Privacy Policy


This Pathways Marriage and Family Therapy PLLC Privacy Policy and Informed Consent form is intended to inform you about Pathways Marriage and Family Therapy PLLC policies and procedures and to confirm your agreement to the services. By electronically signing this form you, the client, will be acknowledging that you understand and agree that Pathways Marriage and Family Therapy PLLC and its provider(s) will provide therapy to you according to this Pathways Marriage and Family Therapy PLLC Privacy Policy and Informed Consent form. The following content must be read, discussed with your therapist at the initial consultation (and any time thereafter as needed), and agreed upon before the client-therapist relationship can begin. Please make sure to read each section carefully. If you have any questions, please discuss them with your therapist before obtaining any Pathways Marriage and Family Therapy PLLC services. Pathways Marriage and Family Therapy PLLC reserves the right to change the terms of this form and to make any new provisions effective for all protected health information that we maintain. Please feel free to print a copy of this policy for your records or we can send you an additional copy if requested. This document is found on the Pathways Marriage and Family Therapy PLLC website in several locations including your account dashboard.


Privacy and confidentiality are  Pathways Marriage and Family Therapy PLLC and to each independent therapist in this group practice. Although no transmission of data can be 100% secure, Pathways Marriage and Family Therapy PLLC takes reasonable steps to ensure that your information is kept private and secure. For people seeking mental health counseling, it is important to know that your Protected Health Information (PHI) is kept safe. PHI is any information that can identify you and that describes your health care. We strictly abide by our codes of ethics as well as by the laws governed at the state and federal levels. The Health Insurance Portability and Accountability Act (HIPAA) contains privacy and security rules that are designed to be a minimum level of protection for your PHI. The Privacy rule gives you the right to your medical information and sets limits on whom else has access to your PHI. The Security rule is a federal law that ensures that your PHI is in electronic form and secure (

Pathways Marriage and Family Therapy PLLC uses several entities to store and transmit your PHI and to provide communication and financial services related to the services we provide to you. Those entities include, for example, our Internet Company and financial merchant. Those entities that are not “covered entities” according to HIPAA do not require a Business Associate Agreement (BAA). Other companies we use such as the video chat provider, texting app and email do provide Pathways Marriage and Family Therapy PLLC with a BAA to ensure that your PHI is protected according to HIPAA requirements. For more information about the Business Associate Agreements, see this link:

Pathways Marriage and Family Therapy PLLC may use your PHI for treatment, payment and Pathways Marriage and Family Therapy PLLC operations purposes with your consent for the following services:

Initial Contact and Consultation:

  • A prospective client (or user) will complete a contact form on the website that will include basic demographic PHI to a Pathways Marriage and Family Therapy PLLC email address in order for a therapist to follow up with you at a later time.
  • During an initial consultation, your therapist will collect additional PHI to help determine if therapy with Pathways Marriage and Family Therapy PLLC is right for you. This information will be stored in a HIPAA compliant secure document for information gathering purposes and future follow-up.
  • Pathways Marriage and Family Therapy PLLC has professional social media accounts (i.e., Facebook). You can choose to “Like” and/or “Follow” us at your discretion. We will, at no time, engage in any way that could be considered “treatment” with a user in these social messenger apps. Do not post your PHI on social media in any way.


  • A client-therapist relationship only begins after the user agrees to this privacy policy and informed consent
  • No outside person or entity will gain access to any client’s PHI unless a) we receive a formal Release of Information (ROI) physically or electronically signed by the client (or legally approved representative, such as a parent/guardian of a minor client) for purposes of, for example, collaboration with family members or external providers to coordinate care, b) we are subject to a court order or subpoena to disclose the PHI, or c) we are under some other legal obligation to disclose the PHI, c) if an investigation is being conducted by a licensing board or other government entity, we may have to disclose information as directed by that board or entity, or d) if there is another federal or state law that requires us to disclose information in other circumstances, we may have to disclose the information to the extent required by that law. (This list is not exhaustive; there may be other situations in which we may have to disclose information about the services we are providing even if you do not want us to do so).
  • It is advised not to send PHI over email. Although Pathways Marriage and Family Therapy PLLC BAA with Gsuite and information coming in (or at rest) is protected, we cannot guarantee that an email sent back to you on your server will be private and secure. Pathways Marriage and Family Therapy PLLC  and your therapist will not send PHI to your email unless verbal permission is granted by you, the client. It is up to you whether you wish to send PHI over email to your therapist.
  • PHI gathered from your Pathways Marriage and Family Therapy PLLC sessions is stored in a secure online Electronic Medical Record system.
  • Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant secure messaging through Simple Practice, this is can be used through your client portal should you choose.



  • Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant, the last 4 digits of your credit card and credit card expiration date are stored on the Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant  website. Your email address will be used for purposes of sending receipt of payment along with links to schedule subsequent sessions. No other information will be saved that could identify you. Please see below on how to create a separate email address to use solely for the intended purpose of Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant correspondence.
  • Stripe is the merchant used for credit card payments and they are not a covered entity, meaning they are not required to comply with HIPAA rules and regulations. To learn more about Stripe’s Privacy Policy, click here

Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant Operations:

  • All therapists within the Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant group practice are able to collaborate and consult with one another and retain the right to share a client’s PHI for purposes of providing the best clinical care possible.
  • Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant are also able to share a client’s PHI in order to send/receive referrals to one another for more appropriate matching of client and therapist.
  • Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant never rents, sells or gives your PHI information to a third party without a signed ROI from you or your legally-approved representative (including a minor’s parent/guardian).
  • Pathways Marriage and Family Therapy PLLC uses a HIPAA compliant uses Google Analytics for gathering user information and browsing experience on our website. This information is anonymous and has no connection to any individual PHI. To learn more about Google Analytics Terms and Privacy click here to opt out of Google Analytics go to


It is our policy to safeguard the privacy of your PHI and records to the fullest extent permitted by law. However, in some circumstances, we may be required to disclose your PHI and/or records to other people even if you have not authorized us to do so. Examples of situations in which we may have to make such disclosures include, but are not limited to:

  • If we receive information from you, the client or others indicating that abuse or neglect of a minor or abuse or neglect of a vulnerable adult has occurred, we may have to report that information to a law enforcement agency or to other government entities;
  • If the client or another person has communicated to us a threat of violence to the client or to some other potential victim, we may have to inform the potential victim and/or a law enforcement agency of the threat;
  • If, in our judgment, disclosure to a parent or guardian of any treatment given to or needed by a minor client is necessary to prevent serious harm to the health of the minor client;


In general, the goals of therapy include improving and/or maintaining your capacity for healthy thought, feelings and behavior individually, in groups and/or in relationships with others. The purposes of therapy include providing you with a safe and supportive environment in which to a) identify issues and obstacles that may be interfering with healthy thought, feelings and behavior, and b) learn and implement techniques and strategies for making improvements in those areas. However, therapy is not intended as a substitute for your own capacity for thought, feelings or behavior.

The procedures utilized at Pathways Marriage and Family Therapy PLLC include: Face to face sessions at the Skaneateles NY office, prepaid scheduled sessions with a therapist via electronic media (e.g., video conferencing or telephone call) during which you and your therapist will communicate about your mental health status and progress toward the goals established for therapy. Because of legal and ethical requirements, your therapist cannot engage in activities or relationships with you that are not reasonably and necessarily related to therapy.

The specific therapeutic techniques that will be utilized include, but are not necessarily limited to: CBT, Psychodynamic, Mindfulness, Skill Building, Motivational Interviewing, Client-Centered, Family Systems, EMDR, Hypnosis and Eclectic. Please discuss the specific techniques your Pathways Marriage and Family Therapy PLLC might use in your initial intake session. It may be necessary or desirable to change the procedures from time to time during the course of therapy. You will be informed if any changes are recommended and will be given an opportunity to decide whether to continue receiving therapy if the provider considers those changes necessary.



Psychotherapy can have benefits and risks.  As with most other forms of treatments, results cannot be guaranteed.


Participation in therapy can result in a number of benefits to you, including increased insight into your patterns of feeling, thinking, behaving and relating to others; improvement in your relationships; solutions to specific problems you bring forward in therapy; and improvement in symptoms of distress.


Benefits to therapy require openness on the part of the therapy client.  When information about your feelings, thoughts, behaviors, relationships, or other difficulties are withheld, it is not possible for the therapist to help you with them or to help you understand how they may be related (or not) to the issue for which you are seeking treatment.  Benefits also require consistent attendance in therapy and work both in and outside of therapy sessions.  Overall, you could experience significant changes and progress in your quality of life as a benefit of the therapy.


Since evaluation and/or therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, helplessness, etc.  Some people notice an immediate sense of relief when they share their pain with someone else.  Others may notice that their symptoms get worse, before they begin to get better.  In either case, it’s important to share your reactions to therapy.

There are a number of potential risks associated with therapy. For example, in some cases, despite the best efforts of clients and their providers, clients make little or no progress toward their goals. It is possible, though unlikely, that the therapy could adversely affect your health temporarily or permanently. For example, the therapy could lead to recollection, awareness or discovery of events, experiences, conditions or situations that are painful, stressful or unsettling in a variety of ways.

When these feelings come up, it is important to talk to your therapist about them.  They may be a natural, tolerable, and expected reactions to your work in psychotherapy. Other times it may be necessary or preferable to change the pace of your therapeutic work if the feelings are too uncomfortable. The therapy could be financially challenging for you, particularly if the cost of the therapy is not covered by an insurer or some other third party. Or, if the treatment is not helping, it is important to talk about other treatment options.



The TeleTherapy that you will participate in is, in some respects, innovative in nature. In other words, TeleTherapy has not been used within the professional community for as long or as extensively as other in person methods of providing therapy.

There are always potential security risks associated with electronic communications over the Internet or cellphones as the web and cellphones may not be 100% secure. Pathways Marriage and Family Therapy PLLC and each independent Therapist are committed to working with you, the client, to maintain the confidentiality of your PHI. Here are some tips to help you safeguard your information:

  • Use your own personal computer instead of a work computer and create complex passwords to protect email correspondence from being seen by others. Do the same for your cell phone. Pay attention to where you store your cell phone when you are not using it as notifications of emails or texts may pop up where others could see your private information.
  • Install a “Firewall” and maintain updated anti-virus protection on your computer.
  • You can also create a Hushmail ( or other separate email account that you can use just for Therapy communication to ensure extra confidentiality and security.


Additional Pro-Tips for Online Therapy

  • If others will be nearby while you are in therapy, ensure that you have adequate privacy prior to session.  Psychotherapy is serious work. You do not want to be interrupted.


  • Turn off notifications on your computer and phone once we are connected.



Emergency and Crisis Support

Pathways Marriage and Family Therapy PLLC and its therapists do not provide 24-hour crisis services.   If a life-threatening crisis should occur, contact a crisis hotline, call 911, or go to a hospital emergency room.


Strengths and Limitations of Online Psychotherapy

Telephone, chat, and video sessions have some advantages over in-person psychotherapy.  Many of my clients share that it is more convenient (no commute) and more comfortable (in their own space).  Some clients share that they feel more able to share “deep” things because it is online rather than in person.


Online therapy is not for everyone.  If a client has a poor internet connection, a lack of privacy, or otherwise would simply be more comfortable meeting in person, it is better to connect them with a provider who offers that service.  It is important to consider if this applies to you and may impact your therapeutic progress and select an in-person provider if so.  In some clinical situations, such as crises or suicidal or homicidal thoughts, in-person treatment may be the most appropriate treatment choice.


Location of Services

Online therapy allows Pathways Marriage and Family Therapy to provide services to a broader geographic range of clients than in person services. Currently we have Licensed Marriage and Family Therapists in Florida and New York.





Many factors can impact the duration and results of therapy. They include, for example, your overall health, as well as your mental and emotional health, your motivation to do the work involved in therapy, and external factors related to finances, employment, family, and other circumstances.


Although the Therapy that is being offered is considered to be safe and effective, it is possible that alternative services or measures could be at least as safe and effective for you. Other mental health providers, physicians, and non-traditional health specialists, for example, could be beneficial, as could clergy, self-help programs and support groups. If you elect to utilize alternative services or measures in lieu of or in addition to therapy being offered by Pathways Marriage and Family Therapy PLLC, your therapist will coordinate care with those other services or measures as much as reasonably possible.


As a client, you have certain rights according to state and federal law regarding the services you receive from Pathways Marriage and Family Therapy PLLC. Some of those rights appear in your state’s Bill of Rights. The state in which your Pathways Marriage and Family Therapy PLLC is licensed will be able to offer you that state’s Bill of Rights.

For example, you have the:

  • Right to Plan – You have the right to know your treatment options, be a part of your treatment plan, and easily understand information about Pathways Marriage and Family Therapy PLLC and services provided.
  • Right to Request Restrictions – You have the right to request restrictions on certain uses and disclosures of PHI. However, we are not required to agree to a restriction you request.
  • Right to Inspect and Copy – You have the right to inspect or obtain a copy (or both) of PHI in our mental health records used to make decisions about you for as long as the PHI is maintained in the record.
  • Right to Amend – You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. We may deny your request. On your request, we will discuss with you the details of the amendment process.
  • Right to a Paper Copy – You have the right to obtain a paper copy of the notice upon request, even if you have agreed to print a copy of the notice electronically.
  • Right to Respect and Non-Discrimination – You have the right to considerate, respectful care from your therapist that does not discriminate against you.


The fee schedule for therapy is as follows: Payment is recieved before a therapy session by credit card. You may purchase one therapy session at a time unless discussed with your therapist.

The billing procedure for therapy is as follows: Payment  received before a therapy session by credit card. You will have access to your Dashboard in your Account on the Pathways Marriage and Family Therapy PLLC client portal,that you can keep for your records along with invoices that are sent directly to your email on file.

Responsibility for payment for Therapy is as follows: Payment is your responsibility. We are a private pay company. You can use an HSA credit card and/or request a Superbill (if appropriate) to submit to your insurance company for partial reimbursement for out-of-network care. There is no guarantee that you will receive any reimbursement from your employer or insurance company and the payment for services is 100% the client’s (or if minor, the minor or parent/guardian’s) responsibility.


Pathways Marriage and Family Therapy PLLC offers therapy on an “as needed” basis, which allows you to choose, in consultation with your therapist, how often you want to receive therapy. Your appointment times are reserved exclusively for you, so if your scheduled time for therapy does not work for you, please contact your therapist directly at least 24 hours before the session start time to reschedule a service already purchased. Otherwise, you will incur a cancellation charge.

We understand that life gets busy! Because of the flexibility of therapy services, if you are late to your scheduled session (late means entering your session before it is halfway over), you will receive your service for the remainder of your scheduled session time slot without refund, and it is up to your Therapist if they have the time to go over your scheduled session time. If you show up after the halfway point of your scheduled session and did not notify your therapist that you will be late, your therapist has the right to reschedule that session and bill it as a “no show.” If you do not show up (e.g., you do not attend at the office or check in for a video chat or answer a phone call for a phone session) at the time of a scheduled session, and you do not contact your therapist within the 24 hour prior cancellation period to let them know you will be late or need to reschedule, the session may also be considered a “no show.” Once a service is purchased and the session becomes a “no show,” you will not receive a refund for that session. If several “no shows” occur, you and your therapist can discuss options for therapy that may work better for you.


If you have a question, comment or complaint about the services you receive from Pathways Marriage and Family Therapy PLLC, and you want to communicate with us about that, you may contact Kirsten Lesch MSW, MA, LMFT Licensed Marriage and Family Therapist and owner of Pathways Marriage and Family Therapy PLLC, via telephone at (315) 291-0025 or via email. Also, you have legal rights under state and federal law regarding the services that you receive from Pathways Marriage and Family Therapy PLLC. We cannot give you legal advice regarding those rights, so you should consult with an attorney if you have questions about them. In any event, Pathways Marriage and Family Therapy PLLC will not retaliate against you for exercising those rights.


I acknowledge that I have read this form and that I understand it, and that I am agreeing to receive services from Pathways Marriage and Family Therapy PLLC according to the policies and procedures described in this form. I understand the risks and benefits of therapy, the nature and limits of confidentiality, my privacy, client rights, and what is expected of me as a client of Pathways Marriage and Family Therapy PLLC services.