Pamela Henry, M.A., L.C.M.H.C.
N.H. #005
845 South Street · Portsmouth, New Hampshire 03801 · (603) 431-3530

 

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Confidentiality:

One of your most important rights involves confidentiality. Within certain limits, information revealed by you during therapy will be kept strictly confidential and will not be revealed to any other person or agency without your written permission. Recognizing the benefit of second opinions, I may occasionally share information with a colleague for purposes of consultation, always preserving your privacy and shielding your identity. You should also know that there are certain situations in which, as a mental health counselor, I am legally required to reveal information obtained during therapy to other persons and/or agencies, without your permission. In the following situations, I am not required to inform you of my actions:

1) If you threaten grave bodily harm or death to another person, I am required to inform the intended victim(s) and appropriate law enforcement agencies.

2) If you indicate a clear and present danger to hurt yourself and refuse to accept further appropriate treatment, I am required to inform your family, agencies or other individuals who, in my opinion, would assist in protecting your safety.

3) Any information indicating the possibility of abuse of children or the elderly must be reported to the proper authorities.

Due to the nature of the therapeutic process and the fact that it often involves making a full disclosure with regard to many matters of a personal and confidential nature, it is agreed that should there be legal proceedings (such as, but not limited to divorce and custody disputes, injuries, lawsuits, etc.), neither you (client/s) nor your attorney/s, nor anyone acting on your behalf will call on me (Pamela Henry, MA, LCMHC) to testify in court or at any other proceedings, nor will a disclosure of the psychotherapy records be requested. My written records are for me alone, and shall not leave my office (nor be photocopied.) Unless releasing this information might be harmful to you, I will release a brief summary of your sessions, including dates of service, diagnosis, and a brief treatment summary. I will require you to read and sign any such report leaving my office.  Written treatment summaries of couple’s therapy contain information about each person.  Therefore, in such cases, treatment summaries can only be released by joint consent. I will not participate in any insurance disability claim process, as I feel these reports are not always helpful to my client’s therapeutic process. Your confidentiality and trust are of my utmost concern. These policies are in place to protect you and your confidentiality.

 

 

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