This document serves as an agreement to engage in telehealth services with Daily DBT and covers information about how these services are provided, recommendations, risks and benefits and related policies, and your authorization.
DESCRIPTION OF TELEHEALTH SERVICE
Telehealth treatment will be provided to you by Daily DBT using Zoom. Session type, length, fees, cancellation and other policies, and general agreements from the Consent Form will remain in place. Please share any concerns you have with your group leader.
Using Zoom you will be able to see the group leaders and all group members (and vice versa), interact with each other, see the power point presentations that are typically used in-person, and have access to all handouts. You are able to log on prior to group and wait in the virtual waiting room.
REQUIREMENTS
In order to participate in any group session you must be alone in a private space, ideally in your own residence or office, and in a space that would prevent anyone nearby from overhearing group. Participate in sessions in a quiet space with little to no background noise. Recording a group in any manner without permission is prohibited.
RECOMMENDATIONS
Password protect any technology you will use for sessions (including using secure wifi). Make sure you are logged out at the end of a session.
BENEFITS AND RISKS OF TELEHEALTH SERVICES
The major benefit of receiving telehealth services is the ability to have uninterrupted mental health care with the same provider/group when there are difficulties attending therapy in person for any reason. Telehealth often allows for greater flexibility and convenience. Common risks involved with telehealth include distractions, technology problems, potential privacy breaches, and a lack of immediate in-person assistance during a crisis. Your group leaders will help you develop an individualized plan for any risks or difficulties you experience during your telehealth sessions.
If your mental health status changes significantly during this course of teletherapy then your group leaders will assess whether or not teletherapy is the most appropriate format moving forward. In the event that a change is necessary you will be provided with recommendations and referrals to more appropriate therapy services. Additionally, you will be asked by your group leaders to identify a local emergency contact person and nearby emergency services (i.e., emergency room, local crisis line, etc) in the event of a crisis.
When using telehealth there are always risks of technology difficulties. In general, if you experience service interruptions or failures during a telehealth group please do the following: attempt to log in again and re-establish connection. If you are unable to re-connect in any manner during your group time, the group leaders will attempt to call or send you an email or text following up and providing options for next steps.
SESSIONS OUT OF STATE
If you are a client participating in telehealth appointments due to changes in location or schedule resulting from COVID-19 and are therefore out of state, please be aware that these services will be considered short-term and temporary in an effort to provide access to ongoing DBT group during unusual circumstances. Every effort will be made to return the full group to our typical in-person group format as soon as recommended by the CDC and other health organizations.
YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ THIS DOCUMENT AND AGREE TO ITS TERMS.