The Importance of Policies in Private Practice

Policies are the most unfun part of private practice. It’s exciting to think about marketing, scheduling, and finding office space. But writing up dry policy for our client’s to sign? YAWN.

And yet, it is one of the most important aspects of creating a sustainable, easy to manage, and profitable practice.

I think the reason we find them SO boring is that we don’t realize how involved we are allowed to be with them. That was my experience, at least.

When I first started my private practice, I just looked to other people for their policies. I used The Paper Office and verbatim included what they had for cancellation policies, communication policies, court hearing policies, etc.

I would have people sign the documents but sometimes I didn’t even really remember exactly what was in them. And, because they were not connected to me in the least, I was unlikely to hold the policies.

There were a couple ways this impacted my practice – my cancellation policy at the time made me feel resentful. The policy stated that cancellations must be made with 24 hours notice and that anything cancelled with less notice than that would be charged a $50.00 fee.

This began to make me feel resentful because when people cancelled I made a much smaller fee than I would have if they came. Yet, I was still holding space for them.

I realized that I needed to come up with policies that fit with who I am, what makes me feel good as a practitioner and a business owner, and what will protect my boundaries.

Here are a few examples of my own office policies (Remember, I am not an attorney. Your own policies should fit your legal and ethical standards in your jurisdiction).

Private Practice Policy Examples

APPOINTMENTS AND CANCELLATIONS:

Please remember to cancel or reschedule 24 hours in advance. You will be responsible for the entire fee if cancellation is less than 24 hours. The standard meeting time for psychotherapy is 50 minutes. It is up to you, however, to determine the length of time of your sessions. Requests to change the 50-minute session needs to be discussed with the therapist in order for time to be scheduled in advance. A $10.00 service charge will be charged for any checks returned for any reason for special handling. Cancellations and re-scheduled session will be subject to a full charge if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time.

TELEPHONE ACCESSIBILITY:

If you need to contact me between sessions, please leave a message on my voice mail. I am often not immediately available; however, I will attempt to return your call within 24 hours. Please note that Face- to-face sessions are highly preferable to phone sessions. However, in the event that you are out of town, sick or need additional support, phone sessions are available. If a true emergency situation arises, please call 911 or any local emergency room.

SOCIAL MEDIA AND TELECOMMUNICATION:

Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it. You may follow our professional social media accounts for advice and practice information, however these sites are not used to communicate directly with clients or otherwise.

ELECTRONIC COMMUNICATION:

I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.

LEGAL PROCEEDINGS:

To contain our costs and remain focused on our primary mission to help our clients improve their quality of life, it is our longstanding policy and practice not to complete character references or offer court testimony. To clarify, we will write a case summary of a client’s attendance and progress in therapy for him or her to take to court. However, we will not appear voluntarily for a legal proceeding. Despite being informed of our practice’s policy, if our staff is subpoenaed for a legal proceeding, the cost of such services is $500/hour/person subpoenaed.

OUTSIDE CONSULTATION:

“Fees for additional time or services, including travel time, will be billed at the regular session fee rate. Such additional services may include, but are not limited to, consultation with other professionals, preparation of reports or correspondence, any necessary court appearances, school meetings, phone calls lasting over 10 minutes”.

Other types of policies in private practice

I like to say there are two types of policies – The first are the written policies. These are the policies that you have in your paperwork and that clients sign. I also suggest you consider what I call “personal policies”. These are policies that you have with yourself to help guide you through challenging situations. For instance, how do you respond to a client that continually reschedules appointments? When this happens to me I always say something like:

“Hi (name),

I hope everything is okay. I want to check in with you because you are my client and I care about you – is everything okay? I have noticed a trend in rescheduled appointments. I want to let you know that it is important for our work together that we are keeping consistent appointments. Let me know if something is coming up for you about therapy”.

If the reschedules continue after conversation about the impact, I let them know that will not work for me and I refer them out.

Knowing how you will respond to clinical issues is important. It makes your decisions and responses fair to you and the client and it also helps you to stay organized and out of the resentment zone.

Your policy might be very different from mine. That is okay. Pick what fits. Pick what feels good. Pick what supports you and the client. Pick what sustains the practice.

Elizabeth Earnshaw, LMFT is a therapist, AAMFT Approved Supervisor & Private Practice Consultant. She believes that you can build a sustainable, thriving, and profitable practice that fits your therapeutic style. Nothing gets her more fired up than the paradigm that therapists can do good work & get money.

To book your free discovery call to see how she can help you click here.

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