Charles E. Lindner, M. Div.
Suite 214
20 West Park
Lebanon, NH 03766
603 448 2414

It is important that from the beginning we have clear understandings regarding certain basic policies. Please read the following policies carefully and discuss with me any questions or concerns that you have regarding these policies.

I am a NH Licensed Pastoral Psychotherapist. My practice is governed by the Code of Ethics of the American Association of Pastoral Counselors. My license is displayed on my office wall and in an Client Information folder in my waiting room. A copy of the Code of Ethics is also available in Client Information folder in my waiting room.

A copy of the mental health bill of rights is included in the Client Information folder in the waiting room.  It is also found under FAQ on HTTP://www.NHTherapist.com

I received my Master of Divinity degree in 1977 from Union Theological Seminary in New York City. I received my Certificate in Pastoral Psychotherapy from the Blanton-Peale Graduate Institute in New York City upon completing a full-time three year psychotherapy residency in 1984. My practice is limited to individual, marriage, couple, family and group psychotherapy. I do not do forensic evaluations, psychological testing, or prescribe medications.

Under New Hampshire law, communications between a client and a licensed psychotherapist are privileged (confidential) and may not be disclosed without the specific authorization of the client except under specific, limited circumstances. For example:

1. If you are in danger of inflicting serious bodily injury to yourself or another, or are in danger of causing damage to real property, I am required by law to take protective actions, but only revealing what is necessary to obtain further assistance.

2. If I learn of child abuse or abuse to an incapacitated adult, I am required by law to report it to the appropriate state agency.

3. If you request in writing that your records be released.

4. If ordered to release records to a court of law.

5. If you plan to use your health insurance to help pay for your therapy, they may require the release of clinical information, including a diagnosis.

6. Records may also be subject to audit by regulatory authorities.

7. The HIPAA Privacy Notice is available in my waiting room and provides more detailed information about privacy rights.

The treatment of minors must be authorized by a parent or guardian (with limited exceptions). I will not undertake treatment without the consent of both parents. Although communications with adult clients are confidential as described above, in the treatment of minors, parents (even non-custodial parents) have a right to access and authorize release of the information. In treating minors I expect parents to agree to good faith limitations on their access to the information the minor shares in therapy. I report to parents a minor’s intent to harm themselves or others. If there is information I believe the parents should be aware of I work with the minor to help them reveal that information directly to the parents. When a minor client turns 18, control of treatment, information, and records reverts to the client.

Treatment records of couples or family sessions contain information about each person. Therefore, all clients agree that treatment records will only be released by mutual consent. In the event of a disagreement, the records will not be released without a court order.

Unless specifically agreed to otherwise, my role is to provide psychotherapy services, not to assess fitness for custody, serve as an advocate on other issues or act as an expert witness.

As part of your treatment, I will discuss with you your diagnosis and my proposed treatment plan including my estimate of the length of therapy.

I maintain a file for each client or set of clients. This includes an intake summary, diagnosis, treatment plan, billing information, consent to treatment, treatment notes, discharge summary, and any other written or electronic communication I receive from or about a client. Treatment notes include the date and time of each session and a brief summary of key facts and issues discussed as well as treatment recommendations. The client is entitled to a copy of the records. If you wish to see a copy of your records, I recommend that you review them with me so we can discuss the contents. The HIPAA Privacy Notice is available in my waiting room and provides more detailed information about your rights.

Licensed psychotherapists are obligated to establish and maintain appropriate professional boundaries (relationships) with present or past clients. For example, therapists should not socialize or become friends with clients and should never become sexually involved with a client. Report of misconduct should be directed to the New Hampshire Board of Mental Health Practice, 49 Donovan St. Concord, NH 03301, 603 271 6762.

If you have not had a basic physical examination within the past six months, I strongly encourage you to arrange for a physical exam as soon as possible and give permission for your physician to share any findings that might be relevant to your therapy. I am required by law to consult with physicians when the symptoms which cause you to seek psychotherapy are deemed to have a physiological cause. Sometimes I will recommend a consultation with a psychiatrist regarding medications that may prove useful to you. I will make referral suggestions should you need them.

If you have an emergency situation and need to speak with me and you cannot reach me directly, please do the following:

1. Leave a message on my answering machine.

2. Call my emergency number 603 359 1085

3. You may then also choose to contact the Headrest 24 hour Hot-Line at 603 448 4543.

4. You may also go directly to the Dartmouth Hitchcock Emergency Room.

5. If your personal safety is threatened, call 911 or your local emergency services number. When safety is at stake, immediate action is always necessary. If I cannot be contacted immediately, use one of the above resources and I will be of assistance as soon as possible.

Cancellations and Termination of Therapy

If for some reason you are unable to make your appointment, please call and cancel at least 24 hours prior to your appointment. Because continuity is an important element is productive psychotherapy, whenever possible I will re-schedule your appointment. If you miss your session, and do not give at least 24 hours notice, you will be responsible for your full fee for that session (insurance companies do not pay for missed sessions).

Ending your therapy is part of the overall process of your therapy. I encourage you to discuss with me when you believe you have achieved your goals for yourself. If for other reasons you are considering stopping therapy, I encourage you to discuss this with me at least once face-to-face.

                                                                            Fees and Insurance Coverage

My fee is $105 per session. If you have health insurance a portion of the fee may be covered by your insurance. I accept assignment of insurance payments and will bill your company for you. To do this, you will need to complete an insurance claim form and return it to me at your second session. You will also need to sign the Consent to Use or Disclose Information for Treatment, Payment, and Health Care Operations.

When you use insurance you are responsible for all co-payments and deductible payments. I will notify you of this balance once I receive payment from your insurance company. Payment is due within ten days of my notifying you of your balance due. You are responsible for any unpaid balance at the end of your therapy. Any balance that goes unpaid for longer than 30 days will accrue interest charges at the rate of a minimum of $1 per month or 1% per month on the outstanding balance, whichever is greater.

If you are not using insurance, I will bill you at the end of each month. Statements are due on presentation. You are responsible for any unpaid balance at the end of therapy. Any balance that goes unpaid for longer than 30 days will accrue interest charges at the rate of a minimum of $1 per month or 1% per month on the outstanding balance, whichever is greater.

Many insurance plans now have managed care provisions. Most of these programs believe psychotherapy is only "medically necessary" while there are measurable signs of emotional distress. For some clients the relief of that distress will be a satisfactory outcome. For others, the process of therapy may identify some areas of important personal growth that you want to pursue both to prevent recurrences of your difficulties and to improve your overall level of emotional satisfaction. If you choose to continue in psychotherapy after your insurance company has either offered you your maximum benefit for the year or beyond what they consider "medically necessary treatment," it will be your responsibility to pay for any further sessions.

To a limited degree, I offer a sliding fee scale for individuals or families for whom my full fee is a financial hardship. Details of this will need to be negotiated directly with me in the initial session.