Texas Counselors Creating Badass Businesses

113 How to Streamline Your Private Practice Forms for 2025

• Dr. Kate Walker Ph.D., LPC/LMFT Supervisor • Season 3 • Episode 113

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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.

Speaker 1:

Hey, I'm Dr Kate Walker, and this is your pre-recorded training for getting your paperwork in shape before 2025. Now I will be using screen share today, but you guys know me, I'm going to talk you through every single thing that I'm looking at Now. The reason I am pre-recording is because my youngest is graduating from Sam Houston State University. So by the time you're watching this, 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 her teaching degree. So, yay, another educator in the family. Super excited about that. Okay, so I will be.

Speaker 1:

Let's see, when we're talking about paperwork, what I mean. There's tons of paperwork when we think about private practice, of course, but the paperwork that I want you to take the fine tooth comb to is your intake paperwork, specifically, your consent form, the piece of paper your client signs where they acknowledge that they have entered into a counseling relationship with you. So when we start with this, you know you may be starting from scratch. I hope you're not. I hope someone has loaned you their form. You know you may be starting from scratch. I hope you're not. I hope someone has loaned you their form. You know. Let you at least use something as a template. Please don't pay money, a lot of money for these forms. You can go to Texas Counselors Creating Badass Businesses and download absolutely free forms in our files. Now, of course, you want to take it to a professional and have them check it once we get it all filled out, but you know this isn't something where you need to stress a lot, because you're going to be modifying it every year for the rest of the time you're in practice. I mean, I like to remind people of the BHEC, lpc, lmft social work boards in Texas had three revisions this year. Now, granted, it's not always going to impact your intake paperwork, but still you need to be aware and you need to get in the habit of doing exactly what we're doing right now, which is get just go over it once a year and make sure that everything is up to date. I'm always surprised when I go through my paperwork, and so you're. Actually. When we get into this, you're actually going to be seeing my paperwork. So if you're listening to this on the podcast or you're listening to it as a Step it Up member in your training, I'm going to also post this in YouTube, so you'll be able to go to my YouTube channel and you can look at it there as well.

Speaker 1:

Okay, so the place we have to start when we're talking about paperwork has to be our licensing board website. And here we are, the Behavioral Health Executive Council, also called BHEC, and if you want to find your rules, you go click. And if you want to find the rules for your license, you just go here and go click and it will take you to a PDF. Now, what I'm showing everyone right now is the link that appears, or the page that appears when you click the link on the BHEC website, and it is dated 8-20-2024. And I love this format because you can always see in that right hand corner of the PDF exactly what revision we're on.

Speaker 1:

Now I will tell you, as of this recording, there's actually another update. It happened November 14th, so this rulebook isn't exactly caught up yet, but it will be. And if you go to the very, very first page and those of you who are listening, I just scrolled to the page two and it will actually tell you new, amended and repealed rules. So just look for that when the new rule book comes out. And how do you know when the new rule book comes out? Well, you sign up for emails. Make sure you are on the email list so that you too can be the first one to know when the new rules come out.

Speaker 1:

Now we could just kind of scroll through here. You know, I love this PDF document because everything is a hot link. I just click here and it takes me to the place in the rules. So I clicked on the rule number and it bam, took me to the actual rule. But we're not going to do that. We're going to do it a little bit differently. So it could take us a lot of time to go through the rules, and I encourage you to go through the latest Zoom the Rules, and I always do this once a year. This year I actually did it with Dr Ashley Stevens and we recorded an hour anda half over LPC, lmft and social work All of the updates for 2024. So that's going to go way more in depth than what I'm about to do right now.

Speaker 1:

So in the BHEC section and so for those of you who are not familiar, your member board that would be LPC, lmft, psychology, social work has BHEC as the administrating body right. So in your PDF document, the first part, about the first 82 pages, will be referring to the Texas Behavioral Health Executive Council rules. So you may be saying, well, kate, don't they duplicate each other? And you know, in some cases they do. But they work that out Again.

Speaker 1:

Not going to deep dive into that now, but I will highlight the areas you should be familiar with as you're getting your paperwork going. So in subchapter B actually okay, not just subchapter B we want to jump to applications and examinations, subchapter B, where it talks about your license. It's very important that you're aware if you have a license I know sounds super obvious, but you want to go to the verification page. Google not Google, sorry do a search for your license and make sure you have one. I mean, if you are in any doubt at all or if you have some kind of a complaint against you or a sanction against you, that will need to go into your paperwork. And so be familiar with BHEC Applications and Examinations. Subchapter B, and we talk about how do I display and advertise my license and, of course, complaints Do I have one?

Speaker 1:

So now that you've become familiar, I hope all of you hit pause and you go run over to your 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, scrolling, scrolling, page, scrolling, scrolling, my goodness, and of course I went too far. Now LMFT I'm going to draw your attention to a few things, even though I'm in the LPC rules. I can still. You know I'm not going to take you back and forth with my screen share, but I will just bring up things that might be similar or different with LMFT. Social work, you're going to have to refer to Dr Ashley Stevens she can help you out and you can always tag her and Texas Counselors Creating Badass Businesses and Texas counselors creating badass businesses. So we get to. When you see the rules change to the 600 numbers. You know you're now in the member board section for Texas State Board of Examiners of professional counselors. So see, it took us to about page 85. The first 85 pages were BHEC and then from 85 to almost the end is going to just be referring to the LPC board.

Speaker 1:

So definitions very important that you know if what you are doing in your counseling practice is allowed right. It's called scope of practice and definitions. You see things like what is a client? What is a consent for services? What is a consent form? So, understanding these terms, as you're putting your consent form together, if you're brand new to this, this is a great place just to start and get a good foundation. And you see that it spells out what a consent form is in the definitions. But don't worry, we'll get to another section where it's a little bit more specific about what that consent form has to have in it. And, of course, mft. You have a similar section and once we get through definitions, we want to jump to methods, counseling methods and practices. So, again, just making sure that what you are doing and what you are calling counseling is actually counseling, and it's a little bit different. So for MFTs, as of this recording, coaching is considered part of your scope of practice. So if you're thinking you're setting up two businesses and coaching over here and marriage and family therapy over here, it's a little bit different. Well, it's a lot different For LPC. Coaching is not included here yet, but you have to stay on top of this so that you understand if the type of counseling you're doing is listed in your scope of practice. And I'll tell you why in a second and right after definitions and methods, is 681.35, our definition of an informed consent In marriage and family therapists. It's going to be a different number but you will see a similar definition for informed consent In marriage and family therapists. It's going to be a different number but you will see a similar definition for informed consent. So here's I'm going to read it out loud to you.

Speaker 1:

Regardless of setting, a licensee must provide counseling only in the context of a professional relationship. Prior to providing services, a licensee must obtain from an individual a signed informed consent, signed written receipt of information or, in the case of involuntary treatment, a copy of the appropriate court order including the following 1. Fees and arrangements for payment. 2. Counseling purposes, goals and techniques. 3. Any restrictions placed on the license by the counsel. Four, the limits of confidentiality. Five, any intent of the licensee to use another individual to provide counseling treatment intervention to the client. Six, supervision of the licensee by another licensed health care professional, including the name, address, contact information and qualifications of the supervisor. Seven, the name, address and telephone number of the counsel for the purpose of reporting violations of the act or this chapter. And eight, the established plan for the custody and control of the client's mental health records in the event of the licensee's death or incapacity or the termination of the licensee's counseling practice.

Speaker 1:

Now, there are a couple of important things here that don't really get into the document itself, but it's important that you understand if you are going to change anything in this document. So what we're about to do? Right, we're about to go in and make some changes to your informed consent. You need to let people who've already signed your informed consent know in writing. So that means give them another informed consent or have the changes laid out so they can sign off on them. I know this time of year I see in a lot of the social media threads I'm going to raise my rates next year. I personally don't raise rates on existing clients. I know some of y'all do so that's one of the things that would be in your informed consent. So if you changed your counseling rate on the person who has previously signed a different rate, you can't change that rate unless you give them an opportunity to sign off on that. You must inform them in writing. This is also that part of the rules for those of you working with kiddos where you have to have a copy of the divorce decree, and you have to. This is important. I talk about this in another podcast episode, another training.

Speaker 1:

A licensee acting within the scope of employment with an agency or institution is not required to obtain a signed informed consent signed informed consent but must document in writing that the licensee informed the client of the information required by subsection A of this section and that the client consented. So that's new. That's it's. You know, if a client is already in the hospital and they've signed tons and tons and tons of paperwork, and then you hand them your informed consent, right, that's helping them understand that what's about to happen is called counseling. And here's what you need to know. Well, you don't have to have that signed informed consent in certain settings, but you would need to document in your notes that you did inform your client and they did consent for services. So I'm going to scroll a little bit more to 681.36, and I'm going to read a little bit of this MFTs. You have something very similar For each client.

Speaker 1:

A licensee must keep accurate records of the informed consent. A licensee must keep accurate records of the informed consent, a signed written receipt of information or, in the case of an involuntary treatment, a copy of the appropriate court order. The intake, assessment dates of counseling, treatment, intervention, principal treatment methods, progress notes, treatment plan and billing information, and then it tells you how long to keep them, and it's a good idea to make sure, if you're employed at an agency, that you know who that records custodian is All right, you are looking at my client services agreement. Now I'm not taking any new clients. I'm slowly limiting my practice down to nothing, but I do have a consent for treatment. I call it a client services agreement.

Speaker 1:

It's also the consent form for my practice, achievebalanceorg, and what I've done is I've gone through those of you who are listening. I've highlighted things that are good or things that are bad and the changes that I plan to make. So what you're going to see is a document that needs some work. 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 and that's why we're doing this.

Speaker 1:

So the first paragraph we're talking to the client, or the client's reading about what counseling is, what it isn't, how to understand what they're about to read. It's just an introductory paragraph. Now, when I first made this, I had several counselors with me, several counselors with me, and so I made sure that I talked about AchieveBalanceorg as A-B-O and All About the Family LLC as A-A-F. Well, it's just me now. So you'll see in yellow that means I need to take care of it. I need to add my actual name and my license number here and that's really also. You know, mft spells it out where it comes to technology and I'll get to that in a second. But I need to have my name, not just my trade name and my license number here.

Speaker 1:

Counseling services or counseling purposes, goals and techniques. I did this in green because it's yay, good job me. So what I'm doing is I'm going through and I'm talking about how I do counseling, the methods and techniques I use, and remember that's in the rules. When you talk about your consent form putting out there for the client to see how you counsel, and that it begins with this assessment of your needs that's in the rules. Your client record has to contain that intake assessment. Now I did highlight this in yellow. Chat GPT could improve. I'm very curious about that. I'm very curious about that, and in December we're exploring how ChatGPT and artificial intelligence can help us with notes, with marketing. So I was very curious to see if ChatGPT could help me with intake paperwork. So I'll do a little experiment at the end of this and we'll see how good of a job Mr or Miss or whatever chat GPT does.

Speaker 1:

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 have my changes and late changes, late cancels, and I have my changes, late changes, late cancels, no-show policy very, very clear. I talk about how I will bill with court testimony. Now you know, if you get a subpoena to go to court, you've got to go right. You can't say, well, I'm not going until I get paid. But if you have this in your records, then you can prepare your client who may be wanting you to come to court, and you can help them understand what your fees will be. If you're going to do a retainer, just it's up to you and of course this is your client, by their signature agreeing that they at least read it, even though it may change later. Even though it may change later Again, I've got this in green.

Speaker 1:

Now, one of the things in our rules is the code of ethics setting and maintaining professional boundaries, and I put this in my consent form so I talk about how you can contact me, how I will respond to these things. I will not respond to those things. For example, I have a social media policy where I help them understand if they reach out to me on social media there will be no response, and so I prepare my clients for that and also helping them understand how our email system works. So we use an online scheduling system, a HIPAA compliant scheduling system, and you know most of us are used to that by now. But I think a few people still think you can hit reply to that email and say I'm canceling today, even though it clearly says in the email do not reply to this email. It doesn't go anywhere. So we make sure that we put it here we will not accept email cancellations. You must call us and leave a voicemail If it's in that under the window of time where they can actually use the system, log in and change it themselves.

Speaker 1:

Limits of confidentiality that is in green, one of the things I want to point out to you. You know, in the digital age we need to show our clients how we are protecting their records, and so here you'll see number one. It says how I utilize a HIPAA compliant version of Google Workspace, an online HIPAA compliant data storage service, to store client records. And then I invite the client to visit their security overview page and when you click this it will take you. Well, not right now, apparently. Oh, there we go. Maybe Click go, no, okay, it doesn't want to. Oh, nope, nope. So it will take them to an actual pdf that explains google workspace and the HIPAA compliant version that I'm using. And I do that again. Let's see, yes, nope, okay, I know I do it again someplace else where I give them the link so that they understand they can go visit the actual website and see how the BAA works, see how the encryption works, so they're not in the dark about how their protected information is actually protected.

Speaker 1:

So, limits of confidentiality I, like most counselors, just listed what is already in Chapter 611. And so if we jump back to the rules, you'll see that Chapter 611, the limits of confidentiality, are spelled out. So here at 681.45, marriage and Family Therapist, you have a similar section. But also what I really like about these rules is that if you scroll to the very last pages, you actually can see Chapter 611, mental Health Records from the Texas Health and Safety Code. This time with the revision that we're on now, it's about page 170. So you don't have to make up the words here. You don't have to stop the video and copy my words down. You can go to the rules and copy-paste what's in Chapter 611. So when I'm informing my client about the limits of confidentiality, I basically it is exactly what's listed in chapter 611.

Speaker 1:

I talk about needing a release of information. So this part in providing coordinated or managing your treatment and other services related to your counseling care ABO that was when I had a big office sometimes interacts with other professionals concerning your well-being, but as a solo person, you know, maybe I need to reach out to their physician, maybe I'm coordinating care with another therapist. I assure them that I will get a release of information to keep on file. Now, one of the things I want to bring your attention to number eight. And so those of you who are new to Texas, it's really important that you get familiar with this the conditions under which you may release confidential information in order to and then there are lots of conditions here. So there's another area. You see the yellow um and the reason. This is in blue for those of you who are listening, I've got a big section in blue.

Speaker 1:

This comes up uh, I'm going back to the confidentiality and required required reporting. You know a lot of us, uh, counselors, you know we, we are bound by our licenses, we're bound by the law, but we also have a conscience, and so if something doesn't fit neat and tidy under these rules, it's important that you follow your conscience. If you know what you want to reveal and you know what you don't want to reveal, you know. Just make sure that it's in your informed consent and you have the conversation with your client and help them understand 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 gotcha moment. This is going to be a conversation and we can decide together what we want to do next.

Speaker 1:

Okay, back to counseling via technology. Now, mfts, you guys say this literally in black and white about counseling via technology. You need to list your license number. So this is just another area where I'm reminding myself. I need to put my license number Also. This is what I was looking for earlier. I use a program I'm reading now called doxyme. I do not use a program called doxyme anymore and I put a note here. I need to list my Zoom information along with that link that shows my BAA and the encrypted how Zoom goes in and encrypts and protects everything, because I do use the HIPAA compliant version of Zoom.

Speaker 1:

All right, so, continuing on, I do have some best practices for technology and counseling that you know we talk about in Texas. It matters where your client's feet are right. Texas laws protect Texans and I explain that here I talk about there's a section for professional records and I've got it in yellow. So this means I need to change something. Oh, I need to remove this. So I again back when I had lots of counselors I put in here if AchieveBalanceorg refuses your request for accessing your clinical record, so this could have been any one of our therapists. I've been informing the client. You have a right of review, which a counselor will discuss with you upon request. I want to make sure that my name is there and that this is clearly written to align with HIPAA and the rules governing protected health and protected health information. Ok, I've got my section for termination, death and incapacity. I've got more about privacy and HIPAA I have. Oh, there's a lot of yellow highlighted right here, so I wanted to draw your attention.

Speaker 1:

This particular consent form has the old information for clients if they want to file a complaint against me. This is the contact information for the LPC and the LMFT boards. That isn't going to work anymore. We must have the information to contact the BHEC website, or their contact information, and so I did copy and paste it right here, and you can find this on the BHEC website. It has the phone number for how to contact the Texas Behavioral Health Executive Council. We cannot list the boards any longer. We have to have BHEC. All right, let me hit pause. Okay, that was fast, so that's it.

Speaker 1:

Going through paperwork doesn't have to be hard. I mean, when you're starting out, you're going to want a template, so please make sure you go to Texas Counselors Creating Badass Businesses. Oh, I was going to do that experiment though, wasn't I? So let me do that. Let me open up a chat GPT window. Just for fun and for those of you watching, I'm going to go ahead and share my screen.

Speaker 1:

Create intake paperwork that a LPC could use with new clients that meets all of the Texas LPC regulations. I just came up with that on the top of my head. So let's see what it does. Here's a draft. Wow. So for those of you who can't see this, it's a lot of bullet points, a lot of sections that the client could sign. So this almost looks more like what the rules were talking about a receipt that shows that the client has read the information.

Speaker 1:

So, while there is a lot of information oh, I just saw the contact information for complaints and it's correct information. Oh, I just saw the contact information for complaints and it's correct. So this might be a good place to start plug the stuff into chat GPT. And the good thing about chat GPT is, if you don't like how it is here like if you want more of a narrative, if you want more of a paragraph form or something like that, you can say same prompt but turn it into paragraphs. So have some fun with that and I can't wait to see what you guys come up with. If you have any questions or comments, you can tag me in Texas Counselors Creating Badass Businesses or the Step it Up membership. All right, have a wonderful day.