related to therapy.

Facebook, LinkedIn, Instagram, Pinterest, Twitter, Etc: It is our policy not to accept requests from any current or former client on social networking sites such as Facebook, LinkedIn, Instagram, Pinterest, etc. because it may compromise your confidentiality. The Center for Living Balance has a business Facebook page, Instagram account, and is on LinkedIn. You are welcome to follow us on any of these pages. However, please do so only if you are comfortable with the general public being aware of the fact that your name is attached to The Center for Living Balance. Please refrain from making contact with us using social media messaging systems such as Facebook Messenger or Twitter Direct Message. These methods have insufficient security, and we do not watch them closely. We would not want to miss an important message from you.

Google, Bing, etc.: It is our policy not to search for our clients on Google or any other search engine. We respect your privacy and make it a policy to allow you to share information about yourself to your therapist as you feel appropriate. If there is content on the Internet that you would like to share with your therapist for therapeutic reasons, please print this material out and bring it to your session.

Blog: We may post therapeutic content on our blog. If you have an interest in following our blog, you are welcome to. However, please do so only if you are comfortable with the general public being aware of the fact that your name is attached to The Center for Living Balance.

In summary, technology is constantly changing, and there are implications to all of the above that we may not realize at this time. Please feel free to ask questions, and know that we are open to any feelings or thoughts you have about these and other modalities of communication.

If you authorize us (in writing) via a "Release of Information" form to send your medical records or any form of protected health information to another entity for any reason, we may need to fax that information to the authorized entity. It is our responsibility to let you know that fax machines may not be a secure form of transmitting information. Additionally, information that has been faxed may also remain in the hard drive of our fax machine. However, our fax machine is kept behind two locks in our office. And, when our fax machine needs to be replaced, we will destroy the hard drive in a manner that makes future access to information on that device inaccessible.

During the course of our treatment, your therapist may recommend that you visit certain websites for pertinent information or self-help. She or he may also recommend certain apps that could be of assistance to you and enhance your treatment. Please be aware that websites and apps may have tracking devices that allow automated software or other entities to know that you've visited these sites or applications. They may even utilize your information to attempt to sell you other products. Additionally, anyone who has access to the device you used to visit these sites and/or apps, may be able to see that you have been to these sites by viewing the history on your device. Therefore, it is your responsibility to decide and communicate to your therapist if you would like this information as adjunct to your treatment or if you prefer that your therapist does not make these recommendations.

We are sincerely looking forward to facilitating you on your journey toward healing and growth. If you have any questions about any part of this document, please ask your therapist.

Please print, date, and sign your name below indicating that you have read and understand the contents of this form, you agree to the policies of your relationship with your therapist/group leader, and you are authorizing your therapist/group leader to begin treatment with you.