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Consent for Treatment & Patient Agreement

Your child’s treatment is a collaborative process during which we will work together to determine how to best understand and address your child’s treatment needs. This page contains information about the psychological services I oﬀer and my business policies.

Psychological Services

Although each patient’s treatment varies, my treatment modality with each child is Play Therapy.

Play is a child’s primary form of communication prior to having the language skills to verbalize his or her thought’s and feeling’s. I use play as a means to understand your child’s inner world as well as help him or her process and work through stressful events, fears and anxieties. Play is also a way to access your child’s wishes and fantasies that he or she may not yet be able to articulate or even have access to on a conscious level. In my use of Play Therapy, I also use play as a way to build social skills and develop more eﬀective ways to cope with feelings of anxiety, sadness and anger in a way that allows the child to practice these skills in a regulated, contained and safe space so that they are better able to apply them at home and at school.

Treatment usually begins with a 60-90 minute intake session with a fee of $200–$250. This is conducted without the presence of your child so that I may meet with caregivers to openly discuss the presenting issues as well as important background information, such as birth history, developmental milestones and any family dynamics that may be relevant to the current symptoms of the patient. During this intake session, initial treatment goals will be established in order to help organize the ﬁrst few treatment sessions during which I will be further assessing and observing your child. Fee’s for treatment will also be agreed upon and consent, patient agreement and Notice of Privacy form’s will all be reviewed. Your child’s ﬁrst Play Therapy session appointment will also be made during this time.

Your child will meet with me once a week for a 45 minute Play Therapy session for a fee of $150–$170. Unless other arrangements have been made, this session time is sole for your child. In order for your child to receive his or her full 45 minutes of treatment, I encourage caregivers to email me at christie@dr-christie.com or call me at (718) 215-0802 the day prior to a session if there were any signiﬁcant events that occurred during the week that would be helpful for me to know about prior to session. I usually use the ﬁrst 4 sessions to observe and assess your child. During these initial sessions my stance and level of interaction may be more passive, as my goal is to create an environment of safety and comfort for your child so that they may explore and express themselves freely. Once this initial assessment period is complete, I will develop speciﬁc treatment goals that will be reviewed with you, as well as determine what the best treatment approach will be based on your child’s level of need, presenting problems and play skills. We may also review any possible initial diagnoses, if relevant.

In addition to your child’s weekly Play Therapy session, it is often necessary and beneﬁcial to arrange collateral sessions for caregivers to meet with me alone. These sessions are used to discuss your child’s treatment, level of functioning at home and in school as well as area’s of progress and concern. These sessions are also helpful in developing eﬀective strategies that can be carried over from the treatment session to the child’s outside, more naturalistic environment. These sessions are also 45 minutes and are the same fee that has been decided upon for your child’s individual session. It is recommended that collateral sessions take place once a month in addition to your child’s individual session, not in lieu of it; however this can be determined based on ﬁnancial resources, scheduling availability and treatment needs.

As needed, family therapy sessions may also be helpful. These types of sessions would include family members that may be playing a part in the diﬃculties the child is experiencing or are seen as a helpful and supportive component to the child’s treatment. Bringing family members into treatment can be beneﬁcial in helping the child feel more cohesion and collaboration between the work they are doing in therapy and their outside environment. Family sessions are 45 minutes and are the same fee agreed upon for individual sessions.

School visits are also a service that I oﬀer. Often times there are signiﬁcant behavior problems being exhibited at the patient’s school. A school visit can be helpful in order to observe your child in his or her natural setting, as well as consult with your child’s teachers and service providers to develop strategies that may be beneﬁcial for your child at school. School visits are always discussed with caregivers ﬁrst to determine their appropriateness. Depending on the child’s age, awareness and level of discomfort they may feel with having the therapist present, a school visit is not always deemed therapeutic. There are also conﬁdentiality issues involved and therefore the therapist would never seek a consultation of this sort without the proper authorization and agreement from caregiver’s ﬁrst. School visits are 60 minutes and are a fee of $180–$250.

There are beneﬁts and risks of psychotherapy. Due to the nature of psychotherapy, uncomfortable and often diﬃcult issues are brought to light. I will always try and be aware and supportive of your child’s comfort level, while also encouraging them in a therapeutic way to face challenging issues and problem solve around how to grow, work past obstacles and develop new skills. The beneﬁts of treatment vary for each individual. Through the use of Play Therapy many children gain improved self-esteem, develop coping skills, learn appropriate social skills, increase their emotional regulation, learn to problem solve and work through traumas and stressful life events. The progress of the child’s treatment is largely based on the family’s level of commitment to bringing the child to weekly sessions. Progress takes time and patience in required. Each child moves at their own pace and my role is to be supportive and respectful of this pace, with the right amount of encouragement to challenge them along their journey. As caregivers, you may also experience uncomfortable emotions throughout the course of your child’s treatment due to the nature of the work. I encourage you to always express these feelings with me so that I can best support you during these times.

Professional Fees & Payment

Payment is expected at the beginning of each session. Payment can be in the form of cash, check or credit card. For patients who need to be seen for treatment on a sliding scale, those fee’s are discussed and agreed upon during intake and prior to the ﬁrst treatment session.

Fees

Intake session (90 minutes): $200–$250
School Visit (60 minutes): $180–$250
Individual/Collateral/Family session (45 minutes): $150–$170

Insurance

I do not accept insurance. However, I will complete out-of-network paperwork if reimbursement is needed.

Collection

In the rare situation that your account has not been paid within 60 days and arrangements for payment have not been agreed upon, I have the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court which will require me to disclose otherwise conﬁdential information. In most collection situations, the only information I release regarding a patient’s treatment is his/her name, the nature of service provided, and the amount due. If such legal action is necessary, any costs incurred will be included in the claim. Please notify me if any problems arise during the course of therapy regarding your ability to make timely payments so that we may try to reach a solution.

Appointments

Play Therapy sessions are usually scheduled once a week for 45 minutes per visit, although sometimes visits can be more frequent if needed. These weekly sessions are a commitment and we value this work together by starting on time. If I am ever unable to start on time, I asks for your understanding and I assure you that you will receive the full time agreed to. If you are late, you will receive the remainder of your scheduled time and are required to pay the full fee. This is necessary so I can seen other client’s at their scheduled time. If I do not have a client scheduled immediately after you and your lateness is not a habitual issue, I will do my best to provide your child with his or her full therapy session. If I have any planned time oﬀ, I will notify you one month in advance. For any unforeseen absences or therapist illness, I will attempt to reschedule your appointment as soon as possible.

Cancellation & Rescheduling Policy

Once an appointment is scheduled, you will be expected to pay for it. If you are unable to make your agreed upon appointment time, you need to provide 24 hour notice at which time we will reschedule your appointment. The point of rescheduling instead of canceling appointments allows for more consistent treatment so that your child develops a routine in coming to session which allows more ﬂuid work and continual progress.

Contacting Me

Due to my work schedule, I am often not immediately available by telephone or email. If you have called me and you reach my voicemail, please leave a message. If an emergency arises, please indicate it clearly in your message.

Do not email me for emergencies. I will make every eﬀort to return your call or email within 24 hours, with the exception of weekends, holidays and planned vacations. During planned vacations I will provide you with the name of a colleague whom you can contact if necessary.

I do not return telephone calls between 8:00 p.m. and 8:00 a.m. If you are unable to reach me and feel that you cannot wait for me to get back to you or if your child is in crisis, please contact your family physician, call 911 or go to your nearest emergency room. You may also call a mobile crisis team at 1-800-LIFENET.

Professional Information

Dr. Christie Sosnowski is a licensed clinical psychologist. She received her B.A. in psychology from The State University of New York at Stony Brook, graduating cum laude in 2002. Dr. Sosnowski spent 3 years in between her undergraduate and graduate training working in special education at Southampton Elementary School. Here she delivered ABA services and specialized in teaching children with Autism Spectrum Disorder. Dr. Sosnowski obtained her doctoral degree in clinical psychology from Alliant International University at the California School of Professional Psychology, graduating in 2011 with her Psy.D. During graduate school, Dr. Sosnowski was enrolled in the Child and Family Program allowing her to specify her training to learn about child psychopathology, child development and family dynamics. In addition to her private practice, Dr. Sosnowski works at a therapeutic preschool program for children with emotional disturbance, behavioral disorders and Autism Spectrum Disorder. If you have any questions about the speciﬁcs of Dr. Sosnowski’s training, experience or license please ask directly for clariﬁcation at any time.

Limits of Confidentiality

With certain speciﬁc exceptions described below, you have the absolute right to the conﬁdentiality of your child’s therapy. I cannot and will not tell anyone else what you have told me, or even that you/your child is in therapy with me, without your prior written permission. The following are legal exceptions to your right to conﬁdentiality. Should one of these situations occur, I will make every eﬀort to discuss it with you fully before taking any action.

If I reasonably suspect that a person under 18 or over 65, or a disabled person, is being abused or has been abused, I must ﬁle a report with the appropriate state agency.
If a patient threatens to harm him/herself, I may be obligated to seek hospitalization for the patient, or to contact family members or others who can help provide protection.
If a patient communicates a serious threat of physical violence against an identiﬁable victim, I must take protective actions, including notifying the potential victim and contacting the police. I may also seek hospitalization of the patient, or contact others who can assist in protecting the victim.
Occasionally, I may ﬁnd it helpful to consult with professional colleagues about my work in order to determine best treatment practices and interventions for your child. In these consultations, I make every eﬀort to avoid revealing the identity of my patient. The consultant is also legally bound to keep information conﬁdential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together.
If you are involved in a court proceeding and a request is made for information about the services that I provide for you and/or records of them, such information is protected by psychologist-patient privilege law. I cannot provide any information without your written authorization, a court order, or subpoena or discovery from another party to the court proceeding where I do not have grounds for objecting under state law (or you have instructed me not to object). If you are involved in or are contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.
If a patient ﬁles a complaint or lawsuit against me, I may disclose relevant information regarding that patient in order to defend myself.
If a patient ﬁles worker’s compensation claims, I must upon appropriate request, disclose information relevant to the claimant’s condition to the workers’ compensation insurer.
Patients under 18 are in the legal care of their guardians. For this reason, caregiver’s are often included as part of the treatment process and general information is often shared with them regarding the treatment goals and progress of their child. Depending on the child’s age, the speciﬁc information that is shared may vary. For very young children it is often therapeutic to share most of the treatment information with caregivers; whereas for older children issues may arise that require more conﬁdentiality in order to preserve and foster the therapeutic relationship between the patient and myself. Regarding these more conﬁdential issues, if I ever feel that the child patient is in any sort of danger or may cause harm to another, I will inform his or her caregiver’s immediately. If there are other types of important issues that I believe the child patient should share with his or her caregiver’s, I will discuss this with the patient ahead of time and work with them to help them share this information with their guardians themselves, or with me present to facilitate the conversation.
I currently do not provide services through insurance companies or managed care panels. However, if you have health insurance it will usually provide some coverage for mental health treatment. If your insurance allows you to seek “out of network” providers than I can provide you with the necessary information needed to submit to be reimbursed for payment of treatment. In doing so, you should be aware that insurance plans often require that I provide relevant information regarding the type of treatment being provided, progress and diagnosis. In such situations, I make every eﬀort to release only the minimum information that is necessary for the purpose of the request.
Although certain measures are taken, due to the nature of electronic communication, it is important to remember that communication via cell phones, e-mails and faxes are not totally secure. Please keep this in mind when there is communication with a therapist through such means.

Special Issues Concerning Treatment of Children

I will assure to the best of my ability, your child’s safety in the sessions.
If your child should become out of control and engage in behaviors dangerous to him/herself or the clinician, the clinician will use a therapeutic hold in a safe and non-punitive manner until your child is able to refrain from dangerous behaviors. This is very rare in Play Therapy but, should this happen, I will inform you about it at the end of session.
In the course of play therapy, some children, especially young children, often seek out physical contact with their therapist (i.e. hug, sitting on their lap, etc). This is typical and often developmentally appropriate. In order to develop a safe and trusting rapport with your child, I will always accept such aﬀection unless there is know sexual abuse and we have determined that there needs to be clear physical boundaries established. Children often express sexualized themes within their play, however if this is ever done so to the point of concern, I will inform you immediately.