Thank you so much for choosing the services of Online Group Therapy. This document is designed to inform you about what you can expect regarding confidentiality, emergencies, and several other details regarding your treatment as it pertains to TeleMental Health. TeleMental Health is defined as follows:

“TeleMental Health means the mode of delivering services via technology-assisted media, such as but not limited to, a telephone, video, internet, a smartphone, tablet, PC desktop system or other electronic means using appropriate encryption technology for electronic health information.TeleMental Health facilitates client self-management and support for clients and includes synchronous interactions and asynchronous store and forward transfers.” (Georgia Code 135-11-.01)

TeleMental Health is a relatively new concept despite the fact that many therapists have been using technology-assisted media for years. Breaches of confidentiality over the past decade have made it evident that Personal Health Information (PHI) as it relates to technology needs an extra level of protection. Additionally, there are several other factors that need to be considered regarding the delivery of TeleMental Health services in order to provide you with the highest level of care. Therefore, I have completed a specialized training in TeleMental Health, (DCC), Distance Credentialed Counselor in 2010 and renewed in 2015). I have also developed several policies and protective measures to assure your PHI remains confidential. These are discussed below.



It is important for you to know that even landline telephones may not be completely secure and confidential. There is a possibility that someone could overhear or even intercept your conversations with special technology. Individuals who have access to your telephone or your telephone bill may be able to determine who you have talked to, who initiated that call, and how long the conversation lasted. If you have a landline and you provided me with that phone number, I may contact you on this line from my own landline in my office or from my cell phone, typically only regarding setting up an appointment if needed. If this is not an acceptable way to contact you, please let me know.


In addition to landlines, cell phones may not be completely secure or confidential. There is also a possibility that someone could overhear or intercept your conversations. Be aware that individuals who have access to your cell phone or your cell phone bill may be able to see who you have talked to, who initiated that call, how long the conversation was, and where each party was located when that call occurred. However, I realize that most people have and utilize a cell phone. I may also use a cell phone to contact you, typically only regarding setting up an appointment if needed. Additionally, I keep your phone number in my cell phone, but it is listed by your initials only and my phone is password protected. If this is a problem, please let me know, and we will discuss other options.


Text messaging is not a secure means of communication and may compromise your confidentiality. Furthermore, sometimes people misinterpret the meaning of a text message and/or the emotion behind it. Therefore, I do not utilize texting in my therapy practice.


I utilize a secure email platform that is hosted by Enhanced Web Services. I have chosen this technology because it is encrypted to the federal standard and is HIPAA compatible. To email me securely write your message via the “Contact” link on my

I also strongly suggest that you only communicate through a device that you know is safe and technologically secure (e.g., has a firewall, anti-virus software installed, is password protected, not accessing the internet through a public wireless network, etc.).

If you are in a crisis, please do not communicate this to me via email because I may not see it in a timely matter. Instead, please see below under “Emergency Procedures.” Finally, you also need to know that I am required to keep a copy or summary of all communications as part of my clinical records.


It is my policy not to accept “friend” or “connection” requests from any current or former client on my personal social networking sites such as Facebook, Twitter, Instagram, Pinterest, etc. because it may compromise your confidentiality and may be outside of the boundaries of our relationship.

However, Online Group Therapy has a professional Facebook page. You are welcome to “like” and “follow” me on this professional page where I post psychology information and counseling information. However, please do so only if you are comfortable with the general public being aware of the fact that your name is attached to Online Group Therapy. Please refrain from making contact with me using social media messaging systems such as Facebook Messenger or Twitter. These methods have insufficient security and I do not access them constantly. I would not want to miss an important message from you.


It is my policy not to search for my clients on Google, Bing or any other search engine. I respect your privacy and make it a policy to allow you to share information about yourself with me as you feel appropriate. If there is content on the Internet that you would like to share with me for therapeutic reasons, please use the secure “Contact” link on my website which confidentially sends this to me through Enhanced Web Services.


Video Conferencing is an option for us to conduct counseling sessions over the internet where we not only can speak to one another, but we may also see each other on a screen. In a couples’ therapy or group meeting, participants can see, hear and interact with one another. I utilize videoconference programs which are encrypted to the federal standard and HIPAA compatible. HIPAA compliance tries to assure that our VC interactions are as secure and confidential as possible. As we utilize this technology, I will give you detailed directions regarding how to log-in securely and will assist you with any technological difficulties that may arise. If need be, we have professional, technical phone assistance available 24/7 in order to resolve any technical problems should they arise.

I strongly suggest that you only communicate through a computer or device that you know is safe (e.g., has a firewall, anti-virus software installed, is password protected, not accessing the internet through a public wireless network, etc.).


If you authorize me (in writing) via a “Release of Information” form to send your medical records or any form of PHI to another entity for any reason, I may need to fax that information to the authorized entity. It is my responsibility to let you know that fax machines may not be a secure form of transmitting information. Additionally, information that has been faxed may also remain in the hard drive of my fax machine. However, my fax machine is behind locked doors in my office which also has an alarm system installed for further security. When my fax machine needs to be replaced, I will destroy the hard drive in a manner that makes future access to information on that device inaccessible.


Please communicate only through devices that you know are secure as described above. It is also your responsibility to choose a secure location to interact with technology-assisted media and to be aware that family, friends, employers, co-workers, strangers, and hackers could either overhear your communications or have access to the technology that you are interacting with.


I am required to make sure that you are aware that I am located in the Southeast, United States and abide by Eastern Standard Time (EST) or Eastern Daylight Time (EDT). If I am located in an overseas location, our sessions will be scheduled using the EST or EDT point of reference. My practice is considered to be an outpatient facility, and I am set up to accommodate individuals who are reasonably safe and resourceful. I do not carry a beeper nor am I available at all times. If at any time this does not feel like sufficient support, please inform me, and we can discuss additional resources or transfer your case to a therapist or clinic with 24-hour availability. I will return phone calls within 24 hours. However, if you are having a mental health emergency and need immediate assistance, please follow the instructions below.


If you have a mental health emergency, I encourage you not to wait for communication back from me, but do one or more of the following:

  1. Call 911.
  2. Go to your nearest emergency room.
  3. Call 1-800-273-TALK (8255)
  4. Call Lifeline at (800) 273-8255 (National Crisis Line)
  5. Call Behavioral Health Link/GCAL: 800-715-4225 or other 24 hour crisis hotline in your area
  6. Call Ridgeview Institute at 770.434.4567 or local hospital
  7. Call Peachford Hospital at 770.454.5589 or local hospital


There are additional procedures that we need to have in place specific to TeleMental Health services. These are for your safety in case of an emergency and are as follows:

  1. You understand that if you are having suicidal or homicidal thoughts, experiencing psychotic symptoms, or in a crisis that we cannot solve remotely, I may determine that you need a higher level of care and TeleMental Health services are not appropriate.
  2. I require an Emergency Contact Person (ECP) who I may contact on your behalf in a life-threatening emergency only. You must provide this information on the intake Questionnaire on my website. Either you or I will verify that your ECP is willing and able to go to your location in the event of an emergency. Additionally, if you, your ECP, or I determine necessary, the ECP agrees to take you to a hospital. Your electronic signature at the end of this document indicates that you understand that I will only contact this individual in the extreme circumstances stated above.
  3. You agree to inform me of the address where you are at the beginning of every TeleMental Health session.


During a TeleMental Health session, we could encounter a technological failure. The most reliable backup plan is to contact one another via telephone. Please make sure you have a phone with you, and I have that phone number.

If we get disconnected from a video conferencing, end and restart the session. If we are unable to reconnect within five minutes, I will call you.


I offer primarily video conferencing for individuals, couples and groups. If we determine that TeleMental Health services are inappropriate for you, we will discuss what is best for you and make the proper referrals.

The structure and cost of TeleMental Health sessions listed on my website and described in my General Information, Authorization, and Consent to Treatment forms on the website.I agree to provide TeleMental Health therapy for the fee of $100 per hourly session and $60 for four group sessions. I require a credit card or PayPal account ahead of time for TeleMental Health therapy for ease of billing. PayPal, Visa, MasterCard, Discover, or American Express and you will provide receive a receipt of payment and the services that I provide. Payment and receipts are handled directly and efficiently on my website for your convenience.

You are also responsible for the cost of any technology you may use at your own location. This includes your computer, cell phone, tablet, internet or phone charges, software, headset, etc.


In the event that you are unable to keep either a face-to-face appointment or a TeleMental Health appointment, you must notify me at least 24 hours in advance. If such advance notice is not received, you will be financially responsible for the session you missed.


Online Therapy may have some limitations as well as benefits. For example, if video quality is lacking for some reason, I might not see a tear in your eye or if audio quality is lacking, I might not hear the crack in your voice which I could easily pick up if you were in my office. We will have to resolve all technical issues to minimize these factors.

There may also be a disruption to the service caused by a drop in Internet accessibility. This can be frustrating and interrupt the normal flow of personal interaction.

Please know that I have the utmost respect and positive regard for you and your wellbeing. I would never do or say anything intentionally to hurt you in any way, and I strongly encourage you to let me know if something I do or say has upset you. I invite you to keep our communication open at all times to reduce any possible harm.


You agree to the following TeleMental Health services and you are authorizing me to utilize them for your treatment or administrative purposes. Together, we will ultimately determine which modes of communication are best for you. However, you may withdraw your authorization to use any of these services at any time during the course of your treatment just by notifying me in writing. If you do not see an item discussed previously in this document listed for your authorization below, this is because it is built-in to my practice, and I will be utilizing that technology unless otherwise negotiated by you.

  1. Landline Telephone
  2. Cell Phone
  3. Texting
  4. Email
  5. Video Conferencing

In summary, technology is constantly changing, and there are implications to all of the above that we may not realize at this time. Feel free to ask questions and please know that I am open to any feelings or thoughts you have about these and other modalities of communication and treatment.

Please fill out the questionnaire via my website and check the box for “I agree” that will be presented to you in order to confirm your electronic signature which indicates that you have read and agree to the “Rights of Privacy”, “Informed Consent” and “Information, Authorization, & Consent to Telemental Health” as posted on this website.

During our first session, any questions you have regarding this information will be answered and discussed.