General Policy

GENERAL POLICY AND INFORMED CONSENT FOR PSYCHOTHERAPY

Aaron Collins, LMFT, LLC - DBA: AKUA Family Therapy 

AaronCollinsLMFT@gmail.com - (808) 646-3150 (call, text, voicemail)


Welcome to the group practice of Akua Family Therapy. This document contains important information about our professional services and business policies. Please read it carefully and jot down any questions you might have so that we can discuss them at our next meeting. When you sign this document, it will represent an agreement between us. Akua Family Therapy is owned and operated by Aaron Akua Collins, who is a Licensed Marriage and Family Therapist. At Akua Family Therapy you may be placed with a pre-licensed therapist. All of our pre-licensed therapists are Masters level graduates, have achieved all their qualifications to practice counseling/therapy and are supervised by Aaron Collins, LMFT. At Akua Family Therapy all our therapists hold to the highest standard of following all laws, ethics and professional boundaries. 


GENERAL INFORMATION

The therapeutic relationship is unique in that it is a highly personal and at the same time, a contractual agreement. Given this, it is important for us to reach a clear understanding about how our relationship will work, and what each of us can expect. This consent will provide a clear framework for our work together. Feel free to discuss any of this with me. Please read and indicate that you have reviewed this information and agree to it by acknowledging your agreement at the end of this document. 


LOCATIONS

Kurtistown Office - Our Kurtistown location is a shared space with Kurtistown Assembly of God church located at 17-550 Volcano Hwy, Kurtistown 96760. We are in the second building as you drive onto the property. You may park on the left of the driveway and wait in your car, on the porch or wait room. Your therapist will greet you in the waiting area within a few minutes of your appointment time. 

Hilo Office - Aaron Works out of the Hilo location on Wednesdays only. The Hilo office is a shared space with Olena Counseling and is located at 17 Furneaux Ln, Hilo 96720. We are on the second floor, suite 208. Upon arrival you will wait downstairs at the brown double doors. We are not allowed to give out the door code to clients. Either Aaron or someone else will let you in the building within a few minutes of your scheduled appointment time. 

Telehealth - If you have scheduled a telehealth appointment, you will be sent a SimplePractice link to join the session. 


PSYCHOTHERAPY SERVICES & THE THERAPEUTIC PROCESS

We provide psychotherapy services for children, adolescents, adults, couples and families. The first appointment(s) serves as an intake appointment. We will want to hear about the difficulties that led to you making an appointment, goals for therapy, and general information about yourself and your current life situation. By the end of this first appointment, we will give you some initial recommendations on what we think will help. If we do not think we are able to best assist you, we will give you names of other professionals who we believe would work well with your particular issues. If you do not agree with our treatment 

recommendations or do not think our personality styles will be a good match for you, let us know and we will do our best to provide the names of a few therapists for you to interview and select.  Please note that providing the names of therapists does not mean that Akua Family Therapy endorses them, so you will need to do your own due diligence.

If you and your therapist decide to work together in therapy, you will collaborate on a treatment plan that incorporates effective strategies to help with whatever difficulties you are hoping to reduce in therapy. Sometimes more than one approach is helpful. Individual, couples and family therapy sessions last 45-60 minutes (depending on your insurance benefits) unless otherwise arranged.  Oftentimes, sessions are set for once each week, but this varies based on what seems most appropriate for your particular situation.

Therapy can be extremely helpful and fulfilling, and it takes work both in and out of sessions to be most effective. It requires active involvement, honesty, and openness in order to change thoughts, emotional reactions and/or behaviors. There are benefits and risks to therapy. Potential benefits include increased healthy habits, improved communication   and   stability   in   relationships, and   lessening   of   distress.   Some potential risks 

include increased uncomfortable emotions as you self-explore, and changes   in   dynamics   or   communication   with   significant   people   in   your   life. Sometimes couples that come for therapy choose to end their relationships. Although there are many benefits to therapy, there is no guarantee of positive or intended results. 

If during your work together with your therapist, noncompliance with treatment recommendations becomes an issue, we will make effort to discuss this with you to determine the barriers to treatment compliance. At times, 

treatment noncompliance may necessitate termination of therapy service. We encourage you to discuss any concerns you have about our work together directly so that we can address it in a timely manner. Other factors 

that may result in termination of therapy include, but are not limited to, violence or threats toward us, or refusal to pay for services after a reasonable time and attempts to resolve the issue.

Deciding when therapy is complete is meant to be a mutual decision, and we will discuss how to know when therapy is nearing completion. Sometimes people begin to schedule less frequently to gradually end therapy.  Others feel ready to end therapy without a phasing out period of time. We may at times seek consultation with other therapists to ensure we are helping you in the most effective manner. We will give information only to the extent necessary, and we make every effort to avoid revealing the identity of my clients. The consultant is also under a legal and ethical duty to keep the information confidential.


CLIENT PORTAL

Akua Family Therapy uses an Electronic Health Record (EHR) system called SimplePractice. At intake, your basic information will be entered into SimplePractice and you will receive an email with access to your SimplePractice Client Portal where you can manage appointments, sign and attach documents, send secure messages to your therapist, make payments for your session fees and copays and add other demographic information. Telehealth appointments are also attended via SimplePractice secure link provided for each appointment. There is currently a smartphone app, for Apple iPhone users, called “SimplePractice Client Portal” 

where you can now manage your client portal conveniently on your smartphone. An app for non-Apple users is currently being developed and you will be notified when this is available. 

We kindly ask for you to add an EMERGENCY CONTACT to your client portal and sign a Release Of  Information (ROI) form so that we have consent to contact the listed person. We only call EMERGENCY CONTACTS when a client is believed to be in crisis, was in an actual or perceived crisis and/or is not responding to a therapist’s attempt to contact the patient. If you are scheduled for a therapy session and you “no-show,” and/or do not respond to your therapist’s attempt to contact you, your therapist may reach out to your emergency contact or contact the police for a wellness check.


LIMITS OF CONFIDENTIALITY

The session content and all relevant materials to the clientʼs treatment will be held confidential unless the client requests in writing to have all or portions of such content released to a specifically named person/persons, or if ordered by a court of law. Limitations of such client held privilege of confidentiality exist and are itemized below:

Occasionally I may need to consult with other professionals in their areas of expertise in order to provide the best treatment for you. Information about you may be shared in this context without using your name.

If we see each other accidentally outside of the therapy office, I will not acknowledge you first. Your right to privacy and confidentiality is of the utmost importance to me, and I do not wish to jeopardize your privacy. However, if you acknowledge me first, I will be more than happy to speak briefly with you, but feel it appropriate not to engage in any lengthy discussions in public or outside of the therapy office.


MINORS

If you are a minor, under the age of 18, please be aware that the law may provide your parents the right to information about your treatment. For teenagers, it is my policy at Akua Family Therapy to request an agreement from your parents that they be provided with only general information about our work together, unless there is a high risk that you will seriously harm yourself or someone else. Before giving them any information, I will discuss the matter with you, if possible, and do my best to address any objections you may have. Please note that for all minor patients, we require the signature and authorization of both parents/legal guardians. We also require proof and documentation for all legal guardians.  

If you are dropping your child/teen off, please be prompt in picking them up after session. We are not responsible for watching them after session. They will be instructed to wait on the porch area of the Kurtistown office if you are not present after session. They will be instructed to wait on the stairs of the Hilo office if you are not present at the end of session. 


AVAILABILITY BETWEEN SESSIONS

If needed, you can leave your therapist a message via text or voicemail, you may do so 24-hours at 808-646-3150. When you leave a message, include your telephone number even if you think we already have it, and the best times to reach you. We make every effort to return calls in a timely manner. In the rare occurrence that a message is missed or accidentally deleted, if you do not hear back from us within one day, please leave a second message. If we are unavailable for an extended time, such as on vacation, we will inform you of the contact information for the therapist on-call during our absence.  

You can also use secure text messaging through your SimplePractice client portal. 

Emergencies: Please do not contact us if you are in an emergency situation, as we are often meeting with other clients and may not be able to get back to you immediately.  If you are in an emergency situation, please go to the nearest emergency room or call 911. Akua Family Therapy is not a crisis facility. Do not contact us by phone, client portal, email or fax in an emergency, as we may not get the information quickly. 


SOCIAL MEDIA AND TELECOMMUNICATION

Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, Instagram, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.


ELECTRONIC COMMUNICATION

It is very important to be aware that e-mail, text and cell phone communication can be relatively easily accessed by unauthorized people and hence can compromise the privacy and confidentiality of such communication. 

For example, e-mails, in particular are vulnerable to such unauthorized access due to the fact that servers have unlimited and direct access to all e-mails that go through them. Texts can be read by others with or without authorized accessed to your phone. Faxes can easily be sent erroneously to the wrong address. In addition, communicating with your provider via electronic communication may compromise your confidentiality as these exchanges may become part of your medical record. Please notify your provider if you decide to avoid or limit in any way the use of any or all of the above mentioned communication devices. Please do not use e-mail, faxes or texts for emergencies.


PROFESSIONAL RECORDS

I am required to keep records of my professional services, your treatment, or our work together. Because these records contain information that can be easily misunderstood by someone who is not a mental health professional, my general policy is that clients may not review them; however, we will provide at your request a 

treatment summary unless it is believed that doing so would be emotionally damaging. If that is the case, we will be happy to send the summary to another mental health professional who is working with you. 


RATES AND INSURANCE

Therapy is a commitment of time, energy and financial resources. In order for us to set realistic treatment goals and priorities, it is important to evaluate what resources you have available to pay for your treatment.

Insurance Reimbursement: If you have a health insurance policy, it will usually provide some coverage for mental health treatment. I will submit claims on your behalf; however, you (not your insurance company) are ultimately responsible for full payment of all fees. It is very important that you find out exactly what mental 

health services your insurance policy covers. You should carefully read the section in your insurance coverage booklet that describes mental health services. If you have questions about the coverage, call your insurance company to check your own benefits by calling the number on the back of your insurance card. Of course we will assist you with whatever information, based on our experience, and will be happy to help you in understanding the information you receive from your insurance company.

You should also be aware that most insurance companies require you to authorize me to provide them with a clinical diagnosis. Sometimes additional clinical information such as treatment plans or summaries, or copies of the entire record (in rare cases) may also be necessary. Whatever the case may be, this information will become part of the insurance company files and will probably be stored in a computer. Though all insurance companies claim to keep such information confidential, I, your provider do not have control over what they do with it once it is in their hands.

We check insurance benefits as a courtesy for our clients. There are times when insurance misquotes benefits. In the event of a misquote, clients are still responsible for their copay/coinsurance/deductible amount that insurance reports after claims are submitted.

Akua Family Therapy is credentialed with HMSA, UHA, HMAA, Blue Cross Blue Shield, HMSA Quest. 

Out of Pocket Billing and Payments: You will be expected to pay for each session at the time it is held, unless it is agreed otherwise (You may agree to have your credit or debit card on file if you prefer Akua Family Therapy to bill your sessions electronically).

OUR FEES

Our current fees are as follows:

•     Initial Intake Appointment: $155.00 (per 53 minute session)

•     Counseling/Therapy Sessions: $155.00 (per 53 minute session)

All cash pay clients will be issued a Good Faith Estimate, as required by law, prior to being billed.

These fees are reviewed annually and an increase of $5 per year applies to our rates every January 1st.

Hawaii State General Excise Tax of 4.712% will be added to fees and copays, including what is covered by insurance (revised 4/29/23 by Aaron Collins). Clients with Quest insurance will not be billed any tax.

We also provide telephone and online therapy sessions. Some health insurance carriers cover telehealth (telephone/online therapy). If your insurance plan does not cover teletherapy, it is your responsibility to pay our full rate per session.

I charge $300 per hour for other professional services including but not limited to writing reports, printing treatment documents, attending meetings on your behalf with other professionals.


CANCELLATIONS

Once an appointment hour is scheduled, you will be expected to responsibly show up to your appointment. Cancellations or missed appointments without 24 hours notice will be subject to $75 fee charge, unless we both agree that you were unable to attend due to circumstances beyond your control. Remember, insurance companies do not pay charges for missed appointments. I may terminate therapy, or put you on a waiting list, after 2 missed appointments for non-emergent reasons. If fees for services are not paid in a 

reasonable amount of time, and attempts have been made to resolve the financial matter to no avail, a client account may be sent to a collection service. In addition, please note that we do not bill secondary insurance. 

Promptness for Scheduled Appointments: Out of respect, your provider will make every effort to begin your 

session on time. However, due to the nature of therapeutic care, some situations may arise that might cause 

minor delays. In these instances, your provider will make every effort to extend your session so that you are afforded your allotted time. 

In order to maintain ethical billing standards, your provider will not bill your Health Insurance Company on your behalf for sessions that start late due to your tardiness in excess of 15 minutes OR no-shows. In these instances, you will be responsible for payment of that session at the rates mentioned above.


COURT RELATED SERVICES

My practice is a family therapy practice aimed at providing psychological healing services. I do not specialize in forensic evaluations (child custody evaluations, other evaluations requested by courts). Although I may be required by a court to provide records or testify (via a valid court order), forensic evaluations are not a part of my regular practice. If you require these services, I will be happy to provide you with a few names of referral sources for you to consider and evaluate. Please note that providing you with the names of therapists does not mean we endorse them, and you will need to do your own due diligence in selecting someone that is right for you.  Therefore, it is understood and agreed that we cannot and will not provide any testimony or reports regarding issues of custody, visitation or fitness of a parent in any legal matters or administrative proceedings.

If we are contacted by an attorney regarding your treatment (either at your behest or related to a legal matter you are involved in) please note the following:

DISPUTES

Litigation Limitation: Due to the nature of the therapeutic process and the fact that it often involves making a full disclosure with regard to many matters which may be of a confidential nature, it is agreed that should there be legal proceedings (such as, but not limited to divorce and custody disputes, injuries, lawsuits, etc.) neither you nor your attorney(s) nor anyone else acting on your behalf will call on Aaron Collins to testify in court or at any other proceeding, nor will a disclosure of psychotherapy records be requested. Should you choose to disregard this policy, I charge $300 per hour for other professional services you may require.


DISCLAIMER

You should understand that the advice provided by the therapist should not be construed as medical or legal or other professional advice.  If you are seeking medical, legal or other professional advice, you should contact such professional.  


BY SIGNING BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD AND AGREE 

TO THE ITEMS CONTAINED IN THIS DOCUMENT.


Please ask before signing below if you have any questions about psychotherapy or our office policies.  Your signature indicates that you have read our Policy and Procedures Consent Contract and agree to enter therapy under these conditions. Your signature below indicates that you are making an informed choice to consent to therapy and understand and accept the terms of this agreement.


Print Name of Patient/ Parent/Legal Guardian   Signature of Parent/Legal Guardian      Date 


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Print Name of Parent/Legal Guardian   Signature of Parent/Legal Guardian      Date 


________________________________ _________________________________       ______ 


Print Name of Therapist                           Signature of Therapist                   Date 


________________________________ _________________________________       ______