Template for Communication Policies with Patients


[Name and address of LCSW]

Template for Communication Policies with Patients

May, 2012


     This document outlines my policies related to communication with patients.  Please read it to understand my views of the best way for us to communicate with each other, protect the privacy of the treatment, and focus on our work together.

Basic Principles

    Psychotherapy is one of the most private endeavors in which anyone can engage.  We will be looking at your personal thoughts and feelings in a way that is different from social, even intimate, relationships outside of therapy. The success of this work, supported by the Clinical Social Work Association Code of Ethics, depends in part on the privacy of what we discuss and awareness that our relationship is not part of our social lives, or our professional lives outside of our work together. 

   To protect the private nature of our work and keep it separate from our lives outside of our work, I encourage patients to not discuss or post any information about our work with anyone else. I will do the same, unless required by law or requested by you, though I do not automatically share information unless we agree that it is necessary.  I will discuss any information I share with others about our work with you before doing so, and have you sign a written release of information. 


    Ideally any communication between us occurs in person at our sessions.  When it is necessary to communicate between sessions, I ask that you call me at my landline number above.  I will call you at your landline number or on your cell phone if you do not have a landline telephone.  I do not communicate with patients online to protect the privacy of our relationship.  I also do not text or communicate on social media sites with patients for the same reason.

    If we should accidentally meet outside of my office, we can acknowledge each other and say hello, unless you prefer not to.  Engaging in conversation related to our work together or social conversation outside the office is not helpful to our work.

My Website

    You may find information about my psychotherapy practice at my website [your website address].  I ask that you and I limit acquiring any other information about each other to what we discuss in my office. 

Other Online Information

     If you do come across personal or professional information about me online or through others, I encourage you to bring it up in our discussions so that we may understand any meaning it has in our work.  I will not seek information about you online or through others, and ask that you do the same.

Communication with Others About Our Work

     If I need to collaborate with other health care professionals as part of my legal responsibilities, or for other reasons, I will discuss what is communicated first, and I encourage you to do the same.  While it may feel odd, or even difficult, to keep the discussions that we have private from others, my experience is that it promotes the best results in our work.

Thank you for respecting these policies.  I welcome your thoughts and feelings about them.



Template-Communication.docx13.13 KB

Legislative Alerts

  • 05/08/2015 - 10:21pm

     We were glad to note this month that NASW is joining us in pursuing our goals for Medicare parity. The more the social work community is united on legislative goals that benefit all LCSWs and our patients, the more successful we are likely to be.