Frequently Asked Questions
We have put together a short list of answers to questions that often come up about treatment. If you are considering coming to us for treatment and you have more questions please fill out the new patient inquiry that is connected to the Information for New Patients page.
Who Will I See?
After our initial sessions, we will determine together what the best treatment plan is for you and what options you feel most comfortable with. You may see a psychiatrist, a psychiatric nurse practitioner or a psychologist. We will discuss with you all of the options during our consultation period.
What is a "psychiatrist" or a "psychologist" or a "nurse practitioner"?
A psychiatrist is a medical specialist (M.D.) who has completed medical training and has gone on to study psychiatry. As a medical doctor, a psychiatrist can prescribe medicine. A psychiatrist is certified by the American Board of Psychiatry and Neurology in the field of Psychiatry.
A psychologist is someone who has completed an undergraduate degree and gone on to receive a doctoral degree (Ph.D. or Psy.D.) in Psychology. Psychologists must also complete a supervised internship and pass a rigorous state licensing exam.
A psychiatric nurse practitioner is a clinical nurse specialist (CNS) that has met higher educational and clinical practice requirements beyond the basic nursing education and licensing required of all registered nurses. Psychiatric nurse practitioners are qualified to address both the psychiatric and medical needs of adults with mental illnesses and those who have common medical illnesses with concomitant mental health problems. Nurse practitioners prescribe medications and work with supervising physicians.
How often will we meet?
Most clients have sessions between twice a week and once a month, depending on the treatment program. Sessions will be 45 to 50 minutes long or 20 to 25 minutes long depending on which clinician you are seeing and the nature of the problem. The staff will make every effort to schedule appointments at convenient times.
How can I reach someone between sessions?
We have two telephone numbers: (415) 551-0520 is our main number, it has a voice recognition program so that you can leave a message for a specific person at Gateway by speaking their name, also, if your message is urgent you can say urgent and get instructions on how to contact us urgently. You can also call (800) 891-1509 which is the number for our answering service (for very urgent matters after hours if you aren't able to reach someone through the main number). Please note that the telephone is not a good substitute for talking face-to-face. However, there may be times when a brief consultation on the phone makes sense.
What happens if I miss an appointment?
Coming regularly and on time is an important aspect of your work with any clinician at the Mood Disorder Clinic. Once we make an appointment, we set aside time for your use. If you miss or cancel an appointment with less than seven days notice, you can expect to be charged for that appointment. You will not be charged if we are able to fill the appointment, which is often possible if we receive more than a couple of days' notice. You should be aware that insurance companies and health plans often do not cover missed sessions. In that case, you will be responsible for the full cost of the session, not just the deductible.
How confidential are my sessions with GPS?
The Code of Ethics of the American Psychiatric Association and American Psychological Association as well as the laws of the state of California ensure the confidentiality of our work together. In general, nothing that we talk about will be revealed to anyone else without your specific permission, except that California law requires psychotherapists to reveal information given to them in confidence if they believe that not revealing such information may result in physical harm or death of any individual. If you send a claim to an insurance company based on our work together, that insurance company may require us to release information to them before they pay you. You don't have to agree to the release of that information, but if you don't agree they may not pay your claim. These records may be sent by mail or they may sometimes be sent by FAX. If the information must be faxed to your company, the office will make every effort to insure that the information remains confidential, but obviously can't be held responsible for delivery errors on the other end. If you have any questions or concerns about this please ask us. We also have a separate section related to our Privacy Policies
What should I do in the event of an emergency?
We distinguish between an emergency (something needs to be done right now in order to avoid possible injury or loss of life) and an urgent request. In the event of an emergency you should call 911. If you have an urgent need for consultation you should either call the main number (415)551-0520 and say "urgent" or call the answering service. A clinician will call you back within an hour. We are contacted immediately for all urgent calls but sometimes the message doesn't get through (cell phones and pagers are not perfect). Please call back if you haven't heard from someone in an hour.
If we are not immediately available and the matter is very urgent, you should call your County's crisis line or psychiatric emergency facility. The telephone number in San Francisco is (415) 206-8125 for San Francisco General Hospital. SFGH is staffed 24 hours a day with crisis counselors and psychiatrists.
What if I run out of medications?
Medication prescriptions should be written during sessions with your clinician. This allows us to discuss how they are working and how long you should take them. Very occasionally, you may need a refill between sessions. Please call as soon as possible if this should happen to you. Please allow one to two days for the office staff to check against your records and acquire clinician approval. You will be charged $5 for refills and we will not authorize refills if you have no future appointments, since we are legally required to ensure that you are in active treatment if we prescribe medications.
What if someone I know might benefit from treatment?
We would be happy to discuss this question with a friend or family member and to provide care for them or to make an appropriate referral. Referrals from people who know us and know our work are a special privilege to receive.
How will our treatment end?
There are many reasons clients decide to end treatment. Most commonly it is because the initial problem is resolved and further work doesn't seem necessary. Many other factors can enter into a decision to end treatment, including frustration with the pace of therapy or with the emotional drain of working on difficult problems. In any event, deciding when and how to end treatment is an important part of the process itself, and should be discussed as soon as the issue comes up for you. You can be sure that we will raise the topic when we believe reducing the frequency of your sessions or ending treatment would serve your best interest. In some cases we may feel that you would be better served by treatment from another professional with special expertise. In rare cases we may feel that further treatment may not be useful. In both situations we have an obligation to help with any referrals that may be necessary and to provide you with care for up to a month during a transition period.
What are my financial responsibilities?
You are expected to pay in full for each session at the time of a visit unless other arrangements have been made. You may also be billed for missed or late-cancelled appointments. There is no charge for occasional very brief phone calls, but more frequent or extended calls will be billed based on the length of the call at the GPS consultation rate. There is also no charge for routine billing and scheduling performed by the office staff, but if significant office time is required to complete a task for you, we may bill for that time. See "Mood Disorder Clinic Fee List" for a complete description of fees. If your financial situation changes during the course of treatment we should talk about this as soon as possible. If you have any questions about charges, please ask me for the current rate sheet.