Professional Disclosure Statement

Psychotherapy can be a very special opportunity to understand more deeply the struggles you are experiencing, and to make the changes which are important to you. Therapy can be a fascinating and stimulating process. It can also be difficult, and, at times painful. While there are no guarantees, your active participation will contribute greatly to this process.

Professional Qualifications

I hold a Master of Science in Social Work from the University of Wisconsin Madison. My BS is also in Social Work, also from the University of Wisconsin Madison. My most recent clinical experience prior to private practice includes working with children and families as a behavioral health provider at a community clinic for the uninsured and prior to that, providing individual and group therapy to adult men and women in the San Francisco county jails. I am a licensed clinical social worker in the state of California since 2007. I have completed the basic EMDR skills training under Dr. Laurel Parnell (2009) as well as the year-long Professional Skills Hakomi training in 2012, and then again as an assistant in 2013. I’ve completed the Emotion Focused Therapy for couples externship and the EFT core skills training module. I participate in regular professional training practice groups and consultation throughout the year.

My approach to therapy

I combine Western psychotherapy with mindfulness-based practices. Mindfulness is a skill that involves slowing down in order to notice--moment by moment, with curiosity and kindness--what you are doing, thinking, and feeling, so that if you like, you can make desired changes. Since our bodies are connected to our beliefs and feelings, by slowing down and bringing awareness to our bodies, the path towards healing can be revealed. Traditional psychotherapy primarily pays attention to thoughts, emotions and behaviors. In body-oriented psychotherapy, attention is also given to sensations and felt experiences in the body. It may be as simple as bringing attention and awareness to a felt sensation, or it might entail “taking over” a particular tension or holding, in order to explore what lies beneath. The goal of therapy is to encourage communication among parts and to bring attention to those parts that are lost, hidden or isolated. Body-oriented psychotherapy can provide an added dimension to the therapeutic process by presenting information that is often overlooked. With the partnership of the conscious mind, it can provide a deeper and more efficient path to work directly with the unconscious mind, facilitating self-discovery and transformation. I am trained in EMDR and the Hakomi method and find both to be powerful ways to bring transformation and healing. I am in the process of training and certification for Emotion Focused Therapy with couples.

Touch in Therapy

I am trained in some therapeutic modalities that can incorporate touch as part of psychotherapy. This sort of touch is always non-sexual in nature. It is always optional and never required for treatment services. If I consider that using a therapeutic intervention that incorporates touch could potentially be beneficial for your treatment, I will explain the prospective intervention to you and ask your permission before touching you. You always have the right to decline or refuse to be touched without any fear or concern about reprisal.

Availability between Sessions

I check messages from 9:00 to 5:00pm, Monday through Friday and attempt to return all calls within 24-48 hours.  I am generally not available for contact on evenings and weekends. If you need to speak to someone after hours you may call the Alameda County 24-hr crisis line at 1-800-309-2131.

Cancellations

If you are late for an appointment, you will have the remainder of the scheduled session available to you; we will not run over the scheduled time. It is important for the continuity of therapy that you come to all sessions. Since your appointment time is reserved exclusively for you, I have a 24-hour cancellation policy. In other words, if you cancel within 24 hours of the appointment time, you will be charged for the full fee of the session. As insurance companies do not reimburse for missed appointments, you will be expected to pay out of pocket if your services are typically covered by insurance. This is standard policy for therapy services.

Vacation Policy

I will take several vacations during the year, usually no more than two weeks in length.  I will provide you with advance notice of any upcoming vacations as well as back-up coverage available.

Fees

The fee for a 50-minute session is $150 and $160 for a couples session. Fees are due at the beginning of each session, payable by cash or check. Fees are reviewed yearly and may be raised $5 to $10 per year. If you are paying on a sliding scale basis, adjustments will be made as your financial situation changes. I encourage you to discuss any financial concerns or hardships as soon as they arise so we can adjust our arrangement accordingly. Phone calls longer than 5 minutes, and written reports and letters, will be prorated at the session rate. I do not accept insurance, however depending on your insurance plan, your insurance may pay for out-of-network providers, in which case I can provide a monthly statement of services provided. I reserve the right to assess a finance charge on past due bills, or in extremely delinquent cases to turn them over for collections.

Confidentiality

In therapy, everything we speak about will be held strictly confidential with the following exceptions:

 

a.     you authorize the release of information in writing

b.     I’m concerned that you may pose a serious danger to yourself or others

c.     I need to release information to your insurance company for billing and/or authorization purposes

d.     abuse of a child, elder, or dependent adult is suspected

e.     I am court ordered to release information

f.      I seek individual or group consultation.  In this case, your full name will never be disclosed.


Consent

I have read the above information and clarified any questions I have. I agree to the stated terms. If I use insurance coverage, my signature authorizes release of information required to process claims and authorizes payment to my therapist.


Name:______________________________________________________

 

Signature: ____________________________________________________         Date: _____________

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