The Nature of Couples Therapy
In couples therapy, the unit of treatment is the relationship itself, rather than either individual and the Therapist is not entering into separate, individual therapeutic relationships with either partner. While the Therapist may discuss individual histories or personal concerns, these discussions are for the purpose of understanding their impact on the relationship and do not constitute separate individual therapy, and the clinical focus remains on the dynamics, communication patterns, and shared goals of the couple, often as it is related to one or both individual’s mental health.
Participation
Participation is voluntary. Either partner may withdraw at any time by notifying the Therapist. Additionally, the Therapist reserves the right to pause or terminate treatment if couples therapy is determined to be clinically inappropriate or if safety concerns arise.
Risks & Outcomes
Therapy may surface painful memories or hidden resentments, temporarily increasing relationship tension. While the goal is often reconciliation, the process may lead to the realization that the relationship is no longer viable. No specific outcome can be guaranteed, and any decisions about remaining together, separating, or divorcing are solely the responsibility of the partners.
Confidentiality
While communications are generally protected by healthcare privacy laws (HIPAA), the Therapist is legally required to notify authorities regarding suspected child, elder, or dependent adult abuse. If a therapist believes a participant is a danger to themselves or others, they must take protective action, which may include sharing information with emergency contact(s) or appropriate authorities.
Documentation & Billing & Records
For insurance and administrative purposes, one partner must be designated as the Primary Patient. This is the individual whose insurance will be billed for the session(s). The Primary Patient will have sole access to the Rula Patient Portal, where they can manage billing information and access session links.
While both partners are active participants in therapy, clinical documentation will be framed through the lens of the Primary Patient’s diagnosis, symptoms, and overall functioning. Both partners must provide written authorization for the release of any couples treatment records, unless otherwise required by law.
To maintain safety and clinical standards for both individuals, and to allow for appropriate identification, communication, and emergency response, the Secondary Patient is required to provide basic demographic information, including: full name and date of birth, phone number and/or email address, physical address, and emergency contact information.
To allow the Therapist to remain fully engaged during sessions, they may utilize Rula’s Recap tool. This is a secure, HIPAA-compliant AI assistant that helps generate clinical documentation. The tool does not store audio recordings. Patients have the right to opt out of the use of this tool at any time by notifying the Therapist.
Telehealth Standards & Safety
Sessions are conducted via the Rula telehealth platform (Zoom). To ensure privacy and compliance, the following standards apply:
Both partners must be physically present in the same state for the duration of each session, and that state must be one in which the Therapist is licensed to practice.
Both partners must be in a private, quiet space free from distractions. Using headphones is recommended to prevent audio feedback and enhance privacy. You are responsible for ensuring that no unauthorized person can see or hear your telehealth session and for using a secure, private internet connection.
At the start of every session, the Therapist will verify the couple's physical address(es). If either individual refuses to disclose their location, the Therapist may refuse to proceed with the appointment.
If the connection drops, the Therapist will attempt to reconnect via the platform. If that fails, the Therapist will call the Primary Patient's phone number on file to determine whether to resume the session, switch temporarily to phone, or reschedule the appointment as clinically appropriate.
Acknowledgement & Signatures
I understand that therapy is only effective when both partners put in a good-faith effort. Dishonesty, deceit, or a lack of motivation will undermine the process.
I understand that my therapist will assess if couples therapy via telehealth is appropriate for us and reserves the right to terminate treatment for non-compliance with policies, missed appointments, or safety concerns.
I understand that ending therapy without a scheduled termination session is not recommended.
I understand that laws that protect privacy and the confidentiality of healthcare information, including HIPAA, apply to telehealth services. And I understand that there may be times when my provider must or should report my healthcare information to others for safety or legal reasons.
The parties acknowledge and agree that the Primary Patient is designated as the primary account holder and maintains administrative access to the Rula Patient Portal for the purposes of managing billing information, retrieving session links, and overseeing administrative tasks such as scheduling session(s).
All information discussed during a counseling session is to be kept confidential. Rula, its group affiliates, and the therapist are not liable for any violations of confidentiality by either patient.
By signing below, each partner acknowledges and consent that they have read, understood, and agreed to the policies above, and throughout this document, for the duration of treatment.
Primary Patient Name: ______________________ Signature: __________________ Date: _________________
Secondary Patient Name: ______________________ Signature: __________________ Date: ______________
If you are experiencing thoughts of suicide, self-harm, or harm to others, please reach out for help immediately. You can call 877-371-5488 to connect with Rula Patient Crisis Hotline or call or text 988 to reach the Suicide and Crisis Lifeline. If this is a life-threatening emergency, please call 911 or go to your local emergency room.
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