Professional Disclosure Statement

Professional Disclosure Statement

Welcome to my practice, and thank you for choosing me as a provider for your counseling services. This document provides you with information about my background, professional services, business policies, and your rights as a client.

 Philosophy and Approach: I believe in a holistic approach to counseling which respects the individuality, autonomy, and complexity of all human beings. I see my role as collaborative as I assist clients in meeting their stated goals. My work is grounded in systemic theory and evidence-based behavioral medicine, acknowledging the unity of body, mind, emotions, and spirit. As a Christian counselor, I view the recognition and inclusion of spirituality as beneficial to the pursuit of optimal individual health. I utilize Cognitive-Behavioral Therapy, Motivational Interviewing, Stages of Change, and the strategies, techniques, and skills of Dialectical Behavior Therapy.  My work is essentially informed by mindfulness-based therapies, focusing on the benefits of awareness in our lives. I have experience working with clients and families of all ages and backgrounds. I have particular expertise in counseling persons experiencing mental health disorders, trauma and abuse, alcohol and drug addictions, sex and gambling addictions, relationship and family problems, grief and loss issues, life threatening illness, communication and assertiveness issues, anger management, and domestic violence.   

 Professional Education and Credentials: I obtained a Bachelors Degree in Psychology in 1992 from Portland State University in Portland, Oregon. I earned my Masters Degree in Human Development and Psychological Counseling in 1995 from Appalachian State University in Boone, North Carolina. A dual emphasis in Addictions and Marriage and Family provided the framework for my training. Coursework and clinical experience focused on a sub-specialization in sex abuse and sex offender treatment. I earned my PhD in Health Psychology in 2011 from Northcentral University in Prescott, Arizona. I am a Licensed Professional Counselor in the State of Oregon, a National Board Certified Counselor, and hold national and state certifications in alcohol and drug treatment.        

 Code of Ethics Adherence: As a Licensed Professional Counselor (LPC: #C1701), licensed by the Oregon Board of Licensed Professional Counselors and Therapists, I will abide by its Code of Ethics. As a National Board Certified Counselor (NCC: #43950), I will abide by the Code of Ethics of the National Board for Certified Counselors. As an Oregon certified alcohol and drug counselor (CADC III: #03-03-55), I will abide by the Code of Ethics of the Addiction Counselor Certification Board of Oregon.  As a National Certified Addiction Counselor (NCAC II: #013993), I will abide by the Code of Ethics of the National Association of Alcohol and Drug Abuse Counselors. To maintain my professional license and certifications, I am required to participate in annual continuing education.

 Billing and Fees:  My current fee is $170.00 per one-hour session. Payment is due at the time service is rendered. A discussion of financial arrangements will occur during the first session, and I will request insurance information at that time. I will verify benefits, deductible, and copay following that session. If my services are covered by insurance, the co-pay amount is due at the time of each session.  A sliding fee scale is available for clients without insurance and facing financial challenges.    

 Appointments, Cancellations, and Termination of Services: Sessions are usually scheduled weekly, but other arrangements may be made. Appointments are customarily made at the end of each session. There is no charge for appointments cancelled or rescheduled more than 24 hours in advance. A $25 fee will be charged if you fail to cancel in advance, except in cases of emergency or sudden illness. You, as the client, are in control of your therapy and can discontinue our counseling relationship at any time.

 Benefits and Risks of Therapy: Although the effects of counseling have been shown to be beneficial, it is not possible to guarantee specific results regarding your counseling goals. Potential benefits of counseling include: relief from negative feelings, increased awareness, increased skills, improved relationships, and improved life satisfaction. Potential risks of counseling include: emotional discomfort, recall of painful memories, lifestyle changes that may disrupt current relationships, and temporary worsening of symptoms. 

 As a client of a Licensed Professional Counselor, you have the following rights:

1. To expect that a licensee has met the minimal qualifications of training and experience required by state law;
2. To examine public records maintained by the Board and to have the Board confirm credentials of a licensee;
3. To obtain a copy of the Code of Ethics;
4. To report complaints to the Board;
5. To be informed of the cost of professional services before receiving the services;
6. To be assured of privacy and confidentiality while receiving services as defined by rule and law, including the following exceptions:
   1. Reporting suspected child abuse;
   2. Reporting imminent danger to client or others;
   3. Reporting information required in court proceedings or by client’s insurance company, or other relevant agencies;
   4. Providing information concerning licensee case consultation or supervision;
   5. Defending claims brought by client against licensee;
7. To be free from being the object of discrimination on the basis of race, religion, gender, or other unlawful category while receiving services.

 You may contact the Board of Licensed Professional Counselors and Therapists at:

3218 Pringle Rd. SE #250, Salem, OR 97302-6312

Telephone: 503.378.5499