Client Orientation Information

Updated November, 2024

Welcome to Central Ontario Psychology!

This orientation guide lets you know about our services and policies, including:

1. Who we are and what we do
2. Policies about psychological assessment
3. Policies about psychological services and fees
4. Policies about privacy & confidentiality of records
5. Information about video and telephone services
6. Information about infection control
7. Information about working with WSIB

Please read these documents and feel free to ask any questions or raise any concerns about this information. Then, please sign and date the statement at the bottom of this page indicating you have read and understand the client orientation information and that we have addressed your questions or concerns.

Who We Are and What We Do

We psychologically assess, support, and treat adults, children, adolescents, and families with a wide range of problems: trauma, anxiety, obsessive-compulsive disorder, depression, learning/school difficulties/disorders, attentional disorders, autism spectrum disorders, behavioural concerns, grief/loss, adjustment to significant life events, life challenges, stress, relationship difficulties, relationship conflict, and other issues.

Our professional style is collaborative and strength-based. We know how important the therapeutic relationship is, so we build a strong, active partnership with our clients. We will work together to find the answers to the questions that bring you in to see us.

We believe in both evidence-based practice (using techniques validated by research) and practice-based evidence (tracking outcomes to ensure that what we are doing is working). Our assessment, diagnosis, recommendations and treatment integrate each client's unique characteristics and preferences, our clinical expertise and experience, and the best available scientific evidence.

Psychological Services: Policies, Approaches, Risks, and Benefits

Depending on the goals of our involvement, there are many potential benefits of psychological services. Goals are generally worked out between the psychologist and the client. In some cases, goals may be assigned by third parties such as schools, insurers, or the courts.

Psychological Service: Policies and Fees

1. Typically, psychological treatment sessions last approximately one hour. Some techniques will require more time, or shorter but more frequent sessions. Psychological assessments may require visits of several hours or may need to be broken into several shorter visits.
2. The fee for a session may include additional time for activities such as preparation for a session, reviewing the file, recording notes, or preparing a letter.
3. Phone consultations lasting more than 10 minutes may be billed, pro-rated at the hourly fee.
4. Fees are billed after each session and are due in full upon receipt of each invoice.
5. Payment options are available, including debit and credit.
6. Except for an emergency or unforeseen illness, at least 24 hours notice (phone or email message) is required in order to cancel an appointment. Failure to let us know may result in full charges for that appointment.
7. Psychological services are not covered under OHIP. Part or all of the cost of psychological services may be covered under an extended health care benefit plan, private insurance policy, or other third-party payor. However, the client is ultimately responsible for the payment of all fees.
8. Some insurers cover services provided by a non-registered provider under the supervision of a psychologist; others do not. It is the responsibility of the client to be familiar with their own insurance policy, and to alert us if services under our supervision will not be covered.
9. The current hourly fee for psychological services is $250.00/hour. Although this is our customary fee, we may adjust our fees based on clients' ability to pay or the complexity of the service offered. Our fee may change, although we will inform clients in advance about the date and amount of impending fee increases. It is the client's responsibility to speak to us about any difficulty paying for services. Lower fees are often available, depending on the provider.
10. No interest will be charged the first time that a past due account occurs.
11. Subsequent non-payment of a psychotherapy account may be subject non-payment fees, currently at a rate of 1% of the outstanding balance.
12. Continued non-payment of fees may result in the withdrawal of service, client referral to appropriate publicly funded mental health services, and referral of the overdue account to a collection agency.

Psychological Assessment Policies

1. The time required for assessments will vary depending on the recommended assessment procedures.
2. When specific assessment procedures are recommended, time and cost estimates will be discussed.
3. We often use highly educated and trained clinical assistants (psychometrists) in our work. They are under our supervision, and we are responsible for their work.
4. When clients seek assessments on their own, the findings of the assessment will be shared with them in a feedback interview as well as in the form of a psychological report. (In some cases, assessments conducted as independent examinations do not permit feedback; you will be informed of this in advance).
5. When third parties request an assessment, in some cases, feedback may not be permitted before a report is submitted. Your provider will explain this prior to the assessment.

Psychological Assessment: Approaches, Risks and Benefits

Psychological assessments help the client, their family, the therapist or third parties to quickly understand the nature of the problems, the factors that contribute to them, and our recommendations for dealing with them.

Our assessments are tailored to the presenting problem. We gather and integrate important and complex information using a range of methods, and from a variety of sources, such as our clients, their families, other health care providers, and other professionals such as teachers or lawyers. These procedures may include interview, observation, and completion of questionnaires, as well as the administration, scoring, and interpretation of psychological tests.

The benefits of psychological assessment may include increased understanding of the nature of the presenting problem, increased self-understanding including areas of personal strength and need, demonstrating the need for services by third parties, and helping us to develop our recommendations for treatment or for accommodations in work or at school.

Possible risks of psychological assessment include raising uncomfortable feelings, frustration with assessment activities, and receiving unexpected information. When assessment reports are provided with your consent to third parties such as schools, lawyers, or insurers, we are not responsible what they do with the reports.

Psychological Treatment: Approaches, Risks and Benefits

Depending on each client's needs and preferences, our integrative approach may include mindfulness, cognitive-behavioural therapy (CBT), positive psychology, client-centred therapy, emotion-focused therapy (EFT), mindfulness, dialectical behaviour therapy (DBT) skills, schema therapy, interpersonal therapy, psychodynamic/attachment-focused therapy, EMDR (eye movement desensitization and reprogramming), narrative therapy, and solution-focused therapy approaches. We may also use neurofeedback and cranial electrotherapy stimulation in our practice, and encourage exercise and good nutrition.

Possible benefits of psychological treatment may include attainment of goals, improved functioning, reduction of symptoms, increased coping skills and resources, decrease in uncomfortable emotions, increase in positive emotions, greater satisfaction with the self or one's external environment, and increased self-understanding.

Psychological treatment is generally safe and beneficial. However, no treatment, including psychological treatment, is entirely risk free. Possible risks include the discussion of uncomfortable topics and activation of negative emotions.

Privacy & Confidentiality of Records

We are committed to collecting, using, and disclosing personal information responsibly and only to the extent necessary for the services we provide. We strive to be open and transparent about how we handle personal information, and we are ethically and legally obligated to collect, use, and disclose your personal health information in accordance with Ontario law.

What Is Personal Information?

Personal information is information about an identifiable individual. Personal information includes information that pertains to an individual's personal characteristics, (e.g., age, gender, home address, telephone number, ethnic background, family status, who to contact in case of an emergency, etc.), health (e.g., health history, health conditions, history of health services used, names of other health professionals currently providing professionals services to the individual, etc.), and activities and views (e.g., opinions expressed by an individual, life history, opinions or evaluation of an individual).

Primary Reasons Why We Collect Personal Information

We collect personal information about our clients in order to provide the best psychological service we can. We need a great deal of information about each client (e.g., name, address, reason for request for professional service, nature and history of the problem, etc.) in order to plan an appropriate and cost-effective psychological assessment or treatment plan, and to meet our profession's standards for the retention of records.

Secondary Reasons Why We Collect Personal Information

We also collect, use, and disclose personal information for secondary reasons. The most common examples of these related but secondary purposes include the following:

1. To invoice clients.
2. To provide a third-party payer, such as an insurance company, with specific information, so that we can receive payment or you can receive reimbursement for psychological services that you received.
3. The College of Psychologists of Ontario, the regulatory body for psychologists in Ontario, also requires that we retain client records in a secure fashion for a period of ten years or, in the case of a client under 18 years, ten years following the client's eighteenth birthday.
4. We may also conduct research using collected information. If we use clinical data from your file, such as test scores, we will ensure that no personal information will be used that can result in your identification.

Protecting Personal Information About Clients

We understand the critical importance of protecting personal information. For that reason, we have taken the following steps:

1. Paper information is either under our direct supervision or secured in a locked or restricted area.
2. Electronic hardware is either under our direct supervision, secured in a locked or restricted area, or is fully encrypted. We require that all computers and external drives be encrypted.
3. Paper information is transmitted through sealed, addressed envelopes by reputable companies.
4. Email is not a secure form of communication. We can provide you with access to our secure messaging system instead.
5. We avoid sending personal health information through email, except in an encrypted form. Fax information is transmitted securely.
6. In our psychological practice, we collect, use, and disclose personal information only as necessary. Our admin staff is bound by this privacy policy and legislation.
7. If external consultations are needed with anyone other than a regulated health professional involved in your care, these are requested with the informed written consent of the client.
8. We may disclose your personal health information to your doctor or other regulated health care professional if that information is necessary for your treatment, if it is not possible to obtain your explicit consent in a timely manner.

Retention and Destruction of Personal Information

We retain personal information to ensure that we can answer any questions a client might have about the services we provided and because of our professional obligations. We keep personal information on each client in secure files for a period of ten years, or in the case of a client under 18 years, ten years following the client's eighteenth birthday.

Limits of Confidentiality

Everything that you tell us will be kept in the strictest confidence; even the fact that you are attending appointments is confidential. However, there are some exceptions to this:

1. If we have reasonable grounds to suspect child abuse or neglect, we must make a report to the Children's Aid Society.
2. Suspected abuse of residents in long term care facilities must be reported to appropriate authorities.
3. If you inform us that you have been sexually abused by a regulated health care professional, the psychologist is required to report the name of the professional to their regulatory body.
4. A court has the power to subpoena us, along with your record, and require us to testify.
5. We will take the appropriate action if there is a significant risk that you may harm yourself or someone else.
6. We may share information with the police to protect ourselves, our homes, our families and our property from criminal activity.
7. We will inform your family physician of a concern about your capacity to drive.
8. We will release information with verbal or, preferably, written consent from you or your legal representative.
9. The College of Psychologists of Ontario may inspect our records as part of their regulatory activities in the public interest.
10. Various government agencies could compel us to share confidential records in accordance with applicable laws or court orders.
11. We are often contacted by insurers to confirm dates of service and amounts invoiced.
12. We may consult with some third party payers, such as VAC, WSIB, or auto insurers, who require us to explain our treatment plans and clinical formulations.
13. Children have similar rights to confidentiality as adults; adolescents have exactly the same rights.
14. Within our clinic, we practise collaboratively. We may discuss your information with others who work in our group practice, unless we have reason to believe that there is a conflict of interest.
15. Occasionally, someone might be seen by the same therapist in an individual session as well as in a session with a partner, spouse, or family member.
16. We use online services including practice management software and outcome management software. These services are highly secure, use bank-level encryption, and meet Canadian standards for the protection of health care information.
17. Under the Missing Persons Act (2018) psychologists must disclose information to the police in a timely manner to facilitate the police work of locating missing persons.

Client's Right to Access Personal Information

With only a few exceptions, a client has the right to see what personal information we have placed in his/her file. A client who wants to see that information simply has to ask for it.

Complaints about Privacy, Professionalism or Competence

If a client has a concern, we invite open discussion, verbally or in writing. However, if the client believes that we did not satisfactorily address the concerns, the client is entitled to file a complaint to the College of Psychologists of Ontario (Tel: 1-800-489-8388; website: www.cpo.on.ca).

Infectious Disease Control

We work with a vulnerable population, and we do our best to provide an environment which is safe for all, including the very young, the elderly, those who may be pregnant, and those with disabilities. We do not require that masks are worn at this time. However, we have a "Mask Mirroring" policy; our staff and therapists will wear a mask if the client is wearing one, or on request. We continue to encourage masks for the safety of all, and high quality masks are freely available throughout the office.

We also attempt to maintain good ventilation (though our ability to do so is hampered by the lack of opening windows). Each office has a HEPA filter, which helps to compensate for the limited supply of fresh air.

We ask that everyone, including our staff and clients, remain at home if they are ill (or if they have been exposed to someone who is ill), and make alternate arrangements, including rescheduling, or using virtual services. There is no charge for cancelling a face-to-face session due to illness.

While we do our best to maintain this safer environment, face-to-face encounters do carry an inherently greater risk of infection. Please note that we cannot be held responsible for any illness which you believe may have been contracted in our office.

Consent for Telepsychology

This information applies to services provided by video or telephone.

We offer video services as an option, for many reasons, including health, convenience, reduced demand on the parking lot, and reducing travel time, fuel costs and greenhouse gases.

The use of telephones or video conferencing can come with some unique risks, and it is important to be familiar with these.

We use a video platform which is integrated into our practice management software (Owl Practice). It is designed for Canadian healthcare, uses end-to-end encryption, and does not record and store the session.

Because loss of communication could happen at any point during online service (eg, loss of the internet connection), it is important to have a plan in place. This will usually involve us calling the phone number we have on file for you; please let us know if any other arrangements are necessary.

It's important for us to know where you are during the session, so that we can take action in the event of an emergency.

You should also ensure that you are in a place where you have adequate privacy to discuss personal matters.

If you are outside of the province of Ontario, to provide you with services we require authorization from the jurisdiction in which you are located. If you plan to travel outside the province and hope to continue services, please discuss this with your provider well in advance.

While evidence shows that video services are as effective as face-to-face sessions, there may be some services that cannot be effectively delivered by video or telephone.

Working with WSIB

This information is based on our understanding of relevant law and WSIB policies. However, please be sure to discuss your situation with WSIB, your union, or your representative.

WSIB requires that injured workers cooperate with them. In addition, the WSIB Act places a requirement on healthcare providers to share whatever information that the WSIB requires to manage an active claim, even without the worker's consent.

The WSIB acts as a barrier between the employer and the personal health information which it collects. The WSIB will inform the employer of:

• A claim being submitted
• The general nature of the claim
• A claim being accepted by WSIB
• The worker's restrictions, accommodations, and limitations
• Information as needed for return to work planning

While WSIB maintains worker confidentiality within these general bounds, there are circumstances in which the employer may gain access to your personal health information.

The employer has the right to request the WSIB's file, so that they may review it and, potentially, challenge the claim. If such a request is made, WSIB informs the worker, who has the right to deny the request.

When we submit reports to WSIB, we do our best to balance our obligation to provide WSIB with honest, comprehensive information, and our concern for the information reaching the employer. We are happy to share with you any documentation we send to WSIB.