Southern Fried Spirituality
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POLICIES
Office Policies and Procedures

Gopita Katharine Manning, M.A., M.S.W.
EIN#: 01-0671399
Updated and Revised: January, 2015

Welcome!
I am delighted to be your psychotherapist/ spiritual mentor/Energy Medicine practitioner/nutritionist/kinesiologist/pastor/life coach/hypnotherapist, etc. My hope is that this document will answer any questions you may have about my professional services.

The following are some very general guidelines to my work with you. Please read this document carefully.

Your weekly appointment time is yours to keep. Your fee for my services is $____________. Should you cancel or postpone without a minimum of 24 hours notice, you will be charged the usual fee. If possible, an alternate appointment may be scheduled at a mutually convenient day and time. The fee for canceled appointments is due and payable at the beginning of your next scheduled appointment.

Therapy may be terminated after two consecutive cancellations at my discretion.

Should you require additional sessions, or longer sessions than the usual one- hour counseling sessions, I will do my best to schedule the time with you.

Fees
PAYMENT IS REQUIRED AT THE BEGINNING OF EACH THERAPY SESSION. That means I require that you hand me a check in advance. The reasons for this are numerous. Please ask. I do not generally use a sliding scale, so please inquire about fees before we begin, so that there is no misunderstanding or disappointment. I raise my fees $5 per hour at the beginning of each new calendar year. Please see a price list of my services, if you have any questions. A $25 fee will be charged for any returned check.

Insurance
If you have health insurance, your visits may be partially reimbursed by your insurance company, although I generally do not qualify as a provider. Please request a SUPERBILL from me and you may submit the paperwork directly to your insurance company. Your insurance company requires diagnostic and treatment information before reimbursing you. I will release information to the insurance company WITH YOUR PERMISSION ONLY.

Confidentiality
Information disclosed in a session is confidential, except when related to physical or sexual abuse of a minor or an elder; or when there is a possibility of physical or sexual danger to the self or others. In the case of family or adolescent counseling, I will share information with other family members with permission only, providing a breach of confidentiality is not indicated for legal reasons.

Terminations
I have an ethical responsibility to continue our relationship as long as it is reasonably clear that you are benefitting from the relationship. We will need to discuss termination if you are unwilling to comply with my therapeutic recommendations or if you do not maintain your agreed financial payment. While I normally request that you schedule a minimum of six and a maximum of eight sessions with me after formally announcing a plan to stop treatment, at the very least please do not announce a plan to terminate over the phone and be willing to participate in at least one to two sessions in person to bring closure to our relationship. Termination can be a constructive and useful process and I request that you consider carefully this request before signing this contract.

Telephone
I do not charge for calls, and encourage my patients and clients to call me and make use of our relationship in this way. Should calls become too numerous and lengthy, we will discuss the appropriate protocol and need for reimbursing for this service.

Using Telephone Counseling in Lieu of In-Person Office Visits
Sometimes clients live a great distance and cannot make it in for a weekly counseling session. I am willing to schedule a session by telephone for 45 -55 minutes to avoid travel time. This has been of great benefit to my clients and I encourage you to take advantage of this option if we are in weekly sessions and work or illnesses intervene in our relationship.

Skype
Since 2012 I have utilized SKYPE as a means to work with clients and patients who are not local. This is also an excellent service for people who become ill or who cannot make a regularly scheduled appointment due to illness. Please inquire. These services are priced accordingly and are listed on my PRICE LIST. I utilize PAYPAL and invoice directly via email unless other arrangements have been made.

E-Mails
Please, under no circumstances, communicate with me through email. I see dozens of clients weekly, and I am unable to read, open, or respond to personal emails. Please do not schedule, cancel, or change an appointment with me through email (or in the rare case you have been given my cell phone number, by text). Any changes MUST be done by telephone. Sometimes you will receive a flyer or advertisement from "me", because you are on my mailing list. These "Email blasts" are sometimes executed by an assistant. PLEASE DO NOT REPLY TO THEM.

My Services
As I do not work under the strict licensure of certain bureaus or protocols, I maintain firm boundaries and decorum, yet I do have many "dual" relationships. It is important that my clients know this, and understand that many of my clients see me professionally in many venues as private patients and clients, as students, and/or as group members. I also consider anyone who sees me a friend. While I do my best to maintain some level of confidentiality and decorum, certain things will be revealed in this type of pastoral- type care, and it is important for new clients to realize that this may be different from other types of psychotherapy or treatment they may have had in the past.

Furthermore, anyone who signs a disclaimer, even and if they do not specifically enlist me at the time for Energy Work, allows me to touch their bodies, unless they specifically state otherwise in a written disclosure.

In Closing
My services to you may include nutritional advice, spiritual counseling, and other advice, but I in no way intend to provide medical or psychological counseling, and my services do not relate to, and are not offered or intended to provide these forms of treatment. My primary objective for you includes having you receive my support in the AWAKENING OF CONSCIOUSNESS. Hypnotherapy clients may receive clinical support for issues such as weight-loss, phobias, or the cessation of cigarette smoking, but these are goal-oriented sessions, and my desire remains primarily to frame all sessions in the light of spiritual counseling and spiritual awakening.


I acknowledge and agree with all the terms and conditions set forth in the above contract. For good and valuable consideration received, I do hereby release and discharge "Gopita" Katharine Manning from any and all claims and demands of whatever nature which I now have or may have in the future, relating to the counseling, advice or other services provided by Gopita Katharine Manning.

Client Signature______________________________________________

Print Name__________________________________________________

Date________________________________________________________

Policies and Procedures Addendum, January 2010, Updated 2013

© Gopita Katharine Manning, M.A., M.S.W. DBA Southern Fried Spirituality
818.248.7258

Pasadena Office: 444 South Marengo Avenue, Pasadena, CA 9441

La Crescenta Office: 2361 Chapman Road, La Crescenta CA 91214

All Counseling and Psychotherapy Sessions are 55 Minutes and cost $165.00.

All Energy Medicine Sessions are constructed as follows:

One Hour Sessions ($165): The initial 15-20 minutes are spent in dialogue. The final 40-45 minutes are on the table, in silence. It is essential to note, for all EM sessions, that, during the dialoguing part of the session, I am actively observing hand gestures, meridians, and taking note (sometimes literally writing) of all facial observations. The lips, nose, eyebrows, eyes, tongue and especially the ears reveal more about the individual than most anything. My first observations are the most valuable. I am not only using my mind to engage, I am using my body as an alchemical tool. Once you are on my table, kinesiology and muscle testing are used to validate what I have already seen and intuited, for the most part.

One and a Half-Hour Sessions ($175): The initial 30-45 minutes are spent in dialogue. (Please see the explanation of the importance of this, above.) Often, clients discharge energy in speaking. It is a highly individual phenomenon. But I will not allow anyone to talk more than 45 minutes, and I insist on silence for the final hour, as the contract you are requested to sign, explains.

Please understand, I am not necessarily giving you a psychotherapy session if I respond and counsel you during our initial dialogue. You are perfectly entitled to request "no feedback." But I find that most of you do not want silence, and most of you want a spiritual analysis of what you are saying to me, whether you have recognized this, or not.


All contents copyright Gopita Katharine Manning, 2006-2017.