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DISCLOSURE STATEMENT
Professional Disclosure Statement
Jeffrey D. Cook, M.A.
0112 SW Hamilton St.
Portland, OR 97239
971.404.1231
Thank you for selecting me as your therapist. The following will provide you with information concerning my approach to therapy, my education, my license, and your rights as a client.
Philosophy and approach:
I work with individual, couple, family, and groups for adults and adolescents. I believe much of therapy revolves around the relationship that client and therapist create. I approach clients with the notion that all people have primary needs that when unmet result in painful experiences. It is my desire that clients come to understand and name the limitations in relation to self and others. This approach is a systemic approach that has come to be known as 'Intersubjective Systems Theory'. I believe that we are all in a process of becoming or emerging, and at times, we encounter experiences that limit our forward movement, and at these times we often seek outside help. This theory allows me to work out of a primary value that views all people as unique, and thus, allows me to move into other psychotherapeutic theories depending upon the special needs and experiences of the client.
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Formal education and training:
I hold a Master of Arts in Counseling from George Fox University, and a Master of Divinity from Denver Theological Seminary and have served within the helping profession for over a decade. Major course work included: human growth and development with an emphasis on adolescent development, psychopathology, group therapy, human sexuality, and family dynamics. In addition, I have completed the foundational courses in Critical Incident Stress Management. Back To Top
As a professional counselor:
I will abide by the Code of Ethics. I am under the ongoing supervision of Terry McGlasson, M.A., N.C.C., which includes a weekly discussion of my cases. Back To Top
Fees:
My fee is $90.00, with sessions running for 50 minutes.
- A sliding scale is available to those who meet a standardized criteria.
- Call for a free 15 minute phone consultation to see if the "therapeutic fit" is right for you.
- In the event that an appointment must be missed, please give the therapist a 24 hour notice. Appointments that are missed or notified with less than a 24 hour notice will be charged a session fee.
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As a client you have the following rights:
- To expect that a licensee has met the minimal qualifications of training and experience required by state law:
- To examine public records maintained by the Board and to have the Board confirm credentials of a licensee;
- To obtain a copy of the Code of Ethics;
- To report complaints to the Board;
- To be informed of the cost of professional services before receiving the services;
- To be assured of privacy and confidentiality while receiving services as defined by rule and law, including the following exceptions:
1. Reporting suspected child abuse.
2. Reporting imminent danger to client or others.
3. Reporting information required in court proceedings or by client’s insurance company, or other relevant agencies.
4. Providing information concerning licensee case consultation or supervision.
5. Defending claims brought by client against licensee;
- To be free from being the object of discrimination on the basis of race, religion, gender, or other unlawful category while receiving service.
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Counseling agreement:
It is agreed that the client shall make a good faith effort at personal growth and engage in the counseling process as an important priority at this time in his/her life. Client gain is most important in counseling. Suspension, termination or referral shall be discussed between counselor and client for a pattern of behavior that reveals disinterest or lack of commitment to counseling or for any unresolved conflict or impasse between counselor and client. Back To Top
If you have any questions regarding the counseling process or this disclosure statement, feel free to ask. If at any time or for any reason, you are dissatisfied with my services, please let me know. If we are unable to resolve your concerns, you may report complaints to: Oregon Board of Licensed Professional Counselors & Therapists - (503) 378-5499 3218 Pringle Rd SE #160, Salem, OR 97302-6312
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