LPCA Professional Disclosure Statement John Taylor Houchens, M.S. (770) 766-4878 (Office) (919) 890-0852 (Fax) www.creasman-counseling.com My Qualifications I received my Master’s of Science in Rehabilitation Counseling and Psychology from The University of North Carolina at Chapel Hill in 2014. I have had one year of direct counseling experience as a clinical intern at New Leaf Behavioral Health, and am pursuing my LPCA in the state of North Carolina. Counseling Background I provide multi-cultural therapy for adults and adolescents with a variety of concerns including anxiety, depression, adjustment, addiction, phobias, ADHD, anger, relationship issues, internet addiction, sexual orientation, purpose, and spirituality. I believe successful treatment is rooted in a warm, supportive, and trusting relationship where I utilize an open-minded and non-judgmental attitude to gain a thorough understanding of your experience. From this foundation, we will surface, explore, and work through the barriers impeding you from the better life you are aspiring towards and are capable of having. We will set goals and collaborate on means to achieve these goals. Theoretical orientations I adhere to include Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Motivational Interviewing (MI). Techniques I implement include cognitive restructuring, mindfulness, self-monitoring, behavioral experimentation, guided imagery, bibliotherapy, Socratic questioning, systematic desensitization, role-playing, relaxation exercises, and reflection. Session Fees and Length of Services To schedule an initial session please contact me via email or phone. Sessions typically last 45-50 minutes. Please arrive at least 15 minutes before your initial appointment and at least 5 minutes before any following appointments. If you are unable to keep an appointment, please notify me at least 24 hours in advance. There will be a $30 missed session fee for missed appointment with less than a 24-hour notice. The session fee is $60. Insurance is not necessary. Cash, personal check, PayPal, and credit card (American Express, MasterCard, and Visa) are accepted. A fee of $35 will be charged for bounced checks. Use of Diagnosis Depending on your insurance company, you may or may not be reimbursed for counseling services. If your agency does reimburse then it is likely that they require a diagnosis. If you meet the qualifications for the diagnosis you are currently experiencing, we will review it together before submitting it to your insurance company. Any diagnosis made will be included in your permanent records. However, some conditions for which people seek counseling do not qualify for reimbursement. Therefore, no diagnosis will be submitted. Confidentiality The information you share with me in counseling is private. The content discussed becomes part of the clinical record, which you may access upon request. Everything that takes place in therapy is confidential, with the following 3 exceptions: (1) you are a danger to yourself or others (including child or harm to the elderly), (2) I am ordered by a court to disclose information, or (3) you direct me to disclose information to someone else. Complaints Although clients are encouraged to discuss any concerns with me, you may file a complaint against me with the organization below should you feel I am in violation of any of these codes of ethics. I abide by the ACA Code of Ethics (http://www.counseling.org/Resources/aca-code-of-ethics.pdf). North Carolina Board of Licensed Professional Counselors P.O. Box 77819 Greensboro, NC 27417 Phone: 844-622-3572 or 336-217-6007 Fax: 336-217-9450 E-mail: Complaints@ncblpc.org Acceptance of Terms <This section should remain the same> We agree to these terms and will abide by these guidelines. Client: ___________________________________________________ Date: ___________ Counselor: ________________________________________________ Date: ___________