PROFESSIONAL DISCLOSURE STATEMENT

I am a solo practitioner in private practice. I share offices and business resources with several other clinicians with whom I consult and, when indicated, I refer clients to these clinicians to better address their psychological needs. Please read the following information before selecting me as your therapist. This Disclosure Statement is designed to inform you of my private practice policies and professional credentials, types of services offered, fees, and my therapeutic orientation and style. Under the Confidentiality and Privacy link, it also contains information about the Health Insurance Portability and Accountability Act (HIPAA), a new federal law that provides privacy protections and client rights with regard to the use and disclosure of your Protected Health Information (PHI) used for the purpose of treatment, payment, and health care operations. HIPAA requires that I provide you with a Notice of Privacy Practices (the Notice) for use and disclosure of PHI for treatment, payment and health care operations. This Notice explains HIPAA and its application to your personal health information in greater detail. The law requires that I obtain your signature acknowledging that I have provided you with this information. Although these documents are long and sometimes complex, it is very important that you read them carefully. I encourage you to ask any questions that arise, either now or during the course of treatment. It is my goal to provide you with the highest quality of psychological services possible.

Training

Graduate The University of Tulsa, Clinical Psychology, Ph.D. (APA-accredited), 1996

Pre-Doctoral University of California-Irvine, Counseling Center (APA-accredited Internship in Clinical Psychology (1992-1993)

Professional Background

My professional experience includes: serving as a forensic clinical psychologist for the Department of State Hospitals in California, the Program Chair and Director of Clinical Training for the University of La Verne, Psy.D. program; Clinical Supervisor and Program Coordinator for doctoral psychology students proving therapy through the Claremont Unified School District and University of La Verne Collaborative; Clinical Psychologist for the California Correctional Institute in Tehachapi, CA; Mental Health Clinician for the Charles Drew University of Medicine and Science, Department of Psychiatry and SPECTRUM in Los Angeles, CA.; Clinical Post-Doctoral Fellow in HIV Mental Health at Harbor-UCLA Medical Center, Torrance in CA.; and Consultant for the Claremont Unified School District’s Implementing and evaluating Response to Intervention (RTI) Program in Elementary Schools

Professional Organizations

American Psychological Association, Member (Divisions 27, 44, 45, & 51)

California Psychological Association, Member (Division 1)

Clientele served and Therapy Philosophy / Approach

I provide psychological assessment for diagnostic and educational purposes and psychotherapy for individuals experiencing anxiety and mood disorders, others grappling with gender issues ,or those adjusting to the many ways of being masculine. In addition, I provide individual and group therapy for persons seeking help related to the lived-experience of AIDS/HIV, gay/lesbian/bisexual/transgender/queer identities, minority status, sexual abuse and PTSD, masculinity, and gender issues.

I view therapy as a collaborative experience and a safe place where self-discovery, learning, and healing takes place. To help you, I need to get to know you and to understand your feelings and experiences as much as possible. The key to effective therapy is providing a safe place where you can explore your thoughts, feelings, and behaviors in a positive and non-judgmental atmosphere. I will listen to you, help you clarify your thoughts and feelings, and help you to begin to gain a better understanding of yourself. We will select goals or objectives together that will help you become the person you want or experience the relief you seek.

I take a holistic (systems/ecological) perspective to treatment. I use an eclectic approach of blending mindfulness, cognitive-behavioral, developmental, and narrative therapies. These perspectives appreciate that significant events and relationships help shape our lives. Often times, how we feel about ourselves, others, and situations has a lot to do with the stories of our lives and problems that are manufactured in social, cultural and political contexts. Each person produces the meaning of their life from the stories that are available in these contexts. I collaborate with clients to create alternate stories that creatively solve their problems and increase your understanding, satisfaction, and fulfillment in life. As a result, I am very committed to understanding and incorporating cultural aspects of your life and our work together into treatment. There is significant evidence that culture influences treatment outcomes, so it is important that we discuss those matters as they arise in addition to cultural differences and how they may influence treatment.

When trauma occurs, the brain stores the memory of the trauma differently than it does for everyday experiences. The original sights, sounds, emotions, and body sensations are stored frozen as when as the trauma first occurred. These phenomena explain why people can become triggered by something in the environment today and react like as if they were experiencing the trauma again. I teach clients to be mindful of what they are experiencing in their body to help them process the trauma. I use meditation and narrative therapy as effective strategies to help people who have experienced traumatic events.

Treatments Delivered

The psychological services that I provide includes: conducting complete psychological and educational evaluations; providing individual and group psychotherapy to survivors of sexual and physical trauma; providing individual therapy to individuals grappling with their gender identity and males exploring masculinity issues; providing psychological services including individual, group, and family psychotherapy and assessment to individuals and families infected with or affected by HIV disease; providing individual and group therapy to gay, lesbian, bisexual, transgender, and questioning individuals; providing individual and group therapy for individuals experiencing anxiety and mood disorders; and providing crisis intervention, individual and group psychotherapy, treatment planning and pre-release planning for prison inmates and judicially committed male adults. The Theoretical Foundations of my psychological practice draw from three evidenced-based frameworks; mindfulness (holistic, ecological, systemic), cognitive-behavioral psychology, and the narrative paradigm.

Appointments and Fees

Individual sessions are 50 minutes. If you are unable to keep an appointment please give at least 48 hour notice to avoid charges. The full session fee will be charged if no notice is given within 48 hours prior to the appointment. My fees are $150.00 an hour paid either by check, cash, or VISA/MasterCard /American Express/Discover at the time of your session. I accept most insurance, and take care of all paperwork. If you use insurance, you are responsible for paying deductibles and co-payments at the time of the session. While I can help you get pre-authorization for services and bill your insurance company, this does not guarantee payment. You are fully responsible for payment of fees and will be billed for any amount not accepted by your insurance carrier. Please check with your specific insurance plan. Health insurance companies require that a statement of diagnosis of a mental health condition be indicated before they will agree to reimburse for therapy services. Any diagnosis made will become part of your permanent insurance records. If you do not have health insurance, I am flexible with payment arrangements.

Returned checks are assessed a $25.00 handling fee. Accounts not paid in full after 90 days may be sent to a collections agency.

If you need me to write a letter, conduct a psychological evaluation, or write a psychological report on your behalf the charge will be discussed with you depending upon what materials are needed and time involved. Letters to the court on your behalf cost $150.00.

Contact and Emergencies

If you need to reach me at any time, you may contact me at (916) 914-5520. You can leave a confidential voice-mail message which I check often. During non-office hours, calls will be returned by the next regular business day. If you are having an emergency and cannot reach me call 911 or go to the nearest hospital emergency room.

Confidentiality

As a professional, I abide by the laws and ethical principles that govern client privilege and confidentiality. I will not disclose to anyone anything you tell me, not even the fact that I saw you, without your specific written permission using a signed Release of Information form. In the interest of safety, state and federal laws list the following exceptions to this standard:

1. It is legally required that I act to prevent physical harm to yourself or others when there is a “clear and imminent” danger of that happening. I will do whatever is necessary to preserve life including but not limited to seeking medical care or requesting police assistance.

2. I am required to report cases of abuse of a child, elderly, or disabled person.

3. If you are requesting to use insurance, I may be required to release clinical information regarding your treatment including a diagnosis and evidence of treatment to your insurance carriers as required for payment or review of your claim.

4. I may have to release records when ordered by a court order. A court order is not just a subpoena, but an order from a judge. If you anticipate being involved in legal proceedings please inform me when we begin therapy so that I may explain how this may impact your confidentiality.

5. In a medical emergency.

Record Keeping

A clinical chart is maintained describing your condition and your treatment and progress in treatment, dates of and fees for sessions, and notes describing each therapy session. Your records will not be released without your written consent, unless in those situations as outlined in the Confidentiality section above. Medical records are locked and kept on site.

Complaint Procedures

If you are dissatisfied with any aspect of the therapy process, please inform me so we can determine if our work together can be more effective or whether a referral would be appropriate. If you think I have treated you unfairly or unethically, and we cannot resolve the problem, contact:

Missouri Committee for Professional Psychologists

3605 Missouri Boulevard

P.O. Box 1335

Jefferson City, MO 65102-1335

573.751.0099 Telephone

573.526.0661 Fax

I encourage you to discuss any questions or concerns you have about entering into a therapeutic relationship with me.