Clinical policies

Section I — Professional conduct

1.1 Ethical standards

All clinicians at Houston Heights Therapy PLLC are expected to adhere to the NASW Code of Ethics and applicable Texas statutes governing the practice of social work. Ethical obligations apply in all professional contexts, including telehealth, written communications, and supervision.

1.2 Dual relationships

Clinicians must avoid dual relationships with clients that could impair professional judgment or increase the risk of exploitation. This includes personal social media contact, financial relationships, and other interactions outside the therapeutic role. Any potential dual relationship concern must be disclosed to the clinical supervisor immediately.

1.3 Professional boundaries

Clinicians maintain clear professional boundaries at all times. Acceptance of gifts from clients is discouraged. Self-disclosure in sessions is limited to what is clinically appropriate and serves the client's treatment goals.

1.4 Continuing education

All clinicians are expected to maintain their licensure through timely completion of continuing education requirements as established by the Texas State Board of Social Worker Examiners. Documentation of CE completion should be maintained and available upon request.

1.5 Mandated reporting

All clinicians are mandated reporters under Texas law. Suspected abuse or neglect of a child, elderly person, or person with a disability must be reported to the appropriate state agency without delay. Reports should be documented in the client's record and disclosed to the clinical supervisor.

1.6 Social media and public presence

Clinicians do not engage in personal social media contact with current or former clients. Professional social media accounts should not include identifying client information under any circumstances. Content posted publicly should reflect positively on the practice and comply with ethical and HIPAA standards.

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Section II — Caseload & case management

2.1 Caseload size

Associate clinicians maintain a caseload appropriate to their experience level and as agreed upon with the clinical supervisor. Caseload size is reviewed regularly during supervision. Clinicians must notify the clinical supervisor if caseload is impacting the quality of care or clinical documentation.

2.2 Intake procedures

All new clients must complete intake paperwork through Sessions Health prior to the first session. Clinicians are responsible for reviewing intake documentation before the first appointment. The intake session uses CPT code 90791 for individual clients. Couples intakes use 90791 and 90847 under the primary client's record.

2.3 Treatment planning

A treatment plan must be completed for each client within the timeframe required by the practice and applicable payers. Treatment plans are reviewed and updated at clinically appropriate intervals. All treatment plans must be documented in Sessions Health.

2.4 Progress notes

Progress notes must be completed for each session using the SOAP format. Notes must be finalized in Sessions Health within 24 hours of the session. Late notes must be disclosed to the clinical supervisor. Notes must reflect the clinical content of the session and support the diagnostic and treatment plan documentation on file.

2.5 Diagnosis

All clients receiving insurance-covered services must have an active diagnosis documented in Sessions Health. Diagnoses should be consistent with the clinical presentation and documented in the intake or first session note. Diagnosis codes used at this practice are drawn from the ICD-10 and must reflect the clinician's clinical judgment.

2.6 Cancellations and no-shows

Clinicians document all cancellations and no-shows in Sessions Health. Per-client cancellation patterns are monitored by the clinical supervisor and practice manager. The practice cancellation policy applies to all clinicians' caseloads regardless of clinician preference.

2.7 Termination

Planned termination should be a collaborative process documented in the client's record. When termination is clinician-initiated, the clinician must provide reasonable notice, a closing summary, and referrals to alternative providers as appropriate. Abrupt termination without clinical justification is not permitted.

2.8 Crisis response

Clinicians are expected to conduct a clinical risk assessment whenever a client presents with suicidal ideation, self-harm, or other safety concerns, using the HHT Universal Clinical Risk Framework. Safety planning should be documented in the client's record. The clinical supervisor must be notified of any high-risk client presentations.

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Section III — Supervision

3.1 Supervision structure

All LMSW associate clinicians at Houston Heights Therapy receive individual supervision from the licensed clinical supervisor (Joe Lenhoff, LCSW-S, TX #68290). Supervision is provided in accordance with Texas State Board of Social Worker Examiners requirements for licensure supervision.

3.2 Supervision frequency

Individual supervision is conducted weekly. Group supervision occurs through the weekly staff meeting. Additional supervision may be requested by the associate or required by the supervisor based on clinical need.

3.3 Supervision content

Supervision sessions address clinical cases, ethical questions, documentation concerns, professional development, and any practice-related matters raised by the associate. Associates are expected to come to supervision prepared with specific cases or questions.

3.4 Supervision documentation

Supervision hours are logged and documented for licensure purposes. Associates are responsible for maintaining their own records of supervision hours. The supervisor and associate review supervision hour totals periodically to ensure compliance with TSBSWE requirements.

3.5 Jurisdiction

Formal supervision hours may only be logged when both the supervisor and supervisee are physically present in or working within the state of Texas. Hours completed while either party is outside Texas jurisdiction cannot be counted toward licensure requirements.

3.6 Supervisory disclosure

Associates must disclose to clients that they are supervised clinicians and that their cases may be discussed in supervision. This disclosure is contained in the Informed Consent for Therapy Services. Associates must not misrepresent their licensure status in any context.

3.7 Performance concerns

If the supervisor identifies concerns about an associate's clinical performance, documentation, or professional conduct, these will be addressed directly in supervision. A written performance improvement plan may be implemented if concerns are not resolved through supervision alone. Serious ethical violations may result in immediate termination of the supervisory relationship.

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