Into the Body | Trauma Healing & Hands-on Bodywork

Ines Manteuffel, CHT, BCST, PLC, LMT, RYT

5717 Arapahoe Ave, Suite 204 Boulder, Co 80303

ines@intothebodytraumahealing.com

 

Disclosure Statement & Policies

This document is designed to inform you about my background as well as your rights as a client and to ensure that you understand our professional relationship.

1. Business Information

Into the Body, operated by Ines Manteuffel, is located at 5717 Arapahoe Ave, Suite 204, Boulder, CO 80305. Phone: 303-746-4626

2. Therapeutic Approach

Into the Body is an integrative practice, combining hands-on bodywork with body- centered psychotherapy and trauma therapy methods. Your intention might be to only receive one or the other or both combined, but my experience is that for some clients who come solely for bodywork, psychotherapeutic work arises during our sessions. Psychotherapeutic work is never required, this is always your choice and there is always the option to do hands-on bodywork only. But I do inform all my clients about the legal guidelines of psychotherapeutic work, even if they only intend to come for bodywork.

I believe in a holistic approach to therapy, with the understanding that we all are beautifully comprised of body, emotions, mind and spirit. Injury and pain that happen on physical, emotional, relational or spiritual levels affect the whole person. For deep and lasting healing to occur, all levels must be considered. It is always your choice, though, which layers you wish to address in our work together.

In my integrative approach I draw from the psychotherapeutic methods of Hakomi Therapy (body-centered psychotherapy), Sensorimotor Psychotherapy, and IFS (Internal Family Systems), from trauma healing approaches of Somatic Experiencing and Polyvagal Theory and Biodynamic Breathwork, and from Osteopathic Bodywork approaches of Craniosacral Therapy and Ortho- Bionomy as well as from the energetic bodywork approach of Polarity Therapy and from my training as a licensed Massage Therapist.

3. Use of touch

Any touch that is used during sessions is meant to be therapeutic only, either as a bodywork modality or to support psychotherapeutic work and is always consensual. There will never be any touch of private areas or of sexual intent. If at any point during a session touch does not feel comfortable or appropriate in any way, it is your responsibility to let me know right away and I will discontinue the physical contact or adjust to make it comfortable for you. I will also do my best to check in frequently and confirm that any touch does feel comfortable to you.

4. Credentials:

• Registered Psychotherapist in the State of Colorado
  
• Certified Hakomi Therapist
• Certified Biodynamic Breath Practitioner
• Ortho-Bionomy Practitioner
• Certified Biodynamic Craniosacral Therapist
• Polarity Life Coach
• Licensed Massage Therapist
• Registered Yoga Teacher

5. Training

I have received training in:

• Hakomi Therapy (body-centered psychotherapy)
• Somatic Experiencing style trauma therapy
• IFS (Internal Family Systems)
• BBTRS (Biodynamic Breathwork Trauma Release System)
• Ortho-Bionomy
• Biodynamic Craniosacral Therapy
• Massage Therapy
• Polarity Therapy
• Polarity Life Coaching
• Yoga Instructor

6. Client Rights and Agreements

a) As a client you are entitled to receive information from me about my methods of therapy, the techniques I use, the duration of your therapy (if I can determine it) and my fee structure.

b) Fees:

60 min session: $120

75 min session: $137

90 min session: $165

120 min session: $220

Fees are collected at the time of service.

Cancellation Policy:

I ask that you give me notice of cancellations at least 24 hours before a scheduled session. Cancellations with less notice than 24 hours will be charged half of the session fee and no-shows will be charged the full session fee. Special considerations may be made for emergency situations, severe weather, or sudden illness.

c) You have the right to seek a second opinion from another provider or to

terminate therapy at any time.

d) In a therapeutic relationship sexual intimacy is never appropriate and should be reported to DORA

7. Confidentiality

Generally speaking, information provided by and to a client in a professional relationship with a psychotherapist is legally confidential, and the therapist cannot disclose the information without the client's consent.

There are several exceptions to confidentiality which include: (1) I am required to report any suspected incident of child abuse,or neglect to law enforcement; (2) I am required to report any threat of imminent physical harm by a client to law enforcement and to the person(s) threatened; (3) I am required to initiate a mental health evaluation of a client who is imminently dangerous to self or others, or who is gravely disabled, as a result of a mental disorder. In this case I might call a welfare check to your home, which involves a police officer and mental health professional to evaluate any risk you might be in. I will be required to notify legal authorities and make reasonable attempts to notify your family. (4) I am required to report any suspected threat to national security to federal officials; and (5) I may be required by Court Order to disclose treatment information. I will report any suspicion or incidence of child abuse or neglect to the proper authorities. You should be aware that legal confidentiality does not apply in criminal or delinquency proceedings. If you file a complaint or a lawsuit against me, according to Colorado law, your right to confidentiality is waived.

8. Regulation of Therapists

The practice of licensed and registered persons in the field of psychotherapy is regulated by the Colorado Department of Regulatory Agencies (DORA), Division of Professions and Occupations. The agency within DORA that specifically has responsibility for mental health professionals is the mental health section.

Complaints can be directed to:

Department of Regulatory Agencies

1560 Broadway, Suite #1350

Denver, CO 80202

303-894-2291

DORA_MentalHealthBoard@state.co.us

9. Levels of Regulation:

• A Registered Psychotherapist is a psychotherapist listed in the State's database and is authorized by law to practice psychotherapy in Colorado but is not licensed by the state and is not required to satisfy any standardized educational or testing requirements to obtain a registration from the state.
•  A Certified Addiction Counselor I (CAC I) must be a high school graduate or equivalent, complete required training hours and 1,000 hours of supervised experience. - A Certified Addiction Counselor II (CAC II) must be a high school graduate or equivalent, complete the CAC I requirements, and obtain additional required training hours, 2,000 additional hours of supervised experience, and pass a national exam. - A Certified Addiction Counselor III (CAC III) must have a bachelor's degree in behavioral health, complete CAC II requirements, and complete additional required training hours, 2,000 additional hours of supervised experience, and pass a national exam.
  
• A Licensed Addiction Counselor must have a clinical master's degree, meet the CAC III requirements, and pass a national exam.
  

• A Licensed Social Worker must hold a master's degree from a graduate school of social work and pass an examination in social work. -
• A Licensed Clinical Social Worker must hold a master's or doctorate degree from a graduate school of social work, practiced as a social worker for at least two years, and pass an examination in social work.
• A Psychologist Candidate, a Marriage and Family Therapist Candidate, andLicensed Professional Counselor Candidate must hold the necessary licensing degree and be in the process of completing the required supervision for licensure.
• A Licensed Marriage and Family Therapist must hold a master's or doctoral degree in marriage and family counseling, have at least two years post-master's or post-doctoral practice, and pass an exam in marriage and family therapy.
•  A Licensed Professional Counselor must hold a master's or doctoral degree professional counseling, have at least two years post-master's or one year postdoctoral practice, and pass an exam in in professional counseling.
• A Licensed Psychologist must hold a doctorate degree in psychology, have of post-doctoral supervision, and pass an examination in psychology.

Your signature below indicates that you have read the information in this document and agree to abide by its terms during our professional relationship.