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Disclosure Statement:

Cindy L. Gilbert, MSW, LICSW

CLIENT DISCLOSURE AND OFFICE POLICY STATEMENT

Experience and Licensure

I am a licensed independent clinical social worker in the state of Washington (LW60446228). I received my Master’s degree in Social Work from Loyola University Chicago and my Bachelor’s degree in Psychology from Edinboro University of Pennsylvania. 

Since 2008, I have worked as a therapist for adults with serious mental illness. My focus is on individual growth and healing work. I have training in working with survivors of many types of trauma. A few of my specialties include working with those struggling with anxiety, depression, trauma, life transitions, and LGBTQIA issues. From 2008 until 2010 I worked at Downtown Emergency Service Center as a clinician in the Adult Mental Health program. I worked with adults with co-occurring disorders at Therapeutic Health Services from 2013 to 2016 and currently work with veterans at Community Psychiatric Clinic.

 

Professional Practice and Orientation

My approach to counseling varies depending on clients’ individual needs. Once you have established what you wish to work on my approach may include, Cognitive Behavioral Therapy, Person Centered Therapy or Psychodynamic Therapy. I will work with you to set treatment goals and structure a plan to achieve those goals. Your initial intake will help me determine what approach to use based on the needs you report and the goals you want to achieve.

 

Fees, Cancellation Polices and Emergencies

I am a provider on most, but not all, insurance panels. If you are planning on using your insurance for mental health services, please verify that I am contracted with your plan prior to the first visit.

My rate for those paying full fee without insurance coverage is currently $145 for each fifty minute session.

If you must cancel or reschedule your appointment it is necessary to do so at least 24 hours in advance of your scheduled time. Missed appointments or late cancellation notices are billed at $100 an hour. Your insurance will not pay this fee.

Right to Refuse Treatment

You have the right to choose a counselor who best suits your needs and purposes. You have the right to refuse treatment. You are here by your own choice. It is your responsibility to decide the goals and the duration of our work together.

Confidentiality RCW 18.19.180

In general, whatever is said during your sessions is held as confidential unless you sign a release of information form allowing me to discuss our work together with another person (e.g. your physician, school counselor, previous therapist, etc.), or unless a judge orders me to release my records to the court. In the State of Washington, all clients age 13 and older are legally required to sign a release of information in order for mental health information to be shared.

There are a few exceptions to confidentiality standards:

1. It is legally required of me to act so as to prevent physical harm to others or to society when there is “clear and imminent” danger of that happening.

2. I am ethically bound to act to protect my client or others from harm.

3. I am ethically bound to report cases of ongoing child, elder, and disabled abuse.

4. I may have to release information regarding your treatment to insurance carriers as required for payment or review of your claim, e.g., Workman Compensation, Motor Vehicle Accidents, etc. Due to this, there are limitations to confidentiality, and the client will be asked to sign a release of information form for treatment.

5. I may have to release records when ordered to do so by court subpoena if any legal proceedings affect treatment. However, I will discuss the details of privilege beforehand and request a written release if we judge this to be in best interest.

6. I may use electronic transmission to send treatment plans, reports or evaluations to insurance companies, specific agencies or other providers.

 

In order to provide the best service possible, I may seek professional consultation on the dynamics and process of your case, if needed. If I discuss your situation in that context, I will not use information that would identify you personally.

If you have any questions about confidentiality, please do not hesitate to ask me.

 

Social Media Policy

Per industry standards, my personal social media presence and professional social media presence are separate. I will not accept a client as a friend on social media nor will I make such a request. I will not view your online activities (websites, blogs, Facebook, etc.) without your consent and without our explicit arrangement towards a specific purpose that will benefit our therapeutic contract.

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