Disclosure Statement of Seattle Counselor, Stefan Schlesinger, MA

Stefan Schlesinger, MA, LMHC

8401 5th Ave NE, Suite 103
Seattle WA 98115
206-522-8700;
206- 526-0444
State Licensed Mental Health Counselor #LH 00004067

As a Washington state Licensed Mental Health Counselor, holding a Master of Arts degree in Applied Behavioral Science, the Washington State Department of Health requires that I maintain records and provide disclosure information to clients as follows, and that counselors make the following statement to clients:

Counselors practicing counseling for a fee must be registered or certified with the department of health for the protection of public health and safety. Registration of any individual with the department does not include a recognition of any practice standards, nor necessarily imply the effectiveness of any treatment.

The State of Washington also requires that I inform you that “the purpose of the counselor credentialing act, the law regulating counselors is (A) to provide protection for public health and safety; and (B) to empower the citizens of this state of Washington by providing a complaint process against those counselors who would commit acts of unprofessional conduct.” As a counseling client you have the right to choose counselors who best suit your needs and purposes. The first session is an opportunity for both client and counselor to evaluate whether or not this particular professional relationship is right for each party.

Method of Counseling

My counseling approach is based on a humanistic model, and is primarily influenced by Re- Evaluation Counseling, Process Oriented Psychology, Family systems. Other influences include 12 steps programs, Client Centered Therapy.

Fees and cancellation of appointments

My work includes individual, couple, family and group therapy. Sessions are one hour long. A telephone session is fifty minutes. No fee will be charge for short telephone consults and questions. For sessions held at my office, I offer a one time free one hour initial consolation.

For a session conducted over the telephone, I offer a one time free initial consolation up to fifty-minutes. My fee is $120 per individual, couple or family session. I realize that not everyone can afford $120 per session. In an attempt to make counseling accessible to most people, I offer discounts. We can discuss this at your free initial consolation. Payment expected at the time of service. You may pay by check, cash, or Pay Pal.

Please understand that when you make an appointment, I am reserving that time for you. If you are late, there may or may not be a possibility of extending your session to give you your full-time. If you miss an appointment, that is time that could be spent with another client, therefore it is necessary for me to charge for missed appointments. There will be no charge if notice is given 24-hour before the session. Or if you are ill or in an emergency.

Confidentiality and legal situations

I hold confidentiality as an essential aspect of the work we do together. I cannot and will not disclose any information from your sessions, with the following exceptions:

1. the client provides written consent in the form of a signed release of information
2. the client is a minor, and is the victim of a crime
3. the information concerns certain crimes or harmful acts
4. the client brings charges against the counselor
5. the counselor receives a subpoena to provide the information
6. the counselor has reasonable cause to believe that a crime has been committed against a child or dependent adult by the client or anyone else

The law does not require that counselors make a report when an adult discloses he or she was abused as a child, except possibly in cases where there is a minor still living with the person who committed the abuse. If you have any questions about reporting requirements, ask your counselor, or contact child protective services.

Occasionally, I confer with other professional therapists about my work as a therapist. In these instances I do not reveal the identity of my clients, and in no way is your confidentiality ever compromised.

I do not go to court for any situation. If you need that kind of intervention, I will attempt to refer you to the appropriate professionals whenever possible.

Record Keeping

Washington state law requires that counselors document services rendered with the following information, except as below*:

1. client name
2. fee arrangement and payment record
3. date(s) service rendered
4. disclosure form signed by counselor and client
5. presenting problem
6. information about client from sessions or through release of information
7. progress notes sufficient to support responsible clinical practice for counselors approach

*Clients may request that no treatment records be kept, except numbers 1 through 4, above, and the written request. This is my preface to protect confidentiality of the client.

For more information about client and counselor rights and responsibilities, confidentiality, an assurance of professional conduct, please refer to the enclosed Washington State Department of Health's brochure for counseling clients. Disclosure statement based on chapter 246 – 810 WAC, Counselors, and draft revisions 1/16/97, and will be updated as necessary.

Please note the therapys mentioned on this site do NOT involve the use of Hypnotherapy. Click here to read the Washington State Department of Health's brochure for counseling clients. The above text is reprinted from the Washington State Department of Health's brochure for counseling clients.