Welcome. To begin your Telemental Health Clinical (web-based) Sessions, this guide will provide you with information concerning my credentials, the process regarding Telemental Health sessions, confidentiality, emergency procedural strategies (if needed), and other details about your treatment. At any time prior to, or during your treatment sessions, please feel free to ask me any clarifying questions.
Regarding my Credentials:
Nevada Lic. # PY0672; California Lic. # PSY10035
Link to verify my Nevada License:
Link to verify my California License:
Certifications: Behavior Therapy Training Institute (Obsessive-Compulsive International Foundation; BTTI)
Link to verify my BTTI Certificaton: https://iocdf.org/providers/barmann-barry-c/
Certified Telemental Health Professional: Telemental Health Training Institute
Link to verify my TMHX :
Clinical/Educational Experience: Over 30 years of providing psychotherapy services (see my Curriculum Vita link below)
B.A. in Psychology: The Ohio State University, 1976
M.A. in Psychology: University of the Pacific, 1979
Ph.D. in Clinical Psychology: University of California, Santa Barbara, 1982
My Curriculum Vita (CV): Barry Barmann CV
Regarding Expectations of my Telemental Health Patients:
Avoid using mind altering substances prior to session
Dress appropriately during web-based sessions as you would if you were attending a session at my office
Hold the session in a room that is appropriate for a web-based session, such as your home, or home office
Do not have anyone else in the room unless you first discuss it with me
Do not conduct other activities while in session, such as driving, watching TV, etc.
Do not record sessions without first obtaining my approval.
Be located within the State of Nevada or California during each session. There are a few (VERY FEW) exceptions to this policy, which I will review with you during our therapist/patient orientation
Minors should have a parent or guardian with them at the location/building of the web-based session, unless otherwise agreed upon between myself and the parent.
Confidentiality & Records
All of your PHI (protected health information) will kept for a minimum of seven years. It is my personal, professional, and legal obligation to keep all of your protected health information (PHI) confidential, with some exceptions. The Notice of Privacy Practices form on which you will be given and asked to sign provides detailed information about how private information about your health care is protected, and under what circumstances it may be shared. Other than the exceptions listed on the Notice of Privacy Practices form, myself, and a legal parent/guardian will be the only people viewing your information. In the event of my death, retirement, or incapacity, your records will be given to the followin records custodian: (Karen Egeretson, LMFT, 805.660.6606). This records custodian will be responsible for responding to any request of records you may have, and for safely destroying your records after the legal time frame for storing them have been satisfied. She will also contact you at the time of transfer of records.
If you are a current patient, the same records custodian will assist you in providing appropriate referrals for further treatment. The following information explains how I handle and store your PHI while you are receiving therapy if you chose any of the following therapeutic modalities. Although it is not guaranteed that these methods will prevent 100% of confidentiality breaches, they are designed with the intention of supporting the confidentiality of all clinical communications:
Face-to-face sessions in my office are provided behind a closed door. Your information is stored via which is designed for healthcare and provides for HIPAA compliance. federal approved, encryption. The only information of yours that is stored on any electronic device of mine is your phone number (on my phone). My phone and computer are both password protected and full disk encrypted. Any paper with your personal information is kept in a locked cabinet behind a locked door.
I rarely use "regular" e-mail with my patients. Instead, you can use secure e-mail with me through my secure and encrypted web site (www.anxietytreatmentinclinevillage.com). I will explain exactly how to do this before we begin our first session.
I do NOT perform any Telemental Health Sessions via chat correspondence.
Video Conferencing Sessions:
All video conferencing correspondences will be done through the ZOOM app, which is encrypted to the federal standard for mental health professionals.
I do not use SMS texting with clients. However, you can use secure texting with me by using my secure and encrypted web site (www.anxietytreatmentinclinevillage.com). I will explain exactly how to do this before we begin our first session.
Risks & Patient Responsibilities/Protection
When using technology for communication there is a risk that it may be forwarded, intercepted, circulated, stored, or even changed, and the security of the devices used may be compromised. Although I make reasonable efforts to protect the privacy and security of all electronic communication with you, it is not possible to completely secure the information. If you use any other methods of electronic communication with me, other than the means recommended by me, there is a reasonable chance that a third party may be able to intercept that communication. With the use of technology it is important to be aware that family, friends, co-workers, employers, and hackers may have access to any technology, devices, or applications that you use. I encourage you to only communicate through a computer, or any other device, that you know is safe, and to follow the safety measures that are detailed on the “Privacy Measures” document provided on my web site (XXXX).
You are responsible for reviewing the privacy settings and agreement forms of any applications or technology you use. Please contact me with any questions that you may have on privacy measures.
When you need to contact me for any reason, these are the most effective ways to get in touch with me in a reasonable amount of time:
By phone (775.831.2436; Voice mail only). You may leave messages on the secure voicemail, which is confidential.
By secure messaging using my web site: www.anxietytreatmentinclinevillage.com
Please refrain from making contact with me using any social media messaging systems such as Facebook Messenger or Twitter. These methods have very poor security and I do not use them with my patients. Also, please refrain from creating reviews/testimonials of my services online. Online reviews are public and therefore they would put your confidentiality at risk.
I may not be able to respond to your messages and calls immediately. For voicemails and other messages, you can expect a response within 24 hours on weekdays, and 72 hours on weekends. Be aware that there may be times when I am unable to receive or respond to messages, such as when out of cellular range or out of town.
If you are ever experiencing an emergency, including a mental health crisis, please call 911, Lifeline 1-800-273-8255, or go to your nearest emergency room.
If you need to contact me about an emergency, the best method is:
By phone (775.831.2436). If you cannot reach me by phone, please leave a voicemail.
I am not a Licensed Marriage, Family Therapist, and therefore do not perform couples therapy. However, I do perform "family accomodation" sessions in which I helpt to explain to any significant other therapeutic strategies to use at home for the purpose if acquiring and maintaining treatment gains concerning the patient I am working with. Withn this process of family accommodation, I, your therapist, do not keep secrets for any party.
Cost of Sessions
The cost of your session will be agreed upon between you and I over the phone. The cost of the session depends on the counseling medium used, the date, the time, and any financial hardship that you may have.
You, the client, are responsible for the cost of any technology at your location, such as a computer, device, phone, phone call charges, software, and headset. If you are in need of additional support between sessions and choose to use telephone calls or secure e-mail you will be billed $1 per minute for every minute that exceed 10 minutes in duration.
Some insurance carriers will cover Telemental Health Therapy sessions via video conferencing, within their given parameters. Before we begin our sessions, I will review with you the insurance carriers in which I am on their panel of providers, since these insurance companies often change from moth-to-month. In general, you are
responsible to pay for a "fee for service" in full, and/or deductible at the time of your session. You are also responsible for any payments in which your insurance provider refuses to reimburse. However, for all sessions, I will provide a billing receipt to you following each session, such that you may mail the receipt to your insurance company for direct reimbursement. In general, my fees are as follows: 90 minutes, $180.00 and 60 minutes, $130.00. I have a Business Associate Agreement, meaning that I use an application (app) which adheres to HIPAA law, and have measures in place to keep your PHI secure and confidential.
I no longer accept credit cards as a form of payment. I apologize for this, but credit card companies have significantly raised their rates, and I do not feel it fair to pass these fees onto my patients. However, I will need to secure information pertaining to th credit card of your choice in the event of a cancellation which you may have made with less than a 24-hour notice (see Cancellation Policy below). Should I need to cancel our session with less than a 24-hour notice there is, of course, no charge to you.
If you need to cancel your appointment, I will need a 24-hour, or more, notice. Otherwise, you will be responsible for the full cost of the session, at the time of the scheduled session.
Limitations regarding TeleMental Health Sessions
TeleMental Health Sessions should not be viewed as a substitute for face-to-face therapy or medication by a physician. It is an alternative form of therapy with certain limitations. By signing this document you agree that you understand that TeleMental Health Sessions:
May lack of visual and/or audio cues, which may cause misunderstanding.
May have disruptions in the service and quality of the technology used.
May not be appropriate if you are having a crisis, acute psychosis, or suicidal or homicidal thoughts.
When using email or texting there might be a delay in receiving your message or I might not ever receive it.
Emergency Management regarding TeleMental Health Sessions
So that I am able to get you help in the case of an emergency and for your safety, the following are important and necessary. In addition, by signing this agreement form you are acknowledging that you understand and agree to the following:
You, the patient, will inform me, your therapist, of the location in which you will consistently be during our sessions, and will inform me if this location changes.
You, the patient, will identify, on your client information form, a person, whom I, your therapist, am allowed to contact in the case that I believe you are at risk.
Depending on my assessment of risk, you, the patient, or I your therapist, may be required to verify that your emergency contact person is able and willing to go to your location in the event of an emergency, and if I deem necessary, call 911 and/or transport you to a hospital. In addition, I may assess, and therefore require, that you create a safe environment at your location during the entire time that you are in treatment with me. This may mean disposing of all firearms and excess medication from your location.
Back-up Plan in Case of Technology Failure
The most reliable backup is a phone. Therefore, it is recommended that you always have a phone available and that I, your therapist, know your phone number. If you get disconnected from a video conferencing, chat, or texting session, end and restart the session. If you are unable to reconnect within five minutes call me. If I do not hear from you within ten minutes you agree (unless you request otherwise) that I can call you on the phone number you provide on the client information form. If you are on a phone session and your phone disconnects call me back, or contact me to schedule another session. If I do not hear from you within ten minutes you agree (unless you request otherwise) that I can call you on the phone number you provide on the client information form. If this happens as a result of my phone or phone service, and we are not able to reconnect, you will not be charged for the session.
In the unlikely event that we need to prematurely terminate our therapeutic relationship, I will make two phone calls to you, leave you two messages, and send you a letter via certified mail.
Please check the manner (one, or both) in which you are authorizing me to begin Telemental Health Treatment with you:
You may, at any time during the course of your treatment, withdraw you authorization to any of these modes of treatment and/or this agreement form as a whole. Simply contact me by phone or e-mail. By signing below you acknowledge that you agree that you have read and understand this agreement and agree to accept Telemental Health services provided by: Barry C. Barmann, Ph.D.
Patient Printed Name: _______________________________
Patient Signature: ___________________________________
Signature for legal guardian and or POA:
Legal Guardian/POA Name: _____________________
Legal Guardian/POA Signature: _____________________
CENTER FOR ANXIETY & CHRONIC WORRY
937 Tahoe Blvd. Ste. 205
Incline Village, NV. 89451
Copyright © 2014-2021: Center for Anxiety & Chronic Worry
All rights reserved: Barry C. Barmann, Ph.D.
937 Tahoe Blvd. Ste. 205 Incline Village, NV. 89451
TELEMENTAL HEALTH AGREEMENT FORM