Services Agreement


Current Practice Changes Due to COVID-19, as of July 2020:

Due to COVID-19, Dr. Minwalla is offering time-limited psychoeducational courses that pertain to the CASRD and Trauma Model. These courses will offer the foundational information and learning concepts that are relevant to understanding compulsive-abusive sexual relational disorders and the trauma model, including education on integrity-abuse disorders and intimate partner abuse. 

It is important to confirm and acknowledge that this is not a form of formal or informal psychological treatment. Participating in a psychoeducational course does not establish a therapist-patient relationship with Dr. Minwalla or ISH. Participation shall not be construed as an alternative to your current clinical treatment already in progress and participants are expected to continue active mental health services during their enrollment with ISH.

The purpose of the course will be to offer participants foundational psychoeducation as a supplement or adjunct to separate ongoing therapy or treatment with an identified and approving external licensed mental health provider. 

 

THE INSTITUTE FOR SEXUAL HEALTH & DR. OMAR MINWALLA

Dr. Minwalla is a licensed psychologist in the State of California. Dr. Minwalla was trained at the University of Minnesota Medical School’s Program in Human Sexuality as a clinical sexologist.  ISH and Dr. Minwalla specialized in the evaluation and treatment of disorders and concerns related to human sexuality, gender health, relationships and intimacy, and sexual and relational disorders and pathology. 

ISH and Dr. Minwalla’s practice also specializes in the evaluation and clinical treatment of compulsive sexual behavior, sex addiction-related concerns, professional sexual misconduct, and sexual offending behaviors, as well as the evaluation and clinical treatment of deceptive sexuality, intimate partner abuse and the resulting traumatic symptoms among victims. 

ISH and Dr. Minwalla founded and developed the concepts and the clinical model referred to as compulsive-abusive sexual relational disorders (CASRD) and trauma model.  This model articulates and treats compulsive-entitled sexuality (CES), integrity-abuse disorders (IAD) and the resulting other-specified trauma referred to as CARSD-Induced trauma, or CAIT.  ISH and Dr. Minwalla provides assessment and treatment services for these clinical concerns and presenting problems as well as education, trainings, workshops, and professional presentation of his model.

 

CONFIDENTIALITY

ISH will maintain and protect all participants' confidentiality. ISH will not release any information to any party without a Release of Information Form signed by the participant, specifying the recipient name, duration of the release and purpose of the release and any limitations. Legal exceptions to this policy, as explained below, will apply.

This office routinely engages in professional consultation with Ellen G. Stein, Ph.D. Dr. Stein is a forensic and clinical psychologist, and serves as a business associate to ISH. Confidentiality extends to all business associates of ISH, for psychoeducational business and administrative functions, including Dr. Minwalla’s administration.

All patients, clients, students and educational participants shall maintain the confidentiality of other participants and no one is permitted to disclose any personal and/or identifying information about any other client participating in any service or program offered by Dr. Minwalla or ISH. 

Limitations to Confidentiality

Participants understand that all services provided by Dr. Minwalla and ISH are completely confidential unless participants sign a written release to provide information held by ISH, to a clearly identified third party. This policy is in effect with the following exceptions:

  1. As required by California law: Please be aware that ISH is a mandated reporter of child, elder and dependent adult abuse. The Institute is therefore required to take action to protect any threatened third party; action may include notifying law enforcement and warning the third party directly. Finally, if Dr. Minwalla or any staff member believes a participant is acutely suicidal, ISH may enact steps which will result in either a voluntary and/or involuntary hospitalization, determined by designated country providers who will be enlisted.

 

  1. ISH and Dr. Minwalla shall break confidentiality should you reveal a serious threat of physical harm to a reasonably identified person or persons, which includes Dr. Minwalla, in order to comply with standards of practice in the state of California, and to protect parties involved in the observed threat. 

 

  1. In cases of emergency, ISH may need to disclose a participant's protected health care information (PHI) to a participant's specific health practitioner to facilitate acute treatment.

 

Complaints: If you believe your privacy rights have been violated you may file a complaint with the federal government. Contact:

Office of Civil Rights
US Department of Health & Human Services
Room 509F HHH Bldg.
200 Independence Ave, SW
Washington, D.C. 20201
Toll Free Phone: 1-800-368-1019
https://www.hhs.gov/ocr/index.html

Should you have any other complaints about the services you receive with The Institute for Sexual Health (ISH), contact:

California Board of Psychology
1422 Howe Ave, Suite 22,
Sacramento, CA 95835
Toll Free Phone: 1-800-503-3221
https://www.psychology.ca.gov/

Reporting Laws Still Apply to Educational Courses

Dr. Minwalla is a licensed psychologist in the state of California and hence all services provided are subject to current state reporting laws.  This is the case whether Dr. Minwalla is conducting education, consultation or direct clinical or treatment services, such as individual or group psychotherapy, assessment, psychological testing, or other services within his professional capacity. All psychoeducational courses assume the same confidentiality practices and procedures with the same limits and exceptions to confidentiality. 

 

ONLINE EDUCATIONAL COURSE(S) AGREEMENT

Voluntary Participation

These particular courses are for men who are experiencing the specific psychoeducational concerns, as outlined. These psychoeducational courses are not open to professionals or otherwise interested parties or identified intimate partner or spouse who has experienced any form of victimization associated with this type of abuse. An online application, a potential interview, and then final selection or other determination by Dr. Minwalla will be required of all participants. Participation in these particular educational courses with Dr. Minwalla is not guaranteed. In order to prepare for the program, all registration paperwork must be completed two (2) days prior to any program commencement. If we do not have completed registration paperwork by the established deadline, you will not be able to participate in the program.

Dr. Minwalla works with people who voluntarily (unless court-ordered) seek his services and are not being pressured or coerced.  The purpose of service is to adequately address psychoeducational needs specific to each participant's current life experiences.

At any time, for any reason whatsoever, if a participant no longer wants to engage or proceed with any type of service being provided by Dr. Minwalla such as the psychoeducational course, the participant has the right to withdraw, and may terminate participation. Further, in such a case, ISH and Dr. Minwalla will provide that participant with a refund for any future or scheduled services that they did not attend or complete. 

ISH and Dr. Minwalla may determine the appropriateness and fitness of any participant; that participant may be terminated if Dr. Minwalla deems that this is necessary and participation is not appropriate at this time, or realistically feasible due to other constraints. Dr. Minwalla reserves the right to terminate a participant’s participation at any time.

Dr. Minwalla shall determine all patient/client eligibility, and Dr. Minwalla is the sole arbiter of this decision.  Please do not assume admission to a psychoeducational program is a guarantee of any continued clinical work with Dr. Minwalla.

Educational Courses and Not Treatment

It is important to note that no psychoeducational courses constitute clinical treatment. Participating in a psychoeducational course does not establish a therapist-patient relationship with Dr. Minwalla or ISH.

The purpose of the course will be to offer participants foundational education as a supplement or adjunct to separate ongoing therapy or treatment with an external mental health treatment provider. 

This agreement acknowledges the distinction and limitations of an online or virtual Educational Course versus psychotherapy or psychological treatment, including that Dr. Minwalla is working/teaching in the State of California while participants are potentially engaging, from a different state. As Dr. Minwalla is not providing clinical or treatment work, and Dr. Minwalla is and will be accessible only via telehealth (including in the event of crisis or emergency), Dr. Minwalla shall not be providing or offering to conduct treatment or psychotherapy with a person residing outside of California or within the State of California.

A Therapist is Required to Participate in Educational Courses

All Educational Course participants are required to have an established and designated therapist-patient relationship with a licensed treatment provider (not Dr. Minwalla), for the entire duration of their participation in a course.

It is each participant’s responsibility to secure and maintain access to a specific licensed mental health professional for the duration of the course. Participants agree that, should clinical symptoms arise, which would require or be benefitted by clinical attention, support or treatment, they shall rely upon their designated treatement provider for relevant services. 

Each participant is required to submit a signed waiver by that designated professional, which confirms an existing clinical relationship with the participant does exist, and states that this professional shall be an active treatment provider during the course of participation in the psychoeducational course(s).  

ISH and Dr. Minwalla will not contact the participant’s therapist unless there is an emergency, or if an important concern presents itself during the course for any reason.  The participant will be informed if this contact is under consideration and/or anticipated, and/or shall be required by Dr. Minwalla in advance. Otherwise, you may not expect Dr. Minwalla to initiate contact with your therapist.

Further, each participant’s signed release of information form authorizes Dr. Minwalla to contact the designated professional, in the case of a clinical emergency, or if an important concern presents itself during the psychoeducational course for any reason, which shall be dated to expire one (1) week after the course ends.

PROCEDURES

Establishing an Environment with Conditions of Active and Focused Learning:

Please do not attempt to email, text, call, or otherwise communicate or contact other participants during any active Course duration.

While in the course sessions, there will be dedicated breaks. You understand that you are not to contact anyone outside of the program, including your intimate partner, spouse, children, family members, friends, work colleagues or others, including when the course is taking a break. You are asked to be present, attend to the process, and to avoid and minimize the use of others for external soothing or emotional regulation, and to further avoid any casual reporting of program content, etc.

It is recommended that each participant spend 30 minutes prior to each session and 30-90 minutes after each session alone, reflecting on the material, reviewing the homework, if assigned, taking any notes upon reflection, writing down any questions related to the session or material presented for next session.  This time should also include techniques to facilitate anxiety-reduction and reduce stress or emotional overwhelm.  This may include breath work and breathing techniques, mindfulness techniques, meditation, various forms and techniques of yoga, stretching, prayer, silence, as may be guided by each participants' own treatment provider.

It is not recommended that you immediately resume normal activity immediately after the course session ends.  A short break and then at least 30 minutes after each session in silent and personal reflection of the material and note taking related to the material is encouraged and strongly recommended.     

Scheduling a session with your designated therapist, a support person, a recovery member or any other type of personal support is recommended after each session, or in some cases, before or after the psychoeducational course. 

It is important that you are free from distraction, as much as possible, to get the most from the course material and the process that Dr. Minwalla will be attempting to create for your educational benefit. 

Please place your phone and all personal devices in a different room, or in a place out of sight for the entirety of the program. Please do not touch your phone or any other technological device during the course, except that which is required to engage the Course.  Engaging your phone may be understood as an attempt to record.  

Please note that only you can be responsible for ensuring you are not distracted during the Educational Course. Securing adequate, sufficient and required conditions and conduct in your personal environment is each participant’s responsibility. If Dr. Minwalla determines that your participation is distracting or disruptive in any manner, including technical disruptions, he may terminate your participation, including during the course. As an example, a minor interrupting the program because they ran into the room, may be grounds for termination. Please make every effort to secure the environment in which you shall be participating, to effectively assure your ability remain uninterrrupted.

You agree to not consume alcohol or use any drugs within 24 hours before, during, or immediately after the sessions.  (It is recommended that each participant avoid the use of substances at least 24 hours before and 72 hours after each session at a minimum, including alcohol). This shall not include any medications for your prescribed use.

These Educational Courses May be an Emotional Process:

The topics covered and the content of the Educational Course may evoke feelings and emotions such as shame, guilt, anger, frustration, sadness, grief, despair, hope, resentment, anxiety, fear and many other emotions that are commonly uncomfortable for many people. Along with such emotions, people may defend against experiencing emotions by employing various defenses, such as checking-out, falling asleep, arguing, intellectualizing, wanting to flee or withdraw.  These are common and reasonable human reactions and may be expected.  

It is important that you share and discuss any such reactions with Dr. Minwalla during the psychoeducational course. Dr. Minwalla will sometimes ask each participant for such reactions so that he can help you with the psychoeducational content and facilitate your learning process. 

These Courses are a Collaborative Learning Process:

This psychoeducational course and process is a cooperative endeavor, requiring knowledge and skills on the part of Dr. Minwalla and each participant’s commitment and investment in the learning process, as well as each participant’s effort and ability to tolerate challenging emotional experiences with other people. For these reasons, it is not possible to predict the ways in which you specifically may or may not benefit.

Please consider that the psychoeducational courses offered by ISH and Dr. Minwalla are interactive.

Participants should expect that the learning process will include times designated for group discussion, asking each participant to share reactions to the content, all of which requires some degree of emotional and relational vulnerability. 

Dr. Minwalla will ask participants to share personally relevant experiences that relate to the topic and content that is being presented and is congruent with the learning objectives of the course.  This is part of the psychoeducational course and style of teaching that Dr. Minwalla will offer in these specific courses.

Each psychoeducational segment or session will offer dedicated time and opportunity for questions and answers.

Participants should expect brief assignments during the Course and also homework assignments in between sessions in order to facilitate the absorption, acquisition, metabolization and synthesis of the psychoeducational process.

Your Intimate or Spouse and Relationship

Participating in any of the Educational Courses should always be shared openly and honestly with your spouse or intimate partner, if possible.

Dr. Minwalla will not be contacting any intimate partners or spouses; only each each participant. 

Each participant must evaluate and determine the consequences of participation on themselves and upon their relationship with an intimate partner or spouse.

Dr. Minwalla expects that if you are in a relationship, then you would discuss honestly your potential participation and proceed, only after gaining support and agreement to participate with your intimate partner or spouse.

Just as participation in the Educational Course does not establish a clinical relationship with Dr. Minwalla, this shall also include no clinical relationship shall be established with a participant's intimate partner or spouse.  

It is understood that should any clinical psychological needs or issues result during or after participation in the psychoeducational program, that the participant shall direct any and all clinical concerns to their appropriate designated mental health treatment provider. 

Participants confirm that if a relationship issue arises that may require or benefit from clinical attention, that the participant shall avail themselves of a relationship or licensed couples’ counselor or relevant treatment provider.

It is recommended that each participant establish the best method and process of sharing any information from the psychoeducational course with their intimate partner or spouse.  One options that is recommended is processing these issues in the context of couples’ therapy or counseling with a licensed mental health treatment professional.  

Your signature below indicates that you understand and accept the stated conditions relating to the psychoeducational courses being offered by ISH and Dr. Minwalla, and that you fully consent to receiving communications from ISH and Dr. Omar Minwalla at the phone number you have provided below.

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Signature Certificate
Document name: Services Agreement
lock iconUnique Document ID: 1ed7b98744c76e47e0b7a631cdcea5e77c730464
Timestamp Audit
July 6, 2020 12:47 pm PDTServices Agreement Uploaded by Dr. Omar Minwalla - ish@theinstituteforsexualhealth.com IP 98.148.17.153