General Information and Counseling Agreement

ORGANIZATION: Our policies and procedures comply with applicable state regulations. Amanda Rausch is a Licensed and Registered Marriage and Family Therapist in the State of Washington Business name Amanda Rausch LMFT LLC. By engaging with Amanda Rausch LMFT LLC (Also referred to as Amanda Rausch or Amanda Rausch LMFT), you understand that the services provided are licensed in the state of Washington unless otherwise noted in the beginning of your session. You agree to the terms and conditions of the State of Washington and the services provided within this state. You agree and understand that the service you are receiving is licensed therapy within this state. If you reside outside of the above-specified state, you understand that it is not licensed services, but rather a confidential consultation. Amanda Rausch holds responsibility only to the state in which she resides and is licensed in and cannot be help accountable for any rules or regulations of other states outside of her licensure and residence. Some sessions may consist of psychotherapy, counseling, psycho-education, art therapy, yoga therapy, EMDR, or other wellness activities including but not limited to mindfulness, yoga, or movements. I understand I am receiving services at my own risk and hereby release Amanda Rausch from any legal ramifications should I injure myself in any way including but not limited to physical, emotional, mental, or psychological distress or injury.

CONFIDENTIALITY: Under the law, what you reveal to your therapist is legally privileged communication. You must sign a written release before any information about your treatment is disclosed. The following are exceptions to the general rule of confidentiality:

1.     State laws mandate that all psychotherapists report all incidents of actual or suspected child abuse or neglect, elder abuse, and dependent adult abuse. The law also requires that incidents of threatened harm to self or others be reported. In addition, State law requires us to report incidents of loss of consciousness to local health officials. Amanda Rausch, LMFT complies with all prevailing laws.

2.     In you are a minor (Under 14), we are required to answer questions your parents or guardians might have about your progress. We do not have to reveal the details of what is said during your session unless we have a concern about someone’s safety. Provider discretion applies to minors ages 14-18.

3.     Your therapist may make a diagnosis that documents the medical necessity of your treatment. Your therapist may also make periodic treatment plans which document that treatment is being providing according to medical necessity. This information may be requested by other health professionals or insurance companies. This information is confidential unless you give written permission to allow Amanda Rausch, LMFT to release this information.

4.     I consult with various experts in specific fields of mental health so that I can better serve my clients. I also participate in regular group consultation and have interns who may observe cases or sessions. If I consult on my work with you, I will not use your name or any information that can identify you. If there is any reason to believe you might know one of these professionals, I will tell you their name so you have the option to request I do not consult with them regarding your care. You also have the option to request that interns are not included in your session or case discussion.

 

I/We understand that Amanda Rausch does not make custody recommendations nor legal or court recommendations nor determine an individual’s fitness to be a parent. I/We understand that Amanda Rausch can only provide verification that I/We are attending counseling and participating in the process. I/We understand the records are confidential unless a signed release of information or a court order allows the release of the records. I/We understand that there are additional state laws and ethical issues that govern the release of information to you or to certain parties. I/We understand that any relevant laws or issues will be explained along with the process for challenging these laws or issues.

COMMUNICATION: Amanda Rausch, LMFT’s, email is Amandarauschmft@gnail.com and is answered and monitored during regular business hours from Monday to Thursday from 9am to 6pm PST. Digital email sessions will be answered within one business day if submitted before 5pm, PST., and within 48 hours if submitted after 5pm, PST. Digital diaries submitted after 5pm on Thursdays or on Holidays will be answered on the next business day.  If you have an emergency and are unable to reach your therapist, please call 911 or your State’s Crises Hotline or the National Suicide Hotline at 1-800-784-2433. You may also go directly to the emergency room nearest to your location.

SESSION LENGTH AND CANCELLATION POLICY: Sessions are 25 minutes long at the scheduled appointment time. You may stack two sessions back to back for a full 55 minute session. You must arrive on time in order to have a full session. After ten minutes of a no show, your entire appointment will be used and must be rescheduled. You will be responsible for the cost of that session. When appointments are scheduled, that time is reserved for you. If you need to change or cancel an appointment you must give 24-hour notice or you will be charged the full cost of the session and loose the credits.

SESSION CREDITS AND POLICIES: All sessions and credits expire 30 days from purchase. No refund or exceptions. You must contact Amanda Rausch LMFT before credit expirations for scheduling extensions.

FEE POLICY: Amanda Rausch does not accept credits or payments from the website Inyourcorneronline.com formally PrettyPadded room. Amanda Rausch will not be held liable for any discrepancies in payment, nor demand for refunds. All fee policy questions and concerns can be sent to Hello@InYourCornerOnline.com

Amanda Rausch LMFT LLC lists all payments on this website. You must purchase prior to scheduling.

SPECIFICS FOR ONLINE COUNSELING: By booking an appointment with Amanda Rausch LMFT and signing this consent, you are providing informed consent to the terms and conditions stated here:

You acknowledge that you understand the nature of online counseling services as well as the duties, qualifications, and limitations of Amanda Rausch and that Amanda Rausch has provided you with this information prior to providing you with any professional services. Also known as Telepractice, Cyberpsychology, Text-Based Therapy, Telehealth, Behavioral Telehealth, and Online Therapy. Distance counseling is providing a psychotherapy service that is not "in person" and is facilitated through the use of technology. Such technology may include, but is not limited to, telephone, telefax, email, internet, or videoconference.  Disadvantages include varying time zones, cultural differences, language barriers, and strength of internet connection, which may impact the delivery of services. Clients may provide off-line contact information in case of a technology breakdown, or if reconnection is not possible.

If you have any history of major psychiatric episodes, suicidal attempts or thoughts, hospitalizations, hallucinations or drug/alcohol dependence or have been diagnosed as any of the following disorders that include but are not limited to –Personality Disorder, Major Depressive Disorder, Bipolar Disorder Type 1, Mentally Ill/Chemically Addicted (MICA), and/or Schizophrenia - you must disclose this information and understand that you will not be able to work with Amanda Rausch and you will be referred out to in person treatment. 

Amanda Rausch reserves the right to terminate membership to any user found ineligible for services, and may refuse all current or future use at any time.

IF YOU HAVE CONSIDERED OR ARE CONSIDERING SUICIDE, OR BELIEVE YOURSELF TO BE A POTENTIAL THREAT TO THE SAFETY OF OTHERS, YOU MUST IMMEDIATELY CALL 911 AND NOTIFY THE POLICE.

ADDENDUM FOR WORKING WITH COUPLES/FAMILIES: When seeing Amanda Rausch, if the unit of treatment is determined to be the couple or the family, a no secrets policy will be implemented. Everything will be confidential between yourself, Amanda Rausch, AND your partner and/or family members. Amanda Rausch will not be held to the limits of confidentiality within the couple/family unit parameter and will not serve or be expected to serve as a secret keeper.  

ADDENDUM FOR EMDR: I have been advised and understand that therapy (including yoga and Eye Movement Desensitization and Reprocessing EMDR) is a treatment approach that may be used. I have also been specifically advised of the following: Distressing emotions and memories may surface through therapy. Some clients experience high reactions that neither they nor the administering clinician have anticipated, including a high level of emotion or physical sensations or issues of harm to self or others. Subsequent to the treatment session, this may continue. Before commencing treatment, I have thoroughly considered all of the above. I hereby consent to all treatment and free Amanda Rausch from any legal responsibility.

YOU AGREE THAT BY USING THIS SERVICE YOU ARE AT LEAST 18 YEARS OF AGE AND ARE LEGALLY ABLE TO ENTER INTO A BINDING CONTRACT. ADDITIONALLY YOU AGREE THAT ALL INFORMATION SUBMITTED BY YOU IS TRUE AND ACCURATE. A PHOTO ID WILL BE REQUESTED OF YOU BEFORE YOUR TREATMENT BEGINS. YOU MAY EITHER EMAIL THIS TO AMANDARAUSCHMFT@GMAIL.COM OR SHOW YOUR THERAPIST AT THE START OF YOUR FIRST SESSION.

BY PURCHASING OR BOOKING A SESSION YOU HEREBY AGREE TO:

I/We read and understood the above paragraphs and do hereby agree to abide by these terms and conditions. I/We also have read and understood the Terms and Conditions and Privacy Policy listen on InYourCornerOnline.com and do hereby agree to abide by these terms and conditions. My signature on this consent is free from pressure or influence from any person or entity.