Qualifications:

I graduated from the University of North Texas with a Master’s Degree in Clinical Mental Health Counseling in 2014. I am a Licensed Professional Counselor with the State of Texas, as well as a Licensed Chemical Dependency Counselor. I am recognized as a Cognitive Processing Therapist for PTSD, a Certified First Responder Counselor, and a Certified Clinical Anxiety Treatment Professional. I am also trained in Critical Incident Stress Management. I have completed a 26 hour continuing education certificate through the Zur Institute for telehealth service provision.

Nature of Counseling:

As your counselor, I will work with you to identify your presenting concerns and to develop treatment goals to make improvements in these areas. I offer two types of counseling modalities. Cognitive Behavioral Therapy is a present-focused, goal-oriented treatment targeting problematic thoughts, behaviors, and reaction patterns with an average length of 12-15 sessions. Sessions are structured so that we can make the most of our time together. Cognitive Processing Therapy is a 12 session, trauma-focused protocol to gain a better understanding of the impact of trauma history, identify stuck points in recovery, and explore thoughts, beliefs, and daily functioning to promote improvements in overall well-being. Counseling is a voluntary process, but it is highly suggested that you attend a closure session or phone call if you choose to stop therapy in order to provide closure and any needed referrals. You and I will have a professional relationship existing exclusively for therapeutic treatment.  This relationship functions most effectively when it remains strictly professional and involves only the therapeutic aspect.  I can best serve clients’ needs by focusing solely on therapy and avoiding any type of social or business relationship.  Gifts are not appropriate, nor are any sort of trades of service for service. My goal is to provide the most effective therapeutic experience available to you.  If at any time you feel that you and I are not a good fit, please discuss this matter with me so that we can attempt to resolve any issues. You reserve the right to transfer to an alternate therapist.  If we decide that other services would be more appropriate, I can assist you in finding a provider to meet your needs. If your concerns are not addressed, you reserve the right to contact state licensing board at 1-800-942-5540.

Experience:

I completed my master’s level counseling practicum and internships with UNT’s counseling center and at Denton County MHMR, providing individual and group therapy. I have worked in a variety of settings and levels of care, including outpatient, an equine-assisted therapy facility, an intensive outpatient program, a crisis residential unit, and providing on-call emergency assessments for an inpatient psychiatric facility. For the past 10 years, I have worked with Denton MHMR in a variety of positions, including outpatient service coordination and case management, the medication room, and the crisis residential unit. I transitioned into the counseling position in 2016. I opened my own virtual practice in 2021. As the spouse of a veteran, I am dedicated to providing quality mental health care for veterans and their family members. I have experience working with a wide range of mental health and substance use conditions and providing trauma-focused therapy.

Risks and benefits:

Counseling can be beneficial, but as with any treatment, there are inherent risks. During counseling, you will have discussions about personal issues which may bring to the surface uncomfortable emotions. Some of the possible benefits are improved personal relationships, reduced feelings of emotional distress, and specific skills training and problem-solving. Of course, these benefits cannot be guaranteed. It is my desire, however, to work with you to attain your personal goals for counseling.

Confidentiality:

What you say in counseling generally is confidential, but there are some limitations to this. If you disclose abuse, neglect, or exploitation of a child, disabled person, or an elderly person, I am obligated to report this to the Department of Family and Protective Services to investigate the welfare of that person. If you disclose mistreatment by a previous therapist, I am required to report this to their respective licensing board. If you are having any thoughts of harming yourself or others, I follow crisis protocols to determine whether a higher level of care is needed. Throughout the course of your treatment, I may consult with other providers using de-identified information in order to maintain the best possible care and to assist in treatment planning. De-identified survey or assessment responses may be used as outcome measures for the purpose of pursuing grant funding. When using insurance for your care, they receive information about your services, including, but not limited to, your diagnosis, dates of service, type and frequency of appointments. There may be instances when records are requested from me, such as disability applications, legal subpoenas, or workers' compensations claims. As a therapist, I am committed to maintaining your privacy, and I have hipaa secure methods for facilitation of sessions, completing documention, and communicating with you. If you are receiving counseling with another therapist, a consent form must be signed so that I can consult with the therapist prior to starting services. It is recommended that you also sign a consent form for any concurrent mental health services, such as psychiatry appointments. If there are medical providers that you would like me to consult with, please let me know. Collaboration helps with providing holistic care.

Communication and Availability:

Our primary communication with each other will be at our scheduled appointments. My standard business hours are Monday-Thursday from 9am-3pm, but much of this time is spent in session with clients. It may take up to one business day to respond to voicemail messages. In the event of a medical emergency or imminent mental health crisis, please call 911. For non-emergent mental health crisis support, there is a 24/7 Suicide Prevention Lifeline at 988. Standard text messaging can be used for scheduling purposes only, but it is not a secure method of communication. I use an encrypted email system called LuxSci, which is hipaa secure and does cover your responses to my emails. If you initiate an email to me outside of these threads, it is not encrypted. Please do not include any protected health information in emails that you send to me. My practice uses Theraplatform for video sessions, messaging, handouts, and session reminders. You will receive a link for the client portal. Spruce Health is an optional phone app that can be used for hipaa secure text messages, document sending, and as a back-up telehealth platform: https://spruce.care/counselingwithinreachpllc. 

Attendance policies:

Late cancellations within 24 hours of the scheduled appointment time may be subject to a $25 fee. No call, no shows are charged at the full session rate and two no call, no shows will result in termination of services. If a session is missed and not rescheduled within 14 days, this will be taken as a notice that termination is desired.

Therapist absences:

If the therapist will be out of the office unexpectedly, you will be notified by message and the telehealth link will be canceled. You will be given an expected timeframe when this information is available so that your session may be rescheduled as quickly as possible. In the unlikely event of an extended absence, alternative referrals can be offered. 

 

Telehealth Overview

Telehealth can be as effective as in-person care when there is a match between the presenting concerns, the
client's preferences, and comfort levels with the technology. Telehealth is not the recommended treatment method in certain sitautions, including, but not limited to: An immediate, mental health crisis; psychosis; active substance use; unstable living environment; lack of privacy; discomfort with technology; or incompatible devices. In these instances, or others that are determined by the therapist or the client, referrals will be given for a higher level of care or for in-person services.

Conditions for Telehealth Service Delivery

• I will send in a copy of driver's license for identity verification purposes, and I agree to notify my therapist to any changes in my contact information, including my address and phone number.
• My therapist will triage appropriateness for telehealth service delivery during the phone consultation, the initial session, and on an ongoing basis throughout the course of my care. 
• My therapist and I will discuss safety planning steps, medical / mental health crisis procedures, and I will designate an emergency contact to be kept on file. 
• A welfare check and / or risk of harm assessment will be intiated in the following instances: Imminent risk of harm to self or others, if a client presents to a session and it is suspected they are under the influence of drugs or alcohol, or when significant disorientation or deterioration is present, regardless of the cause. **The client is responsible for cooperating with any recommended assessments to determine if a higher level of care is needed. If an individual is unwilling to engage in this process, they will no longer be able to be served through telehealth and will be referred to a higher level of care.** 

Telehealth Guidelines: Client Understanding

• I must be physically present in Texas and I agree to provide the address at the time of the session.
• If I attend the session from a vehicle, I must be parked for the duration of the session. In addition to my approximate address, my therapist will also ask for the make / model of the vehicle and the license plate number.
• All sessions must be done from a private place (no one else in the room, appropriate childcare arranged) and a password protected wifi is recommended.
• While there is no specific dress code, I understand that I must be fully clothed, or the session will be disconnected immediately and will need to be rescheduled.
• No part of sessions may be recorded or photographed.
• I understand that telehealth counseling is performed over a secure communication system and that my therapist takes precautions to ensure hipaa compliance. However, there is no way to 100% guarantee that internet-based services or communication will remain secure, despite all precautions taken by the therapist.
• I agree that the therapist and practice will not be held responsible if any outside party gains access to my personal information by bypassing the security measures of the communication system.
• I understand there are potential risks to this technology, including interruptions, unauthorized access, and technical difficulties. 
• I understand that I or my therapist may discontinue the telehealth counseling sessions at any time if it is felt that the video technology is not adequate for the presenting concerns or treatment goals.

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

THERAPIST'S PLEDGE REGARDING PHI:

I understand that information about you, your health, and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal and ethical requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

• Make sure protected health information (“PHI”) that identifies you is kept private.
• Give you this notice of my legal duties and privacy practices with respect to health information. Follow the terms of the notice that is currently in effect. 
• I can change the terms of this notice, and such changes will apply to all information I have about you. The new notice will be reviewed with you, and a new signature would be obtained from you prior to implementing the new policies.

HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures, I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.

• For treatment payment or health care operations: Federal privacy rules and regulations allow health care providers who have a direct treatment relationship with the client to use or disclose the client’s personal health information without the client’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your protected health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition or coordination of care. Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other healthcare providers need access to the full record and /or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers, and referrals of a patient for health care from one provider to another. 

• For Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court administrative order. I may also disclose health information about your child in response to a subpoena, discovery process, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested. 

CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
1. Psychotherapy Notes: I do keep “psychotherapy notes” as that term is defined in 45 CFR§164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:

• For my use in treating you.
  For my use in defending myself in legal proceedings instituted by you.
  For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
  Required by law and the use or disclosure is limited to the requirements of such law.
  Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes. 
  Required by a coroner who is performing duties authorized by law. 
  Required to help avert a serious threat to the health and safety of others.                          

2. As a therapist, I will not use or disclose your PHI for marketing purposes.

3. Sale of PHI: As a therapist, I will not sell your PHI.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION:

Subject to certain limitations, I can use and disclose your PHI without your authorization for the following reasons:

• When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to relevant requirements of such law.
• For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
• For health oversight activities, including audits and investigations.
• For judicial and administrative proceedings, including responding to a court or administrative order, although preference is to obtain an authorization from you before doing so.
• For law enforcement purposes.
• To coroners or medical examiners, when such individuals are performing duties authorized by law.
• For research purposes, including studying and comparing the mental health of patients who received therapy versus those who received another form of therapy for the same condition.
• Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counterintelligence operations; or helping to ensure the safety of those working within or housed in correctional institutions. 
• For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.
• Appointment reminders and health-related benefits or services. I may use or disclose your PHI to contact you to remind you that you have an appointment with me. I may also use or disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.
   

VI: YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

The Right to Request Limits on Uses and Disclosures of your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or healthcare operation purposes. I am not required to agree to your request and I may say “no” if I believe it would affect your health care.

The Right to Request Restrictions for Out-of-Pocket Expenses Paid for in Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or healthcare operations purposes if the PHI pertains solely to a health care item or health care service that you have paid for out-of-pocket in full.

The Right to Choose How I Send PHI to You. you have the right to ask me to contact you in a specific way (for example, cell phone, text, or email) or to send mail to a different address, and I will agree to all reasonable requests.

The Right to See and Get Copies of your PHI. Other than ‘psychotherapy notes,’ you have the right to get an electronic copy of your record, or a summary of it, if you agree to receive a summary, within 14 days of receiving your written request, and I may charge a reasonable, cost-based fee for doing so.

The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or healthcare operations, or for which you provided me an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time.The list will be provided to you at no charge, but if you make more than one request in the same year, I will charge a reasonable, cost-based fee for each additional request.

The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request. 

The Right to Get a Paper Copy of this Notice. You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by email. And, even if you have agreed to receive this Notice via email, you also have the right to request a paper copy of it. 

ACKNOWLEDGEMENT OR RECEIPT OF PRIVACY NOTICE
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information.