Important Information Regarding Your Care
As a psychologist, it is my responsibility to offer you a caring, evidenced-based, ethical and confidential relationship. When people find a psychologist they fit with, they find that through conversations, they are able to develop an awareness of themselves that is different than they had before.
I know that in order to us to work together productively, I am going to do my best to be clear in what your rights are as a client and how I will act to protect those rights. In the initial 2-3 sessions of the therapy relationship we spend quite a bit of time discussing your rights and I provide information about our mutual responsibilities so we both know how to show up to get the most out of our work together. Psychologists are required to obtain Informed Consent prior to starting treatment – which means that collaboratively you and I will create a plan that includes:
- Purpose of our work together
- Mutual responsibilities
- Confidentiality protections and Limits to confidentiality,
- Likely benefits and risks of treatment & Likely consequences of not seeking help
- Alternatives to psychological intervention
- Options to change your mind & How to take back consent
- Period of time our agreement spans
While this all sounds quite clinical – I promise it is not as difficult as it sounds. In these conversations, I get to learn about your ideas of what may work best for you and provide some options of what has worked for others in your situation.
One way to look at the work we will do together in therapy is to imagine we are two people going out on a road trip together. You are in the driver’s seat – we are not going anywhere you don’t want to go. I, as the psychologist, am in the passenger’s seat.
As the passenger I have done some research on the road-trip routes (how to get to where you want to go!) and am willing and able to offer to coach you on the chosen route. There are some routes I taken others through and some routes (i.e., addiction treatment, eating disorders treatment) that I do not know. I will let you know if I don’t know how to get where you want to go! As the passenger, I will do my best to plan for us to get where you want to go, I need to keep informing myself of the conditions and checking in with you on how you are doing in order to know what to plan. I am an encourager and someone who will be with you through the hard patches and the delightful parts of the journey.
As the driver, you have a lot of important responsibilities as well. It is your life and your course that we are working on together. You get to choose when to go faster or slower, when to take breaks, if we need some quiet time in the trip together (i.e., you want something different from me), or if you want to ask me to leave the car and continue your trip with someone else (i.e., end the therapy relationship or receive recommendations for other therapists). As the driver, you really are the boss. You listening to your own needs is so important for us to get where we need to go – if you don’t we might be in for a rough ride. You get to choose if you want to turn around and go back (i.e., stop the plan) or want to take another route all together (i.e., change your mind about a plan).
I like to think of informed consent as the ongoing conversation but it is important that we establish clarity on a few things before we get in the car. Before we jump in, these are some questions we want to be clear on together: where are we headed, how are we going to get there, what do we need to get there, what are the risks and benefits of our route, what are the limits of each of us that we need to respect, what can we count on from one another, have we reviewed other ways of getting there or the risks and benefits of not starting the trip at all, and how do we let one another know when there are parts of the trip that are not working for us or if we want to call it off.
Therapy is different from a friendship – it is not a peer-to-peer relationship. We each have valuable contributions to make if we want to get to where you want to go. Sometimes we can expect that the work will be challenging and knowing where we each stand and you can expect from me is so important in getting through those challenging times.
Informed Consent is explained in the Canadian Code of Ethics for Psychologists (2017) as: “…full and active participation as possible from individuals and groups…in decisions that affect them, respecting and integrating as much as possible their opinions and wishes…..[and] is a process that involves taking time to establish an appropriate trusting relationship and to reach an agreement to work collaboratively, and may need to be obtained more than once.” (p. 12-13)
As a group member you have the right:
– To share as little or as much as you prefer about yourself
– To change your mind
– To choose to say “yes”, “no”, Pass”, “skip”, “goodbye”, “I don’t know”, “I want to stop”
– To make a formal complaint
– To ask questions about your care
– To access your medical record
– To conversations about risks and benefits of various options in your care
– To provide feedback to group leaders to assist them in meeting your needs.
Your group leaders will be prepared at the designated group time (barring emergencies), will respond to communications within 1-3 business days outside of group, and will provide opportunities to learn, reflect and build skills in mental and emotional wellbeing. Both Tracy De Boer and Kayla Chorley have different training background, standards of care, and ethical responsibilities that they are required to meet. More information on these standards can be answered by either provider or from the following bodies: College of Alberta Psychologists & Canadian Counselling and Psychotherapy Association.
Registered psychologists in Alberta are required to adhere to a strict set of practice rules and ethical guidelines to ensure that clients like yourself are offered competent and ethical psychological treatment services.
You can expect me to do my very best to follow these standards:
- Keeping your information very private
- I will notify you at the start of our relationship about the circumstances in which I have to share your information with others
- I will provide access to your file when you request it
- I will provide you information on how to make a complaint if you receive unethical or incompetent service
- I will provide you information about my qualifications
- I will provide you information when you and I are trying something new that I have not been trained in
- I will keep strict boundaries. For example, I will never become romantically involved with a current or past client. I will do my best to limit our relationship to our professional treatment relationship and not develop friendships or business relationships with clients.
- I will let you know about my fees and give you notice when my fees change
Standards of Practice are the rules and standards set out by the College of Alberta Psychologists and can be accessed here: https://www.cap.ab.ca/resources-regulatory-information
The Canadian Code of Ethics for Psychologists is the ethical code that I am bound by as a psychologist: https://cpa.ca/docs/File/Ethics/CPA_Code_2017_4thEd.pdf
1. Attendance: Group therapy is successful (as is any form of therapy) when there is regular attendance on behalf of the participants. If you cannot attend a group meeting, please email or call to let your leader or co-leaders know as soon as possible. In your message please also indicate whether or not it is permissible for your leader or co-leaders to share why you are absent.
2. Respectful Engagement with Group Members
3. Fee payment as per fee policy
4. Active Participation: We find that clients receive the most benefit and satisfaction from their services when they arrive on time for meetings, prepare to focus on the therapy goals and issues, attend with minimal distractions, exert some vulnerability and sharing within their group, and provide feedback to group facilitators about their goals and experience in group.
Members of effective groups actively share thoughts, reactions and feelings during group meetings as a way of increasing their self-understanding and contributing to the personal growth of other members. To support that goal, facilitators will strive to establish and maintain a climate of respect within the group. Each member will undoubtedly share in different ways and be comfortable with different levels of disclosure. It is requested that as a participant you share what is comfortable and actively listen and attend to other group members. Participation does not necessarily mean talking. It can also mean listening to what other members have to say. No one will ever be forced to share anything that they are not comfortable sharing.
FOR GROUPS
Therapy is effective because individuals feel safe to share private information in a confidential atmosphere. Group therapy and support is a unique form of support where a group of people who are likely experiencing similar difficulties come together to both give and receive help from one another and the group leaders. It is important that every member of the group agree to uphold the confidentiality of the therapeutic setting – this means not sharing the stories of others, names or identities of other group members, or experiences of group members outside of the group. Your group leaders will attempt to create an environment where conversation and skill building can occur and benefit all members.
1. One limit to confidentiality is that group facilitators cannot guarantee that all group members will keep and maintain confidentiality to the same level as you would expect of your group leaders.
Psychologists are in many cases the “vault” that safely holds and protects your private information from others. When psychologists protect confidentiality, this can allow people to feel safe to talk about sensitive and personal things they need to discuss in order to move forward to their goals. I know that this takes courage and is a risk that each client takes when they sit across from me. I am very committed to protecting your privacy.
I take some precautions with security and the technology I have chosen to keep your information as secure as I am able to. I do not have conversations with friends and family about what you share with me. If we meet in public, my default is actually to ignore you so that you have the choice of sharing with others that you know me.
However, there are specific times when psychologists must share information from the vault with others. There are situations in which my moral or legal duties to keep people safe and to protect others (including animals) from danger mean I need to share some of your information with others. This means that you do not have 100% privacy or confidentiality in some situations.
I am sharing these limitations with you prior to our first conversation so that you can use this information to make choices in your best interest. You always get to choose what you tell me. My hope is that by sharing this information, you will have a clearer idea of how I will respond when I become aware of information contained below.
I will secure additional help (i.e., calling an emergency contact, parent/guardian, children’s services, senior’s abuse help line, or 911) and share as little information as necessary (i.e., sharing only the information necessary in order to get help) for my clients or participate in sharing information with others in the following situations:
- The client appears to be at risk for seriously hurting themselves or in need of emergency medical attention
- The client shares information with me that identifies another person (or animal) who is in danger (this includes elder abuse, child neglect or abuse, and vulnerable persons who may require care).
I will follow my obligations by law to share information in these situations:
- A judge orders me to release a client’s information (i.e., a search warrant served to me by police, court order to release my file or testify in court)
- The College of Alberta Psychologists conducts an audit of my records
- If the Worker’s Compensation Board requests a summary of my records or if you share with me that you have sustained a psychological injury at your place of work
- If someone discloses that there has been inappropriate sexual conduct by a registered health professional in Alberta
Within my clinic, I have made some choices to include others in my team and to offer some services that might involve me sharing information about your services with others:
- Third Party Payers (i.e., private or group insurance benefits company, disability benefits company, parents of adult clients) often may need some information in exchange for payment for your services
- Debt collection for unpaid accounts require me to release basic client information
- My team at the office may become aware that you are a client and some aspects of your services (i.e., admin person may be scheduling appointments or shredding documents for me, IT person or Accuro Help team may view my online storage records to help me maintain security and functionality of my records system). Individuals who would have access to your information would be bound to keep information confidential by signing a confidentiality agreement or the organization promising protection in accordance with healthcare standards.
In order for me to provide ethical and competent services, I engage in regular consultation with other psychologists and health professionals. By agreeing to work with me, please assume that this is something I will continue to engage in. If I ever need to conduct a specific consultation that would include identifying information about your case, I would ask for your written permission before proceeding.
Please know that sometimes I also need to consult with lawyers and similar to when I consult with other health professionals, I will keep the details of the consult general and only ask your permission in situations where you would be likely to be identified by the specifics of my consultation.
Did you know: You have the right to ask the names of any individuals I am consulting with at any point in your care.
Right now (January of 2023), I am available to see clients in-person and via telehealth (i.e., video conference or phone sessions).
The most recent recommendations from the College of Alberta Psychologists advises psychologists to monitor government health orders and guidelines. As such, I am making plans for in-person or telehealth treatment on a case by case basis with each client. As circumstances or recommendations change, this may mean we have to pivot together so that we can proceed with psychological services in the most effective and responsible manner.
For Groups – I am doing mostly virutal/online sessions with some potential for in-person group sessions.
The answer to this question is that it depends! Sometimes people want to keep continuity in their care and it may be useful to do so as they travel. If your travel plans keep you in the province of Alberta I am able to provide services. As soon as someone leaves the province of Alberta, I am not legally allowed to provide services.
Psychologists keep notes during sessions so that it is possible to keep a record of your words, the issues discussed, and ideas that have been developed in the counselling. These are kept electronically, are secured and confidential, and are maintained according to current health and privacy legislation.
You have full access to your file, and may request it at any time. Your file will be closed after one year without services or if we have closed off our work together. Even if you close your file at our office, you are welcome to return in the future to request additional services.
Files are securely maintained for a period of 10 years after the last session (and for 10 years after the age of majority for a client 18 and under at the time of service). In some cases where the law requires (i.e., in the case of permanent disability, situations where the client has been a victim of a serious crime), your record will be kept permanently.
Engaging in psychological treatment is an investment in energy, time, as well as financial resources. I plan to keep my rates consistent with the rates recommended by the Psychologists Association of Alberta (which can be accessed at:https://psychologistsassociation.ab.ca/resources/recommended-fee-schedule/).
FOR GROUP services:
Payment for your spot in the group is due prior to the start of group in the total amount of $480.00. This rate is consistent with the PAA recommended rate of $60.00/group.
– Once payment is processed there are no refunds. If you miss one or more sessions, you are not eligible for a discounted rate.
– Missed sessions are billed at the same rate of $60.00/group session and are indicated on your receipt as a “Missed Session Fee”.
Note regarding Insurance Coverage:
– If you are planning to submit receipts from the group for coverage under your private/employer insurance plan it may be useful to inquire with your insurance provider if they cover psychological services that are provided virtually and in a group format.
Often insurance plans do not provide coverage for missed sessions.
Group sessions are typically held for 90 minutes with a brief break in the middle of the group session.
For group services, you are reserving your spot in the group which means that if you cannot attend a session, your spot in the group is held. Your fee is paid in full prior to the start of group so you do not receive a refund if you cannot attend a group session.
If you are not able to attend a group session – your group leaders also understand this! We invite you to let us know if you are not able to attend. If you are planning on missing more than 2 sessions of the group, it is recommended that you consider waiting and taking the group at a time where you will be able to attend more of the sessions (and hopefully get more out of the group and the relationships you build in group sessions!).
In the age of emerging communication technologies there are more ways than ever to keep connected. One of my priorities at Curious Paradox Psychology is to find a happy medium between security and convenience of communication. As such, here are the ways I am available to communicate with you:
- Telephone: By calling the office phone number 780-467-8347 you will have access to the Curious Paradox office phone number. At this point in time, Dr. De Boer will be the only one answering that phone or reviewing messages. In future, that phone may be answered by support staff but for now you can be sure that Dr. De Boer is the only one accessing those phone messages. This phone does not receive text (SMS) messages.
- Messaging: Need to cancel your appointment? Have a question about a resource we have discussed? Not quite sure how to interpret a home practice assignment we discussed in session? Is there something sensitive that you wish to discuss with me by phone in-between sessions? We have the option to communicate through a secure message using Medeo. All of these messages are stored in your healthcare record. You will need to login to your Medeo account in order to send and receive messages through Medeo.
- Completing Forms: In order to complete forms (i.e., Demographic Information, Consent Form for Services, Measures to Monitor your symptoms and progress) I have secured a service that will send forms directly to your email. These forms can be completed from your tablet, smart phone, or computer without creating an account or setting up a login. You will need to answer some security items before gaining access to the forms.
- Social Media: Some people are active on social networking sites such as Twitter, Facebook, or LinkedIn. As these sites do not offer secure messaging, please do not use any of these means to contact me. You can also be assured that I will not search for you on social media or use search information such as Google to obtain information about you. In very rare situations, an internet search may be used in times of crisis. I also like to let people know that if I receive requests to connect on social media (i.e., a friend request from current or former clients) I will decline them or not respond. I aim to keep the context of our professional relationship very clear in order to support you in the goals we have established and sometimes blurring the boundaries in the context of relationships or connection outside of our professional relationship might interfere with therapeutic progress.
- Email: Similar to social media, I will not use email to communicate with clients. In the event that I receive a message via email I will respond back by sending a secure message via Medeo or call clients using the phone.
Did you know: All email and telephone communication is documented as part of your clinical file. This means that anything you write to your psychologist becomes part of your clinical record. Why is this important? (see item above about times where your record could be provided to lawyers if there is a court order to release)
Friendly reminder: I aim to respond to messages from these mediums (i.e., phone, Medeo messages, emails) within 2-3 business days. If you have not heard from me within 3 business days, please feel free to resend the message.
Different psychologists have different approaches to crisis support. I commit to doing my best to being available and present during your scheduled appointments with me. If you reach out to me, it is possible I may have an opening in my regular schedule that I can offer you. I cannot commit to providing crisis support outside of sessions. However, if we identify a crisis during a session, I will do my best to get you connected with supports who may be available (i.e., calling your emergency contact to bring you to the ER, to bring you to a walk-in clinic for additional support). If someone contacts me during or following our treatment relationship while they are in a crisis, I will do my best to respond within 2-3 days but there is no guarantee that I will be available to support you in your moment of crisis. For these reasons, I want to ensure you are aware of alternative supports available in times of crisis:
24/7 Support
- Local emergency room
- Calling 911
- Edmonton Distress Line (call): 780-482-4357 OR Call 211
- Suicide Prevention: 1-833-456-4566 OR text 45645
- Addiction Help Line: 1-866-332-2322
- Alberta Mental Health Line: 1-877-303-2642
Other Supports
- Strathcona County Walk-In Therapy Services (check the website for their days and times of operation, pay what you can): 780-464-4044
- Online Crisis Chat: https://edmonton.cmha.ca/online-crisis-chat/
- Alberta Health Services Access 24/7 (adult addiction and mental health crisis intake): 780-424-2424
- Alberta Health Services Children and Mental Health Crisis Mobile Response Team: 780-407-1000
- Bullying Help Line: 1-888-456-2323
- A Safe Place (family violence crisis line and shelter): 780-464-7233
- Kids Help Phone: 1-800-668-6868
- Sexual Assault Centre of Edmonton (support and information line): 780-423-4121
If you feel that I have done something harmful or unethical and you do not feel comfortable discussing with me directly, you can contact the College of Alberta Psychologists and they will review your concerns about my service.
College of Alberta Psychologists
Website: https://www.cap.ab.ca/concerns
Phone: 780-424-5070 or Toll free in Alberta at: 1-800-659-0857
I would like to give credit to Dawn McBride and Nicole Perry for some of their support and resources regarding informed consent and information for clients.
Nicole Perry: http://www.embodiedpsychology.ca
Dawn McBride: https://www.dawn-mcbride.com/counselling