Counseling Disclosure
Jenny Dooley M.Ed. LMHC CPTT
New Life Counseling Center PLLC
Counselor Information:
I am a Washington State Licensed Mental Health Counselor (LH 60822767). I provide counseling services to individuals and groups. I earned a BASW (Social Work) from the University of Washington (1985) and an M.Ed. in Counseling from the University of Puget Sound (2012).
Approach to Treatment:
I take a warm, caring, non-judgmental, and hope-filled approach to treatment with my clients using person-centered, emotion-focused, cognitive-behavioral, mindfulness-based, and existential therapy modalities. I am a trauma-informed counselor and sensitive to the cultural, spiritual, and family backgrounds of my clients. I enjoy exploring what makes each individual unique. I strive to provide a safe environment for my clients to explore sensitive topics, tell their stories, and discover their strengths as they overcome challenges and meet their goals.
I am a certified facilitator for Prepare/Enrich Curriculum
I am a Certified Partner Trauma Therapist (CPTT) with The International Institute for Trauma and Addiction Professionals (IITAP).
Protected Health Information:
The Health Insurance Portability and Accountability Act (HIPAA) mandates how I use and maintain your Protected Health Information (PHI.) The following sections explain the limits to confidentiality, how your clinical records are used, and your rights to them.
Confidentiality:
The information shared with me will remain confidential and will not be shared with anyone without your written consent. However, there are certain limitations to confidentiality, which I’m required by law to disclose without your consent or authorization. These limits include: (1) perceived risks to commit serious harm to yourself or others; (2) information indicating the abuse of children or a vulnerable adult; (3) valuable information in the event of a medical emergency; and (4) an order from a court of law to disclose information from your clinical record.
Occasionally, I may consult with another experienced licensed counselor regarding your case to provide you with the best possible services. Your name will not be used. If you are coming with a family member or spouse, please note that individual sessions are confidential and separate from couple or family sessions. However, I encourage honest and appropriate disclosure between family members.
Mental Health Records:
The Protected Health Information I keep is the intake form you fill out during the first session and my clinical case notes. Clinical case notes include general topics discussed during our session and assessments. The treatment plan, progress toward goals, and any homework assigned are noted.
Patient Rights and Uniform Health Care Information Act:
HIPAA provides you with expanded rights concerning your clinical records and disclosures of Protected Health Information. Washington State Law mandates that you have the right to request, amend, restrict, and disclose your protected health information. These records are yours. However, they are best reviewed with me or another trained counselor. A small fee for the release and copy of your records will be charged. I can deny access to your healthcare information if I reasonably conclude that the information would be injurious to your mental health. Your records are kept secure and confidential. Records can only be released with a signed Release of Information.
Appointments and Cancellations:
Appointments can be made via phone, text, email, or at the end of last session. My office hours are Tuesdays in-person and Wednesdays virtual via Zoom from 12 pm-5 pm Pacific Time. A commitment to counseling is key to reaching your goals. I will work with you to find a set appointment day and time. Please inform me 24-hours in advance of a cancellation. For no-shows or late cancellations, the full session fee will be charged.
Fee Information and Payment Policy:
Individual sessions:
1-hour session (50 minutes) = $150
75-minute session = $180
Group Therapy: 90-minute session = $50
Fees are to be paid by cash, check, debit, or major credit card at the time of service. Surcharges are applied when paying by credit card.
Insurance: I’m an out of network provider and do not take insurance. I can provide a superbill at the end of the month.
For more information and all required forms please visit http://www.newlifecounselingcentergigharbor.com