Verified by 
Many of us are used to blindly signing enormous stacks of paperwork to get a process started. But bringing this approach to your child’s therapy intake could result in some unpleasant surprises down the road. While intake paperwork varies between practices, here are the basics of what your child’s new therapist is likely to hand you on day one.
Confidentiality Disclosure
During your first session, your child’s counselor will discuss your right to confidentiality, which is the unique privacy you and your child have with your therapist. Many clinicians summarize confidentiality with the phrase, “What you say here, stays here,” but there are some important exceptions to this rule.
Most are safety related: if you or your child disclose child abuse, an intention to kill someone, or an intention to kill yourself, appropriate authorities must be notified to ensure the safety of those involved. Additionally, your child’s counselor will most likely discuss your child’s case with a supervisor or experienced colleague on a regular basis to get other treatment perspectives and recommendations. These supervisors and consultants, however, are not allowed to discuss your child’s case with anyone else. Breaches of confidentiality by any mental health professional often result in termination, fines, and loss of licensure.
Notice of Privacy Practices
The Health Insurance Portability and Accountability Act (HIPAA), passed in 1996, keeps your child’s mental health information private, and grants you a host of rights as a client. All mental health practices are required to provide you with information about how they collect, use and store your information, and you will be asked to sign a form acknowledging that you have received these documents.
Here are some of the basics of HIPAA:
- Your health information must be kept in a locked area or password-protected program and accessed only on a need-to-know basis.
- No outside agency, provider or family member without parental rights can access your child’s treatment files without your written consent, with some exceptions, including:
- law enforcement investigating a crime or locating a missing or wanted person.
- legal personnel issuing subpoenas or court orders.
- insurance companies, auditors, and government agencies performing their job duties.
- When information sharing is authorized by you or allowed by law, only the minimum amount of information necessary should be shared.
- The fact that your child attends counseling is in itself considered protected health care information.
- You must be informed if there has been a possible breach of your information (such as an employee’s work computer being stolen).
- You have the right to access your child’s treatment files at any time, and to request a copy for yourself.
You can find a more detailed summary of HIPAA here.
Releases of Information
Because HIPPA keeps your child’s treatment information under lock and key, you will need to sign written consent forms, called releases of information, for any person without parental rights to speak with your child’s counselor or access your child’s files. (Although information can flow freely between providers who work with your child at the same agency, such as a therapist and a psychiatrist.)
Release of information forms often include options for how you would like information to be shared (whether a provider can give information, receive information, or both), what information will be shared, and how long it can be shared for. Additionally, to complete the form you will need to provide the address and contact information of the party you are releasing information to or from.
Most parents are asked to sign a release of information for their child’s pediatrician to help rule out possible physical causes for psychiatric symptoms (low energy levels and difficulty concentrating, for example, could be symptoms of depression or of anemia). Often, it is also helpful for your child’s clinician to speak with your child’s teacher, as well as any other mental health providers your child sees (such as social workers, psychiatrists, or school counselors).
Although you may be wary about what they will share with one another, allowing your child’s providers to coordinate care and monitor progress as a team will help your child’s therapy be as effective as possible. In many cases, a child’s teacher sees side effects of psychiatric medication before their psychiatrist does, and in-home caseworkers have a much better sense of how a child is functioning at home than the therapist who sees that child in an office.
You should also sign a release of information for any extended family members who will be involved in your child’s treatment, even if they will just be transporting your child to and from sessions. Just make sure that the release reflects exactly what type of information you would like to be shared with that relative.
If circumstances change, you have the right to revoke a release of information in writing at any time. You also have the right to decline to complete any releases of information, and treatment cannot be withheld from you for this reason.
List of Cancellation, Payment, and Other Policies
You will also receive information about the counseling organization’s cancellation and payment policies. While some agencies do not charge clients for missed appointments, many do; find out how many hours in advance you need to cancel your child’s appointment to avoid a fee. This is especially important if you have unreliable transportation or your child has a sports schedule that seems to change with the wind.
Additionally, most providers have rules about how late you can be to a session. This is particularly important if your child sees a psychiatrist, whose routine appointments to monitor progress can be 20 minutes long or less. The brevity of these visits means that a five-minute traffic delay could result in your appointment being rescheduled. Your child’s counselor may also refuse to see you or end your session early if you arrive drunk or high, bring weapons or threaten staff members. Knowing your organization’s policies can save you stress and logistical headaches at the check-in desk.
Furthermore, make sure that you understand which services your insurance provider will and will not cover, as well as when and how you are expected to pay for your child’s services. Your co-pay may vary depending on the provider your child is seeing, and you may need to switch counselors if your insurance situation changes. There may also be fees for late payments or returned checks. If your child’s counselor is not able to explain these policies to you, ask to speak with someone who can.
Lastly, you may be provided with miscellaneous policies specific to the services your child is receiving. These may include transportation policies if your child travels off-site for therapeutic activities, fees for court appearances, group therapy rules, emergency procedures, drug testing requirements for substance abuse clients, procedures for ending treatment or changing providers, and grievance policies. It is likely that you will be asked to sign a form stating that you agree to adhere to these policies, so it’s important for you to read them and ask your child’s counselor any questions you may have.
Although you may not have time to fully read every form that is handed to you at your intake session, you can ask your child’s counselor to summarize the content. Make time at home later to review your documents in full, and write down any questions you have for future discussion with your child’s clinician. You should also make sure that any other adults involved in your child’s treatment are aware of the policies that will be relevant to them.
References
U.S. Department of Health and Human Services (2003). OCR Privacy Brief: Summary of the HIPAA Privacy Rule. Retrieved from: https://www.hhs.gov/sites/default/files/privacysummary.pdf
