Policy Statement Form

    Ann E. Drouilhet, LICSW, LMFT
    40 Speen St. Suite 106

    Framingham, MA    01701

    508-877-3660 x2

    adrouilhet@gmail.com

     

     POLICY STATEMENT ON CONFIDENTIALITY

     

    Please review this material carefully so you may discuss any questions or concerns with Ann E. Drouilhet, LICSW. In general, law protects the confidentiality of all communications between yourself, as a client, and your therapist, and information can only be released to others with your written permission. There are, however, a few exceptions:

     

    In most judicial proceedings, you have the right to confidentiality regarding your treatment. However, a judge may require testimony in child custody proceedings, adoption proceedings, and proceedings in which your emotional condition is an important element.

     

    If I believe that someone is threatening serious bodily harm to another, I am required to take protective actions, which may include notifying the potential victim, notifying the police, or seeking the client’s hospitalization.  If a client threatens to harm himself/herself, I may be required to seek hospitalization for the client, or to contact family members or others who can help provide safety.

     

    If I believe that a child, elderly person, or disabled person is being abused, I must file a report with the appropriate state agency. If you reveal information that constitutes physician misconduct, I am required to report the physician to the state medical board, without revealing your mane or identity.

     

    If you use third party reimbursement, I am required to provide the insurer with a clinical diagnosis and sometimes a treatment plan or summery.  Massachusetts’ law prohibits all insurers from releasing any data about outpatient mental health care without your specific permission.

     

    If you have any questions about this material, please discuss them with me.