Private Practice Counseling Policies and Procedures

If you're a mental health professional who owns a private practice, in your initial paperwork, you will need to have clear policies and procedures for your practice. Setting up a practice can initially feel overwhelming, but being thorough can help you be a successful private practice owner.

What you decide to put in your private practice policies and procedures depends on where you practice and what policies are important to you. Many clinicians choose to include their policies and procedures in their informed consent. Some clinicians may choose to add policies and procedures in additional paperwork.

In addition, some clinicians choose to have a lawyer look over their paperwork to ensure all legal requirements are met. Others may look at best practices from other clinicians and model their paperwork after theirs.

Below is a guide to standard policies and procedures a private practice counselor may include in their paperwork. You may include or delete different sections based on your practice's needs.

About you section

In private psychotherapy practice, you may include an “about you” section in your informed consent. This section may include:

• A little bit about yourself
• Years in practice
• Degree(s) and Credentials
• What type(s) of therapeutic interventions you use
• Theoretical orientation
• A little bit about what to expect when working with you
• Your niche

This section gives the client an overview of your experience, where you graduated, and what they can expect from you as the counselor.

Therapy Risks and Benefits

This section outlines what the client should expect out of therapy and their role as a client. This section also outlines your role as the therapist and the benefits and risks associated with ongoing treatment.

In this section, you may also discuss the different therapeutic modalities you use, how you establish relationships with clients, and how goals are formed in therapy. You may consider including how you help your clients achieve their goals.

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Costs of Therapy and Fee Agreements

There should be a section in your policies and procedures that discusses fees. Your fee per session and policies for late payments or declined cards should be outlined. Some counselors may highlight their late cancellation or no-show policy here.

If you charge cancellation fees or have a policy for how much notice should be given before canceling, you should include that in this section. In this section, you should also discuss your fees for record requests or court proceedings.

If you're a private pay practice, you must provide clients with a Good Faith Estimate (GFE). The GFE is a document that outlines the expected cost of mental health services. This document is suitable for up to a year.

The purpose of the Good Faith Estimate is to be transparent with clients about the cost expected for therapeutic services. Clients can dispute their bill if the estimate is more than $400 off from the original estimate.

It's essential to provide an accurate, good-faith estimate. Different providers may choose different time frames. I have outlined my Good Faith Estimate to reflect the cost of services for one session, three months of sessions, six months of sessions, nine months of sessions, and one year of sessions. I provide two rates for clients. One if they were to see me bi-weekly and one if they were to see me weekly. This is a requirement for all private pay clinicians.

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How to Contact You Outside of Therapy Sessions

If you're a private mental health practice therapist, consider including ways clients can contact you outside of therapy sessions. Some mental health professionals have rules about texting and e-mail outside of sessions. If you charge for client contact outside of the session, you should mention that in this part of your policies and procedures.

It would help if you also mentioned in this section what clients can do in case they are in crisis or having an emergency. Consider including local, state, or national hotlines here so your clients have these numbers handy.

Telehealth Policies

Adding some information about telehealth to your policies may be helpful if you use telehealth. Clients should understand the risks and benefits of meeting with you virtually.

You may consider adding information about:

• The security of video conferencing

• Information about the platform you use to provide virtual services

• The steps you're taking to ensure client security

• Information about how the client being in a quiet, secure space away from disruptions is most conducive to telehealth

• Information about what to do in case the preferred or first method of providing virtual services fails

• Limits of telehealth (for example, clients have to be in a state the professional is licensed in at the time of session unless it's an extenuating circumstance or an exception has been made).

Many people include this information in their informed consent; your clients must understand the limitations of receiving treatment through this method.

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The Limits of Confidentiality

The therapeutic relationship is built on trust. 2020 research continues to support the idea that greater therapeutic outcomes are based on the quality of the therapeutic relationship. That's why it is essential to discuss the confidentiality limits.

The limits of confidentiality may be state-dependent; however, most often, therapists can break confidentiality in a few different situations, such as:

• You are a harm to yourself or others
• There has been suspected abuse of a child, elder, or protected population
• You have a duty to warn someone of intended harm
• A court-ordered subpoena is requested for information or records
• For payment purposes, such as providing records to an insurance company

Additionally, you may consult with other therapists to help you increase your competence in a particular area. Many times, when mental health professionals consult, they change client-identifying information. If you engage in consultation, it's necessary to disclose this to the client so they know what information is being disclosed.

Suppose you are in a specific state or jurisdiction. In that case, disclosing additional information may also be necessary, so knowing the laws and policies in all states you live in is essential. This varies greatly for therapists who serve minors.

Therapist Incapacity or Death

If something happens to you in private practice, your clients must know what to do. This policy can be an easy one for many mental health practitioners to overlook, as it can be dark to think about. Life can be unexpected sometimes, so directing your clients to whom to reach out if you cannot continue to practice is essential.

Many mental health professionals choose a trusted colleague to take over for them if something were to happen to them. Creating a professional will with a lawyer may also be necessary to address situations like this.

Social Media

Social media is a big part of today's society. Setting boundaries with clients around social media is important. It's essential to highlight that it's unethical to friend clients on social media. As a mental health practitioner, you must be aware of your social media presence and how that may impact clients.

You may state in your informed consent that you can't accept friend requests from clients, but you may have business-specific social media pages that clients can follow. Clients must know they can choose whether to engage with business social media pages and that doing so may identify them to others.

Client rights

Clients need to know what their rights are before engaging in any mental health treatment. Including your clients' rights in any intake paperwork or on your informed consent helps notify them of their rights as clients.

According to the National Board of Certified Counselors, client's rights include:

• A right to ask questions about therapy
• A right to understand their treatment and methods used
• A right to understand fees and fee agreements
• A right to confidentiality of sessions except in specific circumstances
• A right to receive a notice of privacy practices
• A right to obtain a copy of the therapist's code of ethics they must follow
• A right to ask questions about treatment modalities
• A right to ask questions about the limits of confidentiality
• A right to obtain copies of records and reports

Clients should be informed and understand their rights while seeking therapeutic services.

Complaints

If clients have complaints about their services or believe that their rights have been violated, you may include information for the client about what they can do. Many professionals ask their clients to come to them with any concerns or complaints about the services they are receiving.

If clients feel uncomfortable doing that, you may include information about making an official report to the appropriate state board that licenses them. For example, I'm a Licensed Professional Counselor in Missouri and a Licensed Clinical Professional Counselor in Kansas.

My Missouri clients can address complaints or concerns with the Committee for Professional Counselors. My Kansas clients can address any issues with the Behavioral Sciences Regulatory Board.

I include the numbers of both boards within my informed consent and discuss the steps clients can take to reach the boards. If you're a licensed psychologist, social worker, psychiatrist, or marriage and family therapist, these boards may have different processes based on the profession. It is also state-dependent, so check with your regulatory for your discipline and state.

Privacy Practices

All clients should also receive a notice of privacy practices. A privacy practice document informs your clients of how their health information is used. The privacy practices should include information about what health information is being disclosed to payor sources and other people who may access their data.

Release of Information Form

A release of information (ROI) form should be included in your policies and procedures if you consult with other providers or need to gather or release information to other providers. The ROI is a common form used in private practice, so it may be helpful to create a form for this, or there are many templates you can find online.

Record-Keeping

This policy should include how long you are required to keep records according to the laws and ethics of your jurisdiction. Many states regulate how long record-keeping is required. You must include all ethical and legal standards in your records.

Insurance

Billing insurance is another part of private practice policies and procedures. Your clients should know what insurance you take, co-payment collections if you offer superbills, and how insurance is verified.

Clients also have a right to know what information you disclose to insurance companies. An excellent place to include this is in your notice of privacy practices form.

The Bottom Line

Opening a private practice and knowing what procedures and policies to include can be overwhelming. Your informed consent will consist of many sections of your policies and procedures, and the areas listed above can serve as a guide. Each clinician may have additional sections based on their practice.

You may also have to revise and edit your informed consent as you are further along in your business. You may also consider learning about other aspects of opening a private practice outside of policies and procedures. If you want to try out software that makes documentation easier and writes your notes for you, consider trying Mentalyc for free.

Consider checking out all legal and ethical requirements of your profession and jurisdiction before finalizing your practice's policies and procedures. Keeping clients informed and holding yourself to ethical standards helps create better boundaries for your clients and yourself.

Here are some frequently asked questions related to mental health private practice policies and procedures.

What are the essential policies and procedures for a private practice counseling?

Essential policies and procedures for a private practice counseling include informed consent, insurance reimbursement, office policies, termination, and legal requirements.

How can I join insurance provider panels for my private practice counseling?

To join insurance provider panels for your private practice counseling, you will need to complete an application process with each insurance company and meet their specific credentialing requirements.

What are the necessary steps for starting a private counseling practice?

The necessary steps for starting a private counseling practice include creating a business plan, obtaining necessary licenses and certifications, securing office space, setting clear office policies, and joining insurance provider panels.

What should be included in the authorization form for private practice counseling?

The authorization form for private practice counseling should include details about the client’s consent for treatment, release of information, and consent for billing insurance, among other necessary permissions.

How can I ensure that my private practice counseling is compliant with legal requirements?

To ensure compliance with legal requirements, it is essential to stay informed about state and federal laws, maintain proper documentation, and adhere to ethical standards such as confidentiality and informed consent.

What are the key considerations for managing the office space in a therapy practice?

Key considerations for managing office space in a therapy practice include creating a comfortable and confidential environment, maintaining HIPAA compliance, and implementing policies for scheduling and maintaining the space.

How can I effectively handle termination in a private practice counseling setting?

Effective handling of termination in a private practice counseling setting involves setting clear termination policies, discussing termination with clients when appropriate, and ensuring proper closure and referrals when terminating therapeutic relationships.

How does insurance reimbursement work in private practice counseling?

Insurance reimbursement in private practice counseling involves submitting claims for services provided to clients with eligible insurance coverage, following the guidelines of the insurance provider, and ensuring proper documentation for reimbursement.

What are the important components of a business plan for a private practice counseling?

Important components of a business plan for a private practice counseling include a mission statement, target market analysis, marketing strategies, financial projections, and a detailed outline of services offered.

What are the benefits of using an all-in-one practice management system for running a private practice counseling?

Using an all-in-one practice management system for running a private practice counseling offers benefits such as streamlining administrative tasks, managing client information securely, scheduling appointments, billing, and maintaining therapy notes efficiently.

Resources:

• Baier A, et al. (2020). Therapeutic alliance as a mediator of change: A systematic review and evaluation of research. https://www.sciencedirect.com/science/article/abs/pii/S0272735820301094

• Centers for Medicare & Medicaid Services. (n.d.). No Surprises: What’s a good faith estimate? https://www.cms.gov/files/document/nosurpriseactfactsheet-whats-good-faith-estimate508c.pdf

• National Board for Certified Counselors. (n.d.). Client Rights and Responsibilities. https://www.nbcc.org/assets/Ethics/NBCC_CSI-Booklet.pdf

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About the author

Marissa Moore, MA, LPC

Marissa Moore is a mental health professional who owns Mending Hearts Counseling in Southwest Missouri. She specializes in providing affirming counseling services to the LGBTQIA+ community. Marissa has 11 years of experience working in the mental health field, and her work experience includes substance use treatment centers, group homes, an emergency room, and now private practice work.

Learn More About Marissa