During COVID-19, we are offering teletherapy to new and existing clients.

Practice Policies

General Information

Two Chairs provides a mental health service consultation, psychotherapy, 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 Consult Appointment allows an expert clinician to get to know you and your clinical needs, and understand your preferences. After getting to know you and what brings you into care, 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, goals, and preferences.

From there, we consider your preferences and use our research-informed matching process to identify a high quality fit with a Two Chairs clinician. Our matching process helps ensure you get the most out of therapy, and we are typically able to connect clients to care within 1-2 weeks. However, if you have strict scheduling constraints, it may take longer to find a high quality match that meets your scheduling needs. 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, your 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.
  • After booking your consult appointment, you will be asked to complete a Two Chairs Client Profile. To ensure a high quality consult appointment and allow your consult clinician time to review, it is important that you complete your Client Profile at least 24 hours before your consult. If you have not completed your Client Profile by 3 hours prior your appointment, we may need to cancel and reschedule your appointment.

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.

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 for a therapy session or more than 10 minutes late for a consult session, 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.

Teletherapy

Teletherapy is the provision of psychotherapy services digitally, typically via secure video conference or in some circumstances, via phone. We focus on in-person connection wherever possible at Two Chairs. However, teletherapy offers a highly effective option for continuity of care when in-person care is not possible or not preferred. If you and your clinician decide to engage in care via teletherapy, your clinician will review the below information and obtain your verbal consent to proceed at the beginning of your first teletherapy session.

  • The Two Chairs Notice of Privacy Practices and its other policies and procedures apply with respect to teletherapy services, just as they do to in-office services.
  • Teletherapy sessions are confidential under the same state and federal laws that protect the confidentiality of in-office sessions, and no one is permitted to record a teletherapy session without consent from the other party.
  • There are potential risks to engaging in teletherapy, including:
    • You may experience interruptions, background noise, or technical difficulties
    • While we use secure, HIPAA compliant software for all of our video sessions, we cannot guarantee unauthorized access to your session
    • Your clinician will not be in the same location as you in the event of a crisis
  • There are also benefits to engaging in teletherapy, including:
    • You will experience easier access to care and continuity of care
    • Teletherapy offers the convenience of meeting from your desired location
  • Your clinician may determine that due to certain circumstances, teletherapy is no longer appropriate for your care. Should that be the case, they will provide referrals as needed.

Making sure teletherapy is effective for you

  • Sessions will be conducted via video conference whenever possible, using the secure video provider identified by Two Chairs.
  • We will share instructions about how to join your video session.
  • It is important to be in a quiet, private room to avoid interruption during your session.
  • It is important to use a strong and secure (rather than public/free) WiFi/ cellular connection to avoid technical interruptions or breaches during your session.
  • Please refrain from eating, using alcohol or other substances, driving, or using other devices while in session.
  • Cancellations and billing for teletherapy sessions are handled the same as in-person sessions in accordance with Two Chairs policies above.

Finally, some insurance health plans do not reimburse teletherapy sessions. It is your responsibility to find out if your plan will cover these appointments.

Measurement-based care

Understanding how therapy is going for you allows us to tailor your care.

Measurement-based care (MBC) is the practice of regularly checking in on how therapy is going for you, enabling your clinician to better tailor care to your unique needs, goals, and preferences. In addition to a high quality match and consistent attendance, decades of research show that measurement-based care makes therapy more effective. It is an essential part of our approach at Two Chairs, as we work to deliver the highest quality care possible.

  • As a standard part of ongoing care, two brief surveys will be emailed to you on the day of your session: a pre-session survey and a post-session survey.
  • We ask that you complete the pre- and post-session surveys for each of your sessions.
  • You may ask your clinician to share and discuss your survey responses, and your progress in care, at any time.
  • All questions are clinically-validated and commonly used in care settings.
  • Your clinician may choose to use additional clinically-validated surveys, specific to your care, if appropriate.

The information collected as part of measurement-based care will be a part of your health record and will be used by your clinician to inform your care. Your information may also be used in anonymised and aggregated form to assess the quality and effectiveness of our services across the organization. If you have any concerns about completing the surveys, please discuss them with your clinician.

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

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). Under some plans, in-person and teletherapy sessions may be reimbursed differently. 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 April 7, 2020.