Disclosure Statement
Philosophy and Approach
My practice involves working with individuals, couples, and families with the goal of improving
their quality of life. Therapy works best when both therapist and client determine the goals
collaboratively. These goals can involve, but are not limited to, addressing behavior (e.g.,
reducing conflict), emotions (e.g., feeling happier), or increasing self-awareness (e.g.,
discovering an unconscious attraction to unhealthy partners). Setting therapeutic goals is an
ongoing and fluid process that we will continually evaluate and revise as needed. I use an
integrative approach to therapy that thoughtfully draws from several useful models:
• Relational Psychodynamic theory states that people are influenced by their early experiences
and attachment figures.
• Systems theory states that individuals are a part of many larger interconnected groups
(systems).
• Attachment theory states that we are born pre-programmed to form attachments to our
caregivers for survival.
This integrative approach provides numerous tools one can use to achieve improved
communication, important emotional work, increased awareness, personal exploration,
psychoeducation, behavioral and cognitive changes, and novel ways of functioning within family
systems.
Social Justice
As an advocate of social justice, I understand the role that culture, privilege, racism,
heterosexism, oppression, classism, and ageism play in our everyday lives. These contextual
factors fill an important role and are considered when determining therapeutic goals and client
strengths. I am an LGBT+ ally, poly-friendly, kink-friendly, and accepting of all faiths and
spiritual orientations.
Education
Master of Arts in Marriage and Family Therapy Antioch University Seattle, WA 2017
Bachelor of Science in Psychology University of Phoenix, AZ 2013
Experience
I was an intern at the Center for Human Services for one year and Navos Mental Health and
Wellness Center for another. As part of my internship, I provided therapy to individuals, couples,
and families under the close supervision of a licensed professional. Additionally, I am required to
engage in case consultation with other professionals to ensure that I am providing quality therapy
for clients and am performing my duties in a professional and ethical manner. My education and
training has prepared me to provide therapy to individuals of all ages, races, ethnicities, religions,
and sexual orientations.
Informed Consent
Therapy is a choice you have made among other available options such as, support groups, selfhelp
resources, other therapists, and different therapies. Engaging in therapy has potential
benefits and risks that involve discussing uncomfortable parts of your life and history. As such,
you may experience emotional discomfort such as, sadness, anger, guilt, worry, frustration,
loneliness, and helplessness throughout the therapeutic process. Conversely, this process often
leads to a higher quality of interpersonal relationships, solutions to distressing problems, and
significant changes in quality of life and emotional functioning. Addressing issues that initially
brought you to therapy may result in changes that were not originally intended. The time it takes
to achieve therapeutic goals is relative to the individual. Some clients require only a few sessions
to address their concerns, while others achieve their goals through long-term therapy. You have
the right to terminate therapy at any time. However, premature termination may result in your
initial problems and symptoms returning or worsening.
If you are ever dissatisfied with my services, prefer a second opinion or referral, or no longer
want to attend appointments, I encourage you to speak directly to me. However, if I am unable to
address your concerns adequately, you have the right to file a complaint with the Department of
Health (800-525-0127) regarding any unprofessional conduct on my part.
Confidentiality
All communications (phone calls, emails, texts, etc.) between you and me will be held in strict
confidence. If information about your treatment needs to be released, I will not do so without
obtaining a signed release of information from you. In the case of couple and family therapy, I
reserve the right to discuss information shared in any individual sessions in the joint sessions.
Typically, I will not reveal secrets for you, but will facilitate you telling your family or
significant other if I believe doing so helps achieve the goals set forth in therapy.
There are certain instances in which I am required by law to break confidentiality:
• Suspected child abuse
• Suspected dependent adult or elder abuse and/or neglect
• If a client presents serious danger of physical violence to another person
• To interrupt a client’s potential suicidal behavior
• When required by court or other compulsory process
The Patriot Act of 2001 requires therapists to provide FBI agents with client information under
certain circumstances and prohibits the therapist from disclosing that such information was
obtained under the Act.
Disclosure of your information may also be made if:
• I have your written authorization permitting disclosure
• You file a complaint against me
• You pay by check, permitting bank employees to view names of my clients
• You use caller identification on your phone in which my name will appear on the display
• A third-party agent contacts you to receive payment for a balance due that exceeds 90
days.
Consultation
I engage in ongoing peer review and consultation with other professionals regarding my clients.
However, I never disclose a client’s identity during consultation and confidentiality is fully
maintained. I consult because I believe that various viewpoints may help me provide you the best
therapeutic service possible. Additionally, in order to remain competent and informed on the best
practices and professional skills, I seek out continuing education units through coursework,
workshops, symposia, and lectures.
Professional Boundaries
Once a therapeutic relationship has been established, I can only be your therapist. It is considered
unethical for a therapist to be a friend or socialize with a client. Therapists cannot ever engage in
sexual or romantic relationships with any client before, during, or after the course of therapy. I
will not attend weddings, family gatherings, parties, or other social events. I do not engage in
communication via social media with clients or families of clients. I do not give gifts, nor will I
accept them. I do not engage in multiple relationships in order to protect our therapeutic
relationship from situations that would potentially compromise the efficacy and outcome of
therapy. In addition, I will not acknowledge the existence of my relationship with a client outside
of the therapy session.
Appointment Times and Fees
My fee is $160 ($200 for couples) for a 50-minute session. My fees might increase every few years, but I will
remind you of this increase well in advance. Full payment is required at the end of each session
unless prior arrangements have been made. During a given week, if I spend more than 10
minutes on the phone with you or reading and responding to your emails I will bill you on a
prorated basis for that time. I reserve the right to end the therapeutic relationship if a client has
an overdue balance, is non-compliant with my treatment recommendations, or is not showing up
for appointments consistently. A minimum of 24 hours’ notice is required to cancel or reschedule
an appointment or you will be charged the full fee. Scheduling an appointment involves the
reservation of time specifically for you and so this time cannot be used for another client. If you
fail to make or arrange for payment of an outstanding balance, you agree to pay the legal costs
incurred in the collection of said debt.
Scheduling Appointments and After-Hours Contact
If you wish to speak with me between appointments or outside of normal office hours, please
leave a message on my voicemail. I check my voicemail regularly during normal business hours,
but may or may not have time to listen or respond immediately. If you are experiencing an
emergency, contact 911 or King County Mental Health Services at 206-461-3222.
Vacations
I will give you reasonable notice before taking any vacation time. When I am on vacation or
otherwise unavailable, a colleague will cover my practice and you will be provided with their
name and phone number. This therapist will have access to your client information and is bound
by the same laws and rules as I am to safeguard your confidentiality.
Recordkeeping
I am required by standard practice to keep a record of your treatment such as, what interventions
happened in session, dates of service, payments of service, topics discussed, insurance billing,
and relevant treatment information. If you prefer that I do not keep your treatment records, you
must submit a written request to refrain from doing so. I will store this request in your file along
with your name, signed disclosure statement, session dates, and fee for service.
Public Media
Before engaging in a professional relationship with me, you should know that I am involved in
public media: podcasts, interviews, and posting to professional websites and social media. My
primary mission has been to make a positive difference and decided to extend that mission to
public media. In doing so, I incurred the ethical responsibility of carefully considering whether
or not the benefits justify the risk (AAMFT, 2015; ACA, 2015; APA, 2017).
The benefits include: 1) reaching individuals who don’t have access to care, 2) the
democratization of knowledge, 3) increasing compassion (and self-compassion) for those who
are suffering, 4) combating misinformation, 5) providing an adjunct to care, and 6) advocating
for marginalized groups.
The risks include: 1) confidentiality violations, 2) harmful boundaries, and 3) not representing
the profession well. As an example of a boundary concern, if you listen to a podcast I’ve been
on, you might learn details about my life that could complicate our working relationship—such
as a political belief or my take on a public figure. Also, if you comment on one of my social
media posts, someone might guess that we have a professional relationship, which would
compromise your privacy and confidentiality.
To reduce these risks, I adhere to the following guidelines. I recommend you avoid my public
media involvement since you could learn things about me that might interfere with our working
relationship. If you choose to listen to my media publications, please alert me beforehand so we
can discuss measures to guard against harm to our professional relationship.
I will not discuss anything about you in public media. Whenever I discuss cases, I protect clients’
identities by composing a fictional person, speaking in general terms that don’t reveal the
individual, or obtaining prior consent. This protects your rights to privacy and confidentiality.
I will not respond to “friend” requests, and I will not “follow” you. This protects you from being
exposed to unhelpful details about my life and from being discovered as one of my clients. It also
protects my right to privacy. This extends even after termination of our professional relationship.
I discourage you from commenting on my professional social media accounts. If you do
comment, I will not respond to your comments. This protects you from being exposed as one of
my clients and from you confusing social media with proper care.
If you wish to contact me, use my email address or phone number only. Other methods of
communication are not reliable and may violate your right to confidentiality.
I will not Google you without your consent unless there is a serious risk of harm that justifies the
action. This protects your privacy and safeguards against me losing objectivity. It also protects
against you feeling invaded and betrayed by me.
Similar to in-person meetings with you, I might be required by law to contact the authorities if
you reveal on social media that you or someone else is in serious harm or if you reveal a child or
dependent adult is being abused. If you have any questions or concerns about this, please let me
know. It’s my job to answer your questions and address your concerns.
Client Rights
You have the right to confidentiality. In addition, as one of my clients in therapy, you have the
right to:
• Inquire about my qualification and experience;
• Ask questions regarding any procedures I use in therapy with you;
• Refuse a particular treatment or testing method;
• Discuss your progress in therapy and treatment goals;
• Refuse any psychological testing I recommend;
• Request referral to another therapist;
• Terminate or suspend therapy without my permission or agreement;
• The right to file a complaint with the Washington State Department of Health if you
believe I have behaved in an unprofessional or unethical manner and decide that a
resolution to the problem cannot be reached.
Terminating Treatment
I reserve the right to terminate therapy with you for in the following situations:
• Failure to pay the agreed upon fee
• Failure to cooperate with my treatment recommendations
• Conflicts of interest
• Movement or closure of my practice
• Missing or canceling several appointments