Informed Consent for Psychological Services and Client Services Agreement
Updated 20 September 2024
Welcome to my practice. This document contains important information about my professional services, privacy policy, and business policies and practices.
Although these documents are long and sometimes complex, it is very important that you understand them. When you sign this document, it represents an agreement between you and my practice. You can discuss any questions you have with me at any time. You may revoke this agreement in writing at any time. However, actions taken by Koren Ganas Psychology Pty Ltd (DBA Ganas Clinical Psychology) before the day that you revoke this agreement cannot be reversed. The other exception to this statement is in the case of outstanding debt, I may continue to act on obtaining reimbursement for services provided.
Key Points Summary:
· Service Types: Ganas Clinical Psychology offers both clinical psychology and equine-facilitated psychotherapy & learning (EFPL) programs, which may have different scopes. If you are participating in EFPL, you will complete an additional agreement and liability waiver.
· Telehealth Risks: Telehealth involves certain privacy and technical risks.
· Clinical Psychology Services Expectations:Psychological assessment and psychological therapy are collaborative efforts, with no guaranteed outcomes, and participation may cause temporary discomfort.
· Cancellation & Fees: Sessions cancelled with less than 48 hours' notice incur fees, and all outstanding balances must be paid before scheduling new sessions.
· Termination: Services may be terminated under specific circumstances, including threats, unpaid fees, or failure to follow safety guidelines.
· Emergencies: Ganas Clinical Psychology does not provide crisis services.
About My Services:
Koren Ganas Psychology Pty Ltd DBA Ganas Clinical Psychology offers evidence-supported psychological services, including counselling, psychological therapy (psychotherapy), psychological assessment, and clinical supervision delivered via telehealth. Ganas Clinical Psychology also offers in-person, evidence-supported Equine-Facilitated Psychotherapy and Learning (EFPL) programs.
About Psychological Therapy (Psychotherapy):
Psychological therapy, sometimes called psychotherapy, is a collaborative process that varies depending on the personalities of the psychologist and patient, as well as the particular problems you are experiencing. It requires active participation both during and outside of sessions for maximum effectiveness. Please note: Therapy can involve discussing unpleasant aspects of your life and may result in uncomfortable emotions such as sadness, frustration, and anxiety. However, it also has the potential for significant benefits such as improved relationships, symptom reduction, and personal growth.
Benefits and Risks of Psychological Therapy:
Therapy can lead to better relationships, solutions to specific problems, and reductions in feelings of distress. However, there are no guarantees of success. Engaging in therapy may cause emotional discomfort as difficult issues are discussed.
About Psychological Assessment:
Psychological assessment is a comprehensive evaluation process using various tests, interviews, review of other relevant records, and observational methods to understand an individual's cognitive, emotional, and behavioural functioning. Psychological assessment has both potential benefits and risks. The primary benefit is gaining a clearer understanding of your psychological functioning, which can guide effective treatment planning and interventions. Assessments can provide valuable insights into cognitive, emotional, and behavioural issues, helping to identify strengths and areas for improvement. However, there are also risks involved. You may experience discomfort or stress when discussing personal issues or during testing activities. The assessment process can sometimes lead to emotional reactions or uncover unexpected information. Additionally, while assessments aim to be comprehensive and accurate, there is a possibility of misinterpretation of results. It is important to communicate openly with your psychologist throughout the process to ensure the best possible outcome. There is no guarantee of any specific diagnosis being assigned as the result of a psychological assessment unless findings and data support such diagnosis.
Delivery of Services:
I offer psychological services via telehealth (video or phone) and in-person for EFPL programs. Telehealth has specific risks related to privacy, data breaches, and technical issues. Please note: If telehealth or EFPL services are not suitable for your clinical needs, I will refer you to alternative services.
Telehealth Risks and Consent:
Telehealth services have potential privacy and security risks, including the possibility of data breaches. Technical issues, such as poor internet connection, can also affect the quality of service. By agreeing to telehealth services, you acknowledge these risks and consent to receive services via this medium.
Initial Psychological Therapy Sessions:
Because psychology is a broad field, different psychologists may focus on different kinds of concerns and may be trained in different evidence-based assessment or treatment modalities. During the first few sessions, we will collaboratively evaluate your needs and discuss your goals for treatment. By the end of these sessions, I will be able to offer some impressions of what your services may include, and you will understand your treatment plan and what evidence supported modalities we will engage with, assuming you decide to continue with therapy. If I am not the best person to assist you, or if other therapeutic interventions or delivery methods may be a better fit for your needs, I will refer you to another qualified professional.
Continuing Sessions:
Therapy sessions typically last 50 minutes and are scheduled weekly or fortnightly depending on your needs. You should evaluate this information along with your own opinions of whether you feel comfortable working with your psychologist. Therapy involves a large commitment of time, money, and energy, so you should be very careful about the psychologist you select. If you have questions about the procedures of your psychologist, please discuss them whenever they arise. If your doubts persist, I will be happy to provide referrals to you for another qualified mental health professional.
Ending Sessions:
Ideally, therapy ends when you and your psychologist agree your treatment goals have been achieved. However, situations sometimes arise where termination of psychotherapy services is required for various reasons such as ethical, financial or other conflicts. Professional ethics mandate that treatment continues only if it is reasonably clear you are receiving benefit. In such situations, your psychologist may have to end your treatment before our stated goals are met. In these cases, I will work with you to explain what is happening and ensure you have appropriate referrals. As well, you have the right to stop treatment at any time. If you make this choice, referrals to other therapists can be provided and you may be asked to attend a final session to transition your care.
Termination of Services:
Your psychologist is committed to your wellbeing, however, there are circumstances in which I may not be able to continue my commitment to your services. Circumstances that warrant termination of services may include, but are not limited to:
- Bullying, harassment, intimidation, or threats from you or people affiliated with you
- Weapons or dangerous items brought onto the premises or attending the premises outside of scheduled times.
- Safety or horse handling guidelines for EFPL are not followed.
- Payment is not made at the time of service without prior arrangements.
- Appointments are missed without notice.
- Clients present under the influence of drugs or alcohol.
- Clinical needs falling outside the scope of my professional services.
- Compromised therapeutic relationship without hope for repair.
- In the event of termination, referrals will be provided for continued care.
EFPL-Specific Risks:
Equine-Facilitated Psychotherapy and Learning (EFPL) involves interacting with horses, which carries inherent risks, including the possibility of physical injury. Safety guidelines must be followed at all times. Failure to comply with safety protocols can result in termination of services. Please note: Additional waivers and consent forms are required prior to engagement in EFPL.
Contacting Your Psychologist:
I am not immediately available for communication outside your session times and am not available on call after hours or on weekends/holidays. Please note that I do not provide crisis intervention or emergency response services. If you need to reach me, you can leave a message and I will attempt to return your call within one business day. Please note, outside of appointment confirmation, invoicing, or follow up resources from sessions, I do not communicate directly with my clients via email, text message or via social media. This is for your privacy and security of your information.
Emergency/Crisis Support:
Ganas Clinical Psychology does not provide crisis intervention services. If you are experiencing a mental health emergency, please:
- Contact the nearest emergency department or the psychiatrist on call.
- Call Lifeline on 13 11 14.
- If experiencing a life-threatening emergency, call 000.
Fees, Cancellation Policy, and Payment:
Telehealth Session Fee: 50-Minute Session - $250.00
Telehealth Student, Concession & Sliding Scale Fees: 50-Minute Session $150.00
EFPL Individual Session Fee: 90-Minute Session - $295.00
EFPL Programs: Varies by program
Payment is due at the time of service, unless prior arrangements have been made. Outstanding balances must be paid before additional services can be provided.
Cancellation Policy:
- 0–24 hours notice: Full fee
- 24–48 hours notice: 50% of fee
Unattended appointments: Full fee applies. Medicare and private health rebates do not cover unattended appointments.
Late arrivals: If you arrive more than 15 minutes late without notice, your session will be considered unattended, and the cancellation fee will apply.
Additional Fees:
Additional professional services (e.g., report writing, meetings, or phone calls over 15 minutes) are charged in 15-minute increments at $60.00 per increment.
Medicare and Private Health Cover:
Your services may be eligible for a Medicare rebate with a GP Mental Health Care Plan (MHCP). Alternatively, you may claim through private health insurance if applicable. Note: You cannot claim through both Medicare and private health for the same service.
Student, Concession & Sliding Scale:
Ganas Clinical Psychology is committed to serving the needs of a wide variety of clients and understands fees may be prohibitive to accessing services through my practice. I maintain two sliding fee slots for clients in financial need and offer a student rate to full time students. If you are experiencing financial barriers to care, please discuss your needs to determine if one of these options is available for your services.
Koren Ganas Psychology Pty Ltd
DBA Ganas Clinical Psychology
Copyright © 2024 Koren Ganas Psychology - All Rights Reserved.
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