Practice Policies

MICHELLE WAKELEY LICSW LLC 

dba AWAKEN MENTAL WELLNESS

726 E. Park Ave. #185

Fairmont, WV 26554

(304) 534-9321

APPOINTMENTS AND CANCELLATIONS - LATE CANCEL and NO SHOW FEES

I value our work together, my time commitment to you, and your session time is held exclusively for you.

The standard meeting time for psychotherapy is 50 minutes. Requests to change the 50-minute session needs to be discussed with the therapist in advance in order for time to be scheduled, and additional time may result in additional charges.

A $15.00 service charge will be charged for any checks returned for any reason for special handling.

Please remember to cancel or reschedule 48 hours in advance. Cancellations and re-scheduled sessions may be subject to a full charge on the day of service unless changes have been agreed upon at least 48 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. Unless other agreements have been made, if you are late for a session by 15 minutes you will have forfeited your allotted time and you may be responsible for the full charge. Your therapist will address frequent cancellations (three consecutive appointments are missed or canceled, or three non-consecutive appointments are missed or canceled within a six month period) with you as this may negatively impact planned therapeutic work.

I will make every effort to keep our scheduled appointments. If I am aware of a need to cancel or reschedule well in advance I will discuss this with you in session. If I become aware of a need to cancel between the time of your last appointment and 48 hours from your next appointment I will message you through the Client Portal. If I need to cancel within 24 hours of your next appointment due to illness or emergency I will contact you directly via text or phone call. In the event I am unable to communicate a pre-authorized and appointed representative will reach out to you on my behalf.

I will make deliberate efforts toward maintaining professional standards for self-care and competence by planning time off. I plan to be unavailable for most major holidays (New Year’s Day, MLK Day, Good Friday, Memorial Day, Juneteenth, Independence Day, Labor Day, Thanksgiving, Black Friday, Christmas, and New Year’s Eve). I will also plan at least 4 weeks of time off per year, typically about a week per season, including around Christmas. In addition, I will occasionally be away for trainings, consultation, and continuing education events. Prior to planned time away I will inform you of the planned absence, attempt to reschedule if possible, and review resources you may contact while I am unavailable.

PAYMENT OF SERVICES

Each client will enter into a Payment Agreement prior to the start of services. A credit card is required to remain on file and will be billed within 48 hours prior to or following the time of service. The Payment Agreement will be reviewed bi-annually, and is subject to change.

A Good Faith Estimate will be provided to any client identified as Self-Pay or using Out-of-Network benefits in accordance with the No Surprises Act.

Payment Agreements and Good Faith Estimates cover regular and expected services. Additional services, including request for documents, consultation, and court-related activities may incur additional charges.

COURT-RELATED ACTIVITIES

I understand that requesting this therapist to participate in any court-related activities may jeopardize the client's confidentiality. I agree to pay in advance a Court Appearance fee of $6,000.00 which retains this therapist for three days. I agree to pay in advance all other court-related costs (including communicating with attorneys, preparing documents, providing testimony, etc.) at a rate of $150 per hour. I understand that court-related costs are non-negotiable and separate from typical professional therapy services. I understand these costs are necessary due to the disruption that court activities may cause for others receiving care.

LIMITS OF STATE-BOUND LICENSURE

Although interstate licensure is likely in the near future, currently licensure is state-bound, meaning you must be physically present in the state in which your therapist holds licensure at the time of session. There is no exception. If you are physically outside of the state of West Virginia for any reason or by any proximity (including if you are vacationing in another state or just barely over the state line) you will not be able to meet with your therapist, your session will be forfeited, and you may be held financially responsible for the cost of the session.

TELEPHONE ACCESSIBILITY

If you need to contact me between sessions, it is preferred that you do so through the Client Portal as it is most secure. You may also choose to leave a message on my voice mail or email. I am often not immediately available; however, I will attempt to reply as soon as possible. This is a solo private practice and I am unable to provide 24 crisis support. If a true emergency situation arises, please call 911 or any local emergency room. For other crisis support: You can contact the National Suicide Prevention Lifeline at 988 or 1-800-273-TALK(8255). The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones. You may contact Help304 at www.help304.com (chat), or 1-877-HELP304 (text/call). Help304's professional crisis counselors are available 24/7 and trained to listen and help you find the way forward with stress-management strategies as well as community resources and referrals. You can contact HELP4WV at www.help4wv.com (chat), or 1-844-435-7498 (text/call). Help4WV is a 24/7 call, chat, and text line that provides immediate help for any West Virginian struggling with an addiction or mental health issue. These contacts are also listed under Resources at www.awakenmentalwellness.com

SOCIAL MEDIA AND TELECOMMUNICATION

In accordance with the NASW Code of Ethics, due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.

ELECTRONIC COMMUNICATION

I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. It is preferred that all communication happens through the Client Portal, as it is considered most secure. If you prefer to communicate via phone, email, or text messaging for issues regarding scheduling or cancellations, I will may not be able to answer immediately and will try to return messages in a timely manner. I request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.

Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of West Virginia. If you and your therapist chose to use information technology for some or all of your treatment, you need to understand that: (1) You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled. (2) All existing confidentiality protections are equally applicable. (3) Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee. (4) Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent. (5) There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs. Effective therapy is often facilitated when the therapist gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in therapy services, potential risks include, but are not limited to the therapist's inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition including deformities, apparent height and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what he or she would consider important information, that you may not recognize as significant to present verbally the therapist.

TERMINATION

Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. You may terminate treatment at any time, and it is suggested that you do this openly to allow for closure and referrals, if needed. I may terminate treatment after appropriate discussion with you and a termination process if I determine that the psychotherapy is not being effectively used or if you are in default on payment. In accordance with my professional ethics, I will not allow you to accrue a bill and acquire debt as a result of care, and thus, future services may be canceled if payment for a previous service has not been rendered. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified psychotherapists to treat you. You may also choose someone on your own or from another referral source.

For legal and ethical reasons, the client will have self-discharged from services as soon as three consecutive appointments are missed or canceled, three non-consecutive appointments are missed or canceled within a six month period, or no appointments are scheduled for three weeks. If the client wishes to resume services, there may or may not be a spot available. If services are resumed there will need to be a new Payment Agreement signed.

PROFESSIONAL DISCLOSURE STATEMENT

Therapist’s name: Michelle Wakeley

Position: Therapist for Michelle Wakeley LICSW dba Awaken Mental Wellness

Business Address: 726 E. Park Ave. #185, Fairmont, WV 26554

Business Phone: (304) 534-9321

National Provider Identification Number: 1629465786

Professional License Number: DP00944505

License Level: LICSW

Original License Date: 11/2014

Professional Education: Masters of Social Work, West Virginia University, Graduated 2009; Bachelors of Science in Psychology, Fairmont State University, Graduated 2005

Areas of Competence: Individual assessment, diagnosis, and treatment of mental and emotional disorders, with advanced experience treating trauma and stress-related disorders, mood disorders, substance use disorders, anxiety disorders, grief and bereavement, attention deficit disorders, adjustment disorders, relational dysfunction, and identity issues; Group therapy; Children and Families; LICSW License Supervision; Consultation

Applicable Training: EMDR (Level 1 and Level 2), TFCBT, NMT, FFT

I follow the Code of Ethics for the National Association of Social Workers (NASW). The Code of Ethics can be accessed from the website at: https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English Any questions, concerns or complaints relating to the delivery of service by the therapist listed above, may be directed to the Board office:

WV Board of Social Work

PO Box 5459 Charleston, WV 25361

(304) 400-4980

www.wvsocialworkboard.org