December 20, 2024 • 31 mins
Ensure your counseling practice's paperwork is as polished as your professional skills. Join me, Dr. Kate Walker, as we embark on a journey to refine your intake paperwork and consent forms with the precision and care akin to planning a personal milestone like my daughter's graduation. Discover the vital steps to keep your documentation up-to-date, the importance of annual reviews in light of frequent updates from the Behavioral Health Executive Council (BHEC), and how to navigate their website for rule changes. I’ll share the tips and tools you need, including free resources from Texas Counselors Creating Badass Businesses, and stress the importance of a final professional review.
Explore the intricacies of informed consent, client records, and setting firm professional boundaries. Allow me to shed light on the essential elements of a compliant client services agreement, from professional fees and meeting policies to confidentiality limits. We’ll even touch on the exciting potential of tools like ChatGPT to elevate your intake paperwork and note-taking. Whether you're operating solo or within an agency, understanding the nuances of maintaining accurate and compliant documentation is crucial. Engage with this conversation and leave with actionable insights to keep your practice running smoothly and within regulatory lines.
Get your step by step guide to private practice. Because you are too important to lose to not knowing the rules, going broke, burning out, and giving up. #counselorsdontquit.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hey, I'm Dr Kate Walker, and this is your
pre-recorded training forgetting your paperwork in shape
before 2025.
Now I will be using screenshare today, but you guys know
me, I'm going to talk youthrough every single thing that
I'm looking at Now.
The reason I am pre-recordingis because my youngest is
(00:22):
graduating from Sam HoustonState University.
So by the time you're watchingthis, I am on my way to Conroe,
texas, and then on to Huntsville, texas, where we'll watch her
graduate this weekend.
So super excited about that.
Congratulations to her.
And she's graduating with herteaching degree.
So, yay, another educator inthe family.
(00:43):
Super excited about that.
Okay, so I will be.
Let's see, when we're talkingabout paperwork, what I mean.
There's tons of paperwork whenwe think about private practice,
of course, but the paperworkthat I want you to take the fine
tooth comb to is your intakepaperwork, specifically, your
(01:07):
consent form, the piece of paperyour client signs where they
acknowledge that they haveentered into a counseling
relationship with you.
So when we start with this, youknow you may be starting from
scratch.
I hope you're not.
I hope someone has loaned youtheir form.
You know you may be startingfrom scratch.
I hope you're not.
I hope someone has loaned youtheir form.
You know.
(01:27):
Let you at least use somethingas a template.
Please don't pay money, a lotof money for these forms.
You can go to Texas CounselorsCreating Badass Businesses and
download absolutely free formsin our files.
Now, of course, you want totake it to a professional and
have them check it once we getit all filled out, but you know
(01:49):
this isn't something where youneed to stress a lot, because
you're going to be modifying itevery year for the rest of the
time you're in practice.
I mean, I like to remind peopleof the BHEC, lpc, lmft social
work boards in Texas had threerevisions this year.
Now, granted, it's not alwaysgoing to impact your intake
(02:12):
paperwork, but still you need tobe aware and you need to get in
the habit of doing exactly whatwe're doing right now, which is
get just go over it once a yearand make sure that everything
is up to date.
I'm always surprised when I gothrough my paperwork, and so
you're.
Actually.
When we get into this, you'reactually going to be seeing my
(02:34):
paperwork.
So if you're listening to thison the podcast or you're
listening to it as a Step it Upmember in your training, I'm
going to also post this inYouTube, so you'll be able to go
to my YouTube channel and youcan look at it there as well.
Okay, so the place we have tostart when we're talking about
paperwork has to be ourlicensing board website.
(02:57):
And here we are, the BehavioralHealth Executive Council, also
called BHEC, and if you want tofind your rules, you go click.
And if you want to find therules for your license, you just
go here and go click and itwill take you to a PDF.
Now, what I'm showing everyoneright now is the link that
(03:20):
appears, or the page thatappears when you click the link
on the BHEC website, and it isdated 8-20-2024.
And I love this format becauseyou can always see in that right
hand corner of the PDF exactlywhat revision we're on.
Now I will tell you, as of thisrecording, there's actually
(03:42):
another update.
It happened November 14th, sothis rulebook isn't exactly
caught up yet, but it will be.
And if you go to the very, veryfirst page and those of you who
are listening, I just scrolledto the page two and it will
actually tell you new, amendedand repealed rules.
So just look for that when thenew rule book comes out.
(04:06):
And how do you know when thenew rule book comes out?
Well, you sign up for emails.
Make sure you are on the emaillist so that you too can be the
first one to know when the newrules come out.
Now we could just kind of scrollthrough here.
You know, I love this PDFdocument because everything is a
hot link.
I just click here and it takesme to the place in the rules.
(04:29):
So I clicked on the rule numberand it bam, took me to the
actual rule.
But we're not going to do that.
We're going to do it a littlebit differently.
So it could take us a lot oftime to go through the rules,
and I encourage you to gothrough the latest Zoom the
Rules, and I always do this oncea year.
This year I actually did itwith Dr Ashley Stevens and we
(04:52):
recorded an hour anda half overLPC, lmft and social work All of
the updates for 2024.
So that's going to go way morein depth than what I'm about to
do right now.
So in the BHEC section and sofor those of you who are not
familiar, your member board thatwould be LPC, lmft, psychology,
(05:14):
social work has BHEC as theadministrating body right.
So in your PDF document, thefirst part, about the first 82
pages, will be referring to theTexas Behavioral Health
Executive Council rules.
So you may be saying, well,kate, don't they duplicate each
(05:35):
other?
And you know, in some casesthey do.
But they work that out Again.
Not going to deep dive into thatnow, but I will highlight the
areas you should be familiarwith as you're getting your
paperwork going.
So in subchapter B actuallyokay, not just subchapter B we
(06:00):
want to jump to applications andexaminations, subchapter B,
where it talks about yourlicense.
It's very important that you'reaware if you have a license I
know sounds super obvious, butyou want to go to the
verification page.
Google not Google, sorry do asearch for your license and make
(06:20):
sure you have one.
I mean, if you are in any doubtat all or if you have some kind
of a complaint against you or asanction against you, that will
need to go into your paperwork.
And so be familiar with BHECApplications and Examinations.
Subchapter B, and we talk abouthow do I display and advertise
(06:41):
my license and, of course,complaints Do I have one?
So now that you've becomefamiliar, I hope all of you hit
pause and you go run over toyour rulebook.
But if you didn't, that's okay,I'm gonna continue to walk
through it with you.
Then, when we get to gosh that,let's see a page, mmm,
(07:02):
scrolling, scrolling, page,scrolling, scrolling, my
goodness, and of course I wenttoo far.
Now LMFT I'm going to draw yourattention to a few things, even
though I'm in the LPC rules.
(07:23):
I can still.
You know I'm not going to takeyou back and forth with my
screen share, but I will justbring up things that might be
similar or different with LMFT.
Social work, you're going tohave to refer to Dr Ashley
Stevens she can help you out andyou can always tag her and
Texas Counselors Creating BadassBusinesses and Texas counselors
(07:47):
creating badass businesses.
So we get to.
When you see the rules changeto the 600 numbers.
You know you're now in themember board section for Texas
State Board of Examiners ofprofessional counselors.
So see, it took us to aboutpage 85.
The first 85 pages were BHECand then from 85 to almost the
end is going to just bereferring to the LPC board.
(08:07):
So definitions very importantthat you know if what you are
doing in your counselingpractice is allowed right.
It's called scope of practiceand definitions.
You see things like what is aclient?
What is a consent for services?
What is a consent form?
So, understanding these terms,as you're putting your consent
(08:31):
form together, if you're brandnew to this, this is a great
place just to start and get agood foundation.
And you see that it spells outwhat a consent form is in the
definitions.
But don't worry, we'll get toanother section where it's a
little bit more specific aboutwhat that consent form has to
have in it.
(08:52):
And, of course, mft.
You have a similar section andonce we get through definitions,
we want to jump to methods,counseling methods and practices
.
So, again, just making surethat what you are doing and what
you are calling counseling isactually counseling, and it's a
(09:15):
little bit different.
So for MFTs, as of thisrecording, coaching is
considered part of your scope ofpractice.
So if you're thinking you'resetting up two businesses and
coaching over here and marriageand family therapy over here,
it's a little bit different.
Well, it's a lot different ForLPC.
Coaching is not included hereyet, but you have to stay on top
(09:39):
of this so that you understandif the type of counseling you're
doing is listed in your scopeof practice.
And I'll tell you why in asecond and right after
definitions and methods, is681.35, our definition of an
informed consent In marriage andfamily therapists.
(10:01):
It's going to be a differentnumber but you will see a
similar definition for informedconsent In marriage and family
therapists.
It's going to be a differentnumber but you will see a
similar definition for informedconsent.
So here's I'm going to read itout loud to you.
Regardless of setting, alicensee must provide counseling
only in the context of aprofessional relationship.
Prior to providing services, alicensee must obtain from an
(10:23):
individual a signed informedconsent, signed written receipt
of information or, in the caseof involuntary treatment, a copy
of the appropriate court orderincluding the following 1.
Fees and arrangements forpayment.
2.
Counseling purposes, goals andtechniques.
3.
(10:47):
Any restrictions placed on thelicense by the counsel.
Four, the limits ofconfidentiality.
Five, any intent of thelicensee to use another
individual to provide counselingtreatment intervention to the
client.
Six, supervision of thelicensee by another licensed
health care professional,including the name, address,
contact information andqualifications of the supervisor
(11:09):
.
Seven, the name, address andtelephone number of the counsel
for the purpose of reportingviolations of the act or this
chapter.
And eight, the established planfor the custody and control of
the client's mental healthrecords in the event of the
licensee's death or incapacityor the termination of the
(11:30):
licensee's counseling practice.
Now, there are a couple ofimportant things here that don't
really get into the documentitself, but it's important that
you understand if you are goingto change anything in this
document.
So what we're about to do?
Right, we're about to go in andmake some changes to your
informed consent.
(11:50):
You need to let people who'vealready signed your informed
consent know in writing.
So that means give them anotherinformed consent or have the
changes laid out so they cansign off on them.
I know this time of year I seein a lot of the social media
threads I'm going to raise myrates next year.
I personally don't raise rateson existing clients.
(12:14):
I know some of y'all do sothat's one of the things that
would be in your informedconsent.
So if you changed yourcounseling rate on the person
who has previously signed adifferent rate, you can't change
that rate unless you give theman opportunity to sign off on
that.
You must inform them in writing.
(12:36):
This is also that part of therules for those of you working
with kiddos where you have tohave a copy of the divorce
decree, and you have to.
This is important.
I talk about this in anotherpodcast episode, another
training.
A licensee acting within thescope of employment with an
agency or institution is notrequired to obtain a signed
(12:58):
informed consent signed informedconsent but must document in
writing that the licenseeinformed the client of the
information required bysubsection A of this section and
that the client consented.
So that's new.
That's it's.
You know, if a client isalready in the hospital and
they've signed tons and tons andtons of paperwork, and then you
(13:21):
hand them your informed consent, right, that's helping them
understand that what's about tohappen is called counseling.
And here's what you need toknow.
Well, you don't have to havethat signed informed consent in
certain settings, but you wouldneed to document in your notes
(13:42):
that you did inform your clientand they did consent for
services.
So I'm going to scroll a littlebit more to 681.36, and I'm
going to read a little bit ofthis MFTs.
You have something very similarFor each client.
A licensee must keep accuraterecords of the informed consent.
(14:02):
A licensee must keep accuraterecords of the informed consent,
a signed written receipt ofinformation or, in the case of
an involuntary treatment, a copyof the appropriate court order.
The intake, assessment dates ofcounseling, treatment,
intervention, principaltreatment methods, progress
notes, treatment plan andbilling information, and then it
(14:24):
tells you how long to keep them, and it's a good idea to make
sure, if you're employed at anagency, that you know who that
records custodian is All right,you are looking at my client
services agreement.
Now I'm not taking any newclients.
I'm slowly limiting my practicedown to nothing, but I do have
a consent for treatment.
(14:45):
I call it a client servicesagreement.
It's also the consent form formy practice, achievebalanceorg,
and what I've done is I've gonethrough those of you who are
listening.
I've highlighted things thatare good or things that are bad
and the changes that I plan tomake.
So what you're going to see isa document that needs some work.
(15:06):
All right, so don't be afraid,don't be sad, don't be scared If
you're thinking right now oh no, my intake documents need some
work.
It's okay.
That's why you're here andthat's why we're doing this.
So the first paragraph we'retalking to the client, or the
client's reading about whatcounseling is, what it isn't,
(15:28):
how to understand what they'reabout to read.
It's just an introductoryparagraph.
Now, when I first made this, Ihad several counselors with me,
several counselors with me, andso I made sure that I talked
about AchieveBalanceorg as A-B-Oand All About the Family LLC as
(15:50):
A-A-F.
Well, it's just me now.
So you'll see in yellow thatmeans I need to take care of it.
I need to add my actual nameand my license number here and
that's really also.
You know, mft spells it outwhere it comes to technology and
I'll get to that in a second.
But I need to have my name, notjust my trade name and my
(16:14):
license number here.
Counseling services orcounseling purposes, goals and
techniques.
I did this in green becauseit's yay, good job me.
So what I'm doing is I'm goingthrough and I'm talking about
how I do counseling, the methodsand techniques I use, and
remember that's in the rules.
When you talk about yourconsent form putting out there
(16:37):
for the client to see how youcounsel, and that it begins with
this assessment of your needsthat's in the rules.
Your client record has tocontain that intake assessment.
Now I did highlight this inyellow.
Chat GPT could improve.
(16:58):
I'm very curious about that.
I'm very curious about that,and in December we're exploring
how ChatGPT and artificialintelligence can help us with
notes, with marketing.
So I was very curious to see ifChatGPT could help me with
intake paperwork.
So I'll do a little experimentat the end of this and we'll see
(17:20):
how good of a job Mr or Miss orwhatever chat GPT does.
The next section, meetings,talks about how often we meet
professional fees.
I put it in green because, yay,go me.
I have my actual fee and I havemy changes and late changes,
(17:42):
late cancels, and I have mychanges, late changes, late
cancels, no-show policy very,very clear.
I talk about how I will billwith court testimony.
Now you know, if you get asubpoena to go to court, you've
got to go right.
You can't say, well, I'm notgoing until I get paid.
But if you have this in yourrecords, then you can prepare
(18:02):
your client who may be wantingyou to come to court, and you
can help them understand whatyour fees will be.
If you're going to do aretainer, just it's up to you
and of course this is yourclient, by their signature
agreeing that they at least readit, even though it may change
later.
Even though it may change laterAgain, I've got this in green.
(18:26):
Now, one of the things in ourrules is the code of ethics
setting and maintainingprofessional boundaries, and I
put this in my consent form so Italk about how you can contact
me, how I will respond to thesethings.
I will not respond to thosethings.
For example, I have a socialmedia policy where I help them
(18:49):
understand if they reach out tome on social media there will be
no response, and so I preparemy clients for that and also
helping them understand how ouremail system works.
So we use an online schedulingsystem, a HIPAA compliant
scheduling system, and you knowmost of us are used to that by
(19:10):
now.
But I think a few people stillthink you can hit reply to that
email and say I'm cancelingtoday, even though it clearly
says in the email do not replyto this email.
It doesn't go anywhere.
So we make sure that we put ithere we will not accept email
cancellations.
You must call us and leave avoicemail If it's in that under
(19:33):
the window of time where theycan actually use the system, log
in and change it themselves.
Limits of confidentiality thatis in green, one of the things I
want to point out to you.
You know, in the digital age weneed to show our clients how we
are protecting their records,and so here you'll see number
(19:54):
one.
It says how I utilize a HIPAAcompliant version of Google
Workspace, an online HIPAAcompliant data storage service,
to store client records.
And then I invite the client tovisit their security overview
page and when you click this itwill take you.
(20:14):
Well, not right now, apparently.
Oh, there we go.
Maybe Click go, no, okay, itdoesn't want to.
Oh, nope, nope.
So it will take them to anactual pdf that explains google
workspace and the HIPAAcompliant version that I'm using
.
And I do that again.
(20:35):
Let's see, yes, nope, okay, Iknow I do it again someplace
else where I give them the linkso that they understand they can
go visit the actual website andsee how the BAA works, see how
(20:56):
the encryption works, so they'renot in the dark about how their
protected information isactually protected.
So, limits of confidentiality I,like most counselors, just
listed what is already inChapter 611.
And so if we jump back to therules, you'll see that Chapter
(21:21):
611, the limits ofconfidentiality, are spelled out
.
So here at 681.45, marriage andFamily Therapist, you have a
similar section.
But also what I really likeabout these rules is that if you
scroll to the very last pages,you actually can see Chapter 611
(21:47):
, mental Health Records from theTexas Health and Safety Code.
This time with the revisionthat we're on now, it's about
page 170.
So you don't have to make upthe words here.
You don't have to stop thevideo and copy my words down.
You can go to the rules andcopy-paste what's in Chapter 611
(22:08):
.
So when I'm informing my clientabout the limits of
confidentiality, I basically itis exactly what's listed in
chapter 611.
I talk about needing a releaseof information.
So this part in providingcoordinated or managing your
(22:28):
treatment and other servicesrelated to your counseling care
ABO that was when I had a bigoffice sometimes interacts with
other professionals concerningyour well-being, but as a solo
person, you know, maybe I needto reach out to their physician,
maybe I'm coordinating carewith another therapist.
I assure them that I will get arelease of information to keep
(22:51):
on file.
Now, one of the things I wantto bring your attention to
number eight.
And so those of you who are newto Texas, it's really important
that you get familiar with thisthe conditions under which you
may release confidentialinformation in order to and then
there are lots of conditionshere.
(23:11):
So there's another area.
You see the yellow um and thereason.
This is in blue for those ofyou who are listening, I've got
a big section in blue.
This comes up uh, I'm going backto the confidentiality and
required required reporting.
You know a lot of us, uh,counselors, you know we, we are
bound by our licenses, we'rebound by the law, but we also
(23:32):
have a conscience, and so ifsomething doesn't fit neat and
tidy under these rules, it'simportant that you follow your
conscience.
If you know what you want toreveal and you know what you
don't want to reveal, you know.
Just make sure that it's inyour informed consent and you
have the conversation with yourclient and help them understand
(23:53):
that it's not going to be.
And I mean at least with me,I'll own this, I'll stand on my
own soapbox.
I'm not going to have a gotchamoment.
This is going to be aconversation and we can decide
together what we want to do next.
Okay, back to counseling viatechnology.
Now, mfts, you guys say thisliterally in black and white
(24:17):
about counseling via technology.
You need to list your licensenumber.
So this is just another areawhere I'm reminding myself.
I need to put my license numberAlso.
This is what I was looking forearlier.
I use a program I'm reading nowcalled doxyme.
I do not use a program calleddoxyme anymore and I put a note
(24:38):
here.
I need to list my Zoominformation along with that link
that shows my BAA and theencrypted how Zoom goes in and
encrypts and protects everything, because I do use the HIPAA
compliant version of Zoom.
All right, so, continuing on, Ido have some best practices for
(25:02):
technology and counseling thatyou know we talk about in Texas.
It matters where your client'sfeet are right.
Texas laws protect Texans and Iexplain that here I talk about
there's a section forprofessional records and I've
got it in yellow.
So this means I need to changesomething.
(25:23):
Oh, I need to remove this.
So I again back when I had lotsof counselors I put in here if
AchieveBalanceorg refuses yourrequest for accessing your
clinical record, so this couldhave been any one of our
therapists.
I've been informing the client.
You have a right of review,which a counselor will discuss
(25:44):
with you upon request.
I want to make sure that myname is there and that this is
clearly written to align withHIPAA and the rules governing
protected health and protectedhealth information.
Ok, I've got my section fortermination, death and
incapacity.
(26:04):
I've got more about privacy andHIPAA I have.
Oh, there's a lot of yellowhighlighted right here, so I
wanted to draw your attention.
This particular consent form hasthe old information for clients
if they want to file acomplaint against me.
This is the contact informationfor the LPC and the LMFT boards
(26:27):
.
That isn't going to workanymore.
We must have the information tocontact the BHEC website, or
their contact information, andso I did copy and paste it right
here, and you can find this onthe BHEC website.
It has the phone number for howto contact the Texas Behavioral
Health Executive Council.
(26:48):
We cannot list the boards anylonger.
We have to have BHEC.
All right, let me hit pause.
Okay, that was fast, so that'sit.
Going through paperwork doesn'thave to be hard.
I mean, when you're startingout, you're going to want a
template, so please make sureyou go to Texas Counselors
(27:12):
Creating Badass Businesses.
Oh, I was going to do thatexperiment though, wasn't I?
So let me do that.
Let me open up a chat GPTwindow.
Just for fun and for those ofyou watching, I'm going to go
ahead and share my screen.
Create intake paperwork that aLPC could use with new clients
(27:41):
that meets all of the Texas LPCregulations.
I just came up with that on thetop of my head.
So let's see what it does.
Here's a draft.
Wow.
(28:03):
So for those of you who can'tsee this, it's a lot of bullet
points, a lot of sections thatthe client could sign.
So this almost looks more likewhat the rules were talking
about a receipt that shows thatthe client has read the
(28:24):
information.
So, while there is a lot ofinformation oh, I just saw the
contact information forcomplaints and it's correct
information.
Oh, I just saw the contactinformation for complaints and
it's correct.
So this might be a good placeto start plug the stuff into
chat GPT.
And the good thing about chatGPT is, if you don't like how it
is here like if you want moreof a narrative, if you want more
of a paragraph form orsomething like that, you can say
(28:47):
same prompt but turn it intoparagraphs.
So have some fun with that andI can't wait to see what you
guys come up with.
If you have any questions orcomments, you can tag me in
Texas Counselors Creating BadassBusinesses or the Step it Up
membership.
All right, have a wonderful day.
Hey, I'm Dr Kate Walker, and this is your
pre-recorded training forgetting your paperwork in shape
before 2025.
Now I will be using screenshare today, but you guys know
me, I'm going to talk youthrough every single thing that
I'm looking at Now.
The reason I am pre-recordingis because my youngest is
(00:22):
graduating from Sam HoustonState University.
So by the time you're watchingthis, I am on my way to Conroe,
texas, and then on to Huntsville, texas, where we'll watch her
graduate this weekend.
So super excited about that.
Congratulations to her.
And she's graduating with herteaching degree.
So, yay, another educator inthe family.
(00:43):
Super excited about that.
Okay, so I will be.
Let's see, when we're talkingabout paperwork, what I mean.
There's tons of paperwork whenwe think about private practice,
of course, but the paperworkthat I want you to take the fine
tooth comb to is your intakepaperwork, specifically, your
(01:07):
consent form, the piece of paperyour client signs where they
acknowledge that they haveentered into a counseling
relationship with you.
So when we start with this, youknow you may be starting from
scratch.
I hope you're not.
I hope someone has loaned youtheir form.
You know you may be startingfrom scratch.
I hope you're not.
I hope someone has loaned youtheir form.
You know.
(01:27):
Let you at least use somethingas a template.
Please don't pay money, a lotof money for these forms.
You can go to Texas CounselorsCreating Badass Businesses and
download absolutely free formsin our files.
Now, of course, you want totake it to a professional and
have them check it once we getit all filled out, but you know
(01:49):
this isn't something where youneed to stress a lot, because
you're going to be modifying itevery year for the rest of the
time you're in practice.
I mean, I like to remind peopleof the BHEC, lpc, lmft social
work boards in Texas had threerevisions this year.
Now, granted, it's not alwaysgoing to impact your intake
(02:12):
paperwork, but still you need tobe aware and you need to get in
the habit of doing exactly whatwe're doing right now, which is
get just go over it once a yearand make sure that everything
is up to date.
I'm always surprised when I gothrough my paperwork, and so
you're.
Actually.
When we get into this, you'reactually going to be seeing my
(02:34):
paperwork.
So if you're listening to thison the podcast or you're
listening to it as a Step it Upmember in your training, I'm
going to also post this inYouTube, so you'll be able to go
to my YouTube channel and youcan look at it there as well.
Okay, so the place we have tostart when we're talking about
paperwork has to be ourlicensing board website.
(02:57):
And here we are, the BehavioralHealth Executive Council, also
called BHEC, and if you want tofind your rules, you go click.
And if you want to find therules for your license, you just
go here and go click and itwill take you to a PDF.
Now, what I'm showing everyoneright now is the link that
(03:20):
appears, or the page thatappears when you click the link
on the BHEC website, and it isdated 8-20-2024.
And I love this format becauseyou can always see in that right
hand corner of the PDF exactlywhat revision we're on.
Now I will tell you, as of thisrecording, there's actually
(03:42):
another update.
It happened November 14th, sothis rulebook isn't exactly
caught up yet, but it will be.
And if you go to the very, veryfirst page and those of you who
are listening, I just scrolledto the page two and it will
actually tell you new, amendedand repealed rules.
So just look for that when thenew rule book comes out.
(04:06):
And how do you know when thenew rule book comes out?
Well, you sign up for emails.
Make sure you are on the emaillist so that you too can be the
first one to know when the newrules come out.
Now we could just kind of scrollthrough here.
You know, I love this PDFdocument because everything is a
hot link.
I just click here and it takesme to the place in the rules.
(04:29):
So I clicked on the rule numberand it bam, took me to the
actual rule.
But we're not going to do that.
We're going to do it a littlebit differently.
So it could take us a lot oftime to go through the rules,
and I encourage you to gothrough the latest Zoom the
Rules, and I always do this oncea year.
This year I actually did itwith Dr Ashley Stevens and we
(04:52):
recorded an hour anda half overLPC, lmft and social work All of
the updates for 2024.
So that's going to go way morein depth than what I'm about to
do right now.
So in the BHEC section and sofor those of you who are not
familiar, your member board thatwould be LPC, lmft, psychology,
(05:14):
social work has BHEC as theadministrating body right.
So in your PDF document, thefirst part, about the first 82
pages, will be referring to theTexas Behavioral Health
Executive Council rules.
So you may be saying, well,kate, don't they duplicate each
(05:35):
other?
And you know, in some casesthey do.
But they work that out Again.
Not going to deep dive into thatnow, but I will highlight the
areas you should be familiarwith as you're getting your
paperwork going.
So in subchapter B actuallyokay, not just subchapter B we
(06:00):
want to jump to applications andexaminations, subchapter B,
where it talks about yourlicense.
It's very important that you'reaware if you have a license I
know sounds super obvious, butyou want to go to the
verification page.
Google not Google, sorry do asearch for your license and make
(06:20):
sure you have one.
I mean, if you are in any doubtat all or if you have some kind
of a complaint against you or asanction against you, that will
need to go into your paperwork.
And so be familiar with BHECApplications and Examinations.
Subchapter B, and we talk abouthow do I display and advertise
(06:41):
my license and, of course,complaints Do I have one?
So now that you've becomefamiliar, I hope all of you hit
pause and you go run over toyour rulebook.
But if you didn't, that's okay,I'm gonna continue to walk
through it with you.
Then, when we get to gosh that,let's see a page, mmm,
(07:02):
scrolling, scrolling, page,scrolling, scrolling, my
goodness, and of course I wenttoo far.
Now LMFT I'm going to draw yourattention to a few things, even
though I'm in the LPC rules.
(07:23):
I can still.
You know I'm not going to takeyou back and forth with my
screen share, but I will justbring up things that might be
similar or different with LMFT.
Social work, you're going tohave to refer to Dr Ashley
Stevens she can help you out andyou can always tag her and
Texas Counselors Creating BadassBusinesses and Texas counselors
(07:47):
creating badass businesses.
So we get to.
When you see the rules changeto the 600 numbers.
You know you're now in themember board section for Texas
State Board of Examiners ofprofessional counselors.
So see, it took us to aboutpage 85.
The first 85 pages were BHECand then from 85 to almost the
end is going to just bereferring to the LPC board.
(08:07):
So definitions very importantthat you know if what you are
doing in your counselingpractice is allowed right.
It's called scope of practiceand definitions.
You see things like what is aclient?
What is a consent for services?
What is a consent form?
So, understanding these terms,as you're putting your consent
(08:31):
form together, if you're brandnew to this, this is a great
place just to start and get agood foundation.
And you see that it spells outwhat a consent form is in the
definitions.
But don't worry, we'll get toanother section where it's a
little bit more specific aboutwhat that consent form has to
have in it.
(08:52):
And, of course, mft.
You have a similar section andonce we get through definitions,
we want to jump to methods,counseling methods and practices
.
So, again, just making surethat what you are doing and what
you are calling counseling isactually counseling, and it's a
(09:15):
little bit different.
So for MFTs, as of thisrecording, coaching is
considered part of your scope ofpractice.
So if you're thinking you'resetting up two businesses and
coaching over here and marriageand family therapy over here,
it's a little bit different.
Well, it's a lot different ForLPC.
Coaching is not included hereyet, but you have to stay on top
(09:39):
of this so that you understandif the type of counseling you're
doing is listed in your scopeof practice.
And I'll tell you why in asecond and right after
definitions and methods, is681.35, our definition of an
informed consent In marriage andfamily therapists.
(10:01):
It's going to be a differentnumber but you will see a
similar definition for informedconsent In marriage and family
therapists.
It's going to be a differentnumber but you will see a
similar definition for informedconsent.
So here's I'm going to read itout loud to you.
Regardless of setting, alicensee must provide counseling
only in the context of aprofessional relationship.
Prior to providing services, alicensee must obtain from an
(10:23):
individual a signed informedconsent, signed written receipt
of information or, in the caseof involuntary treatment, a copy
of the appropriate court orderincluding the following 1.
Fees and arrangements forpayment.
2.
Counseling purposes, goals andtechniques.
3.
(10:47):
Any restrictions placed on thelicense by the counsel.
Four, the limits ofconfidentiality.
Five, any intent of thelicensee to use another
individual to provide counselingtreatment intervention to the
client.
Six, supervision of thelicensee by another licensed
health care professional,including the name, address,
contact information andqualifications of the supervisor
(11:09):
.
Seven, the name, address andtelephone number of the counsel
for the purpose of reportingviolations of the act or this
chapter.
And eight, the established planfor the custody and control of
the client's mental healthrecords in the event of the
licensee's death or incapacityor the termination of the
(11:30):
licensee's counseling practice.
Now, there are a couple ofimportant things here that don't
really get into the documentitself, but it's important that
you understand if you are goingto change anything in this
document.
So what we're about to do?
Right, we're about to go in andmake some changes to your
informed consent.
(11:50):
You need to let people who'vealready signed your informed
consent know in writing.
So that means give them anotherinformed consent or have the
changes laid out so they cansign off on them.
I know this time of year I seein a lot of the social media
threads I'm going to raise myrates next year.
I personally don't raise rateson existing clients.
(12:14):
I know some of y'all do sothat's one of the things that
would be in your informedconsent.
So if you changed yourcounseling rate on the person
who has previously signed adifferent rate, you can't change
that rate unless you give theman opportunity to sign off on
that.
You must inform them in writing.
(12:36):
This is also that part of therules for those of you working
with kiddos where you have tohave a copy of the divorce
decree, and you have to.
This is important.
I talk about this in anotherpodcast episode, another
training.
A licensee acting within thescope of employment with an
agency or institution is notrequired to obtain a signed
(12:58):
informed consent signed informedconsent but must document in
writing that the licenseeinformed the client of the
information required bysubsection A of this section and
that the client consented.
So that's new.
That's it's.
You know, if a client isalready in the hospital and
they've signed tons and tons andtons of paperwork, and then you
(13:21):
hand them your informed consent, right, that's helping them
understand that what's about tohappen is called counseling.
And here's what you need toknow.
Well, you don't have to havethat signed informed consent in
certain settings, but you wouldneed to document in your notes
(13:42):
that you did inform your clientand they did consent for
services.
So I'm going to scroll a littlebit more to 681.36, and I'm
going to read a little bit ofthis MFTs.
You have something very similarFor each client.
A licensee must keep accuraterecords of the informed consent.
(14:02):
A licensee must keep accuraterecords of the informed consent,
a signed written receipt ofinformation or, in the case of
an involuntary treatment, a copyof the appropriate court order.
The intake, assessment dates ofcounseling, treatment,
intervention, principaltreatment methods, progress
notes, treatment plan andbilling information, and then it
(14:24):
tells you how long to keep them, and it's a good idea to make
sure, if you're employed at anagency, that you know who that
records custodian is All right,you are looking at my client
services agreement.
Now I'm not taking any newclients.
I'm slowly limiting my practicedown to nothing, but I do have
a consent for treatment.
(14:45):
I call it a client servicesagreement.
It's also the consent form formy practice, achievebalanceorg,
and what I've done is I've gonethrough those of you who are
listening.
I've highlighted things thatare good or things that are bad
and the changes that I plan tomake.
So what you're going to see isa document that needs some work.
(15:06):
All right, so don't be afraid,don't be sad, don't be scared If
you're thinking right now oh no, my intake documents need some
work.
It's okay.
That's why you're here andthat's why we're doing this.
So the first paragraph we'retalking to the client, or the
client's reading about whatcounseling is, what it isn't,
(15:28):
how to understand what they'reabout to read.
It's just an introductoryparagraph.
Now, when I first made this, Ihad several counselors with me,
several counselors with me, andso I made sure that I talked
about AchieveBalanceorg as A-B-Oand All About the Family LLC as
(15:50):
A-A-F.
Well, it's just me now.
So you'll see in yellow thatmeans I need to take care of it.
I need to add my actual nameand my license number here and
that's really also.
You know, mft spells it outwhere it comes to technology and
I'll get to that in a second.
But I need to have my name, notjust my trade name and my
(16:14):
license number here.
Counseling services orcounseling purposes, goals and
techniques.
I did this in green becauseit's yay, good job me.
So what I'm doing is I'm goingthrough and I'm talking about
how I do counseling, the methodsand techniques I use, and
remember that's in the rules.
When you talk about yourconsent form putting out there
(16:37):
for the client to see how youcounsel, and that it begins with
this assessment of your needsthat's in the rules.
Your client record has tocontain that intake assessment.
Now I did highlight this inyellow.
Chat GPT could improve.
(16:58):
I'm very curious about that.
I'm very curious about that,and in December we're exploring
how ChatGPT and artificialintelligence can help us with
notes, with marketing.
So I was very curious to see ifChatGPT could help me with
intake paperwork.
So I'll do a little experimentat the end of this and we'll see
(17:20):
how good of a job Mr or Miss orwhatever chat GPT does.
The next section, meetings,talks about how often we meet
professional fees.
I put it in green because, yay,go me.
I have my actual fee and I havemy changes and late changes,
(17:42):
late cancels, and I have mychanges, late changes, late
cancels, no-show policy very,very clear.
I talk about how I will billwith court testimony.
Now you know, if you get asubpoena to go to court, you've
got to go right.
You can't say, well, I'm notgoing until I get paid.
But if you have this in yourrecords, then you can prepare
(18:02):
your client who may be wantingyou to come to court, and you
can help them understand whatyour fees will be.
If you're going to do aretainer, just it's up to you
and of course this is yourclient, by their signature
agreeing that they at least readit, even though it may change
later.
Even though it may change laterAgain, I've got this in green.
(18:26):
Now, one of the things in ourrules is the code of ethics
setting and maintainingprofessional boundaries, and I
put this in my consent form so Italk about how you can contact
me, how I will respond to thesethings.
I will not respond to thosethings.
For example, I have a socialmedia policy where I help them
(18:49):
understand if they reach out tome on social media there will be
no response, and so I preparemy clients for that and also
helping them understand how ouremail system works.
So we use an online schedulingsystem, a HIPAA compliant
scheduling system, and you knowmost of us are used to that by
(19:10):
now.
But I think a few people stillthink you can hit reply to that
email and say I'm cancelingtoday, even though it clearly
says in the email do not replyto this email.
It doesn't go anywhere.
So we make sure that we put ithere we will not accept email
cancellations.
You must call us and leave avoicemail If it's in that under
(19:33):
the window of time where theycan actually use the system, log
in and change it themselves.
Limits of confidentiality thatis in green, one of the things I
want to point out to you.
You know, in the digital age weneed to show our clients how we
are protecting their records,and so here you'll see number
(19:54):
one.
It says how I utilize a HIPAAcompliant version of Google
Workspace, an online HIPAAcompliant data storage service,
to store client records.
And then I invite the client tovisit their security overview
page and when you click this itwill take you.
(20:14):
Well, not right now, apparently.
Oh, there we go.
Maybe Click go, no, okay, itdoesn't want to.
Oh, nope, nope.
So it will take them to anactual pdf that explains google
workspace and the HIPAAcompliant version that I'm using
.
And I do that again.
(20:35):
Let's see, yes, nope, okay, Iknow I do it again someplace
else where I give them the linkso that they understand they can
go visit the actual website andsee how the BAA works, see how
(20:56):
the encryption works, so they'renot in the dark about how their
protected information isactually protected.
So, limits of confidentiality I,like most counselors, just
listed what is already inChapter 611.
And so if we jump back to therules, you'll see that Chapter
(21:21):
611, the limits ofconfidentiality, are spelled out
.
So here at 681.45, marriage andFamily Therapist, you have a
similar section.
But also what I really likeabout these rules is that if you
scroll to the very last pages,you actually can see Chapter 611
(21:47):
, mental Health Records from theTexas Health and Safety Code.
This time with the revisionthat we're on now, it's about
page 170.
So you don't have to make upthe words here.
You don't have to stop thevideo and copy my words down.
You can go to the rules andcopy-paste what's in Chapter 611
(22:08):
.
So when I'm informing my clientabout the limits of
confidentiality, I basically itis exactly what's listed in
chapter 611.
I talk about needing a releaseof information.
So this part in providingcoordinated or managing your
(22:28):
treatment and other servicesrelated to your counseling care
ABO that was when I had a bigoffice sometimes interacts with
other professionals concerningyour well-being, but as a solo
person, you know, maybe I needto reach out to their physician,
maybe I'm coordinating carewith another therapist.
I assure them that I will get arelease of information to keep
(22:51):
on file.
Now, one of the things I wantto bring your attention to
number eight.
And so those of you who are newto Texas, it's really important
that you get familiar with thisthe conditions under which you
may release confidentialinformation in order to and then
there are lots of conditionshere.
(23:11):
So there's another area.
You see the yellow um and thereason.
This is in blue for those ofyou who are listening, I've got
a big section in blue.
This comes up uh, I'm going backto the confidentiality and
required required reporting.
You know a lot of us, uh,counselors, you know we, we are
bound by our licenses, we'rebound by the law, but we also
(23:32):
have a conscience, and so ifsomething doesn't fit neat and
tidy under these rules, it'simportant that you follow your
conscience.
If you know what you want toreveal and you know what you
don't want to reveal, you know.
Just make sure that it's inyour informed consent and you
have the conversation with yourclient and help them understand
(23:53):
that it's not going to be.
And I mean at least with me,I'll own this, I'll stand on my
own soapbox.
I'm not going to have a gotchamoment.
This is going to be aconversation and we can decide
together what we want to do next.
Okay, back to counseling viatechnology.
Now, mfts, you guys say thisliterally in black and white
(24:17):
about counseling via technology.
You need to list your licensenumber.
So this is just another areawhere I'm reminding myself.
I need to put my license numberAlso.
This is what I was looking forearlier.
I use a program I'm reading nowcalled doxyme.
I do not use a program calleddoxyme anymore and I put a note
(24:38):
here.
I need to list my Zoominformation along with that link
that shows my BAA and theencrypted how Zoom goes in and
encrypts and protects everything, because I do use the HIPAA
compliant version of Zoom.
All right, so, continuing on, Ido have some best practices for
(25:02):
technology and counseling thatyou know we talk about in Texas.
It matters where your client'sfeet are right.
Texas laws protect Texans and Iexplain that here I talk about
there's a section forprofessional records and I've
got it in yellow.
So this means I need to changesomething.
(25:23):
Oh, I need to remove this.
So I again back when I had lotsof counselors I put in here if
AchieveBalanceorg refuses yourrequest for accessing your
clinical record, so this couldhave been any one of our
therapists.
I've been informing the client.
You have a right of review,which a counselor will discuss
(25:44):
with you upon request.
I want to make sure that myname is there and that this is
clearly written to align withHIPAA and the rules governing
protected health and protectedhealth information.
Ok, I've got my section fortermination, death and
incapacity.
(26:04):
I've got more about privacy andHIPAA I have.
Oh, there's a lot of yellowhighlighted right here, so I
wanted to draw your attention.
This particular consent form hasthe old information for clients
if they want to file acomplaint against me.
This is the contact informationfor the LPC and the LMFT boards
(26:27):
.
That isn't going to workanymore.
We must have the information tocontact the BHEC website, or
their contact information, andso I did copy and paste it right
here, and you can find this onthe BHEC website.
It has the phone number for howto contact the Texas Behavioral
Health Executive Council.
(26:48):
We cannot list the boards anylonger.
We have to have BHEC.
All right, let me hit pause.
Okay, that was fast, so that'sit.
Going through paperwork doesn'thave to be hard.
I mean, when you're startingout, you're going to want a
template, so please make sureyou go to Texas Counselors
(27:12):
Creating Badass Businesses.
Oh, I was going to do thatexperiment though, wasn't I?
So let me do that.
Let me open up a chat GPTwindow.
Just for fun and for those ofyou watching, I'm going to go
ahead and share my screen.
Create intake paperwork that aLPC could use with new clients
(27:41):
that meets all of the Texas LPCregulations.
I just came up with that on thetop of my head.
So let's see what it does.
Here's a draft.
Wow.
(28:03):
So for those of you who can'tsee this, it's a lot of bullet
points, a lot of sections thatthe client could sign.
So this almost looks more likewhat the rules were talking
about a receipt that shows thatthe client has read the
(28:24):
information.
So, while there is a lot ofinformation oh, I just saw the
contact information forcomplaints and it's correct
information.
Oh, I just saw the contactinformation for complaints and
it's correct.
So this might be a good placeto start plug the stuff into
chat GPT.
And the good thing about chatGPT is, if you don't like how it
is here like if you want moreof a narrative, if you want more
of a paragraph form orsomething like that, you can say
(28:47):
same prompt but turn it intoparagraphs.
So have some fun with that andI can't wait to see what you
guys come up with.
If you have any questions orcomments, you can tag me in
Texas Counselors Creating BadassBusinesses or the Step it Up
membership.
All right, have a wonderful day.
Popular Podcasts
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com