New Client Information
This document is intended to inform you of your rights and responsibilities as a patient participating in counseling and psychotherapy services at Washington and Lee University Counseling Center. If you have additional questions not addressed in this document, please discuss them with your provider. Please request and retain a copy if desired, and review as needed.
Rights & Responsibilities as a Patient Receiving Counseling Services
- You have the right to confidentiality within the scope of federal and state law, with exceptions, some of which are listed under "Confidentiality and the Limits of Confidentiality" below.
- You have the right to ask questions about anything that happens in counseling, the interventions we use, and about other therapies and treatments that may be helpful for your situation or condition.
- You have the right to decide not to receive counseling from us at any point in time. If you wish, we can provide you with the names of other qualified healthcare providers. The provider-patient relationship may also end by mutual consent of both patient and provider.
- You are responsible for being at your scheduled sessions on time. If you are late, we still need to end at your scheduled time so we do not run over into another person's appointment time.
- If at any point during counseling services we assess that we are not effective in helping you reach therapeutic goals, we are obligated to discuss it with you and, if appropriate, to end counseling and refer you to other more appropriate resources or professionals. If we withdraw from providing counseling services, we will give you a reasonable opportunity to acquire any needed services from another provider.
Appointments, Urgent Needs and Emergency Procedures
The University Counseling Center is open Mon-Fri, 8:30 AM-5 PM during undergraduate sessions, and Mon-Fri, 9 AM-5 PM when only law classes only are in session. The Counseling Center is closed 12-1 PM for lunch. You may request a regular appointment with one of the clinicians by calling the Counseling Center at 540.458.8590 or e-mailing email@example.com. Phone and e-mail messages are NOT checked after regular hours or on the weekends. If you need to cancel or reschedule your appointment, please do so at least 24 hours before your appointment date/time so that we can offer that appointment to other students who are waiting to be seen. If you fail to give us at least 24 hours' notice of cancellation, then you may be limited in your scheduling options for future visits.
If you have an urgent need to see a counselor during regular hours, please call or come to the Counseling Center before 11 AM, Mon-Fri. At other times please call or come to the Student Health Center (SHC) for evaluation, which is open 24/7 during undergraduate sessions, and 9 AM-5 PM daily when only law classes are in session. The SHC staff will assess your condition and contact the counselor on call as needed. You may also contact Public Safety at 540.458.8889 to access campus resources (e.g. dean on call, transportation to the SHC). If you are having a mental health emergency and need immediate assistance, call 911, go to your local emergency room, or call Rockbridge Area Community Services Board Emergency Services Crisis Line 24 hours a day at 855.222.2046.
Interventions that May Be Provided
Providers draw from a wide variety of theories and techniques and apply them in a unique way to each individual based on their needs. There is no "one-size-fits-all" approach to counseling and we will work together to create an environment and treatment that is evidence-based and is most likely to help you reach your desired goals. Providers practice only within their boundaries of competence and with methods in which they have professional experience or training. If you have any questions about any of the methods or interventions used by your clinician, please feel free to ask for more information.
Benefits and Risks of Therapies
Engaging in counseling services involves both benefits and risks. The most common benefits involve a resolution of symptoms or complaints that brought you into counseling and include but are not limited to improved daily functioning, motivation, mood, relationships, sleep, habits, and overall improvement of health and feelings of well-being. The risks of counseling include, but are not limited to, the risk that these therapies will not work for you, and may make your condition, complaints, or symptoms worse. Working through any psychological or emotional concern including unpleasant life events or trauma can involve increased emotional distress, painful feelings or thoughts and can result in you experiencing considerable discomfort. However, psychological damage from psychotherapy is rare and any uncomfortable feelings are usually temporary. If you feel that you are not making reasonable progress or that you are being harmed by your involvement in these therapies, you should discuss these concerns with your provider.
Confidentiality and the Limits of Confidentiality
Privacy is an essential part of the counseling process. With the exception of certain specific exceptions described below, you have the right to the confidentiality of your counseling participation. Your provider cannot and will not tell anyone else outside of the Counseling Center what you have discussed, or even that you are in counseling services, without your prior permission. Under the provisions of the Health Care Information Act of 1992, we may legally speak to another health care provider with whom you are a patient for the purposes of coordinating your care. You may request anyone you wish to attend a counseling session with you, however they are not bound by the same requirements to protect your confidentiality.
If you elect to communicate with us by email at some point in our work together, please be aware that email is not confidential. All emails are retained in the logs of your or our internet service provider. While under normal circumstances no one looks at these logs, they are, in theory, available to be read by the system administrator(s) and the internet service provider.
The following are some, but not all, of the exceptions to your right to confidentiality:
- If we have a signed written release of information/records.
- If we believe that in the near future you are likely in danger of harming yourself, or lack the capacity to keep yourself safe or maintain your choice to keep yourself safe, we may legally break confidentiality and call the police or emergency services. We would explore all other options before taking this step.
- If we have a reasonable belief that you will cause serious bodily injury or death to an identified or readily identifiable person or persons and you have communicated your intent to do so to the provider and have the ability to carry out that threat immediately or imminently, we will attempt to contact that person and will contact the police and ask them to protect your intended victim. This includes the intent to spread a known communicable disease to an identifiable third party.
- If we know or suspect abuse or neglect against a minor child, elderly person, or incapacitated adult.
- Your provider may discuss private health information about you with another counseling professional (who follows the same professional requirements for patient privacy and confidentiality) for the purposes of clinical supervision.
- Your provider may discuss your case with another healthcare provider with whom you are currently under care, including other providers from W&L Student Health & Counseling (who follow the same professional requirements for patient privacy and confidentiality), for the purpose of professional consultation, treatment planning and coordination of care.
Additionally, your clinician may ask you to sign a release of information to another party if:
- You were referred to Counseling (e.g., by a dean, a professor, etc.) and that party wants to know whether you kept the appointment and whether you are currently being seen.
- You are requesting reinstatement to W&L after a withdrawal or leave of absence for health-related reasons.
- Discussing your treatment with a dean is needed to coordinate academic adjustments or accommodations.
- You are participating in counseling because of a legal or disciplinary matter.
- You are enlisting in the military, government employment, or are taking a bar exam.
- Your parents want your clinician to discuss your treatment with them and you agree.
Special Considerations for Couples, Family, Minors, and Deceased Patients
If you are participating in couples or family counseling and decide to have some individual sessions as part of that counseling, what you say in those individual sessions will be considered as a part of the couple or family system and can and probably will be discussed in our joint sessions. Do not tell your provider anything you wish kept secret from your partner or other family members while in couples or family counseling.
Information obtained from a minor client (under the age of 18) involved in individual counseling is generally held confidential with the exceptions listed above. Under Virginia law (§54.1-2969), a minor is "deemed an adult for the purpose of consenting to . . . medical or health services needed in the case of outpatient care, treatment or rehabilitation for mental illness or emotional disturbance;" and the minor is "also deemed an adult for the purposes of accessing or authorizing disclosure" of those records. Minors who consent to their own treatment have the legal right to give, or refuse to give, consent for disclosures to others. However, parents or legal guardians of minors generally have the right to access a minor's records, unless (a) the provider determines that disclosure would cause "substantial harm to the minor or another person" or (b) a court finds "good cause" to disallow disclosure.
A deceased patient's confidentiality is also protected consistent with legal requirements and the previously documented preferences of the patient. The specified personal representative or executor of a deceased patient has the right to access health records. In the absence of a personal representative, executor or documented preferences, the deceased patient's surviving family members have the right to access the records in a specified order of priority.
Non-Professional Relationships with Clients
The likelihood of seeing your provider on campus or in the community is high. If that happens, it is our general policy not to personally acknowledge the provider-patient relationship to protect confidentiality. If you speak to your provider the conversation should not be related to counseling issues, as clinicians cannot provide clinical services outside of a counseling session.
If you are unhappy with what's happening in counseling, we hope you'll talk about it directly with your provider so that they can respond to your concerns. They will take your concerns seriously, and with care and respect. You may also request to switch to a different provider in the Counseling Center. If you believe that your provider is unable to respond in a satisfactory way, or that they have acted unethically, you are encouraged to speak with the Director of Student Health and Counseling, Dr. Jane Horton, whose office is in the Student Health Center, or to speak with Dean Sidney Evans, the Vice President for Student Affairs and Dean of Students. You also have the right to discuss your concern with the respective licensing Board under which your counselor is licensed by the Virginia Department of Health Professions.