This is what my regular policies
form looks like.  I have a special
Teen Confidentiality form that
addresses confidentiality when
working with teens and their parents. 




Healthy Directions Counseling


This is information about my background, counseling philosophy, practice policies, and the privacy laws I will abide by as we work together. Please read this information carefully and please do ask me about anything you don't understand or anything you want to discuss further. Thanks, I look forward to our work together!


My Background: Training, Experience and Approach:


My Bachelor's degree is in Sociology from the University of California at Berkeley. I have a M.S. in Counseling with a concentration in Marriage, Family and Child Counseling from San Francisco State University. I have over 17 years of experience of working in the counseling/social services field. I have lived in the Vancouver/Portland area since 1997, and have worked with teenagers and their families the entire time. Over the years, I have helped literally hundreds of people: people with mental health issues, defiance and anger management issues, general communication issues, work issues, health issues and GLBT and minority identity people. I have worked successfully with lots of people with substance abuse issues, sexual abuse and domestic violence issues, and am very familiar with and enjoy working with teenagers and young adults. Court involved clients or otherwise reluctant clients are welcome and will find respect from me and a non-judgmental atmosphere. I am knowledgeable about and use several theories of counseling (depending on what may be most useful). Some of the main theories I use are Cognitive Behavioral Therapy, Positive Psychology, Systems Theory, Brief Therapy, Adlerian Psychology, Collaborative Problem Solving, Wraparound, and Client Centered Counseling. Most importantly, I value taking a very collaborative approach to working with people. I believe both long term and short term counseling can be useful, and believe in a short term wellness/preventative model when it is appropriate.




I see counseling as a process of a person defining issues, clarifying values and implementing solutions with the help of a counselor. Counseling has often been used to help people when they have had problems, but I firmly believe it can also be used for maintaining wellness and goal setting. Although counselors may give advice at times, it is the client's responsibility to ultimately determine and implement solutions -after all, it is your life to live. My goal is to support you in figuring out ways to live your life in ways that work for you and do not harm others.


The process of counseling often involves dealing with a good deal of uncomfortable emotions and material. I recognize that this is not something that is easy to do. In order to deal with tough feelings or situations productively, we need to have honest and clear enough communication about how well you are coping with the situations at hand. This involves having honest dialog about drug use or things like self -harm or suicidal thoughts. In most cases these issues can be kept confidential. However there are a few exceptions that are described below.





It is important to the counseling process that people feel free to fully explore thoughts feelings and ideas they might have that might seem unacceptable to others. All conversations and even information about whether or not you are a client of mine is confidential unless you give permission (in writing) for me to talk with others -except for the circumstances below. As a Washington State Licensed Mental Health Counselor, I abide by all rules, standards for training, experience, and ethics mandated by state law and those of the American Counseling Association.



EXCEPTIONS: Although in general counseling is –by law- completely confidential, Washington State laws order a few exceptions to this confidentiality.


  • By law, I MUST report abuse of 1) someone under the age of 18, 2) an elder or 3) a disabled person if I am told about it or reasonably suspect it. These reports must be made to certain agencies who have official oversight.


  • By law I MUST also report if any client is a danger to themselves (meaning likely to act on suicidal thoughts or plans, or so impaired they cant feed themselves or stay out of traffic). I must report if any person is a danger to others (homicidal or too impaired to keep others safe). If I hear about a serious threat that could be reasonably carried out to harm or kill another specific person, I also have a duty to warn that person about what the threat is. If the client is under 18, I will give a handout on confidentiality due to their specific circumstances as a minor.


Having worked closely with many of these agencies for several years, I can honestly say that reporting to these agencies does not automatically mean they will“take over,“take away the kids” or that other drastic changes will happen. If a report does need to be made, I will talk with the client about it and do my best to insure that the best outcome for the safety of all involved happens.



Due to how important confidentiality is, a federal law called HIPAA basically requires its own sheet. The HIPAA information basically covers the same things as this form does, but goes into more detail about how a small amount of information can be shared for insurance purposes without a release (so the insurance can cover my services) and about confidentiality if there are legal proceedings. Fair warning: it's written in legalese.


Please initial this part only if you receive the HIPAA information sheet at this time as well.



Policies for fees


I charge $100.00 for a 50 minute session. This is due at the beginning of a session unless other arrangements (like insurance re-imbursements) have been made.


Please check carefully with your insurance company to make sure you understand what will be covered. Although I will help you navigate the system to get your benefits, please be aware that you (not the insurance company or me) are fully responsible for payment in full for my services. The only exception to this is for clients using EAP benefits. Your EAP program will be solely responsible for payment of all completed authorized sessions, however missed my missed appointment policy (below) does apply.


I charge $100.00 (full price) for missed appointments. (Please be aware that your insurance will not pay for missed appointments). An appointment is considered missed if it is not cancelled at least 24 hours in advance. This cancellation policy applies to all clients.



Client Rights and Responsibilities:


You have the right to expect a respectful, collaborative approach in our work together. You have the right to a focused, competent and compassionate practitioner who you feel comfortable working with.


If you are an adult and for some reason you don't feel comfortable working with me, you are under no obligation to do so. If you are under 18, I've got a handout for you! See  this link: Teen Confidentiality for more information.


I do not discriminate, and I will likely challenge discriminatory beliefs of all sorts, whether it is about gender, race, sexual orientation, class, religion, etc. As an out lesbian, I can assure you: I actively work to create a respectful, no hate zone.


Please feel free to ask me about anything we are doing in counseling. Counseling can be a confusing process and it does involve a lot of WORK for the client as well as the counselor. People are complicated, so in general going to a counselor is very different from taking your car in for a diagnosis and repair. Its also different from going to a friend for advice. Again clear and honest communication is key. If you feel things are not working or have concerns about the counseling, please let me know. I do this work because I enjoy helping people, not as an easy way to collect money or judge people!


Please sign to acknowledge that you have received this information. Your signature is also serving as your consent to work with me according to these terms. Again, please talk to me if you have questions about anything on this sheet. Thank You!




Client Signature                           Date  

Additional information