Ridgecrest
6801 Wesley Street
Greenville, Texas 75402
903.455.0020
www.ridgecrest.com
Carolyn Scott, M.A., L.P.C. 

 

Thank you for choosing Ridgecrest Counseling! We respect and applaud you for seeking out help for the sake of your mental health. Counseling here is conducted in a clinical manner, and we believe the professional relationship is therapeutic in itself.

We believe there is a proactive relationship between sound psychological science and the Christian faith. It is our view that mental health results from a holistic approach that includes: thought patterns, emotions, physical health, and spiritual issues. It may be appropriate if we refer you to medical doctors, nutritionists, other specialists, or support groups as part of your personal treatment plan. Our therapeutic approach is eclectic in nature, which reflects various theories and techniques. We focus on systemic issues (i.e., family, faith, culture) and find it necessary to understand this background to better serve your future goals.

In the initial visits we will collaboratively determine a therapeutic goal and draft a treatment plan. You can decline any or all parts of the plan. This is your counseling and it is essential you be personally invested in it. Therapy is a relationship that works in part because of clearly defined rights and responsibilities held by each person.

Although our sessions may seem very intimate and personal, it is important for you to realize we have a professional, not a personal, relationship. This frame helps to create the safety to take risks and the support to become empowered to change. Please note that counseling may promote times of unrest within clients and other relationships. Things may get worse before they can get better. As a client in psychotherapy, you have certain rights that are important for you to know. There are also certain limitations to those rights of which you should be aware. We also have corresponding responsibilities to you.

Client Consent & Therapy Contract

Welcome! We feel it is important that, as our client, you are fully informed about the therapy services you will be receiving. Within verbal and written communication, the title of "counselor" or "therapist" are used interchangeably in regards to the mental health service and professionalism of the one administering such services to the client at Ridgecrest Counseling (RC). This document outlines the agreement that is to be adhered to throughout the therapeutic relationship between the client(s) and counselor. We look forward to serving you!

Client Rights

In therapy, the client has the right to:

• ask questions about my therapy.
• know the Code of Ethics followed by the therapists at Ridgecrest Counseling.
• specify and negotiate therapeutic goals and to renegotiate them when necessary.
• be fully informed of the limits of confidentiality in the therapy setting.
• be fully informed about the fees for therapy and the method of payment
• end therapy at any time without any moral, legal, or financial obligations other than those already incurred

Confidentility

• I understand my RC therapist may discuss general case information with other therapists and/or our pastor; however, the other therapist and our pastor will not be responsible for the case direction.

• I understand the therapist is bound by Texas State Board of Examiners of Professional Counselors and the Code of Ethics of the American Association of Christian Counselors (AACC) set forth by their respective fields of focus and that I can request a copy of those ethics at any time.

• LIMITS OF CONFIDENTIALITY: Communication with my therapist and records of my therapeutic process will remain confidential. I understand that, in accordance with state regulation and/or professional ethics, specific circumstances require my therapist(s) to break confidentiality and report information obtained from the therapy process. Those circumstances only exist when A) a therapist believes a client may be a danger to him or herself or to others, B) the therapist believes a child, elderly, or disabled person may be subject to abuse or neglect, C) when a court subpoenas client information, and D) unless I, the client, sign the Authorization for Release of Confidential Information to be used in conjunction with my counseling - in accordance with Texas laws. I understand that any such breaches of my right to confidentiality will be discussed with the therapist's clinical supervisor. RC therapists are mandated reporters.

• RECORDS: I understand records are maintained for 7 years after discontinuing services, and may be stored, scanned or manually entered into a computer for storage at any time and in the future. I may review my own records only after giving a written notice, and allowing 48 business hours for records to be retrieved. I may not review records sent to RC (even when placed in my file) from another facility.

• "NO SECRETS" POLICY: I understand that Ridgecrest Counseling maintains a "no secrets" policy in marriage counseling. Although the therapist will not consciously force information to be disclosed beyond the client's comfort, the therapist is not responsible if client information is unintentionally made known during counseling. The goal in counseling is always reconciliation and trust within marriage. This means the therapist is an ally and will strongly encourage and help guide mutual exchange between spouses, at their comfort and therapeutic pace.

Counseling Minors

• When counseling minors, parents are expected to be supportive of the development of that relationship by not requesting information pertaining to the specifics of the counseling sessions from the therapist. Minor clients can expect the therapist to share diagnosis/treatment plan goals and periodic summaries of progress while keeping details of the conversations private. The minor client will know those diagnoses and summaries before information is shared with parents. State law allows for parents to review the records of minors. The counselor will not record those details shared in session that will be held as private. The counselor is ethically bound to make parents aware of behaviors that would be dangerous for their child. The therapist will always discuss with the client first before talking to the parents or guardians as to what will be discussed and when it will take place. If questionable issues arise in counseling, the parents or guardian may be asked to come into the session while the client shares important information with them in a controlled and safe manner. Periodic consultations with parents may be scheduled during the last few minutes of the child's session. If more than one family member participates in a session, each and every participating family member must consent prior to the release of the file information. Where a minor is receiving services, the appointment of a guardian ad litem may be necessary prior to the release of the minor client's information. The client's family members are not entitled access to client information just because they are family.

Miscellaneous

• RC therapists do not knowingly accept court-related cases. I agree that I am not involved in a court-related case regarding the circumstances for which I am seeking therapy. I understand that, for court appearance and or court case preparation for cases and consultations with legal and medical professionals by my therapist, I will be charged a fee of $150 per hour - plus expenses - for court preparation (including paperwork, travel, testimony, time, or any other action requiring the therapist's attention.).

• I understand there can be risks and benefits associated with therapy and have discussed those with the therapist. Others may judge me for attending therapy. Therapists may need to refer me to other therapists or services when they are concerned that RC treatment approaches are not helpful, or are not providing enough help. If I am involved with Ridgecrest Church, others may see me attending therapy. My therapist may attend Ridgecrest Church, possibly creating a dual relationship as members. Client's personal relationships may not improve, or seemingly get worse. I understand and accept this dilemma.

• I understand that a standard therapy hour is a 50 minute session. If I come late for any reason, I will be charged for an entire therapy of 50 minutes and the session will end at the appointed time. I understand if a session goes over the 50 minute session time, I may be pro-rated an additional charge based on 15 minute increment based on RC fee- schedule.

• I will receive a receipt for payments made for services, which I understand is not tax deductible as a donation because a service was received in exchange for payment, but may be deductible as a medical expense. I agree to ask for a receipt if I need one and the therapist does not offer it. I understand that RC does not provide any other record during or after service for tax purposes.

• CANCELLATION POLICY: I understand I have to give my therapist at least a 24 hour (normal business day) notice of a cancellation of a therapy session. If not, I will be charged a $30 fee for not following the cancellation policy.

• I understand if there is no session activity, nor phone or email contact recorded (without prior communication) in my file for a period of 3 weeks, my file may automatically be closed. I understand, in some circumstances, my file can be reopened upon completion of a new intake and payment of any balance due. I understand if I miss more than three (3) scheduled sessions in a twelve (12) session period, my therapist may end counseling without liability.

• I agree to pay for any damages to, or theft of, property in this office by me or anyone for whom I am legally responsible. I agree that neither Ridgecrest Church nor RC therapists are responsible for any personal property or valuables I bring or leave in the facility. Behavior threats or police involvement may result in the immediate discharge of client after review.

• AVAILABILITY: I understand RC is not a mental health facility and does not have staff to maintain 24 hour care. Therefore, we cannot be available at all times. We do not take phone calls when we are with other clients. You can always leave a message in the church office and we will return your call as soon as possible. We return messages daily except on Saturdays, Sundays, and holidays. In life threatening emergencies, crisis situations, or thoughts of harming self or others, I should dial 9-1-1. At the bottom of this agreement is a page of helping facilities the therapists will offer to me.

• EMAIL: My therapist and I can communicate through the use of email. Although unlikely, it may be possible for others to see information sent through email. Ridgecrest Counseling recommends careful consideration of any messages sent y way of cell phone or email communication. My therapist is required to keep a copy of the email, or will keep some form of record of any and all communication and meetings that occur between us - in my file. Having been made aware of the information above, I give permission for my therapist and me to communicate through email.

• HOLD HARMLESS: I hereby release, waive, and hold harmless Ridgecrest Church, Ridgecrest Counseling (RC), its curators, officers, agents, volunteers, interns, and employees, from and against any and all claims, demands, or causes of action of any type whatsoever, including property damage, personal injury or death, arising out of or in any way related to my participation in the counseling process. Furthermore, I hereby agree that my participation in the counseling ministry at RC is exclusively for my own personal benefit and that I will not involve RC in any court related matters as references, character witnesses, and/or any other court related matters. This agreement is binding, upon the members of my family, spouse, my estate, heirs, administrator, personal representatives, assigns, and any other person entitled to act on my behalf. This agreement shall be construed under Texas law.

My signature below indicates I have read and understand the terms of this Release and Hold Harmless Agreement and I give my full and informed consent, of lawful age (18+ years old) and my free will to receive therapy services from this site; and that I fully understand and agree with all the items in this informed consent agreement. I have received a copy of this informed consent contract for my personal records, including the "HELP" sheet of phone numbers for further assistance in a crisis situation which is located below, on this agreement page.