What should I expect during my first appointment?

Your first appointment will be an initial assessment where we'll discuss your concerns, history, and goals. This helps us understand your unique situation and develop a personalized treatment plan. The session typically lasts 60-90 minutes and includes paperwork completion, discussion of confidentiality, and addressing any questions you may have.

How long does therapy typically last?

The duration of therapy varies based on individual needs, goals, and the complexity of issues being addressed. Some clients benefit from short-term therapy (8-12 sessions), while others may need longer-term support. We regularly review progress together and adjust the treatment plan accordingly. Our goal is to provide the right amount of support for your specific situation.

Do you accept insurance?

Yes, we accept most major insurance plans. We recommend contacting your insurance provider to verify your mental health benefits and coverage before your first appointment. Our administrative team can also help verify your benefits and explain any out-of-pocket costs you might expect. For clients without insurance coverage, we offer sliding scale fees based on financial need.

Is everything I share confidential?

Confidentiality is a cornerstone of our practice. Information shared during therapy is protected by law and professional ethics. There are limited exceptions where we're legally required to break confidentiality: if there's risk of harm to yourself or others, suspected abuse of children or vulnerable adults, or if required by court order. We'll discuss these limitations in detail during your first session.

Do you offer telehealth services?

Yes, we offer secure, HIPAA-compliant telehealth services for clients who prefer virtual sessions or are unable to attend in-person appointments. Telehealth provides the same quality of care and can be particularly convenient for those with busy schedules, transportation challenges, or health concerns. We can discuss whether telehealth is appropriate for your specific needs during our initial consultation.

How do I know if I need therapy?

Consider seeking therapy if you're experiencing persistent emotional distress, relationship difficulties, significant life changes, or if you're struggling with substance use. Other indicators include changes in sleep or appetite, decreased interest in activities, difficulty concentrating, or feeling overwhelmed. You don't need to be in crisis to benefit from therapy—many people seek support for personal growth, stress management, or to improve their quality of life.

Terms of Service | RuthThomas LLC

Agreement to Terms

By accessing or using the services provided by RuthThomas LLC ("we," "us," or "our"), you agree to be bound by these Terms of Service. If you do not agree to these terms, please do not use our services.

These terms apply to all visitors, users, and others who access or use our website and services.

Services Description

RuthThomas LLC provides mental and behavioral health services, including:

Individual psychotherapy
Psychiatric evaluation and medication management
Adolescent and young adult therapy
Addiction and dual diagnosis treatment
Telehealth mental health services

Services are provided by Harriet Wangia Avedi, PMHNP-BC, a board-certified Psychiatric-Mental Health Nurse Practitioner licensed in the state of Maryland.

Client Responsibilities

Accurate Information

You agree to provide accurate, current, and complete information during registration and all interactions with our practice. You must update this information promptly if it changes.

Appointments

Arrive on time for scheduled appointments (in-person or telehealth)
Provide at least 24 hours notice for cancellations or rescheduling
Understand that late cancellations (less than 24 hours) or no-shows may result in a cancellation fee
For telehealth sessions, ensure you have a reliable internet connection and private space

Payment

Payment is due at the time of service unless other arrangements have been made
Provide current insurance information if using insurance benefits
You are responsible for any co-pays, deductibles, or non-covered services
Understand that insurance claims may be denied, in which case you are responsible for payment

Compliance with Treatment

You agree to:

Follow prescribed treatment plans
Take medications as directed
Inform us of any side effects or concerns
Notify us immediately if you are seeing other mental health providers or taking other medications

Cancellation and No-Show Policy

We understand that circumstances may require you to cancel or reschedule an appointment. To ensure we can accommodate all clients:

24-Hour Notice: Please provide at least 24 hours notice for cancellations
Late Cancellations: Cancellations with less than 24 hours notice may be charged a $50 fee
No-Shows: Failure to attend a scheduled appointment without notice may result in a full session fee
Emergencies: We understand emergencies happen. Please contact us as soon as possible

Telehealth Services

When using our telehealth services, you agree to:

Use a HIPAA-compliant platform (SimplePractice) provided by us
Ensure you have a private, quiet space for sessions
Have a stable internet connection and functioning camera/microphone
Be located in Maryland during the session (we cannot provide services to clients outside of Maryland)
Understand that telehealth has limitations and may not be appropriate for all situations

In case of technical difficulties, we will attempt to continue the session by phone or reschedule at no charge.

Emergency Services

Our practice does not provide 24/7 emergency services. In case of a mental health emergency:

Call 911 or go to the nearest emergency room
Contact the National Suicide Prevention Lifeline: 988
Contact the Crisis Text Line: Text HOME to 741741
For Montgomery County residents: Montgomery County Crisis Center at (240) 777-4000

Confidentiality and Privacy

We are required by law to maintain confidentiality of your health information except in the following circumstances:

You authorize disclosure in writing
There is a reasonable suspicion of child or elder abuse
You pose a serious threat of harm to yourself or others
A court orders disclosure
For purposes of treatment, payment, or healthcare operations

Please see our Privacy Policy for more detailed information.

Scope of Practice

Our services are limited to:

Outpatient mental health services
Services provided to residents of Maryland
Services within the scope of practice of a Psychiatric-Mental Health Nurse Practitioner

We do not provide court testimony, forensic evaluations, or services for legal proceedings unless specifically arranged in advance and at additional cost.

Termination of Services

Either party may terminate the therapeutic relationship, subject to the following:

You may discontinue services at any time
We may terminate services if you fail to comply with treatment recommendations
We may terminate if you fail to pay for services
We may terminate if we determine we cannot provide appropriate care
In case of termination by us, we will provide appropriate referrals

Intellectual Property

All content on our website, including text, graphics, logos, images, and software, is the property of RuthThomas LLC or its content suppliers and is protected by copyright and intellectual property laws. You may not reproduce, distribute, or create derivative works without our express written permission.

Limitation of Liability

To the fullest extent permitted by law, RuthThomas LLC shall not be liable for any indirect, incidental, special, consequential, or punitive damages resulting from your use of our services or website. Our total liability shall not exceed the amount you paid for services in the six months preceding the claim.

Changes to These Terms

We reserve the right to modify these Terms of Service at any time. Changes will be effective when posted on this page with an updated "Last Updated" date. Your continued use of our services after changes are posted constitutes acceptance of the modified terms.

Governing Law

These Terms of Service are governed by and construed in accordance with the laws of the State of Maryland, without regard to its conflict of law principles. Any disputes arising from these terms shall be resolved in the courts of Montgomery County, Maryland.

Terms of Service