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The document is a Professional Disclosure Statement from A New Direction Counseling Services, P.A., outlining the psychotherapy process, therapist qualifications, therapeutic orientations, and specific methods used in couples therapy, particularly the Gottman Method. It details fees, confidentiality policies, availability of services, and the process for filing complaints. The statement emphasizes the importance of client understanding and consent regarding therapy terms.

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What is professional disclosure in counseling?

Professional disclosure statements disclose to clients the nature and boundaries of the counseling relationship they are about to enter.

What is an example of a disclosure statement in counseling?

I will keep confidential anything that you say to me, with the following exceptions: a) you direct me to tell someone else, b) I determine that you are a danger to yourself or others, c) I am ordered by a court to disclose information, d) I suspect or am made aware of physical/sexual abuse of minors, persons with

What is an example of a disclosure statement for a counselor?

A professional disclosure statement for therapy, also known as an informed consent statement, defines the terms and conditions of the therapist-client relationship. First, professional disclosure statements safeguard the interests of both therapists and clients.

What is an example of a disclosure statement?

I hereby certify that, to the best of my knowledge, neither I (including any member of my immediate family) nor any individual or entity with whom or wijt h which I have a significant working relationship have (has) received something of value from a commercial party related directly or indirectly to the subject of

Is a professional disclosure statement the same as informed consent?

To be licensed as a LCMHC in the state of North Carolina an individual must meet the following requirements: Application (Rule . 0305) Education (Rule . 0701) Exam (Rule . 0305) Professional Disclosure Statement (Rule . 0204) Verification of Supervised Professional Practice (Rule . 0205)

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Which of the following should be included in a professional disclosure statement?

A Professional Disclosure Statement is a printed document that includes the following information: (1) name of licensee or applicant; (2) the licensees or applicants highest relevant degree, year degree received, discipline of degree, and name of institution granting the degree; (3) names and numbers of all relevant

Professional disclosure statement counseling example 2025

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Which of the following should be included in a professional disclosure statement?

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