Informed Consent

 

Counseling Style

As an integral, or holistically oriented psychotherapist, I see the individual as a whole as well as a part of many larger and dynamic relationships. Mental well being is an experience that arises from the nervous system, relationships and attachments to family and significant people, a sense of meaningful participation, belonging, environmental health, biology, archetypal patterns, belief structures, and everyday habits of mind. The therapeutic process is unique to each person. There are times when one may begin to experience new or difficult feelings as the inner landscape transforms. For others, the process is less challenging and carries more of a sense of relief and freedom.

I work with the experience of the present as well as memory of the past, with curiosity, compassion, and focus. We explore whatever arises: bodily sensations, images, dreams, and repetition in a way that is unique to every client. Through this exploration clients identify the places where they feel disconnected, rigid, and ill at ease, as well as the places they feel comfort, integrity, and purpose.

I use a combination of modalities, collaborating with my clients in a way that is empowering and client led. Current research shows that collaborative and consistent relationships can restructure the brain and heal trauma. This leads to decreased emotional reactivity and increases brain functions such as creativity, curiosity, flexibility, and playfulness. This process allows clients to lead lives that are increasingly authentic, satisfying, and happy.

My demeanor is compassionate, accepting, warm, and curious. I am also directive, practical, solution focused, and challenging when a client is ready for this. All people need a unique balance of safety and expansion in order for change and growth to occur. As I get to know a client, I develop an understanding of the right pace and balance of these elements to suit their growth.

Appointments & Cancellations

Individual sessions are for 50 minutes. Depending on our work together, it is beneficial at times to schedule 75 minute or 100 minute sessions, especially for initial EMDR or couples sessions. We will make a clear agreement as to the duration of a session if it is to extend beyond 50 minutes, and typically we would arrange this ahead of time.

An important part of the therapeutic relationship is the mutual commitment to the time we schedule for appointments. If you are late, we will still end at our scheduled time. If I am late starting your session, you will get your full time. If you miss an appointment, or cancel with less than 24 hours of notice, you will be charged the full fee.

There are unforeseeable emergencies which I understand may prevent cancelation with 24 hours notice, and I honor those emergencies in a reasonable way. If you need to cancel, please call (415) 279-3642 and leave a voicemail.

Fees

50 minute sessions are $180. Payment is due on the same day as the session. Payment can be made to me at session time via cash or check (checks written to Laurel Lococo, LMFT), or via venmo: @Laurel-Lococo 

For youth clients, there may be additional clinical hours outside the session with the minor. These would be:

~conversation with a parent regarding the client's treatment or

~case consultation with other professionals involved in child client's life.

Any additional hours I offer for these services will be billed as clinical case management at the rate of $180/hr, and prorated at a minimum of 15 minutes, for $45.

These additional clinical services will be agreed upon ahead of time.

I will email an invoice for said services, if they occur, the week of the service, and payment is expected upon receipt of invoice.

 

Phone and Video Sessions

At times you may choose to schedule a phone session or video session, due to travel, lifestyle needs, or other special circumstance. In my experience phone and video sessions, although different than working in person, are absolutely effective and supportive.

Fees for phone and video sessions are the same as in person sessions. Fees for phone and video sessions are to be paid the same day of our scheduled session.

You may leave confidential messages on my voicemail, and I return calls within 24 hours during the week. I am happy to do initial consultations, answer simple questions, and address concerns, without charge via telephone.

Confidentiality

I take the confidentiality of my clients and the work we do very seriously. The content and nature of each session is totally private. If I were to seek professional support from a supervisor, I would do so with your signed consent, and this would be within limits of a psychotherapeutic supervisory consultation, bound to the same ethics and agreements of confidentiality that exist between therapist and client.

Because we live in a relatively small community, there is a chance that we would encounter one another in a public setting - such as a grocery store or post office. I will leave it up to you to greet me or not, whatever feels comfortable for your needs for privacy. I do not consider it rude, but rather the client right to confidentiality in therapy.

As a licensed mental health provider, I am legally bound to break confidentiality in the following circumstances (described below under permission to treat):

Reported or suspected child abuse, serious threat of self-harm, serious threat to harm another person.

 

Boundaries in Therapeutic Relationship and Dual Relationships

There is also a possibility that during the course of our work, we may learn that we personally know people in common, or are connected via other avenues in the community. My commitment is that we maintain the boundaries necessary to make sure that our relationship serves therapeutic goals. I am genuine in my care and demeanor with clients. This includes that I will always hold boundaries that ensure that our time together and the content of our interactions serves the therapeutic relationship.

Permission to Treat

I authorize Laurel Lococo, LMFT #52720, to provide psychotherapy services to me. I understand that I may ask questions at any time and disagree with suggested modalities or approaches. I understand that therapy is a collaborative process and the outcomes are diverse. I affirm that my request for services is voluntary and that I may discontinue at any time, and that I am responsible for payment for the services rendered to me.

I understand that my therapist, Laurel Lococo, is a Licensed Marriage and Family Therapist in the State of California. I understand that I am the holder of privilege within the client-counselor setting. This means that information discussed during counseling is confidential and that no information about my case can be released to anyone without written authorization from me.

I further understand that, by law, the following exceptions exist to the client- therapist privilege of confidentiality: therapists must report knowledge of child abuse or suspected child abuse to the authorities; therapists have a duty to warn intended victims if a threat of physical harm from a client is judged to exist; a client's serious threat of self-harm will also be reported. I understand that if my counseling becomes an issue in a court proceeding that the judge may order confidential information disclosed. I understand my therapist will not volunteer such information within a court without my express written permission. I understand that if a judge orders such disclosure within the court, my therapist will obey the order.

I understand that my therapist may discuss elements of our work together in confidential settings with a supervisor for the purposes of learning and better service. I understand my name will not be used and potential identifying elements will be changed in these circumstances.

I have received, read and understand the Professional Disclosure Statement, and Informed Consent information sheets, and agree to abide by the policies outlined therein. I certify that I have read, and had explained to me where necessary, fully understand, and agree with the contents of this Permission to Treat form.