Privacy and Forms

Paula Chu, Ph.D.
Licensed Professional Counselor

Fees:

For individuals, my fee is $100 per 45-minute session. The initial session, which runs 60 minutes, incurs a fee of $125. The fee for a half-hour session is $70. Sessions that run longer are occasionally necessary; these are scheduled in advance and incur an proportionally increased fee. If you are paying by cash or check, payment is due at the beginning of each appointment. You may also pay by credit card; I will provide an authorization form if this is your preferred method of payment. I'm happy to provide you with a receipt for any form of payment.

For couples therapy, the fee is $120 per 45-minute session; sessions that are scheduled for or run longer incur a fee that is roughly proportional to this charge.

I do not work with managed care (insurance). If your insurance provides reimbursement for counseling services, I can complete the clinician's portion of the necessary forms to get that reimbursement. It is still your responsibility to pay the full fee at the time of service. Note that health insurance companies generally require that I provide them with a diagnosis before they will agree to reimburse you. Please be aware that any diagnosis given to insurance companies will become a permanent part of their records.

Confidentiality:

I treat any information shared with me during sessions with great respect. You are entitled to confidentiality, and that privilege is protected both by State law and by the American Counseling Association's code of ethics. I work with local psychotherapists who may serve periodically as a professional sounding board and support for my practice; on occasion I may offer general case overviews - without information that would reveal your identity - to test my perspective or to ask for other perspectives in difficult situations. Beyond that relationship, except in the situations that follow, I will not tell anyone about your treatment, or even that you are a client, without your written permission. Your verbal communication and clinical records are strictly confidential except for:

information you and/or your child or children report about physical or sexual abuse of a minor or an elder person; in such cases I am obligated by Connecticut State Law to report this information to the CT Department of Children and Families,
if you provide information that informs me that you are in danger of harming yourself or others,
where you sign a release to have specific information shared,
information shared with your insurance company to process your claims.

If you are in treatment with another clinician, such as a physician who is monitoring medication, I will ask your permission to speak with him or her so as to facilitate optimal treatment. In rare situations, Licensed Professional Counselors can be ordered by a judge to share client records.

Emergency Situations:

Since I am in a solo practice, I do not provide emergency coverage. If an emergency arises for which the client or his/her guardian feels immediate attention is necessary, the client or the guardian needs to contact the emergency services in the community for those services. I will follow those emergency services with counseling and support to the client or the client's family.

Below are some contact numbers for emergency services in our area:
Wheeler Clinic Emergency Mobile Psychiatric Services: 866-261-0893
Institute of Living 24-hour Assessment Line: 860-545-7200
Dial 911 for any life-threatening emergency.

"Dual Relationships":

The American Counseling Association's Code of Ethics prohibits "dual relationships" between counselors and their clients. This means that our relationship is solely a professional one, limited to the time we spend in sessions or in counseling-related communication. Because of this code, and because of my own belief that responsible counseling has a distinct, protective boundary around us as counselor and client, I am prohibited from having social or business relationships with clients outside the context of counseling.

Forms That Must be Signed Before we Begin:

When you come in for your first appointment, I will need you to sign an "informed consent" form. This contains much of the information that you see on this site, and states that you agree to certain conditions regarding privacy, payment, and the like. We cannot proceed with our work until this is signed. You may, of course, retain a copy for your files.

If you are an adolescent under the age of 18, a parent or guardian must sign a "consent to treat" form.

Additionally, I am required to have you sign HIPAA forms, the full text of which outlines in great detail your privacy rights.

"A problem cannot be solved by the same consciousness that created it." -- Albert Einstein