Professional Disclosure Statement

LCMHCA Professional Disclosure Statement

Paige Patrick Bohart

Office/Cell: 910-824-5445

My Qualifications

I am a Licensed Clinical Mental Health Counselor in the State of North Carolina and hold the National Counseling Certification. I have a Tele-Health certification through the University of North Carolina at Pembroke and am qualified to provide remote counseling. Along with a certification in Tele-Health, I hold certifications in suicide prevention, access to lethal means, and Psychological First Aid.

Restricted Licensure

As a Licensed Clinical Mental Health Counselor Associate, LCMHCA, I will work under a supervisor for approximately 2 years before being a fully licensed LCMHC. After 3 years of practicing as an LCMHC, I will work to become a supervisor for other new counselors, LCMHCS. I have passed the appropriate exams for National Counseling Certification, NCC. The restricted license simply means that I am a new counselor and will receive guidance from a more experienced counselor for my first two years of providing therapy.

Counseling Background

I have worked with all age groups in a variety of settings. I have facilitated group therapy and individual therapy sessions as well as presented research on group therapy at national conferences. I have conducted research at the college level and have provided therapeutic support for the counseling departments at nearby schools, such as Southview High School. I specialize in mood disorders, anxiety disorders, and PTSD, primarily utilizing a Mindfulness-based CBT approach.

Session Fees and Length of Service

Sessions are typically 45-50 minutes in length with an average of 6–8 sessions, relative to client growth and evolving needs. I accept private pay in the form of cash or credit card. In the case that a client is experiencing a hardship and does not have insurance, please inquire about a sliding scale rate. Insurance information should be presented and verified prior to our first session. If you cannot make an appointment, please call and/or email as soon as possible so that I may try to fill the appointment hour. If you are running late, no problem; I will be waiting for you. Please attempt to notify me if you are unable to keep an appointment. If there is no attempt to notify of appointment cancelation or reschedule, a fee may be assessed.

50 Min Individual Session = 150

50 Min Couples Session = 150

90 Min Family Session = 150

Use of Diagnosis

Some health insurance companies will reimburse clients for counseling services and some will not. In addition, most will require a diagnosis of a mental-health condition and indicate that you must have an “illness” before they will agree to reimburse you. Some conditions for which people seek counseling do not qualify for reimbursement. If a qualifying diagnosis is appropriate in your case, I will inform you of the diagnosis before we submit the diagnosis to the health insurance company. Any diagnosis made will become part of your permanent insurance records.

Confidentiality

All of our communication becomes part of the clinical record, which is accessible to you upon request. I will keep confidential anything you say as part of our counseling relationship, with the following exceptions: (a) you direct me in writing to disclose information to someone else, (b) it is determined you are a danger to yourself or others (including child or elder abuse), or (c) I am ordered by a court to disclose information.

Complaints

Although clients are encouraged to discuss any concerns with me, you may file a complaint against me with the organization below should you feel I am in violation of any of these codes of ethics. I abide by the ACA Code of Ethics (http://www.counseling.org/Resources/aca-code-of-ethics.pdf).

North Carolina Board of Licensed Clinical Mental Health Counselors
P.O. Box 77819

Greensboro, NC 27417
Phone: 844-622-3572 or 336-217-6007
Fax: 336-217-9450
E-mail: Complaints@ncblcmhc.org

Acceptance of Terms

We agree to these terms and will abide by these guidelines.

Client: ___________________________________________________ Date: ___________

Counselor: ________________________________________________ Date: ___________