Young People, Addiction, Mental Health, and Self Trueness

Agreement to and Informed Consent for Psychological Treatment and for Uses and Disclosures to Carry Out Treatment, Payment, and Psychological Health Care. California residents only.

January 2025

Following is a brief contour of professional services provided by Bradley Smith, Licensed Professional Clinical Counselor, (LPCC), BBS #5325, and Licensed Advanced Alcohol and Other Drug Counselor (LAADC), LR01880216, and his business practices and policies. If you choose to enter therapy or consulting services with Bradley Smith, a more comprehensive set of documents will be provided and will collectively represent a cohesive, signed agreement and understanding between you and Bradley Smith and the scope of services to be provided. 

These additional documents may include standard onboarding questionnaires and release of information forms (if applicable), and will always include a Notice of Privacy Practices, detailing additional information on Confidentiality and how your Personal Health Information (PHI) may be used and shared.

Educational and institutional consulting services may be provided worldwide.

Psychological Services at a Glance:

Bradley Smith is licensed to provide individual, family, and group psychotherapy for individuals residing in the State of California. These services are bound within established guidelines of Scope of Practice and Appropriate Level of Care. Not all individuals seeking or receiving psychotherapeutic care are eligible or appropriate for services by Bradley Smith.

Psychotherapy seeks to collaboratively address a variety of emotional, behavioral, interpersonal, or experiential puzzles or predicaments. Psychotherapy can also seek to reduce or eliminate certain psychological symptoms and improve social and occupational functioning. Unlike medical consultations, psychotherapy occurs by having all parties actively and regularly work together to gain shared insight into the conditions and perceptions of our lives, and then to alter or improve specific emotional states or behaviors. 

The psychotherapeutic process varies depending on the personalities of the psychotherapist and patient, the particular issues brought forward, and the methods, techniques, and theoretical rationales that are mutually agreed upon and regularly reviewed. This variance is broadly understood as “goodness of fit” and may require multiple sessions to accurately discern.

Psychotherapy is especially contingent upon an active and authentic effort on the part of the client/patient (you). Please Note: “Client” and “Patient” titles may be used interchangeably in this and other documents to designate the same person/s or systems receiving psychotherapeutic or consulting services. 

Psychotherapy can have benefits and risks. Since it typically involves discussing and exploring unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, or frustration. Conversely, psychotherapy has also been shown to have significant benefits. It can often lead to better relationships, solutions to specific problems, and reductions in distress.

You have the right to ask about other treatments and their risks and benefits. Psychotherapy involves a significant commitment of time, money, and intimate energy, so it is wise to be mindful about the psychotherapist you select. Questions about policies, procedures, methods, techniques or rationales are discussed collaboratively with you during the creation and ongoing mutual assessment of your individualized care plan.

If at any point during psychotherapy it becomes evident that you are not reaching your therapeutic goals, Bradley Smith, will discuss this with you, and, if appropriate, establish a transition period and then terminate treatment. In such cases, Bradley Smith will provide at least two referrals to individuals or agencies that may be equally or more qualified to be helpful to you.

If at any time you desire another professional’s opinion or wish to consult with another therapist or helping professional, Bradley Smith will, upon your request, assist you in finding someone equally or more qualified, and, if you provide a written consent, will provide essential information to that consentee. You have the right to terminate therapy at any time by written communication to Bradley Smith.

Sessions:

Up to ten (10) psychotherapy sessions will last at approximately 50 minutes, though in some cases session length may be extended. If less than a 24-hour notification of non-attendance is given prior to a scheduled psychotherapy session, there is a charge of the full fee. By or at the end of the fifth (5th) 50-minute session, a collaborative review of the effectiveness and utility of these psychotherapy services will occur in session; specifically, by the creation, review, assessment or modification of a written care plan. At this time either the patient or Bradley Smith may terminate psychotherapeutic or consulting services in writing.

It is understood that emergencies and other circumstances beyond the control of all parties control may arise, and fee amelioration and rescheduling may be considered on a case-by-case basis. The term “sessions” may also include supplemental consultation with colleagues and relevant treatment team members, review or origination of medical or psychological reports, research and inquiry, collaboration/interviewing with concerned significant others (CSOs), and/or other routine aspects of case management.

By or at the end of the tenth (10th) session both parties will determine if the counseling relationship continues or is to be terminated. If services are terminated, Bradley Smith, LPCC, will provide at least two referrals to similarly qualified psychotherapists or to more-appropriate entities. If services continue, this agreement remains in force and effect except as amended in writing and by mutual concurrence. The client may terminate this agreement at any time in writing. 

Please Note: Effective psychotherapy necessarily anticipates higher orders of communication and mutual access - and ideally a degree of psychological safety and therapeutic intimacy that reflects the “integrity of the therapeutic alliance.” Prompt and authentic communication regarding session scheduling or other interpersonal conditions is the standard within this relationship. Repeated failures to attend scheduled sessions or to communicate faithfully 1., Distorts the therapeutic alliance, 2., Disrupts the integrity of the treatment plan, and 3., May be cause for referral and/or termination of treatment.

Bradley Smith operates a private pay practice, and fees are pre-determined on a case-by-case basis and paid prior to each session. Bradley Smith does not accept insurance and as a provider is not a member of any health insurance group or third-party payment system. He will provide a Superbill detailing dates of service and procedure codes that can be submitted to your insurance. Reimbursement amounts vary between these insurance providers, and no assurance of any reimbursement is intimated here.