Straight Talk About 24-7 Help and Rational Emotive Behavior Therapy (REBT)
THERAPIST:
My name is James R. Lathrop, LCSW, BCD. I am a state of Texas licensed social worker. I hold the following credentials:
Academy of Certified Social Workers:
National Association of Social Workers (NASW)
Diplomate:
National Association of Social Workers (NASW)
Board Certified Diplomate:
American Board of Examiners in Clinical Social Work (ABE)
Training Faculty Member (Institute-certified supervisor):
Albert Ellis Institute
THERAPY:
Rational Emotive Behavior Therapy (REBT) aims to assist the patient to resolve problems of everyday living, emotional disturbance, maladaptive behavior, and relationship issues through education, patient homework, and consultation with a therapist. REBT is an active-directive, dynamic form of psychotherapy.
THERAPEUTIC REALITY:
You may have the idea that psychotherapy is not only safe but also comforting; a special experience during which you get the pleasant attention you desire. The therapist will keep to himself all your most sensitive personal secrets and guide you perfectly through life's difficulties; after all, you may think he can handle every problem in life.
This is not reality. Let's take things one at a time to determine just what the limits really are in counseling or psychotherapy.
PRIVACY:
You may have a right to privileged communication. This means that your communication with the therapist may not be admissible as evidence against you in a court of law. There are several exceptions to this. You may have a right to confidential communications. This means that your communications with the therapist may not be shared by the therapist with anyone else without your consent, except as mandated by law, if it is not also privileged. Likewise there are several exceptions to this.
Please understand clearly that in 24-7 HELP online clinic, I intend to follow ethical and legal guidelines. If I think that you have maltreated a child, I am going to report that suspicion to Child Protective Service or the police; moreover, I am going to tell the case worker or police everything I know or suspect that may be helpful in assuring protection for the child. If I think you are likely to be dangerous to another person, I am going to make reasonable efforts to warn that person, or to assure protection for that person and I may contact the police. If I think you may harm yourself, I am going to seek some restraint or protection for you including calling the police. Frankly, though I care what you think about this, I am going to do it anyway. These are just examples of the several circumstances or reasons I may divulge to others information from our sessions.
CONFIDENTIALITY:
Discussions between a therapist and a patient are confidential. No information will be released without the patient’s written consent unless mandated by law. Possible exceptions to confidentiality include but are not limited to the following situations: child abuse; abuse of the elderly or disabled; abuse of patients in mental health facilities; sexual exploitation; AIDS/HIV infection and possible transmission; criminal prosecutions; child custody cases; suits in which the mental health of a party is in issue; situations where the therapist has a duty to disclose, or where, in the therapist’s judgment, it is necessary to warn, notify or disclose; fee disputes between the therapist and the patient; a negligence suit brought by the patient against the therapist; or the filing of a complaint with a licensing board or other state or federal regulatory authority. FOR FURTHER INFORMATION REVIEW THE NOTICE OF PRIVACY PRACTICES FURNISHED TO YOU BY YOUR THERAPIST IN CONJUNCTION WITH THIS PATIENT INFORMATION AND CONSENT DOCUMENT. If you have any questions regarding confidentiality, you should bring them to the attention of the therapist when you and the therapist discuss this matter further. By signing the Patient Information and Consent to a Working Agreement with 24-7 Help, you are giving your consent to the undersigned therapist to share confidential information with all persons mandated by law and with the agency that referred you and the managed care company and/or insurance carrier responsible for providing your mental health care services and payment for those services, and you are also releasing and holding harmless the undersigned therapist from any departure from your right of confidentiality that may result.
DUTY TO WARN:
In the event that the undersigned therapist reasonably believes that you are a danger, physically or emotionally, to myself or another person, you specifically consent for the therapist to warn the person in danger and to contact any person in position to prevent harm to yourself or another person, in addition to medical and law enforcement personnel, and the person(s) you designate as your Trusted Point of Contact.
This information is to be provided at my request for use by said persons only to prevent harm to yourself or another person. This authorization shall expire upon the termination of your therapy with the undersigned therapist.
You have the right to revoke this authorization in writing at any time to the extent the undersigned therapist has not taken action in reliance on this authorization. Even if you revoke this authorization, the use and disclosure of your protected health information could possibly still be permitted by law as indicated in the copy of the Notice of Privacy Practices of the undersigned therapist that you will receive for your review.
Be advised of the potential of the redisclosure of your protected health information by the authorized recipients and that it will no longer be protected by the federal Privacy Rule.
Treatment provided to you by the undersigned therapist is conditioned on you providing this authorization.
LINKS:
24-7 Help provides links to other web sites for your convenience as well as to help you. However, we cannot know that these links are maintained, or that they actually will be helpful to you. Moreover, we cannot verify the accuracy, validity or value of these other web sites' content.
24-7 Help contains links to other sites that are not owned or controlled by 24-7 Help. Please be aware that 24-7 Help is not responsible for the privacy practices of such other sites.
We encourage you to be aware when you leave our site and to read the privacy statements of each and every Web site that collects personally identifiable information.
This privacy statement applies only to information collected by 24-7 Help.
ONLINE SECURITY:
Username and password protections are the responsibility of the patient. 24-7 Help cannot be responsible for or accountable for patient misuse of username or password.
The security of your personal information is important to us. When you enter sensitive information (such as credit card number) on our registration form, we encrypt that information using secure socket layer technology (SSL). To learn more about SSL, follow this link http://www.verisign.com/ssl/ssl-information-center/.
We follow generally accepted industry standards to protect the personal information submitted to us, both during transmission and once we receive it. No method of transmission over the Internet, or method of electronic storage, is 100% secure, however. Therefore, while we strive to use commercially acceptable means to protect your personal information, we cannot guarantee its absolute security.
Be aware that the computer you use is your primary security risk. A computer owned, leased, or otherwise provided by your employer, or provided by anyone other than yourself, such as computers available in Internet cafes, office support stores, or even your friends might have monitoring in effect. Hardware or software monitoring or monitoring rights may be in effect on these computers. Monitoring may also include phone, fax, and Internet, World Wide Web, e-mail, or chat programs.
24-7 Help has no control over, nor any responsibility for, the computer or equipment you choose to use.
If you have any questions or suggestions regarding our privacy policy, please email us. Please note, this email should not be used for any personal communications or therapy requests.
SOME BENEFITS:
REBT is a dynamic psychotherapy model designed to help patients achieve pleasure and satisfaction while eliminating pain and discomfort. In order to achieve these benefits, REBT focuses on eliminating or reducing emotional disturbance, physiologic upset, and maladaptive behaviors. REBT also strongly encourages everyone to develop and maintain an abiding interest in some healthy or worthwhile pursuit. Only the patient who studies the principles and methods, practices diligently, and suffers the pain and discomfort to actually make the desired life changes can realize these benefits. There is no magic here; but magic isn't necessary to achieve therapeutic results. Diligence and hard work are necessary.
SOME DANGERS:
Not often but sometimes therapy can be dangerous or result in danger. It is risky business to confront the issues involved in such disturbances as depression, anxiety, or delusional thinking; or such relationship issues as child abuse or extramarital sexual encounters. Sometimes as a result of these confrontations, people choose to do harm to themselves or another.
Moreover, sometimes as a result of developing insight or awareness, people may assess that their predicament or life situation is hopeless, which it hardly ever is, but they may make that assessment. They may assess that they are helpless, which they hardly ever are, but they may make that assessment. They may assess that they are hopeless or worthless, which they of course never are, but they may make that assessment. In these cases, sometimes people choose to act rashly, destructively, or against their interests. This is unfortunate and unnecessary.
I am accountable for negligence, so I have developed policies, procedures, and methods to reduce these threats. First and foremost is an attempt to assess your problem, likely consequential reactions, resources, and coping skills.
I am dependent upon your open, honest, and full cooperation in this effort. After all, though I may make every attempt to help you, I can't read minds or predict the future. You must be responsible for your choices and your behavior.
I trust that you will not act maliciously, rashly, destructively, or against your interest; rather, I trust you will confide in me any such concerns, ideas, beliefs, or choices before you irrevocably act on them. I also trust that you will work diligently with me to resolve them constructively.
SOME PROBLEMS:
After discussing the painful dysfunction of marital relations in the context of therapy, sometimes a partner chooses to dissolve the marriage. An adolescent may decide during the therapy that her or his parents really are intolerably demanding so chooses to escape by running away or getting married. There can be undesirable consequences of risking the confrontations or risking the insights or risking the awareness necessary to succeed at therapy. You are well advised to seriously consider the timing and the risks involved; I trust you will discuss your concerns with me.
RATIONAL EMOTIVE BEHAVIOR THERAPY MODEL:
In order to understand and appreciate the relevance and utility of this model for you, it is necessary for you to learn about REBT. It is sufficiently presented in the following:
How to Stubbornly Refuse To Make Yourself Miserable About Anything—Yes, Anything! REVISED 2nd Edition, by Albert Ellis, Ph. D.
Helping Yourself with REBT: First Steps for Clients, by Windy Dryden, Ph.D.
Feeling Better, Getting Better, Staying Better, by Albert Ellis, Ph.D.
A Guide to Rational Living, by Albert Ellis, Ph.D. & Robert Harper, Ph.D.
These are popular and can be found at the Albert Ellis Institute
Guide to Rational Emotive Behavior Therapy, by James R. Lathrop, LCSW, BCD, is available free to print on 24-7 Help.
OTHER THERAPY MODELS:
REBT is the original model in the Cognitive Behavior School of psychotherapies. The home of REBT is the Albert Ellis Institute in New York. Some other models in the Cognitive Behavior Therapy School of psychotherapies are presented through links on 24-7 Help. In order to evaluate the relevance and utility of REBT, it may help you to review these linked sites.
Schools of psychotherapy or models of therapy outside the models of the Cognitive Behavior Therapy School of psychotherapies may be useful as well; however, I am not expert in these schools or their models, so I shall not attempt to lead you to them.
GOALS, PURPOSES AND TECHNIQUES OF THERAPY:
There may be alternative ways to effectively treat the problems you are experiencing. It is important for you to discuss any questions you may have regarding the treatment recommended by the therapist and to have input into setting the goals of your therapy. As therapy progresses these may change. The initial goals, purposes and techniques of therapy agreed upon by you and the therapist will be agreed upon in the Service Agreement.
ETHICAL BEHAVIOR:
Sometimes therapists become inappropriately involved with patients. The relationship may develop into a friendship or even into sexual intimacy. These types of relationship developments are ethically forbidden and definitely wrong; it is the therapist's responsibility to set proper limits to prevent harm, protect the patient, and allow for the real possibility for therapy to take place. Though I shall attempt to be cheerful and friendly, I am not going to become your friend, or have any other relationship with you other than that of therapist-patient.
I am not going to suggest or permit us to meet except online through 24-7 Help; therefore, I am not going to permit physical contact of any sort. I am not going to suggest that either of us undress or become sexually intimate by audio, video, instant messaging, chat or any type of multimedia, nor in person. I shall not participate in any of these activities if you suggest them.
PROTECTION:
To some degree it is the therapist's job to see to the protection of the patient and those who may be at risk from the patient. Therapists don't like this, but it’s our job. I may recommend or cause the involvement of others in your case. I am not the least shy about trying to get limits set in other people's lives.
PROHIBITED PATIENTS:
In order to provide ethical services, any therapist is wise not to treat some individuals. Some of those individuals 24-7 Help decline to serve follow:
- Personal friends
- Financial associates
- Social or organizational acquaintances
- Political associates or cronies
- Family members
You must assure that you do not knowingly fall into any of the categories listed here.
THERAPY:
Whether therapy is effective depends upon several factors. It has to be an appropriate therapy for the issue, the therapist has to be competent to use the therapy, the setting has to be conducive to therapy, the timing for therapy has to be appropriate, and the patient has to be willing and cooperative. I practice Rational Emotive Behavior Therapy (REBT). An assessment prior to beginning REBT may help us to decide if this is an appropriate therapy for you.
If I think that REBT is not the correct therapy for you, I shall decline to offer therapy to you. You may then seek therapy elsewhere, if you please. At best I can only guide you through REBT. You have to suffer the pain and do the work to succeed. REBT is a therapy of some value in the relief of emotional disturbance, physiologic upset, maladaptive behavior, and relationship dysfunction.
However, it is only a useful tool, not the only useful tool. Even then it is often not enough. You had better be prepared to take charge of your life and use other resources as well.
THERAPY LIMITS:
Patients are accepted by 24-7 Help based solely upon the therapist’s discretion, which shall control. 24-7 Help approach may not be suitable for all persons requesting therapy. Some individuals would better benefit from inpatient care, in office consultation, or where the therapist may be more immediately available, especially at times other than during the scheduled appointment time.
The judgment to accept or decline a request for service at 24-7 Help shall rest exclusively with the therapist. The therapist’s discretion shall control.
24-7 Help is not set to offer services to those who cannot use the computer interface to participate in therapy, to those needing a deaf interpreter, even one provided by the patient, or those speaking any language other than American English fluently.
EVALUATION AND ASSESSMENT:
24-7 Help requires evaluation and assessment to be sure we are capable of meeting your needs, as well as to assure suitable referrals when appropriate. Your cooperation is necessary if this is to be effective and in your interest. Initially, standard tools are employed in order to assure that our services are compatible with your needs. Upon the start of therapy, REBT will be the primary tool to continue evaluation and assessment.
The best means available for useful evaluation and assessment is open reflective communication by the patient with the therapist. I am not going to judge you regardless what you reveal to me. The more you risk, the more likely we can decide on a treatment plan or a referral that will meet your needs.
Outcome evaluations help us determine how well REBT is working for you. They help us determine when or whether a referral is in your interest.
TREATMENT PLAN:
Treatment planning is based on your stated needs and developed by mutual agreement. As we work out the plan dynamically using REBT, progress is assessed, the treatment plan modified and your prognosis is developed. These are not static statements but dynamic developments. The better and more effectively you study REBT, diligently perform appropriate homework and openly work in sessions, the more progress you are likely to make and the better prognosis you will have of achieving your stated treatment goals.
REFERRALS:
Of course, if appropriate, I shall try to help you find suitable assistance. For Social Work assistance referral to the Albert Ellis Institute is a suitable source to find an REBT therapist using that site's referral list. You may be instrumental in this process by helping to clarify your needs and desires. Not all referrals work out as hoped; however, you must make reasonable attempts to utilize the referrals effectively.
Benefits of a referral include the opportunity to get needed treatment, assistance, support or services. On the other hand, risks of a referral include concluding that maybe no one can help since the referring therapist indicates that she or he cannot provide the needed care alone. The next therapist may not be the right referral, delaying the patient’s ultimate goal achievement.
COMMUNICATIONS:
24-7 Help provides e-mail and web posting. Patient and therapist can post messages to the Patient Information Page.
EMERGENCIES:
24-7 Help does not provide emergency services of any kind. We may not be able to predict an emergency, but we can prepare for them. 24-7 Help may experience problems of various sorts. In that hopefully unlikely event, I shall inform you as soon as practical by posting a note to 24-7 Help web site. You may send e-mail as well. However, you may require emergency assistance. Of course, 24-7 Help or I may attempt to assist you with a referral, but you may find that you are completely on your own to request emergency services from the proper authorities or sources. You would be wise to arrange for psychiatric, medical, psychological, legal or other emergency services so that in the event of need you can access them quickly. You might consider confiding in a trusted significant other such details, including properly drafted Powers of Attorney that would allow that person to access these services for you.
URGENCIES:
Sometimes we experience events that to us are urgent. For example, during an online session, you or I might receive a call that you or I must take. Brief interruptions to manage urgencies are acceptable.
FEES AND SESSIONS:
An initial assessment session is 75 minutes; the fee is $150 for this session. Follow-up sessions are 50 minutes; the fee is $120.00 per session. In order to schedule a session, the fee must be paid through 24-7 Help. One session may be scheduled at a time. Sessions will begin on time. Session times are fixed and will not be extended. A session not attended by the patient is paid. Fees are refundable by patient cancellation not less than 24 hours prior to the session. The patient can cancel sessions through 24-7 Help. Refunds will be applied to the credit card used by the patient to pay for the session.
Brief interruptions to manage urgencies are acceptable. The session time will continue until the appointed end. Sessions will not be extended to accommodate patient urgencies; however, if 24-7 Help or I must make brief interruptions of fewer than 10 minutes total in a session, that time will accounted as if it did not occur. If greater than 10 minutes total interruption(s) in a session will be accommodated by an additional session at no charge to the patient.
24-7 Help does not accept third party payments. I am concerned that third party payers may require information that could be revealed by them to others without your consent or without even informing you they revealed it.
MY EXPECTATIONS OF YOU:
I expect that you are serious about using REBT to make your life better for you. I expect that you will value gaining pleasure and satisfaction from life while avoiding pain and discomfort. I expect you to value long term gain over short-term gratification. I expect you to be open, honest, and forthcoming with me in therapy. I expect you to manage desires to resist the necessary discomfort of developing awareness and insight.
I expect you to work effectively using the REBT model. I expect you to diligently do appropriate homework whether assigned by me, or discovered by you through your reading and work at REBT.
I expect you to comply faithfully to the rules, guidelines, understandings, and agreements stated by 24-7 Help or the therapist in Straight Talk About 24-7 Help Online Clinic And Rational Emotive Behavior Therapy (REBT), by James R. Lathrop, LCSW, BCD, Patient Information And Consent To A Working Agreement With 24-7 Help, Consent To Service Plan And Service Contract With 24-7 Help, as well as any and all rules, guidelines, understandings, and agreements made with the therapist during online sessions, including the assessment, treatment, and termination sessions.
If, in my judgment, you fail to comply with homework assignments or you fail to work effectively in session using of REBT, even though you may be trying diligently, then I shall terminate therapy with you. I believe that such failure by the patient, even when the patient tries diligently, likely makes continued REBT therapy attempts detrimental rather than helpful.
TIME TO QUIT THERAPY:
REBT is designed to be a therapy that you continue for the rest of your life on your own; not with your therapist. At some point it may be appropriate for you and I to terminate our professional relationship. When you are able to master the basic elements of REBT; are no longer so disturbed, upset, maladaptive or dysfunctional that you need the assistance of a therapist to continue to safely and adequately progress; and when the risk of relapse is minimal; then it is time for us to plan to terminate this therapeutic relationship.
Sometimes the prospect of terminating the therapeutic relationship provokes the patient to regress or to relapse to presenting issues. This does not mean progress is not valid. It is merely Nature's way of holding on to a comfortable thing.
We can manage those problems during the process of therapy. In some therapy models, there is a termination-planning period. During this period, the therapist may help the patient to prevent relapse. REBT incorporates all aspects of therapy, including relapse prevention and termination planning, during the dynamic application of the model.
COMPLAINTS:
I trust that we can resolve any complaint, problem or issue to your satisfaction. I desire to assist you with your REBT needs of course, but also with your 24-7 Help needs as well. I shall seriously consider any complaint, problem or issue you present. I hope you will discuss these with me openly and fully.
If this is not satisfactory, mediation and/or arbitration may provide acceptable results quickly without unnecessary expense or delay.
An individual who wishes to file a complaint against a Licensed Social Worker may write to:
- Texas State Board of Social Worker Examiners
- Complaints Management and Investigative Section
- P.O. Box 141369
- Austin, Texas 78714-1369
Or call 1-800-942-5540 to request the appropriate form or obtain more information.
BOTTOM LINE:
OK, that's the deal. Along the way you will become better attuned to the reality of REBT. I'll gladly talk with you more deeply about all these areas; I'll work hard to teach you REBT; I'll keep you apprised of my assessment of your issues and my impressions about your progress; I'll be open and honest with you, serious and sincere about your case; but I'll do the distasteful jobs just as diligently also. Here I'll set the basic limits; others we can set together.
If you prefer to work differently or to have a different relationship with your therapist, you’ll have to find another therapist or another clinic.
WELCOME TO THERAPY:
If you want therapy and you are willing to operate within these limits; if you are willing to be responsible for your life and work hard, then I welcome you to 24-7 Help and REBT psychotherapy.
