Professional Disclosure Statement
The following document has been created to inform you of the counseling process and my counseling style. Please take your time reading it and make sure you understand each section before signing. If you have any questions, please discuss them with me.
Qualifications
I completed a Master of Social Work degree with a concentration in clinical work and addictions from East Tennessee State University. Additionally, I have a Master of Arts degree with a major of Appalachian Studies from Appalachian State University. I completed my internship of 600 hours working at Daymark Recovery Services in Boone, NC. I was employed at Better Days & Nights, PLLC, from September 2021-September 2024. The North Carolina Social Work Certification and Licensure Board issued me the license of Licensed Clinical Social Worker ID #C017151.
Counseling Background and Process
My clientele has included adults with mental illness and substance abuse disorders who I have worked with in individual and group therapy sessions. The concerns I have helped to address include anxiety, depression, trauma, addictions, stress-management, relationship issues, and societal/global crisis. My approach to therapy is person-centered with a strengths-based perspective. I believe that each client can make positive changes, but not necessarily the right tools to do so. I often use Motivational Interviewing to assess a client’s readiness to change. I mainly use Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) to help clients develop tools/coping skills to assist them in changing unhelpful and negative thought processes. I am currently on the path to be certified in Eye Movement Desensitization and Reprocessing (EMDR), an empirically proved method of treating trauma. I view the client-therapist relationship as a collaborative effort. I expect both of us to be equally prepared to engage in the therapeutic process. Together we will determine treatment goals and develop exercises and “homework” for you to use between sessions. My role is to assist you in reaching your therapeutic goals while providing a non-judgmental, safe environment.
Length of Therapy and Termination.
Sessions will be 50 minutes long. The duration of treatment will be based on each individual’s treatment goals. When it is time to terminate treatment, I will help you transition by discussing a termination plan and providing you with information on community resources.
Fee for Services
If you do not use insurance, a sliding scale fee with the range of $85-$150 based on your household income level will be established with the office manager before your first session. You will be charged $75.00 for missed appointments unless you cancel with at least 24-hour notice. Cash, Venmo, or credit cards are acceptable methods of payment and a receipt will be provided upon request for all fees paid. All fees are expected at the time of service. If you are paying through your insurance company, they will only allow one hour of therapy per day. If your session runs over the hour session, you will be billed out-of-pocket in 15- minute increments at $31.25 per 15-minute increment. Self-payers will also be billed the same for sessions that go over one hour. Letters, and correspondences: All letters written for clients will have a prepaid administrative charge of $40, plus postage if necessary. This includes letters for DSS, School, Jobs, etc., but not to other healthcare professionals Missed Appointments or Cancellations Please contact the front office at 828-333-4170 at least 24 hours in advance to change a scheduled appointment. I request that all clients arrive on time for all their sessions to ensure a productive hour. Please let the office know if you will be running late to a scheduled appointment.
Effects of Counseling
Going to counseling takes courage, and it will challenge you at times. The counseling process may bring you to new levels of awareness that could initially cause more pain and anxiety. Change is often difficult, and you may experience this as disruption or discomfort in you Going to counseling takes courage, and it will challenge you at times. The counseling process may bring you to new levels of awareness that could initially cause more pain and anxiety. Change is often difficult, and you may experience this as disruption or discomfort in your life. While this challenge can ultimately help you to grow and reach your goals, you have the right to refuse to participate in certain therapeutic techniques. Given the nature of counseling, it is difficult to predict your therapeutic outcome or to provide an estimate of the time it will take for you to reach your personal goals. However, clients who are open to the process of change, are consistent in attendance, and are willing to do therapeutic homework outside of sessions, tend to benefit the most from counseling and experience the most positive change.
Use of Diagnosis
Some health insurance companies will reimburse clients for counseling services, and some will not. In addition, most will require that a diagnosis of a mental-health condition is made and indicate that you must have an “illness” before they will agree to reimburse you. Some conditions for which people seek counseling do not qualify for reimbursement If a qualifying diagnosis is appropriate in your case, I can inform you of the diagnosis before we submit the diagnosis to the health insurance company if you choose to. Any diagnosis made will become part of your permanent insurance records and may have ramifications in terms of costs of insurance and long-term insurability.
Confidentiality
I take client confidentiality very seriously. Confidentiality is a key factor in creating an environment where you feel safe enough to share information that will benefit your treatment. Your information will only be revealed to other parties in the following instances: you reveal intent to kill yourself or others, you reveal abuse of a child, elderly, or disabled person, or I receive a court order to disclose your counseling records. A subpoena is not a court order. In the case of a subpoena, I will consult other professionals and review my options. If you are under 18 years of age, your parent or legal guardian will need to give their permission for your counseling. In this case, your parent or legal guardian can also have access to your clinical records until you turn 18. I will not respond to friend requests on Facebook or any other social media as this violates confidentiality and is therefore, unethical. You have the right to review your own records if you choose to do so. Please inform me if you would like to access them. Your records are confidential documents in which I record information from our sessions as well as from any phone conversations. The purpose of the records is to document the goals of your therapy and keep track of your progress. If you are under 18, your parents or legal guardians also have access to them. I can never release your information to outside parties without your written consent. Technology I respectfully ask that while you are in a counseling session with me that you turn off all electronic devices so that you can be as fully present as possible. DO NOT email me for emergency situations of for communicating personal information concerning counseling sessions. In case of an emergency, please call 911 or go to the ER. Complaints If you have any concerns about my counseling, I encourage you to discuss these with me. You may file a complaint against me with the organization below should you feel I am in violation of any of these codes of ethics. I abide by the NASW Code of Ethics:
http://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
North Carolina Social Work Certification and Licensing Board
PO Box 1043
Asheboro, NC 27204
Phone: (336) 625-1679 Fax: (336) 625-4246
Email: [email protected]