Practice Policies

We ask for at least 24 hours notice to cancel or reschedule a session. Late cancellations and no-shows are typically billed at the full session rate, and insurance does not cover a missed appointment, so that charge falls to you.

The reason is practical rather than punitive. A therapy hour is reserved for one person. When it is released with a day's notice, someone on a waitlist can usually take it. When it disappears at 9am for a 10am session, that hour is gone.

We make reasonable exceptions for genuine emergencies, illness, and the ordinary chaos of life with children. Tell us what happened. We are not looking for documentation, and we are not counting.

If missed sessions become a pattern, your clinician will raise it directly, because it is usually telling us something about the work rather than about your calendar.

Confidentiality and its limits

What you say in therapy is confidential. We do not disclose that you are a client, or anything you tell us, without your written authorization.

There are narrow legal exceptions, and they are the same for every licensed clinician in Massachusetts:

• Imminent danger. If there is a serious and imminent risk of harm to you or to someone else, we are required to act to protect safety, which can include contacting emergency services or a person who can help.
• Abuse or neglect. We are mandated reporters. Suspected abuse or neglect of a child, an elder, or a person with a disability must be reported to the appropriate state agency.
• Court order. A judge can order the release of records. A subpoena from an attorney is not the same thing as a court order, and we do not release records on a subpoena alone without your authorization or a judge's ruling.

Your clinician will review these limits with you in the first session so they are never a surprise mid-conversation. If you are ever unsure whether something you want to say falls inside or outside confidentiality, ask first. That is a completely normal question and we would rather answer it than have you hold back.

Working with minors

For clients under 18, a parent or guardian consents to treatment and has certain legal rights to information. We handle that with a specific approach, explained to both the teenager and the parent in the first session.

We share themes and progress with parents. We do not share verbatim content. A teenager who believes every sentence will be repeated at dinner will not use the hour, and the treatment fails. Safety concerns are always shared with parents regardless of the usual arrangement.

For families with separated or divorced parents, we ask for documentation of custody and decision-making authority at intake. Where both parents hold legal custody, both generally need to consent to treatment.

Records

You have the right to access your record. Requests should be made in writing, and we respond within the timeframe Massachusetts and HIPAA require.

In some circumstances a clinician may provide a summary rather than the raw record, where releasing the full file would be reasonably likely to endanger someone. This is rare, and we will discuss it with you if it applies.

Psychotherapy notes, meaning a clinician's private process notes kept separately from the medical record, have distinct protection under HIPAA and are not part of a standard records release.

We retain records for the period Massachusetts requires for licensed mental health professionals.

Telehealth

Telehealth sessions are held on a HIPAA-compliant, encrypted platform. We do not conduct sessions over ordinary consumer video or messaging apps.

You need to be physically located in a state where your clinician is licensed at the time of the session. This is a licensing requirement rather than a preference, and it means a session cannot move with you on vacation. Across the practice, our clinicians are currently licensed in Massachusetts, Vermont, Michigan, Florida, and Connecticut. Tell us before you travel and we will tell you whether the session can go ahead.

We ask that you take the session somewhere private where you can speak freely, and that you are not driving. If the connection fails, your clinician will call you at the number on file.

Communication between sessions

Email and text are convenient and are not secure. We use them for scheduling and logistics, not for clinical content. If something clinical needs discussing, call and we will arrange time.

We are not an emergency service and do not monitor messages outside business hours. If you are in crisis, use the options on our crisis resources page: call or text 988, or call 911.

Fees and billing

Our self-pay rate is 200 to 250 dollars per session depending on the clinician and the service. If you are using in-network insurance, your cost is set by your plan. The full breakdown, including the plans we accept and how to verify your benefits, is on rates and insurance.

If you are uninsured or not using insurance, you have a right to a written Good Faith Estimate of expected costs under the No Surprises Act. See Good Faith Estimate.

Payment is due at the time of service unless we have agreed otherwise. We accept credit and debit cards and HSA and FSA payments.

Ending therapy

You can end therapy at any time, for any reason, and you do not owe anyone an explanation. We do ask, where possible, for one final session. Endings are clinically useful, and an abrupt stop leaves work unfinished that a single conversation usually closes well.

If your clinician concludes that we are not the right fit or that you need a level of care we do not provide, they will tell you directly and help you find an appropriate referral rather than continuing.

Accessibility

Our Natick office is on the second floor and is not currently wheelchair accessible. We state that plainly rather than burying it, because discovering it at the door is worse. If stairs are a barrier, tell us when you reach out and we will arrange telehealth or another accommodation.

If you need an interpreter, a specific communication format, or another accommodation to use our services, tell us at intake and we will work it out with you.