Review your care, one section at a time.

01 · Purpose of counseling

What treatment is for

Pathway is a private telehealth practice for adults with OCD and related concerns. Co-occurring concerns may be addressed when they interfere with OCD treatment and remain within the counselor’s competence.

Treatment orientation

• A highly individualized, rumination-focused approach influenced by Dr. Michael J. Greenberg’s clinical model.
• Attention to obsessions, compulsions, avoidance, reassurance seeking, emotional conflict, and relational patterns.
• Possible use of psychoeducation, rumination prevention, behavioral exercises, and approaching desired but avoided activities.
• Exposure may be used when appropriate, but standard ERP is not necessarily the foundation of treatment.

Evidence and limitations

• Some components overlap with established cognitive-behavioral and response-prevention principles.
• The complete RF-ERP/psychodynamic model has not been adequately studied as a distinct treatment package.
• Some explanations remain theoretical. The approach is not presented as proven or superior to standard ERP.
• Symptoms may improve, persist, fluctuate, or worsen. Outcomes cannot be guaranteed.
• Treatment may be changed or referral offered if the approach is ineffective, another concern needs primary attention, or telehealth is insufficient.

02 · Sessions and telehealth

How sessions work

• Initial assessment: 90 minutes. Regular sessions: 50 minutes, typically weekly at a consistent time.
• Sessions may include assessment, psychoeducation, behavioral exercises, between-session practice, and discussion of emotional or relational concerns.
• Cancel or reschedule at least 24 hours in advance. Late cancellations and missed sessions are charged the full fee.
• Late arrival does not extend the scheduled ending time.

Communication

• Scheduling and routine communication occur through the secure client platform.
• Routine responses generally take 1–2 business days.
• Therapy is not ordinarily conducted through messaging.
• Pathway does not ordinarily use social media, text, telephone, or regular email for client communication. Phone or email may be used during platform failure or an emergency.

Your telehealth responsibilities

03 · Confidentiality

How your information is protected

Your counselor generally keeps information shared in counseling confidential. Confidentiality continues after death. Routine disclosures generally require written authorization, and Pathway aims to disclose only what is necessary.

When disclosure may occur

• When required by federal or state law, a licensing investigation, or a valid court order.
• When there is a clear and present danger to someone’s health or safety.
• When abuse or neglect must be reported.
• When necessary in a legal or disciplinary action arising from the counselor’s services.
• For supervision, professional consultation, billing, practice operations, insurance reimbursement, or authorized coordination of care.

Harm-related OCD

Violent or other harm-related fears can occur in OCD. Intrusive thoughts, fears, fantasies, or therapeutic simulations are not automatically considered an intention to cause harm. Actual intent or planning may require further assessment and protective action.

Telehealth privacy

Electronic care carries risks including technology failure, unauthorized access, shared devices, public or employer networks, and conversations being overheard. Pathway uses a HIPAA-compliant platform and reasonable security safeguards, but no system can eliminate every risk.

04 · Fees and payment

Financial policies

• Pathway is self-pay and does not accept insurance.
• The client is responsible for verifying out-of-network benefits.
• The platform may provide receipts, itemized statements, or superbills. These may include an appropriate diagnosis code. Reimbursement is not guaranteed.
• Additional administrative work for insurance may be billed at the standard session rate.
• Reports, letters, forms, record copies, legal consultation, depositions, and testimony may involve additional fees.

Payment timing

• Credit cards and bank transfers are accepted through the platform.
• Payment information is due two hours before the session.
• Credit-card payment is authorized one hour before and captured after the session.
• Accounts generally must be current before the next session. One session may be used to discuss options; unresolved nonpayment may lead to appropriate termination and referral procedures.
• Pathway aims to provide approximately three months’ notice before reasonable fee changes.

05 · Therapy process

Assessment, treatment, and risk

Ongoing assessment

Assessment may include symptoms, rumination and other compulsions, avoidance, co-occurring concerns, relationships, medical and family history, medication, and other treatment. Case conceptualization is a working hypothesis that can be revised collaboratively.

The counselor and client may distinguish compulsive rumination from curious reflection, productive problem-solving, trauma processing, neurodivergent processing, and cultural or religious practices. The function of a behavior—not merely its appearance—guides treatment.

Possible interventions

• Psychoeducation and collaborative identification of obsessions, compulsions, and core fears.
• Rumination prevention and reduction of checking, reassurance seeking, and avoidance.
• Exploration of emotional conflict, history, beliefs, and relational dynamics.
• Approaching desired but avoided activities and other individualized behavioral exercises.

Potential risks

• The exact efficacy of the complete approach is unknown because it has not been adequately researched as a distinct package.
• Symptoms may not improve or may worsen, and use of this approach could delay access to a better-established intervention.
• Emotional and behavioral change may bring up difficult feelings.
• An exercise could lead to distress, shame, self-blame, excessive self-monitoring, or unintended thought suppression.
• Approaching a feared activity may involve ordinary real-world risk, emotional pain, or accidental physical injury.

Potential benefits and monitoring

Possible benefits include recognizing covert compulsions, spending less time analyzing doubts, reducing checking and avoidance, and engaging more fully in meaningful activities. Periodic reviews may consider symptom severity, rumination, compulsions, avoidance, functioning, and adverse effects. Treatment may be modified or referral offered if meaningful improvement does not occur.

06 · Emergencies, rights, and responsibilities

Safety and shared responsibilities

• Pathway maintains current contact information, an emergency contact, and local crisis resources.
• If the platform disconnects during an emergency, the counselor will attempt to call you.
• Emergency or protective action may be taken when required for safety or reporting obligations.
• If an emergency occurs during a behavioral exercise, call 911.
• Non-imminent significant risk may require additional evaluation or referral to a higher level of care.

07 · Qualifications, technology, records, and accessibility

Who provides care and how information is handled

Counselor qualifications

Pathway is operated by Robert J. Yedlin, LPC (“Rob”), who holds a master’s degree in Clinical Mental Health Counseling from The College of New Jersey. The complete consent identifies the applicable New Jersey license information. His approach combines OCD training, supervision, clinical practice, lived experience, and ongoing consultation with Dr. Michael J. Greenberg.

For this academic prototype, credentials and license details must be verified before real clinical use.

Technology

• The platform includes telehealth, health records, a client portal, messaging, and payment processing.
• Sessions are not recorded by Pathway without a clinically relevant reason and written consent.
• Third-party vendors may support payment or other operations under appropriate privacy agreements.
• Pathway does not use AI for transcription or clinical documentation.

Records

• Records may include identifying information, history, assessment, diagnosis, formulation, session notes, interventions, progress, referrals, releases, billing, and legally relevant disclosures.
• Materials submitted through the platform may become part of the record.
• Records are maintained in a secure electronic system. Access and transfer requests follow applicable law and generally require separate authorization.
• A custody and continuity plan addresses retirement, relocation, incapacity, death, or practice closure.

Accessibility and neurodiversity

• Treatment aims to distinguish OCD from ADHD-related attention shifts, stimming, sensory monitoring, preferred routines, religious practices, and other non-OCD behavior.
• Executive functioning, sensory needs, communication preferences, and predictable structure can be incorporated.
• Hearing, speech, and visual accommodations may be offered. Referral may be provided when an accommodation cannot be made.

08 · Informed consent

Review and acknowledgment

Please confirm each item. You may return to any section before completing this review.

All acknowledgment boxes and signature fields are required. This academic prototype does not transmit or store your entry. Use Print / Save PDF to create a copy for demonstration purposes.