Professional Disclosure Statement

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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: ___________
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