St. Louis DBT Policies


  • Appointment times vary depending on the needs of clients and the availability of therapists.

  • We will make every effort to meet at convenient times for your schedule.

  • Appointments are typically 50 minutes unless otherwise arranged between yourself and the therapist.

  • Our scheduling system sends out emails and/or text reminders 48 hours in advance.



Payment for individual sessions is due at the time of the session. Payments may be made by cash or credit card.  We do not accept checks.  An active and valid credit card, debit card or HAS card must be kept on file regardless of preferred payment method.



All groups and classes at St. Louis DBT are packaged in the same way many classes and wellness services (i.e. physical training, spas, etc) package their services.  This structure helps us offer our skills groups at a lower prices compared to other organizations that may have to pad session costs to account for cancelations and low group census.  

As a courtesy, we ask that you give class facilitators notice if you are going to miss a class (we tend to worry of we don't hear from you).  Class fees will not be returned for any reason.  In a case of a missed session, clients have the right to request session materials.  Clients may also request to meet with group leaders outside of session for a quick recap.  If an emergency or unforeseen situation comes up in which you are unable to continue a 6-10 week module you should discuss this with the facilitators.



We ask that you give your therapist 24 hours notice when canceling an individual session.  Clients will be billed, using the credit card information on file, the full session fee for their individual sessions that are cancelled less than 24 hours in advance.  You may call 24 hours a day at 314.932.7415 and leave a message stating you need to miss or reschedule your appointment.   You may also contact your therapist directly to cancel or reschedule.  



It is our goal to make services affordable and to NOT add to a client’s stressors.  In order to preserve the therapeutic relationship, we make every effort to settle outstanding debt directly with clients.  However, if your account has not been paid for more than 30 days and arrangements for payment has not been agreed upon, we have the option of using legal means to secure payment.  This may involve hiring a collection agency or going through small claims court which may require us to disclose confidential information.  In most collection situations, we would have to release the client’s name, nature of services provided, and the amount due. If such legal action is necessary, its costs will be included in the claim.  



We offer between session coaching calls (5-10 minutes focused on skills use).  Due to our work schedule we may not be immediately available by telephone.  

You may also leave a message for your therapist by calling the main office line at 314.932.7415 and she will contact you as soon as she is able to.  

In the event of an emergency, when your therapist can not be reached, other community 24-hour crisis and helpline numbers are: Life Crisis 314.647.HELP (4357)and Safe Connections 314.531.2003.  You may also dial 911 if you are in immediate danger.



It is the policy of St. Louis DBT, LLC to protect the privacy and confidentiality of all clients receiving services.  The therapist will not reveal to any person, including parent(s)/legal guardian(s) -- even if they are paying for the therapy -- what is discussed during therapy sessions unless the therapist has the client’s permission or is required to do so by law. Circumstances that may require the disclosure of information without the client’s consent are:

(a)Suspicion or knowledge of child abuse/neglect.

(b)When there is serious risk or threat of physical harm to self or others including suicidal or homicidal thoughts.  

(c)When ordered by a court of law.  

(d)In natural disasters whereby records may become exposed.

Should it become necessary to release the client’s information to an outside source such as an outside mental health professional, family member, school, doctor, employer, court, or other social service agency, the therapist will ask the client and if necessary, parent/guardian, to sign a “Release of Information”form. St. Louis DBT, LLC will not give out any information about the client without written authorization.  



St. Louis DBT, LLC Clinicians: We may disclose client’s protected health information to other St. Louis DBT, LLC clinicians as part of consultation in order to ensure top quality services.

Medical Emergencies: We may disclose client’s protected health information in a medical emergency situation to medical personnel only.  

Deceased Clients: We may disclose client’s protected health information regarding deceased clients for the purpose of determining the cause of death, in connection with the laws requiring the collection of death or other vital statistics, or permitting inquiry into the cause of death.

Criminal Activity: We may disclose client’s protected health information to law enforcement officials if the client has committed a crime on program premises or against program personnel.



A clinical chart is maintained describing your condition and your treatment and progress in treatment, dates of and fees for sessions, and notes describing each therapy session/class. Active charts are always kept on site and locked up. Inactive charts are locked and kept at an offsite location for five years.  After five years of inactivity, charts will be destroyed.  

St. Louis DBT Social Media Policy


We do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). We believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.


We keep a St. Louis DBT Facebook Page for our professional practice to allow people to share blog posts and practice updates with other Facebook users. All of the information shared on this page is available on our website.

You are welcome to view our Facebook Page and read or share articles posted there, but we do not accept clients as Fans of this Page. We believe having clients as Facebook Fans creates a greater likelihood of compromised client confidentiality and we feel it is best to be explicit to all who may view my list of Fans to know that they will not find client names on that list. In addition, the National Association of Social Workers and the American Psychological Association’s Ethics Code prohibits our soliciting testimonials from clients. We feel that the term “Fan” comes too close to an implied request for a public endorsement of our practice.

Note that you should be able to subscribe to the page via RSS without becoming a Fan and without creating a visible, public link to the Page. You are more than welcome to do this.


Upon occasion, we publish blog articles on our Facebook page and website and we post practice-relevant news on Twitter. We have no expectation that you as a client will want to follow the blog or Twitter stream. However, if you use an easily recognizable name on Twitter and I happen to notice that you’ve followed me there, we may briefly discuss it and its potential impact on our working relationship.

Our primary concern is your privacy. If you share this concern, there are more private ways to follow us on Social Media (such as using an RSS feed or a locked Twitter list), which would eliminate your having a public link to our content. You are welcome to use your own discretion in choosing whether to follow us.

Note that we will not follow you back. We only follow other health professionals on social media and we do not follow current or former clients on blogs or social media. Our reasoning is that we believe casual viewing of clients’ online content outside of the therapy hour can create confusion in regard to whether it’s being done as a part of your treatment or to satisfy our personal curiosity. In addition, viewing your online activities without your consent and without our explicit arrangement towards a specific purpose could potentially have a negative influence on our working relationship. If there are things from your online life that you wish to share with me, please bring them into our sessions where we can view and explore them together, during the therapy hour.


Please do not use messaging on Social Networking sites such as Twitter, Facebook, or LinkedIn to contact your therapist(s). These sites are not secure and we may not read these messages in a timely fashion. Do not use Wall postings, @replies, or other means of engaging with us in public online if we have an already established client/therapist relationship. Engaging with us this way could compromise your confidentiality. It may also create the possibility that these exchanges become a part of your legal medical record and will need to be documented and archived in your chart.

If you need to contact your therapist(s) between sessions, the best way to do so is by phone. Direct email at is second best for quick, administrative issues such as changing appointment times. See the email section below for more information regarding email interactions.

Use of Search Engines

It is NOT a regular part of our practice to search for clients on Google or Facebook or other search engines. Extremely rare exceptions may be made during times of crisis. If we have a reason to suspect that you are in danger and you have not been in touch with your therapist via our usual means (coming to appointments, phone, or email) there might be an instance in which using a search engine (to find you, find someone close to you, or to check on your recent status updates) becomes necessary as part of ensuring your welfare. These are unusual situations and if we ever resort to such means, we will fully document it and discuss it with you when we next meet.

Google Reader

We do not follow current or former clients on Google Reader and we do not use Google Reader to share articles. If there are things you want to share with your therapist(s) that you feel are relevant to your treatment whether they are news items or things you have created, we encourage you to bring these items of interest into your sessions.

Business Review Sites

You may find your therapist or St. Louis DBT on sites such as Yelp, Healthgrades, Yahoo Local, Bing, or other places which list businesses. Some of these sites include forums in which users rate their providers and add reviews. Many of these sites comb search engines for business listings and automatically add listings regardless of whether the business has added itself to the site. If you should find our listing on any of these sites, please know that this listing is NOT a request for a testimonial, rating, or endorsement from you as our client.

The NASW and APA’s Ethics Codes states that it is unethical for social workers and psychologists to solicit testimonials: “Psychologists do not solicit testimonials from current therapy clients/patients or other persons who because of their particular circumstances are vulnerable to undue influence.”

Of course, you have a right to express yourself on any site you wish. But due to confidentiality, we cannot respond to any review on any of these sites whether it is positive or negative. We urge you to take your own privacy as seriously as we take our commitment of confidentiality to you. You should also be aware that if you are using these sites to communicate indirectly with us about your feelings about our work, there is a good possibility that we may never see it.

If we are working together, we hope that you will bring your feelings and reactions to our work directly into the therapy process. This can be an important part of therapy, even if you decide we are not a good fit. None of this is meant to keep you from sharing that you are in therapy with us wherever and with whomever you like. Confidentiality means that we cannot tell people that you are our client and our Ethics Code prohibits us from requesting testimonials.

If you do choose to write something on a business review site, we hope you will keep in mind that you may be sharing personally revealing information in a public forum. We urge you to create a pseudonym that is not linked to your regular email address or friend networks for your own privacy and protection.

If you feel your therapist or this practice have done something harmful or unethical and you do not feel comfortable discussing it with us, you can always contact the State Committee for Social Workers, which oversees licensing, and they will review the services we have provided.

Committee for Social Workers
3605 Missouri Boulevard
P.O. Box 1335
Jefferson City, MO  65102-1335
573.751.0885 Telephone
573.526.4220 Fax
800.735.2966 TTY
800.735.2466 Voice Relay


Location-Based Services

If you used location-based services on your mobile phone, you may wish to be aware of the privacy issues related to using these services. St. Louis DBT and Gateway Wellness Associates are not set as a check-in location on various sites such as Foursquare, Gowalla, Loopt, etc. However, if you have GPS tracking enabled on your device, it is possible that others may surmise that you are a therapy client due to regular check-ins at the office on a weekly basis. Please be aware of this risk if you are intentionally “checking in,” from our office or if you have a passive LBS app enabled on your phone.


We prefer using email only to arrange or modify appointments. Please do not email your therapist content related to your therapy sessions, as email is not completely secure or confidential. If you choose to communicate with your therapist by email, be aware that all emails are retained in the logs of your and our Internet service providers. While it is unlikely that someone will be looking at these logs, they are, in theory, available to be read by the system administrator(s) of the Internet service provider. You should also know that any emails we receive from you and any responses that we send to you becomes a part of your legal record.


Thank you for taking the time to review our Social Media Policy. If you have questions or concerns about any of these policies and procedures or regarding our potential interactions on the Internet, do bring them to my attention so that we can discuss them.

This policy is based on Social Media Policy created by © Keely Kolmes, Psy.D. – Social Media Policy – 4/26/10

This work is licensed under the Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License. To view a copy of this license, visit or send a letter to Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA.



At St. Louis DBT we know that all clients have the right to be treated with dignity and respect.  If you have a complaint about your treatment, therapist or any office policy please inform us immediately and we will try to resolve the issue in a timely manner. Concerns regarding discrimination and privacy rights that aren’t resolved to your liking may be directed to the Office for Civil Rights (816) 426-7277.