What is relational psychotherapy?

Therapy is first and foremost a relationship. Like any relationship, therapy works reciprocally, offering each partner clearly-defined rights and responsibilities. This framework of mutual collaboration cultivates the trust and safety to share your struggles and hopes, and the support and empowerment to make meaningful changes. As a client in psychotherapy, you and your therapist both have choices and commitments in your relationship. These corresponding, but not necessarily identical, components of the therapeutic relationship are integral to creating a secure, stable container where you and/or your child can begin healing toward greater well-being.

What does Small Steps do?

• Provide counseling for children, adolescents, couples, and families which supports resilient mental health and adaptive family dynamics.

• Recommend resources such as links, books, referrals, support groups, classes, and information for parents that may help with custody, visitation, and shared parenting circumstances.

• For court-ordered clients, record and report the number of sessions attended, session dates, and the client's involvement in therapy.

• Report harm to self or others according to New Mexico Law.

What will Small Steps not do?

• Mediate disputes, including custody and visitation disagreements.

• Get involved in the legal aspects of court cases or testify in court, except in special circumstances and with specific arrangements between Small Steps and the judicial system.

• Make recommendations for parenting time, custody or visitation for children in divorce and separation situations.

• Evaluate a child for possible sexual or physical abuse or neglect.

Do I have a responsibility in therapy?

• You are expected to display the same reasonable behavior of any person, as required by law and agency policy. In counseling, emotional expressions are appropriate; however, extreme behavior is not. Your behavior may not violate New Mexico State Criminal Statutes, especially as they relate to harm to self or to the person or property of others.

• In order to promote the successful resolution of the reasons you came to counseling, you will in general be expected to work toward mutually-agreed-upon goals.

• You are expected to pay the agreed-upon rate for services.

• You are expected to attend your appointments as scheduled, or to give 24-hour notification if an appointment will be missed.

• It is important to come to counseling sessions with a clear mind. If you are under the influence of any mind-altering chemical, you will be asked to reschedule for another time and will be charged for the session.

• Clients are expected to arrange for childcare for sessions in order to participate fully in your therapy. Only children who are enrolled in services and booked for a specific session may attend that given appointment. Children are very sensitive to emotions, and it is not appropriate that they be present for parents’ sessions. Also, for liability reasons, children under 12 years old may not stay in the waiting room unaccompanied. Counselors will need to reschedule appointments if children are brought unsupervised. You will be charged for the session.

Do I have rights in therapy?

Therapists with Small Steps Child Counseling pledge to protect the rights of each individual who is provided counseling services. You, as our client have the right:

• To give informed consent.

• To refuse treatment.

• To be advised of the potential consequences of refusing treatment or medication.

• To actively participate in the development of an individualized treatment plan/goals.

• To know the qualifications of staff providing treatment.

• To a grievance procedure.

• To a humane and safe environment.

• To be free from abuse, neglect, and exploitation.

• To be treated with dignity.

• To personal privacy and confidentiality.

• To transparent communication within the constraints of the individualized treatment plan.

• To have the justification for any restrictions on communications documented in the client record.

• To know the cost of treatment.

• To know about third party coverage of treatment, including full charge and any available sliding scale program assistance.

• To be informed as to any limitations of treatment or services for the duration of the treatment.

• To refuse to participate in research.

• To not be refused access to services without informed communications from counselor, and informed as to reason and duration of this decision.

• To receive a complete explanation of client rights in clear, non-technical terms and in a language the client can understand.

• To receive treatment that is non-discriminatory based on race, gender, religion, age, disability, or sexual orientation.

What is HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) provide safeguards to protect your privacy. There are rules and restrictions on who may see or be notified of your Protected Health Information (PHI). These restrictions do not include the normal interchange of information necessary to provide you with office services. HIPAA provides certain rights and protections to you as the patient. We balance these needs with our goal of providing you with quality professional service and care. Whenever Small Steps transmits information about you electronically (for example, sending bills or faxing information), it will be done with special safeguards to ensure confidentiality. If you elect to communicate with your therapist by email at some point in your work together, please be aware that email is not completely confidential.

What is Small Steps confidentiality policy?

With the exception of certain specific exemptions, you have the utmost right to the confidentiality of your therapy. Small Steps cannot and will not tell anyone else what you have told your Small Steps therapist, or even that you or your child are in therapy with Small Steps, without your prior written permission. Small Steps will always act so as to protect you or your child’s privacy, even if you do release Small Steps in writing to share information about you. You may direct Small Steps to share information with whomever you chose, and you can change your mind and revoke that permission at any time.

What is the exception to the confidentiality policy?

The following are legal exceptions to your right to confidentiality. The therapist will inform you of any time when we think we will have to put these into effect.

1. If the therapist has good reason to believe that you will harm another person, the therapist must attempt to inform that person and warn them of your intentions. The therapist must also contact the police and ask them to protect your intended victim.

2. If the therapist has good reason to believe that you are abusing or neglecting a child or a vulnerable adult, or if you give the therapist information about someone else who is doing this, the therapist must inform Child Protective Services or Adult Protective Services immediately.

3. If the therapist believes that you are in imminent danger of harming yourself, the therapist may legally break confidentiality and call the police. The therapist is not obligated to do this, and would explore all other options with you before they took this step. If at that point you were unwilling to take steps to guarantee your safety, the therapist would call the police.

Does Small Steps accept health insurance?

We accept most health insurances, including medicaid.

Does Small Steps offer Self-Pay services?

We do. Our initial appointment fee is $120. Our follow-up sessions per session fee is $75.

When are copays due?

All copays are due at the time of service and may take up to 5 days to process.

What is Small Steps billing policy?

Small Steps accepts most major health insurance and processes the billing of your services for you. We ask that an active credit card be placed on file so that the copays and uninsured amounts can be charged to the card in a timely manner. However, we cannot bill your credit card until after we have confirmed that your deductible has been met, as well as the amount the insurance company verifies as your copay. Small Steps will make best efforts to charge copays and deductibles for services within 2 weeks of date of service. Although Small Steps makes every attempt to confirm insurance coverage, deductible amounts and copay information, it is your responsibility to know and keep track of your deductible and how much of that you have met, along with your copay amounts. You will receive a statement from us each month with the balance owed on your account, and a prompt payment is expected. If your account accrues a past due balance for more than 30 days, services may be suspended until the account is brought current. Should the account remain outstanding without payment arrangements for 60 days, it will be sent to collections and a 20% fee added to the balance. Should your insurance coverage become inactive upon monthly verification, services will cease immediately unless it is deemed therapeutically harmful by the therapist.

Billing questions and payments should be directed to our Practice Manager, Kim Stout, at (505) 349-5470.

What is the Small Steps cancellation policy?

A cancellation made with less than 24 hours’ notice significantly limits our ability to make the appointment available for another patient in need. Multiple cancellations in a month significantly limits our ability to provide adequate treatment to your child/ family.

• Please provide our office a 24-hour notice in the event that you need to reschedule your appointment. This will allow us the opportunity to provide care to another patient. A message can always be left on our voicemail to avoid a “No-Show”.

• After one (1) “No-Show” or cancellation within 24 hours, your therapist will be in communication with you that week. After a second no show or cancellation within 24 hours, you may lose your regularly-scheduled appointment time.

• After two (2) cancelled appointments within a month, you also may lose your regularly-scheduled appointment time.

• After three (3) “No-show” or cancellations within 24 hours, you will be referred to another mental health provider for services.

What is Small Steps records request policy?

Small Steps policy is to not disclose any psychotherapy notes without the express written consent of the client and/or client representative, and to that end will only disclose records to other providers for continuity of care. All requests for records must be submitted in writing and will be processed within 30 days of the request. Small Steps does charge a fee for all records requested.