Beginning therapy is an important decision. The purpose of this document is to provide information about my background, the therapy process, confidentiality, policies, and your rights as a client. Please read this information carefully and ask any questions you may have before beginning services.
Therapy is intended to help you develop insight, skills, and strategies that support meaningful change and improved well-being. My role as a therapist is to support you in building the tools and understanding necessary to move forward independently and confidently in your life.
Therapy is a collaborative process and requires active participation from both the therapist and the client. While therapy can be very helpful, progress and outcomes vary depending on the individual and the concerns being addressed.
If at any time you feel that therapy is no longer beneficial or you wish to discontinue services, please let me know. It is understandable that not every therapist-client relationship is the right fit.
Standard individual, couples, and family therapy sessions are approximately 45 minutes.
IDENTIFYING INFORMATION
Lindsay Powelson, MA, LPC, LCPC, NCC, CCTP-II, CSTIP
Licensed Professional Counselor – Missouri (#2004024728)
Licensed Clinical Professional Counselor – Kansas (#03464)
Master of Arts in Professional Counseling – Lindenwood University, 2004
National Board Certified Counselor (NCC)
Certified Clinical Trauma Professional Level II (CCTP-II)
Certified Sex Therapy Informed Professional (CSTIP)
Certified in Dialectical Behavior Therapy (C-DBT)
Certified in Personality Disorders (C-PD)
Clinical experience includes work with trauma, mood disorders, grief, disordered eating, relationship challenges, sexual intimacy concerns, gender identity support, family systems, adoption and foster care systems, infertility, and LGBTQIA+ affirming care.
CONFIDENTIALITY
Information shared during therapy is confidential and protected by law. However, there are certain legal exceptions where confidentiality must be broken.
These include:
• Situations involving suspected abuse or neglect of a child, elder, or vulnerable adult
• Situations where there is a serious risk of harm to yourself or others
• Court orders requiring disclosure of records
• When you provide written authorization for release of information
• When consultation or supervision is needed to support treatment
If concerns arise regarding your safety or the safety of others, emergency contacts or appropriate authorities may be contacted when necessary.
Before your first session you will be asked to provide identifying information including:
Full name
Date of birth
Address
Phone number
Emergency contact
Primary care physician information
A copy of a valid photo ID
TELEHEALTH SERVICES
All services are provided through secure telehealth platforms.
While telehealth offers convenience and accessibility, there are some potential risks including:
• Technology failures or interruptions
• Unauthorized access to communications if someone has access to your device
• Potential data breaches despite secure platforms
If telehealth is determined to be inappropriate for your needs, referrals for alternative services will be provided.
Sessions are conducted through secure HIPAA-compliant platforms.
EMERGENCY SITUATIONS
Services provided through Mindful Solutions Behavioral Counseling LLC are not designed for emergency or crisis situations.
If you are experiencing a mental health emergency, please call 911 or go to your nearest emergency department.
If you believe you may need urgent mental health services or a higher level of care, appropriate referrals will be provided.
Communication between sessions is limited primarily to scheduling matters.
APPOINTMENT POLICY
Appointments are scheduled in advance and begin at the agreed-upon time.
If you need to cancel or reschedule, please provide at least 24 hours notice whenever possible.
Missed appointments are defined as:
• Not attending a scheduled session
• Cancelling with less than 24 hours notice
The first missed appointment will result in a $75 fee.
The second missed appointment will be billed at the full session rate.
After three consecutive missed appointments, future scheduling may no longer be available.
Sessions will be held for up to 10 minutes after the scheduled start time before being considered a missed appointment.
SUBSTANCE USE
Clients are expected to attend sessions free from the influence of alcohol or drugs. If it is determined that a client is intoxicated during a session, the session will be rescheduled and may be considered a missed appointment.
COORDINATION OF CARE
With your consent, it may be beneficial to coordinate care with your primary care physician or other healthcare providers.
FINANCIAL RESPONSIBILITY
Sessions may be billed through insurance when applicable. Any fees for services not covered by insurance are the responsibility of the client.
Letters requested for work, court, custody, or other documentation may be declined at the therapist's discretion. If a letter is agreed to be written, the fee is $125 and must be paid out-of-pocket.
COURT INVOLVEMENT
Mindful Solutions Behavioral Counseling LLC does not provide court testimony or legal opinions regarding custody, parental fitness, or visitation.
If a subpoena or legal request for records or testimony is received, a non-refundable retainer of $3,500 will be required for services related to court involvement. These services include record preparation, court appearances, affidavits, travel time, and consultation.
Court-related services are not billable through insurance.
PROFESSIONAL RECORDS
Your clinical record may include information such as:
• Reasons for seeking therapy
• Treatment goals and progress
• Medical and social history
• Prior treatment history
• Billing records
• Consultation notes
You may request access to your clinical records in writing. In certain situations where disclosure may cause harm, records may be reviewed with a therapist present or through another mental health professional.
Psychotherapy notes used by the therapist for personal clinical use are kept separate from the clinical record and are not released.
PATIENT RIGHTS
You have the right to:
• Request amendments to your clinical record
• Request restrictions on certain disclosures
• Request an accounting of disclosures
• Receive a copy of privacy practices
• File complaints regarding privacy practices
Mindful Solutions Behavioral Counseling LLC does not discriminate based on race, ethnicity, gender, sexual orientation, religion, disability, or national origin.
SOCIAL MEDIA POLICY
To protect your confidentiality and avoid dual relationships, I do not accept friend or contact requests from current or former clients on social media platforms.
TERMINATION OF THERAPY
Ending therapy is a collaborative process. If therapy ends for any reason, referrals to other qualified providers can be provided upon request.
CLIENT AGREEMENT
By signing the consent form, you acknowledge that:
• You understand the nature of therapy services
• You have reviewed the policies outlined in this document
• You understand confidentiality and its limitations
• You agree to the financial and appointment policies
• You understand the risks and benefits of telehealth services
Contact Mindful Solutions Behavioral Counseling LLC