Disabilities and Accommodations for Therapy Clients

"Disability is not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person's body and features of the society in which he or she lives."

World Health Organization

Teletherapy and Accommodations

Do you have any needs or disabilities that would require accommodations? If so, I will try my best to make teletherapy feasible for you. Online services may be challenging for you, depending on the accommodations you need, your comfort level with technology, and the assistive resources you have access to on your end.

We can talk about what sort of accommodations you might need to make this work, but there are certain parameters that must be observed.

  • Teletherapy will involve video conferencing, phone calls, and/or text messaging - possibly all three but definitely at least one. If you are unable to connect via any telecommunications methods, my practice is not a good fit for you.

  • I will need to obtain your informed consent before we can start therapy services. We may have to adapt the intake process to make that happen.

  • I will need to confirm your identity as part of the intake process. This cannot be done solely through a third party. Again, we may need to adapt my usual process to make this possible.

  • Because you may require me to read forms and content to you in a session instead of completing them on your own, it is important that you understand that this in-session time is billable time.

  • It is standard security protocol to limit access to your treatment records (see my notice of privacy practices and technology and security policies and procedures). If you would like to give a support person access to your records and your private therapy and training site so they can help you navigate content outside of our sessions, we will need a written agreement as to the boundaries of their access. Note that this accommodation for a support person's access to the private therapy and training site is for persons whose physical accommodation needs justify this accommodation, such as visual, hearing, or manual issues that affect your ability to navigate the site independently. This accommodation does not extend to emotional support persons or other professionals. Additionally, you will need to sign an authorization for release of information to clarify the permissions you are granting to that person(s).

  • There are some disabilities that make it challenging to set and keep appointments. This is a common concern for people with presenting problems that involve depression, anxiety, chronic pain, and mobility challenges. Teletherapy eliminates a lot of the hassle and stress that comes with getting ready for and travelling to in-person office visits. Establishing and maintaining a routine can be a crucial part of the healing process. Because my practice is a small, online concierge practice, I am able to schedule appointments outside traditional business hours. I may be able to reschedule appointments that are cancelled with less than 24 hours for reasons directly related to disability issues, depending on frequency of cancellations and clear communication about these issues during therapy. That said, for therapy to be successful, it is important to commit to the appointments you schedule. If your disability routinely prohibits you from keeping scheduled appointments, a large agency may be a more appropriate service for you than a concierge private practice.

If you find that site content or learning materials are not accessible to you, please let me know in session or via my contact page. Within the limits of my knowledge of accessibility standards, I design my materials to work with assistive technologies. I create most of my e-learning content in WCAG-compliant authoring software. Though I do my best to provide accessible content, I do not have formal training in Section 508 compliance. I am in the process of learning WCAG (web content accessibility guidelines), so I ask for your patience on occasions when I do not realize that content is not accessible. It is important to me to make corrections when I become aware of the need for them. Upon request, I can adapt and present content in different ways to accommodate disabilities.

Some assistive technologies are more comprehensive than others. For example, the NVDA screen reader seems to be compatible with a wider range of e-learning programs than other screen readers. Please note that I am not qualified to provide installation or technical support for assistive technologies.

For the purpose of accommodations, a disability is defined as a condition that restricts your functioning during activities. Some folks prefer the term "persons with disabilities" and others prefer "disabled person". Please let me know if you prefer person-first language or identity-first language.

Visual Impairments

If you have a visual impairment, I am happy to assist you with forms and content by reading aloud to you in session with the exception of intake forms that must be filled out prior to booking an appointment. If you have a disability that prevents you from completing this process prior to scheduling your first appointment, please be prepared to explain the details to me during first contact and we will discuss the feasibility of adapting my teletherapy services for you. You can reach out to me with questions about disability accommodations via this form. If you are unable to fill out the form on your own, the form allows for a representative to complete the form on your behalf.

Deaf or Hard of Hearing

If you are deaf or hard of hearing and would like to include a sign language interpreter in your sessions, we will need to incorporate the risks and authorizations into your informed consent agreement. Please allow a little extra time to prepare this additional documentation for you during the intake process. If you require a sign language interpreter for telemental health counseling sessions, you will be responsible for providing this service. For purposes of HIPAA, your interpreter is not considered a business associate, since they will be employed by you rather than by my practice. This means that the only type of agreement needed for them to be present during your therapy is your signed authorization for release of information specific to this situation. I ask for this release to verify your consent to their presence and participation during the sharing of your personal health information.

Dexterity Impairments

If you have a manual dexterity impairment that makes it prohibitive or physically impossible to sign online forms, you will need to designate a representative to assist you with the intake process. It is preferable for you to provide consent yourself. To make this possible, we will make an exception to my no-recordings policy for the purpose of accommodating your disability. During your first video session, you will provide informed consent via video. This consent will be recorded. You will do the same to provide authorization for release of information when a release is needed. These video recordings will be stored and maintained in the same manner as all other protected health information (see my notice of privacy practices and my technology and security policies and procedures).

Fee Transparency

The entire intake process is normally completed prior to scheduling your first appointment. Persons with disabilities may elect to have me complete the biopsychosocial history with them during the initial session. There is no additional fee for completing the biopsychosocial history during that initial session. That appointment is usually an orientation and evaluation and typically lasts 60-120 minutes.

In subsequent sessions, I can read forms and materials to clients who need accommodations upon request. These tasks may extend the length of a session or involve additional sessions. Additional time will be charged at the hourly rate listed on my therapy services and fees page. An alternative is to for clients who need accommodations to designate a support representative to assist them with these tasks between sessions. If a representative is used, a release of information will be required to clarify the representative's access to the client's protected health information.

Making a Decision

Communication → Support

If we run into the need for additional considerations throughout the intake or therapy process, I will do my best to provide accommodations based on what is realistic and practical in a 100% online therapy practice. Clear and open communication between us will make this process smoother and less stressful for you. Let me know what you need and I will be honest with you about what is and is not possible. If you have additional questions, please send them via this form. If you cannot fill out the form without assistance, please ask a representative to assist you. This representative may be a family member, partner, friend or other emotional support, healthcare provider, or legal representative.