Informed Consent for Treatment in Florida

The Process

You have taken a very positive step by deciding to seek support for your mental health. The outcome of treatment depends largely on your willingness to engage in this process. While treatment offers benefits like reduced distress, improved relationships, greater self-awareness, and better stress management, sometimes, the process may result in considerable discomfort. Remembering unpleasant events and becoming aware of feelings attached to those events can bring on strong feelings of anger, depression, anxiety, etc. There are no miracle cures. Two Chairs cannot promise that your behavior or circumstances will change. Two Chairs can promise to support you and do our very best to understand you and your repeating patterns, and help you clarify what it is you want for yourself.

Confidentiality

The session content and all relevant materials to your treatment will be kept confidential unless you request in writing to have all or portions of session content released to specifically named person(s). 

Limitations of such client held privilege of confidentiality exist and are listed below:

1. If a client threatens or attempts suicide or otherwise conducts him/her self in a manner in which there is a substantial risk of incurring serious bodily harm.
2. If a client threatens grave bodily harm or death to another person.
3. Clinicians are mandated reporters and must report for legal or ethical reasons. This includes suspected child abuse or neglect or suspected abuse or neglect of elders and dependent adults. Suspected abuse includes, but is not limited to, physical, emotional, sexual, or financial abuses. Reporting requirements vary by state. If you have questions regarding the mandatory reporting statutes for your state, please speak with your clinician.
4. If a court of law issues a legitimate subpoena for information stated on the subpoena.
5. If a client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert’s report to an attorney.

Occasionally, your clinician may need to speak with other professionals in order to provide the best treatment for you. These consultations may occur internally within Two Chairs or externally with providers outside the organization, depending on the circumstances.

1. Internal communications: Two Chairs clinicians who are currently providing health care to you for the purpose of diagnosis or treatment, or who have previously provided treatment to you, may share relevant information, to the extent that the records pertain to the provided treatment, and to collaborate and coordinate care, as permitted under HIPAA and state law.
2. External communications: Two Chairs clinicians may need to speak with other professionals in their areas of expertise in order to provide the best treatment for you. Information about you may be shared in this context without using your name or other personal identifying information (PII). Disclosure of any PII or release of records will require your written consent via a Release of Information (ROI) form.  You understand and agree that Two Chairs will coordinate care with the provider who referred you to Two Chairs and may share information relating to your treatment at Two Chairs as permitted under HIPAA and state law and this document acts as consent for the sharing of such information.

Other uses and disclosures are outlined in the Two Chairs Practice Policies.

If you and your clinician see each other accidentally outside of your sessions , they will not acknowledge you first. Your right to privacy and confidentiality is extremely important to Two Chairs, and we do not wish to risk your privacy. However, if you acknowledge your clinician first, they will be more than happy to speak briefly with you. But, it would not be appropriate to engage in any lengthy discussions in public or outside of your sessions.