DISCLOSURE STATEMENT 

PATRICK C. GERACIE Trinity Counseling
2400 Donovan Ave. #43 Bellingham, WA. 98227 360-715-3230 

TRAINING AND PROFESSIONAL BACKGROUND

I am a licensed mental health counselor in the state of Washington (# LH00008435), a national certified counselor (57828) and a Board Certified Christian Counselor. I received my Bachelor of Arts degree in biblical studies and general education at Oak Hills Christian College in Bemidji, Minnesota. I received my Master of Arts degree in counseling psychology from Western Evangelical Seminary (now George Fox Evangelical Seminary) in Portland, Oregon. I also hold a master of divinity degree and a Master of Arts degree in exegetical theology from Western Seminary in Portland, Oregon. I have been working as a clinician since 1993 providing individual, marriage, family and group counseling in a variety of settings. I am a member of the American Association of Christian Counselors and abide by its’ code of ethics.

THEORETICAL ORIENTATION AND APPROACH TO COUNSELING

As a Christian counselor I believe that real change takes place as people understand and appropriate the grace of God in their lives. I try to facilitate this by promoting a better understanding of God’s word and a deeper appreciation for God’s community. In doing this I will try to assess and ameliorate those issues that may be standing in the way of progressing Christian maturity. This process will include prayer and Bible study but may also include family systems work, cognitive- behavioral methods and psycho-educational approaches. I stay abreast of the latest Christian and secular counseling research and will use new techniques and approaches if I find them to be Biblically sound and effective in promoting real change.

FEE STRUCTURE

I charge $175.00 per 60 minute session. Fees may be adjusted for those experiencing financial difficulties.

CLIENT RIGHTS & CONFIDENTIALITY

It is appropriate for clients to raise questions about the counselor, the therapeutic approach, and progress. As informed consumers, it is the client’s responsibility to choose the counselor and modality that best suits his/her needs. Clients have the right to request a change of counseling approach, a referral to another counselor, or termination at any time.

Confidentiality is an important part of the therapy process. Your identity and ongoing work in therapy will be kept strictly confidential with the following exceptions:

State law requires suspected abuse (physical or sexual) and/or neglect to be reported to the appropriate authorities.

Threat of harm to self or others may be reported to family and/or appropriate mental health or law enforcement professionals.

Case records and testimony may be subpoenaed by court order. When insurance coverage is requested, a billing form containing the diagnosis, dates of service and type of service is sent to the billing service and the insurer. They may also request information about presenting problems and symptoms, treatment plan, indication of progress and outcome of therapy.

The Uniform Health Care Information Act, Section 501, requires health care providers to present the following statement of information practices: “We keep a record of the services we provide you. You may ask to see and copy that record. You may also ask to correct that record. We will not disclose your record to others unless you direct us to do so or unless the law authorizes or compels us to.”

PERSONS TO NOTIFY OF CONCERNS ABOUT YOUR THERAPY

Department of Health
Health Professions Quality Assurance Division Counselor Registration/ Certification
PO Box 47869
Olympia, WA 98504-7869
(360) 236-4903

IN CASE OF EMERGENCY

In case of a mental health emergency, contact the VOA Care Crisis Line at 988.



CONSENT FOR TREATMENT

I have read the above statements and I am requesting to be involved in counseling services at Trinity Counseling I understand the initial session will be used to determine whether ongoing sessions will be necessary and appropriate and that I have the right to cancel services at anytime during the counseling process. I understand that if I choose to use insurance it is my responsibility to verify insurance coverage and I will pay any fees not covered.