Offering psychotherapy, wellness coaching, personal training and group
workshops to encourage positive change and growth in your life.

Policies & Procedures

Social Media & Technology Policies


Karen Fisher, LCSW does not accept friend requests from current or recent former clients on any social networking site. Adding clients as friends on these sites can compromise client confidentiality and client’s respective privacy. It may also blur the boundaries of the therapeutic relationship.


Clients are not to use messaging on Social Networking sites such as Twitter, Facebook, or LinkedIn to contact Karen Fisher, LCSW. These sites are not secure and may not read these messages in a timely fashion. Do not use Wall postings, @replies, or other means of engaging with us in public online if you have an already established client/therapist relationship with Karen. Engaging in this way could compromise your confidentiality. It may also create the possibility that these exchanges become a part of your legal medical record and will need to be documented and archived in your chart. If clients need to contact their psychotherapist between sessions, the best way to do so is by phone or direct email. See the email section below for more information regarding email interactions.


It is NOT a regular part of my practice to search for clients on Google or Facebook or other search engines. Extremely rare exceptions may be made during times of crisis. If I have a reason to suspect that a client is in danger and we have not been able to connect with a client via our usual means (coming to appointments, phone, or email) there might be an instance in which using a search engine becomes necessary as part of ensuring client safety. These are unusual situations and if I ever resort to such means, it will be fully documented discussed the next time you meet with your psychotherapist.


E-mail is not completely secure or confidential. For those who choose to communicate with us by email, be aware that all emails are retained in the logs of your and my Internet service providers. While it is unlikely that someone will be looking at these logs, they are, in theory, available to be read by the system administrator(s) of the Internet service provider. E-mails I receive from clients and former clients along with any responses that are related to treatment and diagnosis may be printed out kept in respective treatment records. Current and former client e-mail information is always kept secure and not shared with any third parties. I ask that clients use email or our secure voicemail system to connect with me.


Thank you for taking the time to review my Social Media Policy. If you have questions or concerns about any of these policies and procedures or regarding our potential interactions on the Internet, please bring them to my attention so that they can be discussed in session.

Policies & Procedures


Your therapist is required to report suspected past or present abuse and/or neglect of children, dependent adults, and elders to the appropriate authorities based on information provided by the client or collateral sources. Information may also be released to designated parties by written authorization of clients or legal guardians. Therapists are required to release information obtained from clients or from collateral sources (other individuals involved in a client’s psychotherapy, such as parents, guardians, spouses) to appropriate authorities to the extent to which such disclosure may help to avert danger to a client or to others, e.g.; imminent risk of suicide, homicide, or destruction of property that could endanger others. If a client is using confidentiality as a means of avoiding legal punishment, the therapist must break confidentiality because the therapist may not aid or abet committing a crime. Psychotherapists reserve the right to release financial information to a collections agency, attorney, or small claims court for delinquent client accounts. Other than the above exceptions, your therapy sessions are held with the strictest ethical standards to honor your confidentiality. Protected as confidential information includes: the acknowledgment of your presence in therapy, documentation you give to your therapist, and all of your therapist’s clinical notes. With the goal of giving you the best clinical care, your therapist will regularly engage in peer consultation or supervision during which relevant information about clients may be disclosed. Your cases may be discussed with colleagues for consultation on a monthly basis. Your confidentiality is still honored strictly during these supervision meetings. If you have any questions or concerns regarding your confidentiality and clinical supervision, please make sure to address these concerns with your therapist.


You may leave messages at any time on my 24-Hour voicemail system. You will receive a response within 24-48 hours. If you have a life-threatening or urgent situation, please call 911, or the Portland Crisis Hotline at 774-HELP. Phone consultations more than 10 minutes will incur a pro- rated charge. Email communication is also appropriate for brief questions or communications to your therapist and will discussed at your next session. It is important to note that email is not 100% secure. 24 hour notice is expected when canceling an appointment. For cancellations within 24 hours, you will be charged your full fee, which is usually not reimbursed by insurance. Emergencies and extreme circumstances are taken into consideration.


Payment is due at the time services are rendered either by Cash or Check. Consultations with other professionals and reports prepared on your behalf will be charged a pro-rated fee. Assessment testing is charged on a per instrument basis. A $25 charge is made for any check returned to us as non-payable for any reason. Accounts over 90 days past due may be sent to collections and additional fees may be applied.


I am reimbursable by many insurance companies and can submit claims for services rendered on your behalf. Please check with your behavioral health provider to determine your copay amount, possible annual deductibles and whether of not your need a prior authorization before services can be delivered. Accrued and uncovered costs such as these are the full responsibility of the client.


As with any professional relationship, the psychotherapeutic relationship requires high standards of moral, ethical, and appropriate conduct on the part of the psychotherapist. Clinical/client relationships such as socializing and interpersonal interactions, specifically, any form of sexual intimacy between a therapist and a client is a boundary violation.

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