Virtuously Unveiled Christian Resource Center Professional Disclosure Statement & Consent For Biblical Counseling in Person or Virtual Services
Here are some facts about Virtuously Unveiled Christian Resource Center that will help you to know
what to expect as you apply for Biblical Counseling. Please take a moment to read over the fact sheet and
sign it. Feel free to call us if you have any questions.
Email *
Virtuously Unveiled Christian Resource Center is a non-profit ministry designed to serve people who have problems they cannot handle alone. The range of problems with which I deal with is multifaceted. It includes broken and dysfunctional marriages, parent-child relationships, depression, anxiety, and any number of other problems that result in personal and interpersonal turmoil and distress. I will only operate in my realm of expertise. If I am unable to provide effective counsel I will let you know immediately.
As a Biblical Counselor, I have been intensively trained in the principles and practices of Biblical Counseling. I am not a trained psychotherapists or licensed professional counselors, nor do I practice psychological therapy.
As a Biblical Counselor, I maintain that the Scriptures provide practical, in-depth solutions to every type of problem of attitude, behavior and emotion. They are committed to the position that the Scriptures provide the only authoritative rule of faith and conduct for life.
I believe in the total health needs of the counselee. As your counselor, I may recommend that you have a full or specified medical examination.
NATURE OF COUNSELING: It has been said that through relationships we are wounded and by relationships we are healed. My goal in counseling is to foster a collaborative, healing relationship that provides safety for healing and growth. Unfortunately, there are no “quick fixes” in counseling. It takes hard work in the form of vulnerability in sessions, completing homework assignments, writing, reading, using learning tools and techniques, and attending workshops, when appropriate. As a Biblical Counselor, I are committed to help your spiritual life develop and enable you to understand Biblical truth and apply it to your life. *
CONFIDENTIALITY: Virtuously Unveiled Christian Resource Center respect the information you share and how difficult it can be to open up. I may review “unidentifying details” of your case with other counseling professionals whom I consult with in order to help you in the best way possible. Our conversations and/or our written/taped records will be kept confidential and are protected by Virginia state law and American Association of Christian Counselors Code of Ethics, with a few exceptions, which are for your own protection: (1) when we believe that you intend to harm yourself or another person (2) when we believe a child, elderly, or disabled persons has been - or will be - abused or neglected and (3) when there is domestic violence in the home. In rare circumstances, Biblical and/or Professional Counselors can be ordered by a judge to release information. Otherwise, we will not tell anyone else about your treatment, diagnosis, history, or even that you are a client without your full knowledge, and usually with a signed Release of Information Form. A copy of the HIPPA (Health Insurance Portability and Accountability Act) Patient Notification of Privacy Rights will be made available to you. Signing at the end of this disclosure will indicate that you have had an opportunity to review and understand this (HIPAA) document. *
SCHEDULING AND LENGTH OF SESSIONS: A counseling session is 45-50 minutes. I will schedule our sessions per mutual agreement, as time is available. Because, I operate on an appointment basis only, I may not be able to handle urgent emergencies that may arise with clients. If your situation is out of control cannot wait on an appointment, it is important that you contact 911 or your local emergency services. If you are unable to keep an appointment, please send me an email at any point on the day before the appointment. *
COUNSELING RELATIONSHIP: During the time of your treatment we will meet regularly for 45-50 minutes sessions. Our relationship is a professional relationship and must be respected by both sides. There may be opportunity for us to run into each other in a social context i.e. church, the grocery store or school, etc. Let’s both keep our professional relationship in mind at this time. To protect you, I’ll tend to avoid initiating with you in public. However, you always have the freedom to initiate with me. Please feel free to discuss this with me at any time when this happens. My goal is to make you comfortable with our professional relationship and best meet your needs as a client. *
TERMINATING TREATMENT: Treatment is typically terminated when it becomes reasonably clear that the client no longer needs care. Other situations that could warrant termination include: a change in the client's treatment needs or focus; failure to make progress; refusing to follow recommendations critical to client safety or standards of care; scheduling inconsistencies on the part of the client; if the counselor feels threatened or endangered by the client (or the client's family member, friend, etc); and more. When possible, pre-termination counseling and alternative referrals will be provided. *
APPROPRIATE REFERRALS: I am qualified to meet the needs of the vast majority of the people who come to see me. If I cannot help you, I will try to refer you to another appropriate professional in the community to meet your needs. If you have any questions, please feel free to ask me. Once you have read and understood this statement, please sign and date. Thank you for choosing Virtuously Unveiled Christian Resource Center to meet your needs.
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Upon completion of the Virtuously Unveiled Christian Resource Center Biblical Counseling application and submission of this Biblical Counseling Fact Sheet, I will call you to schedule an Assessment. The purpose of this appointment is to evaluate your situation and needs, and to give recommendations, which could include: weekly counseling sessions and/or referral to another counseling organization. Necessary administrative processing will also take place. This includes an orientation to counseling, along with signing the necessary release forms.
A copy of your responses will be emailed to the address you provided.
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