Practice Policies

General Information

Two Chairs provides a mental health service consultation, psychotherapy, group therapy, and other mental health services. Our role is to help identify appropriate care, recommend a provider and a type of therapy that we think may be a good fit for you, and provide ongoing care. The Consult Appointment helps us evaluate whether Two Chairs is right for you; if we determine that Two Chairs is not the most appropriate treatment option for you at this time, we will make a quality referral to an outside provider/organization.

If you’d like a copy of these policies, please reach out to [email protected]

Our Promise

We are committed to providing the highest quality care for every client, because we believe that we all deserve access to high quality mental healthcare. The in-person Consult Appointment allows an expert clinician to get to know you and your clinical needs, and understand your preferences in the comfort of our clinics. After getting to know you and what brings you in, your consult clinician will summarize your discussion and share their clinical recommendations, make a joint decision with you regarding next steps, and match you to the right service and therapist for your unique needs.

From there, you will hear from us regarding next steps within 48 hours. We prioritize finding the best fit for you; this means that it may take longer than 48 hours to identify a therapist who is a high quality match and has availability. As part of our promise, we will keep you updated as we work to connect you to care. To ensure a smooth transition into ongoing care, our Consult Clinician will provide your ongoing therapist with context from your Consult Appointment. However, 45 minutes can go by quickly - you will dive into your needs and goals in much more detail with your ongoing therapist, over several sessions, in order to build the foundation for successful work together.

If you are dissatisfied in any way with your experience getting connected to care, please let us know by emailing [email protected] Whether you felt under-served by the Consult Appointment, the onboarding process, or your interactions with our team, we will always work with you to understand what went wrong and course correct together.

We take the time to understand every client’s unique needs, goals, and preferences, so we can tailor care and ensure a high quality match between you and our clinicians & services. As such, we cannot guarantee to accommodate requests for a particular clinician or service. After we’ve made a match, we will follow up with you to ensure that you are satisfied and that ongoing treatment is going well (often in the form of an online questionnaire). If at any time you would like to request a re-match to a new clinician, please contact both your Consult Clinician and [email protected]

Client Attendance Policy

We cannot treat an empty chair

At Two Chairs, we believe everyone should have access to exceptional mental healthcare. In addition to a high quality match, decades of research show that continuity and consistency of attendance is one of the best predictors of whether therapy will be effective for you. Coming to your appointments regularly and on time allows you to make the most out of your time with your clinician and ensures that you are both set-up to do the best work possible together.

Additionally, we do our best to prioritize your scheduling needs and preferences. In order to both make sure you have your desired weekly appointment slot and to offer empty slots to other clients seeking care, advanced notice of appointment cancellations is needed. Advance notice also allows us to accommodate rescheduling, when appropriate, as we know some changes are unavoidable.

Your care, the care of our other clients, and the empowerment of our clinical team are our highest priorities. Our attendance policies are built with that in mind.

Cancellations

For Consult Appointments:

  • Out of respect for your clinician and for other clients who are waiting for consult slots, notification to cancel or reschedule a consult appointment must be provided at least 48 hours before the appointment start time.

Notification can be sent via email to [email protected] or by phone at 415-202-5159 (9:00 am - 6:00 pm, Monday through Friday).

You will be responsible for the entire consult appointment fee if cancellation or a request to reschedule occurs fewer than 48 hours before the start of the appointment, regardless of our ability to reschedule.

For Individual Therapy Appointments:

  • At minimum, 48-hour written (e-mail) cancellation notice is required via email to your Clinician’s individual email. You will be responsible for the entire fee if cancellation occurs fewer than 48 hours before the start of the appointment.

Earlier notice, especially for multiple cancellations (e.g., due to extended vacation) is greatly appreciated, as it allows your clinician to accommodate other clients’ needs during that time. With earlier notice, we might be able to reschedule your session. If you give us more than 48-hour notice and we are able to reschedule your session within the same Monday - Friday week, it will not count as a cancellation or towards your missed appointment count. If notice is given less than 48-hours in advance, the appointment will count as a cancellation/missed appointment regardless if we are able to reschedule.

We recognize physical illness can’t be predicted. If you are not well enough to meet in-person, we strongly encourage you to arrange a Teletherapy (virtual) session with your clinician. As with above, 48-hour notice is greatly appreciated, though rare exceptions will be made on a case-by-case basis for illness.

2) In order to hold your slot and ensure the continuity needed for high-quality care, we allow a maximum of 4 missed appointments (advanced cancellations and/or no shows) every 6 months (January - June; July - December)

After 4 cancellations, your clinician will work with you to find a solution if a different time slot would work better for you.

For Group Therapy (ReGroup) Appointments:

  • ReGroup is our Group Therapy offering. Each group offers a limited number of spots and is designed to maximize group cohesion and learning. As such, we ask clients to commit to the full 12 session program in advance. The total cost of ReGroup is $600, either paid upfront ($600) or charged weekly ($50). We consider payment a commitment. As such, Two Chairs does not offer refunds or reschedules if a client misses a ReGroup session, or if a client drops out of the group after the first session.

Out of respect for your fellow members and facilitator, and in order to build and protect group cohesion, we kindly ask that you do not miss more than 2 sessions. If you plan to be out for a session, please inform the group facilitator as soon as possible, so we can share the materials with you. If you have extenuating circumstances that will result in you missing more than 2 sessions, please be sure to discuss this with the group facilitator.

Timeliness

Please try to be on time for your appointments to make the most use of your time with your clinician.

  • If you are running late, please contact your Clinician via e-mail and phone with an approximate arrival time.
  • If you arrive more than 15 minutes late, there may not be sufficient time for a productive session and the appointment may be cancelled and charged at our full rate. Please note that we always bill for full sessions, even if you are late.
  • Standard meeting length is 45 minutes for consult sessions, 50 minutes for individual therapy sessions. In some cases, your clinician may recommend two back-to-back sessions to administer specific treatments. These would be billed as two separate sessions.

Payment

Payment is due at the time of the appointment. We will automatically charge the credit card number you provide to us once the session has concluded. Our fees listed below are subject to change with 30 days written notice.

Consult: $159 / session

Individual Therapy: $190 / session

Group Therapy: $50 / session

If your credit card is declined, we will contact you directly to coordinate an alternate payment method. Please note that if you have a balance, your care may be interrupted or terminated.

Insurance Reimbursement

Two Chairs is not in-network with any health plans. We therefore require direct payment from our clients. However, we can help you submit paperwork to your insurance company to help you obtain reimbursement for a portion of the cost of your care if your health plan includes out-of-network coverage (common with PPO plans, for example). We cannot guarantee that we will be able to get you reimbursed for any of the cost of a session.

Confidentiality

The session content and all relevant materials to the client’s treatment will be held confidential unless the client requests in writing to have all or portions of such content released to a specifically named person/persons. Limitations of such client held privilege of confidentiality exist and are itemized below:

  1. If a client is at imminent risk of harming themself or attempting suicide or otherwise conducts him/her self in a manner in which there is a substantial risk of the client incurring serious bodily harm.
  2. If a client expresses an intent to cause grave bodily harm or death to another person.
  3. If the therapist has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional or sexual abuse of children under the age of 18 years.
  4. Suspicions as stated above in the case of an elderly person (65 or over) or a dependent adult who may be subjected to physical, emotional, financial, or sexual abuse, or isolation (“dependent adults” are persons ages 18 – 64 who have physical or mental limitations that restrict their ability to carry out normal activities or protect their rights).
  5. Suspected neglect of the parties named in items #3 and # 4.
  6. If a court of law issues a legitimate subpoena for information stated on the subpoena.
  7. If a client is in therapy or being treated by us by order of a court of law, or if information is obtained from us for the purpose of rendering an expert’s report to an attorney who represents you.

Digital Communication

We will use digital forms of communication with you (unless you would prefer an alternate means of communication), including text message, email, and our online client portals. Please know however that we cannot ensure the confidentiality of any form of communication through electronic media, including text messages.

Our care coordination team will seek to return messages in a timely manner, but we cannot guarantee an immediate response. We request that you do not use these methods of communication to request assistance for emergencies. You should instead seek appropriate emergency services. If you or someone you know is experiencing an emergency or crisis and needs immediate help, call 911 or go to the nearest emergency room. Additional crisis resources can be found at https://twochairs.com/crisis-resources/

These practice policies were most recently updated on December 4, 2019.