Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office.
You can find my Privacy Practices at the bottom of this page and as a handout on the Forms page of this site. Please read it mindfully. I welcome open dialogue that helps empower people in all forms of healthcare.
You can expect that what you discuss in session will not be shared with anyone with just a few critical exceptions mandated by law (see below).
Sometimes, however, you may want me to share information or provide an update to someone you deem appropriate and I will gladly do so once you have given me a signed release authorizing me to do so. The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
Exceptions to the right to confidentiality:
- Suspected child abuse or dependent adult or elder abuse, for which I am required by law to report this to the appropriate authorities. I often work with clients to make these reports themselves as an act of self-empowerment; however, I do make the reports on their behalf as appropriate. In the case of child abuse it has been my experience that many children want my help reporting this information to another adult with whom they have a loving and trusting relationship. When appropriate I am able to do this and then support the non-offending adult in making the report with me.
- If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.
- If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.
Notice of Privacy Practices
When you visit us, a record is made of your symptoms, examination, test results, diagnoses, treatment plan, and other mental health or medical information. Your record is the physical property of the medical health care provider, the information within which belongs to you. Being aware of what is in your record will help you to make more informed decisions when authorizing disclosure to others. In using and disclosing your protected health information (PHI), it is our objective to follow the Privacy Standards of the Federal Health Insurance Portability and Accountability Act (HIPPA) and requirements of Wisconsin law.
- a basis for planning your care and treatment
- a means of communication among the health professionals who may contribute to your care
- a legal document describing the care you received
- a means by which you or a third-party payer can verify that services billed were actually provided
- a source of information for public health officials charged with improving the health of the source of data for planning
- a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
-Maintain the privacy of your protected health information (PHI) as required by law and provide you with notice of our legal duties and privacy practices with respect to the protected health information that we collect and maintain about you.
-Abide by the terms of this notice currently in effect. We have the right to change our notice of privacy practices and to make the new provisions effective for all protected health information that we maintain, including that obtained prior to the change. Should our information practices change, we will post new changes in the reception room and provide you with a copy.
-Notify you if we are unable to agree to a requested restriction.
-Accommodate reasonable requests to communicate with you about protected health information by alternative means or at alternative locations. e.g. you may not want a family member to know that you are being seen by Nikki Cohen-Wichner, LMFT. Upon your request, we will communicate with you, if needed, at a different location.
-Use or disclose your health information only with your authorization except as described in this notice.
-review and obtain a paper copy of the notice of information practices upon request and of your health information, except that you are not entitled to access, or to obtain a copy of, psychotherapy notes and a few other exceptions may apply. Copy charges may apply.
-revoke your authorization in writing at any time to use, disclose, or restrict health information except to the extend that action has already been taken.
-request a restriction on certain uses and disclosures of protected health information, but we are not required to agree to the restriction request. You should address your restriction request in writing to Nikki by asking for an available form. We will notify you within 10 days if we cannot agree to the restriction.
-request that we amend your health information by submitting a written request with the reasons supporting the request to Nikki. We are not required to agree to the requested amendment.
-obtain an accounting of disclosures of your health information for purposes other than treatment, payment, health care operations and certain other activities for the last six years but not before April 14, 2003.
-request confidential communications of your health information by alternative means or at alternative locations.
Disclosures for Treatment, Payment and Health Operations
I. Nikki Cohen-Wichner, LMFT will use your PHI, with your consent, in the following circumstances:
Treatment: Information obtained by a nurse, physician, psychologist/counselor, dentist or other member of your health care team will be recorded in your record and used to determine the management and coordination of treatment that will be provided for you.
Disclosure to others outside of therapy: If you give us a written authorization, you may revoke it in writing at any time but that revocation will not affect any use or disclosures permitted by your authorization while it was in effect. We will not use or disclose your health information without your authorization, except (as described below) to report serious threat to health or safety or child and adult abuse or neglect.
For payment, if applicable: We may send a bill to you or to your funder. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis to obtain reimbursement for your health care or to determine eligibility or coverage.
For health care operations. Members of the mental health staff ... or members of the quality improvement team ... may use your information in your health record to assess the performance and operations of our services. e.g. sending a satisfaction follow up survey. This information will then be used in an effort to continually improve the quality and effectiveness of the mental health care and services we provide. At the time of your first appointment, you will be asked to sign a release so that we can mail you a follow up survey.
II. Nikki Cohen-Wichner, LMFT may use your PHI, without your consent or authorization, in the following circumstances:
Child Abuse: If we have reasonable cause to suspect that a child seen in the course of professional duties has been abused or neglected, or have reason to believe that a child seen in the course of my professional duties has been threatened with abuse or neglect, and that abuse or neglect of the child will occur, we must report this to the relevant county department, child welfare agency, police, or sheriff’s department.
Adult and Domestic Abuse: If we believe that an elder person is the victim of abuse, neglect or domestic violence or the possible victim of other crimes, we may report such information to the relevant county department or state official.
Serious Threat to Health or Safety: If we have reason to believe, exercising best judgment and our professional care and skill, that you may cause harm to yourself or another person, we may take steps, without your consent to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition in order to protect you or another person from harm. This may include instituting commitment proceedings.
Judicial or administrative proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law and we will not release the information without written authorization from you or your personal or legally-appointed representative, or a subpoena/court order. The privilege does not apply when you are being evaluated by a third party or where the evaluation is court ordered.
Law/Health Oversight: As required by law we may disclose your health information. For example, if the Wisconsin Department of Regulation and Licensing requests that we release records to them in order for the Psychology Examining Board to investigate a complaint against a provider, we must comply with such a request.
Research: We may disclose health information to researchers when Nikki Cohen-Wichner, LMFT’s review board has reviewed and approved the research proposal and established protocols to ensure the privacy of your health information. You would be informed of such research at time of intake.
Student Educational Records: If you are a student and Wisconsin state law and the federal Family Educational Rights and Privacy Act of 1974 (“FERPA”) permit the disclosure to institutional officials with a need to know, we may so disclose your personal health information to those persons. The privacy of student educational records is governed by FERPA. Student health information, including that arising from student use of Nikki Cohen-Wichner, LMFT, is generally considered a student educational record subject to FERPA rather than HIPAA. The HIPAA privacy regulations specifically exclude from HIPAA health information that is considered a student educational record covered by FERPA. Wisconsin state law also restricts the disclosures of student mental health information that may be made without your written authorization or consent and we will abide by those restrictions.
If you have questions and would like additional information, please ask your clinician. He/she will provide you with additional information or put you in contact with the designated Privacy Officer, Nikki Cohen-Wichner, LMFT.
If you are concerned that your privacy rights have been violated, or if you disagree with a decision we have made about access to your health information, or if you would like to make a request to amend or restrict the use or disclosure of your health information, you may contact Privacy Officer (see above). If you believe that your privacy rights have been violated, you can also file a complaint with the Secretary of the U.S. Department of Health and Human Services. We will provide you with the address for filing a complaint with the U.S. Department of Health and Human Services upon request.
Nikki and all staff at Interstate Horse Center respect your right to the privacy of your health information.