Professional Disclosure Statement

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EDUCATION

Masters, Rehabilitation Studies and Substance Abuse Counseling

  • East Carolina University, Greenville, NC

B.S., Psychology

  • Western Michigan University, Kalamazoo, MI

 

LICENSURE AND ACCREDITATION

  • Licensed Clinical Mental Health Counselor (LCMHC), honored by the North Carolina Board for NC Board of Licensed Clinical Mental Health Counselors    (2006 - Lic#5531)
  • Licensed Clinical Addiction Specialist (LCAS), honored by the North Carolina Substance Abuse Professional Practice Board  (Lic#1540)
  • Certified Clinical Supervisor (CCS), honored by the North Carolina Substance Abuse Professional Practice Board (Lic#567)

POPULATION AND SERVICES

My education has prepared me to counsel individuals, groups, families, and special populations such as substance abuse, persons with disabilities, adults, and adolescents.  I offer services that entail: addiction counseling specializing in relapse prevention, solution focused and cognitive behavioral techniques, anger management, group based therapy, and family counseling.

 

COUNSELING SESSIONS AND PAYMENT

Counseling Relationship

During the time we work together, we will meet as scheduled for the amount of time allotted in an attempt to address person centered treatment objectives and goals.  This can be done in either an individual or group setting.  Although our sessions may be very intimate psychologically, ours is a professional relationship rather than a social one.  By acknowledging this document you understand that I cannot accept invitations to social gatherings, gifts, agree to write references for you, or ask me to relate to you in any other way than in the professional context of the counseling sessions.  You will be served appropriately in our sessions exclusively on your goals and concerns.

 

Client Rights

Some clients need only a few counseling sessions to achieve their goals, others require months or years of counseling.  As a client (or the parent of a client), you are in complete control and may end our counseling relationship at any time, although, I do ask you to participate in a formal “termination” session.  You also have the right to refuse or discuss modification of any of my counseling techniques or suggestions that you believe might not be helpful.

 

I accept legal and ethical standards governed by the state of North Carolina.  If at any time, for any reason, you are dissatisfied with the services, please let me know.  See “formal complaints”.

 

Formal Complaints (as defined by the North Carolina Board of Licensed Clinical Mental Health Counselors)

Formal complaints of a Licensed Professional Counselor’s unethical conduct shall bear the complainant’s signature, include the complainant’s address and telephone number, date and location of the alleged violation(s), a detailed description of the incident(s), and required signed releases.  Send the complaint via mail to:

North Carolina Board of Licensed Clinical Mental Health Counselors
P.O. Box  77819
Greensboro, NC 27417
(336) 217-6007

Record and Confidentiality

Through appropriate and meaningful assessment procedures, I will use diagnoses to help define and describe some of your problems that may exist.  All diagnosing information will be supported by the Diagnostic and Statistical Manual for Mental Health Disorders, Fourth Edition.

 

All of our communication becomes part of the clinical record.  Records are my property, but you have the right to the information within your record.  Most communications are confidential, but the following limitations and exceptions do exist: (a) you provide me with your consent to release information; (b) I have reasonable suspicion that you are a threat to yourself or someone else; (c) you disclose abuse or neglect a minor, elderly, person with a disability; (d) you disclose sexual contact with another mental health professional; (e) I am ordered by the court to disclose information; (f) you involve me in a lawsuit and I need to release specific information in order to receive compensation for services rendered; or (h) I am otherwise required by law to release information.  If I see you in public, I will protect your anonymity by acknowledging you only if you approach me first.

 

Fees

Clinical Assessments (both Mental Health and Substance Abuse) = $160.00.
Individual Sessions = $160.00 per hour or agreed upon amount of  $___________
Consultation/Family Therapy = $160.00 per hour
Case Management = $100.0 per hour
Blue Cross/Blue Shield accepted = co-pay TBD
Clinical Supervision for counselors and/or supervisors = $200 - $250 per month

 

Cancellation Policy

While understanding there may be times an appointment is missed due to emergencies or obligations, COUNSELING CHOICES, PLLC  requires at least 24 hours’ notice on all cancelled appointments.  There is a $50.00 charge for failing to notify (i.e., text, email, phone call) within 24 hours. This fee will be invoiced and charged to the credit card on file. ***Please note, if 3 late cancellations occur during the duration of the therapy enrollment, then subsequent late cancellations or no shows will result in a full charge of an out of pocket cost therapy session.

Please use the links below to complete the forms necessary for Counseling Choices services.

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