FINDING YOUR ACE SCORE

Prior to your 18th birthday:

 

Welcome to AWC Centers (AWC).

 
This informed consent document is intended to provide you with comprehensive information regarding our business practices and counseling services that are available to you. We kindly ask you to read this document carefully. Please note that the informed consent is subject to change; however, you will receive written notification regarding any modifications, affording you the opportunity to consent to such changes. Additionally, you may request a copy of this document for your records.    

APPOINTMENTS   

All counseling sessions will commence and conclude punctually, with each session having a duration of 50 minutes. In the rare event that your counselor experiences a delay or must address an emergency, you will be informed of the approximate wait time, and your appointment will be rescheduled if deemed necessary. We kindly ask that you refrain from arriving late for your appointment. Should you arrive more than 10 minutes late, your appointment will be rescheduled. AWC also observes a 24-hour cancellation policy, which requires you to cancel your appointment at least 24 hours in advance. For appointments scheduled on Mondays, cancellations must be made by 2pm on the preceding Friday. We appreciate your mindfulness regarding this matter, as our sessions are limited and other clients may be awaiting appointments. Failure to notify the counselor of a missed appointment will be categorized as a 'No Show. ' Accumulating three (3) No Shows within a 90-day period will result in the termination of counseling services.  

CHILDCARE 

To maintain the highest quality of services, we respectfully request that children and infants over the age of nine months not be brought to counseling sessions. 

CONFIDENTIALITY   

The contents of the session and all pertinent materials related to the client's treatment shall remain confidential, unless the client provides written consent for the release of all or specific portions of such content to expressly designated individuals. Limitations to this client-held privilege of confidentiality are delineated as follows:   
1. In instances where a client poses a threat or attempts suicide, or engages in behaviors that present a substantial risk of serious bodily harm.   
2. In cases where a client threatens grave bodily harm or death to another individual.   
3. When the therapist has a reasonable suspicion that a client or another identified individual is either the perpetrator, witness to, or an actual victim of physical, emotional, or sexual abuse involving minors under the age of 18.   
4.  Suspicions as described above in regard to an elderly individual who may be vulnerable to such abuses.   
5.  Suspected neglect concerning the parties referenced in items #3 and #4.  
6.  If a court of law issues a valid subpoena for the specified information.  AWC operates as a teaching facility, wherein many of the counselors are in training as students or Licensed Professional Counseling Associates (LPC-A).  
I acknowledge that my counselor may be a master’s level counseling graduate student, a Licensed Professional Counseling Associate, or a Licensed Marriage & Family Associate in the state of Texas. All associates and students are under the supervision of a licensed supervisor, and they are mandated to participate in regular meetings during which cases may be discussed. I hereby consent to waive confidentiality concerning case discussions between my counselor and their clinical supervisor to ensure that I receive the most effective counseling experience.  

 

PRIVACY PRACTICES 

Effective counseling may require the sharing of confidential information at times with AWC employees, counseling students and LPC-As at the center, and their supervisors.  AWC shares information for both clinical and administrative purposes.  Center personnel abide by the rules of confidentiality and maintain strict privacy standards.  

 

COUNSELING SERVICES 

AWC services include individual counseling for our medical clients, members of their immediate support systems, and those who qualify. Your counselor will determine during the initial session if you qualify for counseling services at AWC and how to best meet your needs. Referrals will be made if you don't qualify for AWC's counseling program or if the counselor believes you'll be better served by another provider.  

CUSTODY OF FILES 

Electronic counseling records are kept by AWC. All records are kept for the period required by the Texas Behavioral Health Executive Council Board of Examiners (TBHECBCE) for the counselor's specific licensure. Most records are kept for a minimum of five (5) years. Security and privacy are also governed by TBHECBE.  

FEES AND PAYMENT 

AWC is a nonprofit health center funded by donations from the community. All counseling services are free of charge.  

COURT ORDERED COUNSELING, PROBATION REQUIREMENTS, CUSTODY EVALUATIONS, AND OPEN LEGAL CASES 

AWC counselors do not perform forensic mental health services related to child custody, divorce, or other legal proceedings or for disability or unemployment claims.  AWC cannot provide "forensic opinions, reports, assessments, and/or recommendations" according to Rule 456.18 of the Texas Administrative Code. Due to the experience level of our counselors, we cannot offer counseling services to those on probation or those engaged in open or active legal cases. 

PHONE CONTACT 

Counselors are not usually available to take calls, but you can leave a message, and they will call you back at the end of the day or during their next shift.  They have permission to contact you by any method you approve on the case opening form.  If you need immediate assistance, contact your psychiatrist or primary care doctor.  In the event of an emergency, call 911 or go to the nearest emergency room. 

 

PROFESSIONALISM 

The counseling relationship is strictly a professional one.  Contact with your counselor is usually limited to scheduled sessions.  Counselors at AWC will use the portal on Therapy Notes to communicate electronically.  You will benefit greatly when the counseling relationship remains professional, and the sessions concentrate exclusively on your concerns. 

RECORDS REQUESTS 

It is advisable to refrain from relying solely on written notes intended for healthcare professionals, as these may be subject to misinterpretation due to the frequent use of medical shorthand. Should you require it, a verbal summary or a written narrative can be provided upon request. 

 

STATEMENT OF ETHICS

Licensed Professional Counselors (LPCs) are regulated by the Texas State Board of Examiners of Professional Counselors, while Licensed Marriage and Family Therapists (LMFTs) are governed by the Texas Board of Examiners of Marriage and Family Therapists. These regulatory boards oversee the practice of licensed counselors within the state of Texas. Licensed counseling professionals render services in strict accordance with state law and board regulations, which includes adherence to a code of ethics established for the counseling profession. You should expect to be treated with dignity and professionalism at all times. Should you have any concerns, please address them directly with your counselor or with the supervisor of AWC’s counseling site. If the issue remains unresolved, you are entitled to file a consumer complaint by contacting the state’s toll-free complaint hotline at 1-800-942-5540. Written complaints may be directed to: Complaints Management & Investigative Section, P.O. Box 141369, Austin, TX 78714-1369. For further information or to verify the licensure status of a counselor, please visit dshs.state.tx.us/counselor.

 

STATEMENT OF FAITH

AWC is a faith-based ministry, and our counselors approach practice from a Christian worldview. Nonetheless, it is imperative that professional counseling remains a client-centered experience. There are no religious prerequisites, and any discussions regarding faith or religion will be initiated according to your preferences as the client.

 

TELEHEALTH CONSENT

Please be informed that while telehealth/teleconferencing services offer various benefits, they also pose potential risks, such as limitations to confidentiality that differ from those associated with in-person sessions. By signing below, you acknowledge the inherent risks associated with this technology, including interruptions, unauthorized access, and technical difficulties. The AWC is authorized to provide telehealth services only within the state. The AWC’s address is 14855 Blanco Road, San Antonio, TX 78217; telephone number (210)370-3939. Recording of sessions is strictly prohibited. Confidentiality remains paramount for telehealth/teleconferencing services, and participants are not permitted to record sessions without explicit consent from all other participants. To uphold confidentiality, it is crucial to conduct the session in a quiet, private space free from distractions. Additionally, utilizing a secure internet connection rather than public or complimentary Wi-Fi is strongly advised. The AWC maintains that the provision of services via telehealth/teleconferencing aligns with the standard of care provided during in-person visits and is deemed appropriate. Either participant reserves the right to terminate the consultation if it is deemed that the connection is insufficient for the circumstances. In-person services may be arranged as deemed necessary.

 

TERMINATION OF SERVICES

You retain the right to discontinue the counseling relationship at any time, and your counselor will support this decision. The primary objective of professional counseling is to empower you to successfully confront life’s challenges independently of a counselor. Should you decide to terminate services, please inform your counselor.

 

TREATMENT OF MINORS

 

For minors under the age of 18, treatment will only proceed with the explicit consent of a parent or legal guardian. In instances of divorce, it is mandatory for the parent with legal custody to sign the requisite documents authorizing professional counseling. The non-custodial parent may accompany the child to counseling appointments only after obtaining permission and the signed informed consent from the custodial parent. Please understand that in order to foster trust with your child, the counselor will not disclose any confidential communications that take place during counseling sessions. Should a child feel uncomfortable confiding in their counselor, the therapeutic process may be significantly compromised. While parents generally have the right to access their child’s records, AWC recommends against this practice and prefers to provide a summary upon request. If the child’s counselor believes that disclosing the records would jeopardize the child's safety in any manner, they will consult their clinical supervisor or the Texas State Board of Licensure before any records are released. Furthermore, in cases involving suicide prevention, substance abuse or addiction, or instances of physical, emotional, or sexual abuse, records will not be disclosed to parents.

 

WHAT TO EXPECT IN YOUR INITIAL APPOINTMENT     

 

Following the completion of the informed consent process, you will engage with your counselor for an introductory session. During this session, the counselor will evaluate your needs and ascertain your eligibility for our program. Furthermore, the counselor will determine whether they possess the requisite skills and experience to assist you effectively, or if a referral to another professional may be more appropriate.  This session also serves as an opportunity for you to ascertain whether this therapist aligns with your therapeutic expectations.  The decision to pursue counseling necessitates a commitment of time, hence it is crucial that you feel confident in your choice.  This interaction marks the commencement of the therapeutic relationship. Once the counseling relationship is established, your counselor will meet with you on a regular basis for sessions lasting 50 minutes each. The frequency of these sessions may vary, being conducted weekly or less frequently, based on your personalized treatment plan.  It is essential to collaborate with your therapist, providing honest feedback should you feel discomfort with any proposed techniques or approaches.  Counseling is an interactive endeavor that necessitates effort both during sessions and in your personal time.  You are expected to fulfill the commitments established between yourself and your counselor to fully benefit from the counseling experience. There are both advantages and challenges associated with professional counseling. Counseling can enhance relationships and self- image, aiding in your self- understanding, values, and goals. It may also evoke unexpected emotions that could affect you and your interpersonal relationships.  Your counselor at AWC Centers will work collaboratively with you to cultivate a positive therapeutic experience.  I acknowledge that I have read, comprehend, and agree to the Counseling Informed Consent of AWC Centers, LLC. I hereby consent to AWC's evaluation, treatment, and/or referral to other service providers as necessary. I affirm my understanding of the confidentiality agreement as documented herein.

 

 

CONSENT FOR COUNSELING SERVICES FOR A MINOR

I hereby acknowledge that I am the natural custodial parent or legal guardian of the minor child named below, and I authorize AWC Centers to evaluate, treat, and/or refer this minor child for psychological services. I understand that it is mandatory for a parent or legal guardian to grant permission for individuals under the age of eighteen to receive counseling services. In instances of divorce, the legal custodial parent of the minor child is required to provide consent; however, both natural parents may have the right to obtain information regarding the nature and course of treatment for their child. If I am a divorced parent, stepparent, grandparent, or other guardian, I agree to provide a copy of the court order designating me as the legal custodian of this minor child. I understand that services will not be provided without proof of legal guardianship.