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Chariti Ministries at Windsor Chapel
Informed Consent for Counseling Services
Please read this document carefully. It provides important information regarding our counseling relationship. If you have any questions or concerns at any time, please discuss them with me.
The Counseling Relationship
The counseling services offered by Chariti Ministries at Windsor Chapel are Christ-focused and Biblically-based. At the heart of this counseling is relationship: counselee and counselor come together before the Lord in order to bring health, wholeness, and strength. A foundational truth in Christian counseling is that healing and change can be accomplished only by the Lord through the work of His Word and the Holy Spirit. The role of the counselor, then, is to provide truth and encouragement so that the client can in turn promote the work of the Holy Spirit. Because our God is a God of abundance, both client and counselor experience growth and blessing.
Ethics
It is my responsibility to maintain the strictest confidentiality of any information you may share with me. There are circumstances, though, that limit this confidentiality:
- If I believe there is a significant possibility of your harming yourself or someone else.
- If you disclose the abuse or neglect of a child, elderly, or disabled person.
- If you authorize me to release records.
- If counseling records are required by a court of law or I am legally obligated to disclose them.
If I find it necessary to disclose any information, I will inform you of this in advance unless I believe that an emergency situation may exist.
Marital counseling raises additional confidentiality issues. It must be understood that any information shared in joint sessions may discussed in individual sessions, and information shared in individual sessions may be shared in joint sessions, at my discretion.
I am a member in good standing of the American Association of Christian Counselors (AACC). I am certified as a Biblical Christian Counselor by the Board of Christian Professional and Pastoral Counseling (the accrediting arm of the AACC). A copy of the ethical standards of the AACC is available upon request. I counsel under the authority of Windsor Chapel and remain accountable to its Pastor and Elders.
Risks of Counseling
It is my heart’s desire that my clients experience the abundant redemption that God delights to offer us. Redemption means that the Lord redeems, or buys back, our bondage to sin and its devastation. It is the outworking of Romans 8:28—“And we know that God causes all things to work together for good to those who love God, to those who are called according to His purpose.” While that is my desire for each client, there is no guarantee that you will see the changes you desire. The counseling process may reveal truths about yourself that you do not like. Growth and change often require confronting painful issues, recognition of loss and sin, grieving, forgiveness, and repentance. Indeed, there is often short-term pain to achieve long-term gain.
Your attendance at our counseling sessions is entirely your choice; the choices you make are entirely your own: you are free to accept or reject my advice, suggestions, etc. whenever they conflict with your own convictions. Either of us may elect to end the counseling relationship at any time. If I believe that it is not in your best interest to continue our counseling relationship, I will inform you of that and help you find another counselor if you wish.
You are never obligated to continue, and if you do not believe that counseling is helping you, please seek help elsewhere. I will be happy to help you find another counselor if you reach that point. I do ask, though, that you give our counseling your sincerest commitment and best effort; an ambivalent attitude is not likely to lead to success.
Qualifications and Licensing
It must be made very clear that I am a Christian counselor. I have a Master’s degree in Christian Counseling, and I have been certified by the Board of Christian Professional and Pastoral Counselors as a Christian Counselor. However, this certification is not recognized by the State of New Jersey. I am not a medical doctor, and I am not licensed as a therapist, counselor, psychologist, psychiatrist, social worker, or mental health professional. Since God has created us as whole creatures, it is not always possible to clearly distinguish the spiritual component of our lives from the mental and biological. Therefore, it may become necessary to enlist the help of another mental health professional in addition to or in place of our counseling. I will be happy to provide referrals to medical doctors or licensed mental health professionals should you request them. It is not only appropriate but wise to take advantage of all resources that the Lord provides, including medical and secular resources. The counseling I provide is designed to support, not replace, services from other providers. Please do not discontinue treatment or medication without first consulting the appropriate clinician.
Appointments
Appointments must be made with me in advance. I am happy to maintain flexibility, but I appreciate timely communication to the degree it is possible. Please do not assume that I have received a message if I have not confirmed with you. Appointments are generally an hour long and are usually scheduled on a weekly or bi-weekly basis.
Fees
Although my work is fundamentally a ministry, it requires financial support in order to exist.
If you regularly attend Windsor Chapel: There is no required fee for those who regularly attend Windsor Chapel.
If you do not regularly attend Windsor Chapel: For those clients who do not attend Windsor Chapel, a fee of $60.00 per session payable to Windsor Chapel is requested. Insurance is not accepted, but if the co-pay under your insurance policy for counseling services would have been less than $60.00, the fee will be reduced to the co-pay amount. Please do not let finances prevent you from coming to counseling. The fee will be reduced by as much as 50% in cases of financial hardship; please discuss it with me. The minimum fee is $30.00 per session. FEES ARE NOT TAX DEDUCTIBLE.
Voluntary Donations: Anyone who would like to support this counseling ministry may do so by making a voluntary donation. Donations may be given to me, placed anonymously in the box in the counseling office, or given to Windsor Chapel with a notation that the gift is to be used for the counseling ministry. Checks should be made out to Windsor Chapel.
Dispute Resolution
The parties to this agreement agree to resolve disputes with each other in private or within the Christian church (see Matthew 18:15-20; 1 Corinthians 6:1-8). Therefore, the parties agree that any claim or dispute arising from or related to this agreement shall be settled by biblically-based mediation and, if necessary, legally binding arbitration in accordance with the Rules of Procedure for Christian Conciliation of the Institute for Christian Conciliation, a division of Peacemaker® Ministries. Judgment upon an arbitration decision may be entered in any court otherwise having jurisdiction. The parties understand that these methods shall be the sole remedy for any controversy or claim arising out of this agreement and expressly waive their right to file a lawsuit in any civil court against one another for such disputes, except to enforce an arbitration decision.
