Disclaimer

Last updated July 12, 2026

THERAPY PROCESS

Therapy begins with the intake process. First, you will review your provider’s policies and procedures, talk about fees and identify emergency contacts. Second, you will discuss what to expect during therapy, including the type of therapy, the length of treatment and the risks and benefits. Next, you will form a treatment plan, including the type of therapy, how often you will attend therapy and your short and long-term goals, and steps you will take to achieve them. Over time, you and your provider may edit your treatment plan to be sure it describes your goals and steps you need to take. 

After intake, you will attend regular therapy sessions either in-person or online. Participation in therapy is voluntary: you can stop at any time. At some point you will achieve your goals. At this time, you will review the progress, identify supports that will help you maintain your progress, and discuss how to return to therapy if you need it in the future. Counseling often involves expressing and recalling deep, vulnerable, and painful experiences, which may cause emotional discomfort at times. The purpose of therapy is to process these experiences together, helping you build the tools to confront and manage them effectively.

YOUR RIGHTS

I encourage ongoing, honest dialogue regarding your progress. If you feel unsatisfied with your counseling at any time, I invite you to share your concerns with me so we can evaluate where the challenges lie and redirect our sessions.

You maintain the right to terminate counseling at any time and seek a referral for a different provider. However, if your treatment is involuntary, please be aware that I have a professional obligation to report the termination of services to the court, school, or applicable agency specified in your Release of Information.

FEE SCALE

I do not accept insurance. Fees will depend on a variety of factors including but not limited to; site of practice, mode of telehealth, and requested role of the counselor. Sliding scale options may be provided upon request. I believe financial barriers shouldn't prevent access to quality care.

Typical Fees:

Initial Diagnostic Assessment (55 minutes) $225

Individual Psychotherpy (53+ minutes) $175

No-show/late cancellation $175

Paperwork $175/hour

Court Appearances: $525 non-refundable one week prior court date. $175 every hour in court, including traveling,

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PROFESSIONAL ETHICS

Professional Ethics Counseling is personal in nature and the counseling relationship is designed to be kept professional and confidential, enforced both by HIPAA and the ACA code of ethics I adhere to. This professional disclosure statement obtains specific boundaries as a guideline to honor the integrity of the therapeutic relationship. You are encouraged to discuss any of the following with me in session. 

1) no socializing outside of the counseling session 

2) no interaction or communication on social media 

3) no gifts 

4) no contact with my personal email address or telephone number; the use of e-mail and/or text messaging is not a secure form of communication; thus, confidentiality cannot be guaranteed. 

To protect the counseling relationship and ensure that extraneous factors do not interfere with my ability to best serve the client’s needs, the boundaries mentioned will be established. 

SOCIAL MEDIA AND TECHNOLOGY POLICY

To protect the integrity of the therapeutic relationship and maintain appropriate professional boundaries, the following social media and technology policies are in place:

Social Media: I do not accept friend, follower, or connection requests from current or former clients on any personal social media platform, including but not limited to Facebook, Instagram, LinkedIn, TikTok, or Snapchat. This boundary exists to protect your confidentiality and preserve the professional nature of our relationship. You are welcome to follow my professional practice pages, which are maintained solely for educational and informational purposes.

Searching Clients Online: It is not my standard practice to search for clients on the internet or review their social media profiles. Exceptions may occur in rare clinical circumstances where there is a significant safety concern and no other means of contact is available. If this occurs, it will be documented in your clinical record and discussed with you at the next available opportunity.

Public Reviews: I appreciate that clients may wish to share their experiences. However, if you choose to leave a public review of my services on Google, Psychology Today, or any other platform, please be aware that I am unable to respond in a way that confirms or denies our therapeutic relationship, as doing so would violate your confidentiality. I encourage you to discuss any concerns or feedback with me directly in session, where they can be most meaningfully addressed.

Email and Text Communication: As noted above, email and text messaging are not secure forms of communication and confidentiality cannot be guaranteed through these channels. For non-urgent communication between sessions, please use the secure client portal through TherapyNotes. I will make every effort to respond to non-urgent messages within 48 business hours. For urgent matters, please call 911 or your nearest emergency room.

Communication Between Sessions:

For non-urgent matters between sessions, please contact me through my HIPAA-compliant email at julieartinian@hushmail.com. I will make every effort to respond to non-urgent messages within 48 business hours. Please be aware that standard email and text messaging are not secure forms of communication — confidentiality cannot be guaranteed through those channels. Only my Hushmail address meets HIPAA compliance standards for electronic communication.

For urgent matters that require a same-day response, please contact me by phone at 517-442-2777. If you are unable to reach me and are experiencing a mental health crisis, please call 911, go to your nearest emergency room, or contact the National Suicide Prevention Lifeline at 1-800-273-8255 or text HOME to 741741.

Please note that phone and email communication between sessions are intended for scheduling, administrative matters, and brief non-clinical questions only. Therapeutic work is best conducted within the boundaries of our scheduled sessions. If something significant arises between sessions that requires clinical attention, please contact me to schedule an additional appointment.

Telehealth Platform Security: All telehealth sessions are conducted through a HIPAA-compliant, encrypted platform, typically Doxy.me. You are responsible for ensuring your own device security, including keeping software updated and using a secure, private internet connection during sessions.

DUAL RELATIONSHIPS:

A dual relationship occurs when a therapist and client share a connection outside of the therapeutic relationship, for example, as friends, family members, romantic partners, business associates, or colleagues. Dual relationships have the potential to compromise the objectivity, integrity, and effectiveness of the therapeutic relationship and are therefore avoided whenever possible.

I will not enter into a therapeutic relationship with anyone with whom I have a pre-existing personal, professional, or social relationship. If a dual relationship is discovered or develops after treatment has begun — including circumstances that were not initially apparent to either party — I am ethically obligated to address it promptly and transparently.

In such circumstances, we will discuss the situation openly and collaboratively determine the most appropriate course of action. In most cases, this will involve a referral to another qualified mental health professional to ensure continuity of your care without compromise to the therapeutic relationship. Any transition of care will be handled with the utmost sensitivity, professionalism, and regard for your wellbeing.

If you believe a dual relationship exists or may develop, I encourage you to bring it to my attention as soon as possible so it can be addressed appropriately.

CODE OF CONDUCT:

Clients who have concerns about the professional conduct of their counselor may contact the Michigan Department of Licensing and Regulatory Affairs (LARA) at 517-241-0199 or www.michigan.gov/lara

Clients residing in Ohio who have concerns about the professional conduct of their counselor may contact the Ohio Counselor, Social Worker, and Marriage and Family Therapist Board (CSWMFT Board) at 614-466-0912 or visit www.cswb.ohio.gov.

Clients residing in Florida who have concerns about the professional conduct of their counselor may contact the Florida Board of Clinical Social Work, Marriage & Family Therapy and Mental Health Counseling by calling (877) 425-8852, visiting floridasmentalhealthprofessions.gov, or submitting a complaint through the Florida Health Care Complaint Portal at complaint-portal.mqa.flhealthsource.gov.

PRIVACY:

Your Right to Privacy and Confidentiality The communication which occurs during our sessions may be part of a client clinical record kept for your benefit and are available to you at your request. I will keep confidential anything you say as part of our counseling relationship, with the following exceptions: (a) The client provides consent to release their records, (b) The client discloses abuse, neglect, or exploitation of a child, elderly, or disabled person, (c) I am ordered by law, specifically, a judge, to disclose information or legally protect myself in the event I’m accused of misconduct. 

CONSULTATION AND SUPERVISION

To ensure the highest quality of care, I engage in ongoing professional consultation. This may take the form of peer consultation with a licensed mental health professional colleague, or clinical supervision with a licensed supervisor, depending on the clinical needs of the case and my own professional development goals.

In either context, strict confidentiality is maintained. Any case discussion involves only the minimum necessary clinical information to address the matter at hand. Identifying information — including your name, contact details, and any other information that could reasonably be used to identify you — is never disclosed during consultation or supervision. All consultants and supervisors are bound by the same ethical and confidentiality standards that govern my own practice.

Consultation and supervision are considered a hallmark of ethical, responsible clinical practice and are conducted solely in the interest of providing you with the best possible care. The existence of this practice does not diminish the confidentiality of your therapeutic relationship in any meaningful way.

PSYCHOTHERAPY NOTES AND CLINICAL RECORDS

As your therapist, I maintain two distinct types of records related to your care, each of which carries different levels of legal protection under HIPAA.

Clinical Records include standard documentation such as your intake assessment, treatment plan, progress notes, diagnoses, session dates, and billing information. These records constitute your general medical record and may be used and disclosed for standard treatment, payment, and healthcare operations purposes as outlined in this document and in the Notice of Privacy Practices.

Psychotherapy Notes are a separate category of documentation entirely. These are my personal notes analyzing the content of our sessions: my private clinical impressions, observations, and reflections that I keep separately from your general clinical record. Under HIPAA, psychotherapy notes receive a significantly higher level of legal protection than standard clinical records.

In my practice, psychotherapy notes are maintained selectively and are used specifically in the context of EMDR treatment. Standard progress notes are maintained for all other session types. This distinction reflects the particularly sensitive and clinically complex nature of EMDR processing work and is consistent with HIPAA's framework for protecting the most private elements of the therapeutic record.

Regarding psychotherapy notes maintained in connection with EMDR sessions, the following apply:

• Psychotherapy notes may not be released for standard treatment, payment, or healthcare operations purposes without your explicit written authorization

• A separate, specific written authorization from you is required before psychotherapy notes can be disclosed to anyone — including other treating providers, insurance companies, or attorneys — regardless of the purpose

• Psychotherapy notes are not included in a standard release of records, even if you sign a general Release of Information

• Psychotherapy notes are kept separately from your general clinical record in accordance with HIPAA requirements

• There are limited exceptions where psychotherapy notes may be disclosed without your authorization, including but not limited to: a court order, a serious and imminent threat to health or safety, or oversight of the therapist by a licensing board

If you have questions about what type of documentation exists for any aspect of your treatment — including the distinction between your EMDR psychotherapy notes and your standard clinical record — please ask me directly. You have the right to request an accounting of disclosures of your records at any time.

MULTI-STATE PRIVACY REGULATIONS

My practice is licensed in Michigan, Ohio, and Florida. Each of these states maintains its own laws governing the privacy and confidentiality of mental health records, some of which are more protective than standard federal HIPAA requirements. Where state law is more stringent than federal law, I am legally and ethically obligated to follow the stricter standard. This means your records may receive a higher level of protection than the federal HIPAA baseline depending on the state in which you are receiving care.

Therapist-Client Privilege: Both Michigan and Ohio maintain strict therapist-client privilege laws that provide significant protections regarding when and how mental health records may be released without your consent. Florida similarly maintains strong confidentiality protections for mental health clients under state law. These privilege laws apply to the therapeutic relationship and to the records generated within it.

Subpoenas vs. Court Orders: Under federal HIPAA rules, a provider may in some circumstances release records in response to a standard attorney-issued subpoena. However, under the therapist-client privilege laws of Michigan and Ohio in particular, mental health records generally cannot be released in a civil legal proceeding based solely on an attorney-issued subpoena. In most circumstances, one of the following is required before mental health records can be released in response to a legal proceeding:

• Your written authorization specifically permitting the release, or

• A formal court order signed by a judge compelling disclosure

If I receive a subpoena for your records, I will notify you promptly and consult with legal counsel before releasing any information, unless I am legally prohibited from doing so. I will make every reasonable effort to protect the confidentiality of your records within the bounds of the law.

Florida Telehealth Clients:For clients receiving services via telehealth while physically located in Florida, Florida's mental health confidentiality laws under Chapter 491 of the Florida Statutes apply in addition to federal HIPAA protections. I am committed to honoring the most protective standard applicable to your care regardless of which state you are located in at the time of service.

General Principle:Regardless of the state in which you are receiving care, it is my policy to apply the most protective privacy standard available under applicable state or federal law. Your mental health records will never be released in response to a legal proceeding without either your explicit written authorization or a formal court order, consistent with the stricter privilege standards of the states in which I am licensed.

EMERGENCIES:

Emergencies can arise in people’s lives. In case of an emergency or crisis (suicidal, homicidal, psychosis thoughts or actions, severe panic attacks, etc.) please call or present to your nearest emergency room or 911. You can also call the National Suicide Prevention Hotline at 1(800) 273-8255. For a crisis text line, text HOME to 741741. 

RECORD KEEPING

Your provider is required to keep records about your treatment. These records help ensure the quality and continuity of your care, as well as provide evidence that the services you receive meet the appropriate standards of care. Your records are maintained in an electronic health record provided by TherapyNotes. TherapyNotes has several safety features to protect your personal information, including advanced encryption techniques to make your personal information difficult to decode, firewalls to prevent unauthorized access, and a team of professionals monitoring the system for suspicious activity. TherapyNotes keeps records of all log-ins and actions within the system.

CLIENT RESPONSIBILITIES

Client Cancellations and Rescheduling:Clients who need to reschedule or cancel an appointment must do so at least 24 hours prior to their scheduled session to avoid being charged. If you need to reschedule, please contact me as early as possible to secure an alternative appointment time. In the event of a genuine emergency, you may reschedule up to the time of your appointment without penalty. What constitutes an emergency will be considered on an individual basis and discussed with you directly.

Late Arrivals:If you arrive more than 10 minutes late to a scheduled in-person or telehealth session, the session may be shortened to the remaining available time or rescheduled at my discretion. The full session fee will still apply regardless of the time remaining in the session.

No-Shows:Clients who do not attend their scheduled appointment and do not provide advance notice will be charged the full session fee of $175. Repeated no-shows may be discussed as a clinical matter and could result in reassessment of our working arrangement.

Provider Cancellations:In the event that I need to cancel a scheduled appointment, I will notify you as promptly as possible and offer a make-up session at the next available appointment slot. I will make every reasonable effort to minimize disruption to your care. Please note that make-up sessions are offered subject to availability and cannot always be guaranteed within a specific timeframe.

Illness-Related Cancellations:As noted in the Telehealth and Infection Control Addendum, if you are experiencing symptoms of contagious illness prior to an in-person session, you will not be charged a late cancellation fee. Please contact me as soon as possible so we can arrange to transition your session to telehealth or reschedule as appropriate.

Counseling is an interactive experience and participation is crucial in effective counseling. It is expected that the client participates in practicing skills learned, being open and honest, and doing occasional “homework assignments” geared toward deepening our experience together.

Client please read and acknowledge:

1. I am responsible for providing necessary information to facilitate effective treatment.

2. I am expected to play an active role in my treatment, including working with my therapist to outline my treatment goals and assess my progress.

3. I may be asked to complete questionnaires or do homework assignments. My progress in therapy often depends much more on what I do between sessions, than on what happens in the session.

4. Outcomes cannot be guaranteed because of factors beyond the therapist’s control.

5. I may experience periods of emotional stress during treatment.

LENGTH AND FREQUENCY OF TREATMENT

The length and frequency of therapy varies significantly from person to person and cannot be predetermined or guaranteed. Treatment duration depends on a range of factors including the nature and complexity of the concerns being addressed, your individual goals, your pace of progress, and your personal preferences regarding the therapeutic process.

Most clients begin with weekly sessions, particularly in the early stages of treatment when establishing rapport, completing assessments, and building foundational skills. As treatment progresses, session frequency may be adjusted collaboratively based on your needs, progress, and life circumstances.

At the outset of our work together, we will collaboratively establish treatment goals that reflect what you most want to achieve through therapy. These goals will be revisited and reviewed regularly throughout our work to ensure that our sessions remain aligned with your evolving needs and priorities. You are always welcome to share feedback about the direction, pace, or focus of treatment at any time.

Either party may raise the topic of ending or transitioning treatment at any point in the therapeutic process. Ending therapy is ideally a collaborative decision made when treatment goals have been met, when progress has plateaued, or when a referral to a different provider would better serve your needs. If you wish to end treatment at any time, please refer to the Termination of Services section of this document for guidance on how that process works.

TERMINATION OF SERVICES

It is requested that you notify me if you wish to terminate the counseling relationship or prefer to see another mental health professional.

If a client ceases to make and keep an appointment within 30 days of their last appointment, their file will be considered INACTIVE, which means the client will no longer be considered a client of Julie Artinian Callaway, LLC. 

GOOD FAITH ESTIMATE 

You have the right to receive a Good Faith Estimate explaining how much your medical care will cost. Under the law, healthcare providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.