This section contains the informed consent information I ask new clients to review and sign consent to after the first session.
Populations I work with
I work individually with adults, and with couples, either married or unmarried. I also work with adolescents when the adolescent expresses a desire for the counseling. I usually do not work with children under 16 individually, unless they are unusually motivated to receive counseling. I provide family counseling provided all participating family members freely consent to the family counseling. In general, I am strict regarding client consent: I will not provide counseling to individuals, whether child or adult, who do not want to receive counseling from me.
I generally do not give advice or make recommendations regarding the use of medications. I will, however, help you think through the decision to use medications. If desired, I will provide referrals for psychiatrists who do advise and prescribe medications, and I will work collaboratively with medication providers.
I comply with the professional counseling ethics established by the American Counseling Association (ACA), and by the Virginia Board of Counseling (VBC). If you feel I have treated you unethically, you may file a complaint with either the ACA or VBC.
Fees and Payment
My fee for a 50 minute counseling session is $150. I ask for the payment at the beginning of the session. I accept cash, checks and credit cards. I will charge a $45 fee for returned checks. I will bill you for any reports, letters, assessments, evaluations, telephone conversations (except for very brief ones), or any other types of professional activities that you request of me, at the rate of $145/hour.
If I am asked by you or your attorney to appear in court on your behalf, I will charge you $145/hour for the following: court preparation, travel time to the court, time waiting at the court, time spent testifying, and travel time from the court. I will probably require that you pay me in advance a deposit of funds sufficient to cover anticipated expenses. Be aware that I am not an expert on child custody, disability, or any other types of legal evaluations, and therefore cannot provide them.
An important right of yours as my client is confidentiality: I will not provide anyone with any information about you, verbally, in writing, or otherwise, without your written permission to do so. There are however, some important exceptions to this rule. For example, I may disclose information about you, even without your permission, if:
You give me information indicating intention to do serious physical harm to yourself or another person.
You give me information about child or elder abuse.
A judge orders me to provide information about you.
These are the main exceptions to the general rule of confidentiality; there may be others as well. In these situations, it is my policy to provide as little information as possible to insure a person’s safety or comply with a judge’s order. Please understand that it is my personal policy to protect your confidentiality unless I am legally unable to do so.
Internal confidentiality in couples and family counseling. In the course of providing couples or family counseling, I will often arrange one or more individual sessions with members of a couple or family. In these situations, I ask you to allow me to use my professional judgement regarding sharing with other member(s) of the couple/family any information revealed during those individual sessions. I will not reveal anything to your partner that I believe puts you at risk of injury.
External confidentiality and couples or family counseling. When I agree to provide couples or family counseling, I consider the couple or family to be my “client,” not any one individual person. Therefore, I will release records or provide clinical information only with the consent of all members of the couple or family to whom I am providing counseling.
Confidentiality and minor clients. When your minor child is in counseling with me, I will usually respect any wishes he or she may have for me not to share non-life-threatening information with you. This may include such things as drug and alcohol use, and sexual behavior. If you object to this, please let me know right away.
Confidentiality and insurance. If you request that I submit claims for reimbursement for counseling services to your insurance company, understand that your insurance company will request information about you from me, including, but not necessarily limited to, your diagnosis. Your request for us to submit insurance claims for you constitutes your consent for me to release clinical information about you to your insurance company. If you object to this, you can submit insurance claims on your own, or you can avoid involving insurance in your counseling.
Confidentiality and Consultation. In order to provide the best possible services to my clients, I participate in regular consultation groups with other counselors. I may, in a way that does not identify who you are, ask my colleagues for advice or ideas regarding something you and I are working on.
I see clients for fifty-minute sessions, weekdays only, in the mornings and afternoons. I have very limited evening hours. I am off major holidays. My schedule tends to fill 1-2 weeks in advance, therefore I recommend scheduling yourself several weeks in advance. In many cases the best strategy is for you and I to pick a day and time and reserve that slot for you as long as it is needed.
Typical counseling frequency is once a week. In special circumstances, or if we have been working together for some time, I may agree to see you less frequently than weekly. If I believe you are in crisis, I will probably recommend meeting more frequently than once a week. I sometimes counsel clients who are not in crisis more frequently than once a week when the client wants to work intensively in counseling.
Double sessions can be scheduled depending on availability, by scheduling back to back fifty minute sessions.
Canceling appointments and missed appointments
You can cancel or reschedule appointments with me without financial penalty, provided give me 24 hours notice. If you cancel or reschedule an appointment with less than 24 hours notice, or if you forget an appointment, I will charge you the full amount of the session ($145 for a 50 minute session). This is to insure that I am not financially affected by the cancellation.
Sometimes clients feel angry about the enforcement of this cancellation policy, and think that it is unfair. Please consider whether you can agree to this policy, and let me know if you cannot.
Phone and email. You are encouraged to contact me at any time. You can call me by telephone (703-771-4041), and if I’m not available I will return voicemail messages as soon as I can. Please be advised that I will bill you for all but brief communication at my hourly rate. You can also contact me by email at JackChildersLPC@yahoo.com. Please be aware that email is not a secure form of communication.
In-person meetings. If we happen to see each other outside the counseling office, I will not acknowledge I know you unless you initiate an exchange. This is to protect your confidentiality. If you do initiate a greeting I will of course respond, but I will keep the pleasantries brief, and I will not introduce you to people I may be with. I’m not trying to be rude; I’m trying to protect you and our counseling relationship.
Social media. I will not respond to social media contacts, for example, a “friend” request on Facebook. This is to protect your confidentiality and our counseling relationship.
If you are experiencing a crisis that is not life-threatening, please contact me right away, even if it is a holiday or I am on vacation. You can request an emergency appointment with me either that day or the next day.
If you are experiencing a crisis that is life-threatening, for example,thoughts or urges to suicide, contact 911 or go to the nearest hospital emergency room. You may also access trained volunteers at CrisisLink by calling 703-527-4077 or 1-800-SUICIDE. This service is available 24 hours/day.
After every counseling session, I write notes in your chart about what happened during the session. You’ll probably notice me glancing at your chart from time to time while we talk. I do this to help me remember things about you, or about what we’ve talked about. You may also notice me referring to a schematic diagram, called a “genogram” I’ve made of your family.
Though my notes are primarily to help me be a better counselor to you, you have a right to know what’s in the notes if you wish. Please don’t hesitate to ask me about the notes if you are curious. You also have a right to a copy of your records if you so wish. If you do request a copy of your records, I recommend you schedule an appointment with me to review your records together so I can help you understand the information.
Risks and Benefits of counseling
As with any form of treatment, there are risks to counseling. Examples of these risks include, but are not limited, to: experiencing uncomfortable thoughts or feelings, being distressed by unpleasant memories, and experiencing relationship difficulties. A partner may decide to divorce as a result of couples counseling. Some people, despite my best efforts, do not benefit from counseling with me, and some people may even feel worse. Unpleasant but temporary feelings (anger, pain, fear, shame, for example) are quite commonly a part of a counseling experience.
Despite these risks, you should be aware that most people who remain in counseling with me for six or more sessions report benefit from the experience. Benefits include, but are not limited to: reduction in the overall frequency and/or intensity of distressing thoughts, feelings or behaviors, overall improvement in self-concept, and overall improvement in satisfaction in relationships with others. Nevertheless, I do not guarantee that your counseling with me will be successful.
Risks of courtroom testifying
If I am requested by you or your attorney, or compelled by a court order, to testify about you in court, the testimony I provide could be harmful to you or to your case. If I testify, I will be asked questions not only by your attorney, but by the opposing attorney as well. As your counselor, I may know very intimate and personal details about you, and having this information shared in an open court could be devastating to you and/or your reputation. Additionally, once testimony is provided, that information may then remain openly available as public record. For these reasons, I urge you to very carefully consider the risks before requesting that I testify in court on your behalf.
The counseling relationship
The counseling relationship is unique and special. It is set up to provide you with a safe place to reveal and explore very intimate and private matters. That you have no responsibilities to me, other than paying my fee, is an important part of creating this safety. I am not your parent, spouse or best friend: people to whom you have personal responsibility and therefore must consider how what you share affects them. By contrast, our sessions are solely for your benefit. For this reason, it’s a good idea for you and me to limit our relationship to counseling. To the extent that you and I develop another relationship (doing business, becoming friends, etc.), we place at risk the safe sanctuary of the counseling relationship. This is also why I ask you to refrain from giving me any gifts that have more than nominal intrinsic value.
What to expect in counseling with me
Counseling can seem like a mysterious process, so I want you, as much as possible, to know what to expect. Some things you can expect are:
• I will, except in very rare circumstances, start our counseling sessions promptly at the time we are scheduled to meet, and promptly end the session fifty minutes later.
• In most cases, I will call you to see what’s going on if you do not arrive for your appointment within about fifteen minutes of the start time.
• During the session, I will direct my undivided attention to you, except for very brief periods when I may be thinking about something you said.
• At all times, I will be courteous and respectful towards you.
• I place great emphasis on understanding your thoughts and feelings accurately.
As previously mentioned, you will probably find that unpleasant thoughts or feelings occur at times during or after counseling sessions. This is normal in counseling, and occurs, I believe, because very often our upset is related to efforts we make to avoid things that are sad, scary, or otherwise unpleasant. Counseling often largely involves encountering and dealing with these things. This can be distressing, but may be short-lived and result in an overall improvement in life satisfaction.
You may also find that at times you have strong feelings about me, be they negative feelings such as anger, fear or frustration, or positive feelings such as admiration, love or sexual feelings. These feelings are quite common for clients in counseling relationships. You may be surprised that I often view client’s anger towards me as very good sign. It can mean we are accessing important areas. For this reason, it is critically important that we explore your feelings about me, be they anger or otherwise, and you are encouraged to share with me any feelings about me you have.
How to maximize your benefit from counseling
Counseling is very much a collaborative enterprise, and there is much you can do to contribute to the success of your counseling. I urge the following:
• Think about what you hope will happen as a result of counseling.
• Think about how much time and effort you want to devote to making changes you want.
• Take an active role in your counseling. Ask a lot of questions. Do not be afraid to challenge me as to what I am doing or why. Tell me when something is happening that you don’t like.
• Make a commitment to speak only truthfully in counseling.
• Decide that no amount of counseling can help you change things that are not in your control.
• Decide to take some risks: to try doing things differently that haven’t been working.
• Make a commitment to pushing your “comfort zone” by doing things that make you a little uncomfortable or anxious.
• Ask any questions of me you like, personal or otherwise. I may decline to answer some questions, but I won’t be upset that you asked them.
Three research findings regarding counseling effectiveness may be helpful. First, research shows that the majority (60-65%) of clients report being helped by counseling. Second, the vast majority of clients who are helped through counseling begin to benefit very quickly (within one to seven sessions). Lastly, the vast majority of clients who do not benefit early on do not go on benefit later in counseling, no matter how long the counseling lasts (Duncan, Miller & Scott, 2004). What this seems to suggest is that you should expect to feel some benefit fairly early on, and that if you do not, something probably isn’t working in our counseling.
How do I know if you are the right counselor for me?
This is a very important question, though not always easy to answer. First recognize that, though your relationship with me as your counselor is a professional relationship, it is also intimate. Largely for this reason, there is no one counselor, including me, who is right for every client who walks in his or her door. So, how do you tell? I suggest considering the following:
• You should feel that I “get” you, or understand you to some degree, and that I want to understand you better as we continue working together.
• You should feel that I care about you, and want the best for you.
• You should find that your trust in me gradually increases as we continue working together.
Certain feelings, for instance anger and anxiety, regarding counseling are not always reliable indicators, however. Often, a big part of my job as your counselor is to help you encounter uncomfortable thoughts and feelings, for instance shame and fear. Anger at me, or anxiety regarding coming to a session, may be more a sign we are making progress than an indication you should stop counseling or switch counselors.
It is important for you to know that you can stop counseling with me at any time for any reason. A good counseling experience, however, will almost always include you and I discussing and understanding reasons for stopping counseling. Many people, when feeling upset, feel the urge to abruptly cut off contact with their counselor. Abruptly cutting off counseling though, I believe, is likely to result in persistent negative feelings about the counseling for you. I urge you to make a commitment to discussing with me your negative feelings about me or counseling before stopping. You are likely to feel much better about stopping counseling if you share with me your reasons for stopping.
For my part, I will typically not end our counseling relationship before you are ready for it to end. I do, however, have an ethical obligation not to continue counseling with you if I feel I am unable to help you. As well, I will almost certainly end our relationship if you assault me, deliberately damage my property, bring legal action against me, or fail to pay for my services. It is also possible that other unforeseen circumstances could force me to end the relationship. In such instances, I will provide you a referral to another counselor.