The law requires that none of your personal information from a counseling session is disclosed without your written permission. I don’t even acknowledge that you are my client unless I have your written permission. My goal is for you to work on your personal therapy in a safe and unrestricted environment. Example: If there is domestic violence in your relationship – your spouse/partner will not have access to any of your information. They will not learn from my office that you are in therapy, the time of your appointment, the number of times you have come or what you are saying in your therapy sessions.

Exceptions to Confidentiality: I do disclose information to the Insurance Company/EAP Plan if that is the method in which you are using to pay for your session.

• If I learn of Child or Elder Abuse, I am mandated by law to report any suspicion of abuse.
• When in session, should you tell me that you intend to do harm to yourself or others, I will take whatever steps necessary to keep you and others safe.

The following information explains what your rights are in a Family Evaluation and how your personal information is protected and how you can request your information to be shared with others. If you don’t understand this information, ask me to explain it to you.

• You have the right to revoke or cancel this authorization at any time.
• Once the information about you leaves this office according to the terms of this authorization, this office has not got control over how it will be used by the recipient. You need to be aware that at that point your information may no longer be protected by HIPAA.
• If this office initiated this authorization, you may receive a copy of the signed authorization.
• HIPAA provides special protections to certain medical records known as “Psychotherapy Notes”. All Psychotherapy Notes recorded on any medium (i.e., paper, electronic) by a mental health professional (such as a counselor, psychiatrist, psychologist) must be kept by the author and filed separate from the rest of the client’s medical records to maintain a higher standard of protection. “Psychotherapy Notes” are defined under HIPAA as notes recorded by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint or family counseling session and that are separate from the rest of the individual’s medical records. Excluded from the “Psychotherapy Notes” definition are the following: (a) medication prescription and monitoring, (b) counseling session start and stop times, (c) the modalities and frequencies of treatment furnished, (d) the results of clinical test, and (e) any summary of diagnosis, functional status, the treatment plan, symptoms, prognosis and progress to date.
• The Notes gathered for a Family Evaluation are not therapy notes or part of any medical record but still considered confidential. Once they are turned over to the court they can be admitted as public record by the Court.

I, may disclose your information without your signed written consent for the following reasons:

• Child Abuse: If I have cause to believe that a child has been or may be, abused, neglected or sexually abused I must make a report of such within 48 hours to the Texas Department of Protective and Regulatory Services, or to any local or state law enforcement agency.
• Adult and Domestic Abuse: If I have cause to believe that an elderly or disabled person is in a state of abuse, neglect or exploitation, I must immediately report such to the Department of Protective and Regulatory Services.
• Health Oversight: If a complaint is filed against me with the State Board of Examiners of Licensed Professional Counselors, the Board has the authority to subpoena confidential mental health information from me relevant to that complaint.
• Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the Psychotherapy Notes, I will not release your privileged information as allowed by Texas State Law, without written authorization from you or your personal or legally appointed representative or a court order. The privilege does not apply when you are being evaluated for a third part or where the evaluation is court ordered. You will be informed in advance if this is the case.
• Serious Threat to Health or Safety: If it is determined by me that there is a probability of imminent physical injury by you to yourself or others, or there is a probability of immediate mental or emotional injury to you, I may disclose relevant confidential mental health information to medical or law enforcement personnel.

If you are concerned that your privacy rights have been violated, or you disagree with a decision made about access to your records, you may contact me, B. Karen Griswell, MA, LPC at 817-774-2696.  You may also send a written complaint to U.S. Department of Health and Human Services or The Texas Board of Examiners for Licensed Professional Counselors. Mail Code 1982 P.O. Box 149347 Austin, Texas 78714-9347 Email: lpc@dshs.state.tx.us Web: https://www.bhec.texas.gov/discipline-and-complaints/index.html