Consent to Treatment

Nature of services

Pasadena Clinical Group provides outpatient psychotherapy, including perinatal mental health group therapy and individual therapy, for women experiencing pregnancy- and postpartum-related mental health concerns. Treatment is provided by licensed clinicians (psychologists, marriage and family therapists, and clinical social workers) and supervised trainees in accordance with California law.

Psychotherapy is not easily described in general terms. The course of therapy varies depending on the personalities of the therapist and client, and the specific concerns being addressed. There are many approaches we may use to address the issues you bring to therapy. Treatment requires your active participation, including time spent both in and out of session, and may involve discussion of unpleasant or painful experiences.

Potential benefits and risks

Psychotherapy can yield benefits including reduced symptoms, better relationships, improved functioning, and resolution of specific concerns. There is no guarantee of any specific outcome. Risks include experiencing uncomfortable feelings such as sadness, guilt, anxiety, or anger, and recalling distressing memories. Group therapy carries the additional risk of becoming aware of others' experiences in ways that may be uncomfortable; the benefit is the connection and support that group provides.

Psychotherapy is not a guarantee against future mental health concerns, and is not a substitute for psychiatric medication, medical care, or emergency services.

Confidentiality

Information you share in therapy is confidential and protected by California state law and federal HIPAA regulations. With few exceptions, we will not disclose information about you or your treatment without your written consent.

For group therapy, all members are required to maintain confidentiality of what is shared in group. While we cannot guarantee what other members will do outside of group, group agreements about confidentiality are reviewed at the start of every cohort.

Limits of confidentiality

California law and our ethical obligations require that we break confidentiality in specific situations:

• Suspected abuse or neglect of a child, dependent adult, or elder — we are mandated reporters and must report to the appropriate agency.
• Imminent danger to yourself — we are obligated to take reasonable steps to ensure your safety, which may include contacting emergency services or initiating a psychiatric hold.
• Imminent danger to a specifically identified other person — under the Tarasoff duty, we may be required to warn the intended victim and notify law enforcement.
• Court order or valid subpoena — under specific legal circumstances, we may be required to release records.

Whenever possible, we will discuss any required disclosure with you before it is made.

Sessions, scheduling, and cancellations

Individual therapy sessions are typically 50 minutes long. Group therapy sessions are typically 90 minutes long. Frequency is determined collaboratively with your clinician.

You will be billed the full session fee for missed appointments or appointments cancelled with less than 24 hours notice, except in cases of genuine emergency. Insurance does not cover cancellation fees. See our Office Policies for detail.

Communication and electronic contact

Email, voicemail, and text messages are not fully secure forms of communication. We use these channels for scheduling and administrative matters only and ask that you do not send clinical information by email or text. Your clinician will respond to non-urgent messages within one to two business days. We are not an emergency service — see crisis resources at the end of this document.

Fees and billing

Our fees are discussed at intake and are listed in our fee schedule. We bill insurance directly for in-network plans. For self-pay clients, payment is due at the time of service. We provide Good Faith Estimates upon request — see Good Faith Estimate.

Your right to end treatment

You have the right to end therapy at any time. We ask that you discuss the decision with your clinician when possible, so that we can support a thoughtful ending and any needed referrals. There are no penalties for ending care.

Crisis resources

Application to all Released Parties

Every protective provision of this Consent to Treatment — including provisions regarding limits of confidentiality, session policies, communication, fees, ending treatment, crisis routing, and dispute resolution — applies for the benefit of, and may be enforced by, each and every "Released Party" as defined in Terms & Conditions Section 2. The Released Parties include, without limitation, Pasadena Clinical Group; its parent, subsidiary, and affiliated entities; its directors, officers, members, owners, and shareholders; all employees, clinicians (psychologists, marriage and family therapists, clinical social workers, and other licensed mental health professionals), supervisors, supervisees, trainees, interns, externs, and post-doctoral fellows; all independent contractors, consultants, agents, vendors, business associates (including telehealth-platform providers, billing companies, electronic-health-record vendors, and other HIPAA business associates), service providers, and successors and assigns. Each Released Party is an intended third-party beneficiary of this Consent and may enforce it directly. Nothing in this Consent waives or modifies any non-waivable rights you have under California professional-licensing law, HIPAA, the California Medical Information Act (Civ. Code §56 et seq.), the No Surprises Act, or other applicable law.

Dispute resolution: mediation, arbitration, class-action and jury-trial waivers

By signing this Consent, you agree that any past, present, or future dispute, claim, or controversy between you and any Released Party — other than (i) bona fide professional malpractice claims that, under California law, may not be subjected to mandatory arbitration without a separate signed agreement compliant with California Code of Civil Procedure §1295, and (ii) small-claims actions if eligible — will be resolved through the stepped process described in our Office Policies and Terms & Conditions Section 11: (a) thirty (30) days of good-faith informal resolution; (b) mandatory non-binding mediation in Los Angeles County, California, before a JAMS or AAA mediator; and, if not resolved, (c) binding individual arbitration in Los Angeles County, California, before a single JAMS or AAA arbitrator. You and the Released Parties each waive the right to participate in any class, collective, representative, or private-attorney-general proceeding, and waive any right to trial by jury, to the maximum extent permitted by law. The Federal Arbitration Act governs the interpretation and enforcement of this provision; California substantive law applies to the merits.

You may opt out of binding arbitration (but not pre-suit mediation) by sending written notice to Pasadena Clinical Group, Attn: Legal, 301 N. Lake Ave, STE 600, Pasadena, CA 91101 within thirty (30) days after the date you sign this Consent. Opting out is not retaliation and will not affect your right to receive care. If you do not opt out, binding individual arbitration is your exclusive remedy for non-malpractice disputes within the scope of this Section. This Section survives termination of the clinical relationship.

Your consent

By signing the intake paperwork at your first session, you confirm that you have read this document and the linked Office Policies, Telehealth Agreement (if applicable), HIPAA Notice of Privacy Practices, Privacy Policy, and Terms & Conditions; that you have had the opportunity to ask questions and have received satisfactory answers; that you understand the limits of confidentiality and the nature, benefits, and risks of treatment described above; that you consent to receive treatment from Pasadena Clinical Group and its assigned clinician(s) under the terms described; and that the protections, releases, limitations, indemnities, and dispute-resolution provisions extend to all Released Parties as described in the "Application to all Released Parties" section above. You may withdraw consent at any time; we will work with you to ensure continuity of care or appropriate referrals.