Restore Your Relationship

DISCLOSURES AND DISCLAIMERS FOR ONLINE RESTORE YOUR RELATIONSHIP COURSE AND INTENSIVE COUPLES WEEKEND IN CALIFORNIA

Disclosure -- Education and Training: Soni Dani-Cox, LMFT is licensed as a marriage and family therapist in California, but in providing the Online Restore Your Relationship Course and the non-professional therapy activities of the Intensive Couples Weekend in California, she is operating in the non-professional capacity of relationship guide only, and, she is not necessarily relying on her marriage and family therapy license in offering these services. Thus, the services contemplated hereunder may be considered alternative or complementary to licensed healing arts services.  

Nature and Theory of this Product:

Benefits: Benefits are variable, unique, and depend completely on you. Company cannot guarantee any benefits or effects but in taking the course, I could expect that if I participate consistently, I will come closer to my goals, especially if I am committed to long-term work. Results are extremely variable, unexpected events happen, and unforeseen challenges arise all the time, and Company cannot guarantee any results. However, expected benefits include achieving a better understanding of your relationship to come up with practical plans and strategies to improve the relationship.

Alternatives and Risks: Alternatives include self-help techniques, seeking professional therapy, and seeking psychiatric services. Risks include dissatisfaction with results and over-relying on the services when I know I should see a licensed mental health therapist, psychologist, or psychiatrist.

Information and Education Only: The services are educational and informational in nature.   The information is not intended to create and does not constitute any professional relationship between Company and me, nor does it create any doctor-patient or any other professional relationship. The education and information is not and should not be relied upon as psychological or other professional advice of any kind or nature whatsoever. Even if the services are provided by a licensed healthcare provider, such individual is limited to providing information and education, and are not providing any clinical service. The information provided should not be used for diagnosing or treating a mental health problem or disease. The information contained in these communications is not comprehensive and does not include all the potential information regarding the subject matter, but is merely intended to serve as one resource for general and educational purposes.

No Medical or Psychological Services:  I am not engaging Company for any psychological or professional healthcare services.  I understand that Company does not diagnose, treat, or claim to cure any medical or psychological condition, and that Company’s services are not designed to replace conventional treatment methods of medical or psychological conditions. I am responsible to seek professional healthcare services or any other appropriate physical or mental diagnosis and treatment from a duly licensed practitioner if I find there to be any distressing aspects of the services that could create a danger for myself or for others. Never disregard or delay medical advice received from your licensed healthcare provider based on information in these courses. Company is not replacing care currently provided to me by physicians or licensed healthcare providers, such as my current psychiatrist, psychologist, marriage and family therapist, licensed clinical social worker, or other specialty care.

Group Formats: The activities in the Couples Therapy Intensive Weekend in California are beneficial because they use a group session format that allows participants to discuss their own journeys and allow others to benefit from hearing from others and feedback provided to those participants. I acknowledge and understand that if I share my own personal information or protected health information with others in a group context, my information will no longer be confidential or private. I may choose to either not participate in the group activity or I may choose not to share personal information or protected health information. I agree not to disclose the protected health information of other participants who may share protected health information.

DISCLOSURES AND DISCLAIMERS FOR PROFESSIONAL COUPLES THERAPY SESSIONS

*NOTE: This is a California licensed professional service only offered to couples located in California at this time.

Benefits, Risks, and Alternatives: Licensed therapy services often lead to a significant reduction in feelings of distress, increased satisfaction in interpersonal relationships, greater personal awareness and insight, increased skills for managing stress, and resolutions to specific problems. However, Company cannot guarantee that this will be your experience. A joint effort between therapist and the couple is essential for therapy to be successful. Company will use multiple different methods to help you address the specific concerns that you bring forward in therapy and I will create a plan tailored to your unique needs. Therapy involves active effort and participation on your part, and the couple will need to work on things we discuss outside of sessions for treatment to be most effective. Overall progress and success in therapy will vary depending on several factors, including the couple’s motivation, effort, and life circumstances. 

While there are many potential benefits of couples therapy, there are some risks as well. These may include experiencing uncomfortable feelings, such as sadness, guilt, anxiety, anger, frustration, loneliness and helplessness, because the process of therapy often requires discussing the unpleasant aspects of your life. However, these are all natural parts of the therapeutic process and can be necessary for change. 

Alternatives include self-help techniques, seeking individual therapy sessions, and seeking medical and/or psychiatric care.

No Secrets Policy for Couples Therapy: When Company agrees to provide a couples therapy session, Company considers that couple to be its client. Accordingly, Company requires both members of the couple present for the couples therapy session. However, should one member of the couple share information with Company outside of the presence of the other member of the couple, this information may be disclosed to the other member of the couple at Company’s discretion. In other words, Company will not be put in the position of holding the secrets of individual members of a couple participating in couples therapy.

Confidentiality: The couples therapy session records and all other relevant materials will be held confidential unless the client requests in writing to have all portions of such content released to a specifically named person/persons. Legal limitations of such confidentiality exist and are itemized below:

1. If a client threatens or attempts to commit suicide or otherwise conducts themselves in a manner in which there is a substantial risk of incurring serious bodily harm. 

2. If Company has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional, or sexual abuse of children under the age of 18 years. 

3. Suspicions as stated above in the case of an elderly person who may be subjected to these abuses. 

4. Suspected neglect of the parties named in items #3 and # 4. 

5. If a court of law issues a legitimate subpoena for information stated on the subpoena. 

6. If a client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert’s report to an attorney.

Telehealth Disclosure: Professional couples therapy may involve the use of audio-visual or other electronic communications to interact with me. Anticipated benefits include improved access to Company and allows for Company and me to communicate while in different physical locations. Potential risks include gaps of failures in communication, complicating Company’s furnishing of professional services, notwithstanding reasonable efforts to ensure the quality and reliability of transmitted information. There may be limitations to image quality or other electronic problems that are beyond the control of Company. Despite reasonable security measures, online communications can be forwarded, intercepted, or even changed or falsified without my knowledge. In addition, the information transmitted to Company may be insufficient for Company to provide proper services. Alternatives to using electronic communications include an in-person visit.

Session Times and Cancellations. All professional couples therapy sessions are scheduled at the mutual convenience of Company and you. If I need to cancel or change the time of an appointment, I will provide at least 48 hours advance notice. Company will make reasonable efforts to reschedule sessions that are cancelled in a timely manner, but reserves the right to charge $150 for sessions that are cancelled less than 44 hours in advance.

GENERAL DISCLOSURES AND DISCLAIMERS

No Claims or Guarantees:  I understand that Company makes no representations, claims or guarantees that my relationship will improve. Expected benefits are variable, unique, and depend completely on me. Company cannot guarantee any benefits or effects but in working with Company, I could expect that if I participate consistently, I will come closer to my goals. Results are extremely variable, unexpected events happen, and unforeseen challenges arise all the time.

Copyrighted Materials: I understand that Company may present me with copyrighted materials owned by Company and that I may not disseminate the same without Company’s advance written authorization.

Referrals: I understand that Company may recommend that I seek other types of services from health professionals or health-related companies that may not be affiliated with Company. I understand that Company does not supervise any such professionals or companies and is not responsible for them. I understand that they are not Company's employees and that they will bill separately for their services. 

Assumption of Risk; Indemnity:  I knowingly, voluntarily, and intelligently decide to receive the services described herein, and I knowingly, voluntarily, and intelligently assume all risks involved in the same. As a result of my assumption of these risks, I agree to release, hold harmless, indemnify, and defend Company from and against any and all claims which I (or my representatives) may have for any loss, damage, or injury arising out of or in connection with the services described herein. As a result, I agree not to pursue a claim against any of the foregoing, if I am dissatisfied with the results of the above services. 

Limitation of Liability: Company is not liable to me or any third party for any damages (including, without limitation, direct, indirect, incidental, special, consequential, exemplary, incidental, special, or punitive damages, personal injury/wrongful death, lost profits, good will, use data or other intangible losses (whether or not I have been advised of the possibility of such damages)) or damages arising from or relating to this document or any other agreement, even if advised of the possibility of such loss or damages, and whether under negligence or some other theory of liability. Because some states do not allow the exclusion or limitation of liability for consequential or incidental damages, in such states, liability is limited to the fullest extent permitted by law. Notwithstanding the above, Company's sole liability for any reason to me, and my sole and exclusive remedy for any cause or claim whatsoever, shall be limited to the amount paid by me for services or other service provided by Company, and, must be brought within one (1) year since the event giving rise to such action occurred. I understand and agree that my participation with respect to receiving services is predicated upon my waiver of any right to participate in a class action suit for any losses or damages resulting from the same.

Arbitration. Any dispute, claim, or controversy arising out of or relating to this Agreement or the breach, termination, enforcement, interpretation or validity thereof, including the determination of the scope or applicability of this agreement to arbitrate, shall be determined by arbitration in Orange County, California, before one (1) arbitrator.  The arbitration shall be administered by the American Arbitration Association ("AAA"), in Orange County, California. Judgment on the award may be entered in any court having jurisdiction. This provision shall not preclude either party from seeking provisional remedies in aid of arbitration from a court of appropriate jurisdiction.  The arbitrator may, in the award, allocate all or part of the costs of the arbitration, including the fees of the arbitrator.  Each party has read and understood this Section (Arbitration) and understands that it thereby agrees to submit any claims arising out of this Agreement to binding arbitration, and that this dispute resolution provision constitutes a waiver of the Party’s right to a jury trial. HOWEVER, prior to either party initiating Arbitration of any dispute, the parties agree to attempt mediation of the dispute with a mutually agreeable trained mediator in the county of Orange County. “Trained mediator” means a professional with actual training and experience in the field of Mediation and/or dispute resolution. EACH PARTY HAS READ AND UNDERSTANDS THIS SECTION and UNDERSTANDS THAT BY SIGNING THIS AGREEMENT, THE PARTY AGREES TO SUBMIT ANY CLAIMS ARISING OUT OF, RELATING TO, OR IN CONNECTION WITH THIS AGREEMENT, OR THE INTERPRETATION, VALIDITY, CONSTRUCTION, PERFORMANCE, BREACH, OR TERMINATION THEREOF TO MEDIATION AND ARBITRATION, AND THAT THE DISPUTE RESOLUTION PROVISIONS SET FORTH IN THIS SECTION CONSTITUTE A WAIVER OF THE PARTY’S RIGHT TO A JURY TRIAL.