DISCLOSURE STATEMENT FOR RESIDENTS OF MAINE
A. Andrew Kushnick, MF6867
Andrew Kushnick Psychotherapy
870 Market Street, Suite 980
San Francisco, CA 94102
(415) 596-5321
Business hours (all times PST):
M 1pm - 7pm
T 1pm - 7pm
W 1pm - 6pm
T 12pm - 7pm
F 12pm - 6pm
B. Licensure:
Marriage and Family Therapist, prospective first issue: 9/15/22, expiration 9/14/24.
C. Degrees:
University of Michigan, Bachelor of Arts in Political Science and Communications.
-Awarded May 1992.
University of Miami School of Law, Juris Doctor.
-Awarded May 1995.
University of San Diego, Master’s Degree in Marital and Family Therapy.
-Awarded May 2013.
D. Confidentiality:
The information discussed during your therapy sessions is confidential. Under the following circumstances, I may be compelled or allowed by law or ethical guidelines to disclose confidential information:
You are a danger to yourself or to the person or property of others, or unable to care for. [Involuntary hospitalization may be required.]
You make a serious threat of physical violence against a reasonably identifiable victim.
I have a reasonable suspicion that a minor is the victim of neglect or sexual, physical or emotional abuse, or an elder or dependent adult is the victim of abuse.
My records are subpoenaed or my testimony is compelled, and I must comply with a court order.
I am appointed by a court to assess you, to determine your sanity in a criminal proceeding, or to establish your competence under law.
I must file a report that may become public (such as court-ordered psychotherapy within a drug treatment program).
You have introduced your mental or emotional state into a legal proceeding.
During the course of couples or family therapy, when multiple family members are seen individually, confidentiality and privilege do not apply between the couple or between family members.
When minor children receive individual treatment with parent/legal guardian consent, parents/legal guardians are the holders of privilege. However, details regarding the treatment of your minor child/children may not be shared with you.
If you, as a client of mine, are under sixteen years old and the victim of a crime.
If, in the event of your death, our communications are important to establish your actions or intentions regarding your will or other disposition of property, or important to an issue between parties claiming through you.
If you seek my services in order to enable yourself or another to commit a crime, or to avoid detection of or apprehension for a previous crime.
If you make or threaten a legal, administrative or ethical claim against me.
If you default on a fee due to me, I reserve the right to seek restitution through a third party, which would require disclosing that you had been my client and the balance of your outstanding fee(s).
If you choose to sign a Release of Information that will allow me to consult with a third party (for example, a physician, psychiatrist, former therapist, or family member), in the interest of furthering my work with you. If I am treating you as a couple, I need to obtain written consent from both of you before I am able to exchange information with any other party.
If I periodically discuss your therapy in consultation with other licensed professionals outside of my practice, to ensure quality service. In such cases, your name and other identifying information will be omitted. I may, only with your prior written permission, record some or all of our sessions, for the purpose of improving my work and receiving feedback from consultants and colleagues.
E. Areas of competence:
I am trained for work with individuals and couples. I most commonly work with clients to address anxiety, work/life stress, depression, relationship problems, and trauma. I also work with clients to cope with changes in their life, to discover their true purpose, and to address disconnection from others, conflict resolution, low self-esteem, anger management, family conflict, career transitions, a harsh self-critic, and sexual orientation / identity issues.
I have extensive, advanced training in treating trauma and post-traumatic stress disorder, and in couples therapy. I am trained and certified in Attachment-Focused EMDR.
Maine Revised Statutes §13851(6) provides that “marital and family therapy services mean the assessment and treatment of intrapersonal and interpersonal problems through the application of principles, methods and therapeutic techniques for the purpose of resolving emotional conflicts, modifying perceptions and behavior, enhancing communication and understanding among all family members, and preventing family and individual crises.”
F. Course of action:
I offer a complimentary 15-minute phone consultation, in which you can describe what you’d like to work on, and ask any questions you might have. I might ask a few basic screening questions as part of an “intake” process. If it feels like a good fit, we’ll schedule a first session. Prior to the first session, I’ll send 2-3 quick forms to fill out.
The first few sessions include an “assessment” phase in which you’ll further describe what’s been happening, what you’d like help with, what you’re looking to work on, etc. I’ll ask further questions to gain overall context and perspective. This usually takes 1-3 sessions, sometimes longer.
By the end of the “assessment” phase, we’ll ensure that your goals for therapy are clearly defined, and that we have a concrete treatment plan going forward. That way you’ll know what we’re working towards, and what progress looks like.
My professional opinion is that diagnoses don’t always encompass the complexity of the human condition. They can also feel stigmatizing. That said, in order to conform with a professional standard of care, to benefit our work together and for insurance purposes, I will carefully form a diagnosis.
During the “treatment” phase, we’ll be working directly towards the treatment goals that we agreed upon. What this looks like (including the methods or models that I use) will be different for each client.
Throughout our work together, we’ll keep tracking your progress, discussing any roadblocks and how to address those roadblocks, etc.
You’ll always have the opportunity to provide feedback as to what’s working and what’s not. I’ve found that helps clients get results.
G. Fee schedule, method of billing and terms of payment:
My fee for individual therapy is $210 for a standard 50-minute therapeutic hour.
My fee for couples therapy is $220 for a standard 50-minute therapeutic hour.
Payment is by credit card and is due at the start of each session. In the first session, you’ll provide credit card information, which is then stored in a HIPAA-compliant, secure payment processing platform. I charge the card on the day of the session, unless you cancel with more than 48 hours’ notice.
H. Fee modification:
I offer a limited number of sliding-scale spots in my schedule. Feel free to ask about this during the complimentary 15-minute phone consultation. At present, I do not offer pro bono therapy.
I. Insurance:
I am out of network for all major insurance plans, and am not part of MaineCare. That said, if you have a PPO, it’s possible they’ll reimburse you for a large percentage of the fee; many clients have gotten reimbursed up to 80%. I’d be happy to give you a monthly receipt with all of the detailed codes that insurers require. I recommend that contact your carrier to determine the extent of out-of-network coverage. Also, if you have a Flexible Spending Account (FSA) or Health Spending Account (HSA), those typically cover psychotherapy.
J. Accountability:
The practice of counseling is regulated by the Board of Counseling Professionals Licensure. The board is authorized by law to discipline counselors who violate the board’s law or rules. To learn about the complaint process, or to file a complaint against a counselor, contact: Complaint Coordinator Office of Professional and Occupational Regulation, 35 State House Station, Augusta, ME 04333. Phone: (207) 624-8660. Web: www.maine.gov/professionallicensing.