Practice Policies

Sessions & Length of Treatment

Sessions are generally 50 minutes. Sessions are scheduled for one or more times per week. Due to the depth-oriented nature of TherapySmith’s approach, most patients choose to remain in treatment with our therapists for a year or more.

Payment, Fees, & Sliding Scale

Payment is due at time of service unless we make other arrangements. Failure to provide payment on-time results in a $25 late fee. Payments can be made by check or cash. The fee for an Individual session is $250. The fee for a couple’s session is $300. Time spent reading documentation or reports from other healthcare providers, reading clinical material provided by you, or writing letters or reports on your behalf is billed on a prorated basis ($3/minute).

Sliding scale fees are determined on a case-by-case basis and are dependent upon several factors, including therapist availability. Fees may be re-evaluated or changed at any time, at a minimum on an annual basis every October.

Cancellations, Lateness, & Missed Appointments

If you are going to be late or miss a session, please notify me as soon as possible. To avoid charging for late cancellations/missed sessions, rescheduling within the same week is encouraged. However, less than one week’s notice for cancellations may result in a missed session fee. No policy can account for every exception, so please discuss your specific circumstances with your therapist as needed. If you arrive late, your session will still end at the regular time.

Therapist Absences

Your therapist will notify you via email or in-person at least one week prior to any scheduled out-of-office absence. If they will not be checking voicemail, email, or texts during my absence, your therapist will provide contact information for a back-up therapist while they are unavailable.

Phone Calls, Emails, & Texts

Due to the insecure nature of texts and email, please limit these messages to canceling, rescheduling, or to letting me know that you will be late. Phone calls of a clinical nature will be charged as regular sessions, as will any time your therapist spends reading texts or emails that include clinical material.

Consent for Telehealth

Telehealth means receiving therapy over the phone (audio only) or via videoconference (audio and video). You can withhold or withdraw consent for telehealth at any time. If you choose to engage in telehealth, you must identify and provide your therapist with your local resources in case of a medical or mental health emergency.

Risks, Benefits, & Termination

Psychotherapy can result in significant and dramatic changes in your life and way of being, but the process of change can often be slow, sometimes painful, and may result in periods of feeling worse or experiencing increased symptoms. You have the right to terminate therapy at any time, but it may be helpful to discuss your thoughts and feelings about ending therapy. If you choose to terminate, you may request referrals to other providers.

Inappropriate Sexual Contact & Session Safety

Talking about sexual thoughts and feelings is part of therapy for many patients. Sexual contact, including verbal sexual advances, between patient and therapist is never acceptable. It is illegal and unethical. You may review the booklet entitled Professional Therapy Never Includes Sex ( for more information.

No weapons of any kind, alcohol, or drugs (except as prescribed by a doctor) may be brought to or used during session.

Exceptions to Confidentiality

Communication (including patient records) between a patient and therapist is confidential and private, except where required by law. Exceptions to confidentiality include: If you threaten to physically harm an identifiable victim or if there is a reasonable suspicion of child abuse or neglect (past and present), dependent adult abuse, or elder abuse or neglect. If you may be a danger to yourself, your therapist has discretion in breaking confidentiality to ensure your safety. Confidentiality differs in couples or group therapy because other patients are present. In group, for example, participants may choose to share information with their individual therapists or their partners. In couples or group, you and your therapist will collaborate and decide how to hold confidentiality together.

If you should unexpectedly encounter your therapist outside of the office, you may choose to initiate contact. Your therapist will not initiate contact in order to maintain confidentiality. Your therapist will never reveal the nature of your relationship, but you are free to do so.