Welcome to Healing Powers of Therapy, PLLC! I am so glad you are here. This document contains important information about my professional services and business policies. WAC 246-809-710 requires the disclosure of the following information in written form by counselors to their clients. When you sign this document, it will represent an agreement between us. If you have any questions, please let me know and I am happy to answer them.

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I have partnered with Mindful Therapy Group for administrative services. If you have questions about scheduling, billing, or technology issues, please contact: frontdesk@mindfulsupportservices.com | (425) 640-7009 7am-7pm Monday-Friday; 8am-4pm Saturday-Sunday.

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Qualifications and License 

My Washington State Department of Health Independent Clinical Social Work License number is SC61097791. My National Provider Identification is 1306577523. I have a Master of Social Work (MSW) degree from University of Washington (2020), a Doctorate of Philosophy (Ph.D.) in Higher Education Leadership from Old Dominion University (2012), a Master of Arts degree in International Relations from University of Oklahoma (2007), as well as a Bachelor of Arts degree in Military History (with minors in Leadership and Womens Studies) from Virginia Tech (2004). I am also a member of the National Association of Social Workers and the American Counseling Association. 

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I am a veteran and I have worked with veterans. Post-military, I have worked in academia, social services, mental health, and counseling fields for 15 years. During this time, I have been in administrative, professor, facilitator, case manager, and counselor roles for individuals with post-traumatic stress disorder, traumatic brain injury, military sexual trauma, complex trauma, eating disorders, depression, anxiety, transitional issues, and more. I have worked in community, academic, emergency, and outpatient treatment settings. In addition to this professional experience, I participate in continuing education as part of my ongoing professional development.

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Therapeutic Services

I provide counseling for adults with a wide range of emotional and behavioral health issues, including PTSD, TBIs, MST, depression, anxiety, transitional issues, adjustment issues and more. The way I help you heal from the issues you are facing is through person-centered and integrated evidence-based practices. Along with these therapeutic approaches, I provide a client-centered space for you to share your struggles with empathy and without judgment. Together, we can start to recognize how other people and events in your environment and culture affect these issues, the way you are coping with these issues, and the way you think about these issues. 

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Person-centered counseling is a treatment approach that emphasizes the importance of empathy, unconditional positive regard for others, and congruence in the therapeutic relationship. Through these therapeutic aspects, a therapeutic relationship can become stronger and more powerful, and ultimately help you achieve your goals and effect change. Person-centered therapy comes from the humanistic psychology movement, which places clients at the center of treatment and views clients as experts in their own lives.

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Course of Treatment 

You have taken an incredibly positive step by deciding to seek therapy. Therapy can help transform your life and the way you navigate the world. The outcome of therapy often depends on your willingness to engage in this process, despite the discomfort that may occur when strong emotions arise. My goal is for your individual counseling experience to be a rewarding and compassionate experience. It will be an interactive process that improves the quality of your life, helps you attain your counseling goals, and increases your sense of well-being. To maximize the benefits of therapy and achieve your counseling goals, I suggest that clients schedule to see me consistently and weekly, although sometimes sessions will be more or less frequent as needed.

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Although I wish I could guarantee a quick and easy fix to your problems, I cannot. What I can guarantee is that I will support you, advocate for your needs, and do my best to understand you and your world. I can also help you clarify what you want for yourself as you work toward your desired changes.

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The goals of therapy are personalized to you. Oftentimes, goals are long-term, such as improving the quality of your life and increasing your sense of well-being. Other times, goals are short-term, such as reducing anxiety and depression symptoms, developing healthy relationships, or changing other behaviors. No matter what your counseling goals are, we can develop them and strategize how to work towards them together. I might make suggestions about how to reach your goals, but you ultimately decide your course of action.

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Firstly, therapy begins with an intake assessment and evaluation. It is my practice to conduct an assessment that typically lasts for the first 3-4 sessions. This assessment allows me to gain a detailed, thorough understanding of the issues that brought you into therapy, important aspects of your mental health, family and relationships, life history, and other factors that influence you and why you are seeking counseling. The assessment also provides time for you to decide if I am a good fit for you and for me to determine whether I am the best provider to meet your needs. At the end of your assessment, should you decide that you would like to continue working with me, we will collaborate to define your goals for therapy, and I will establish a treatment plan detailing how we will achieve your goals.

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Secondly, therapy will involve a commitment of time, energy, and money, so it is your right to be thoughtful about the therapist who you select. If you have questions about any of the interventions that I recommend, feel free to discuss these openly with me. Be aware that you have the right to refuse treatment and the right to choose a provider and treatment modality that best suits your needs. I will be happy to help you find another mental health provider should you want this.

 

Thirdly, termination of therapy will ideally occur when both you and I agree that you have met your goals for therapy. Termination may also occur, after appropriate discussion, if either you or I believe that progress is not being made, therapy is not being used effectively, or if you are in default on payment. Termination and referral to another provider may be made if you or I believe that you need a higher level of care or a more specialized type of treatment than what I can provide. I will not terminate the therapeutic relationship without first attempting to discuss and explore with you the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I can provide you with a list of qualified therapists to treat you. You may also choose someone on your own or from another referral source.

 

Risks and Benefits of Therapy

Naturally, therapy might feel uncomfortable. You may choose to discuss issues that are uncomfortable to visit or try new strategies and coping skills that are different from what you have been implementing. New ways of managing your life can feel scary and out of your comfort zone. However, if you are not happy with how your life currently is, then trying new coping skills, gaining insights through therapy, and changing certain aspects of your life and your behavior may have benefits. There are no guarantees that counseling will work for you, but keep in mind that progress often happens slowly and is not linear. 

With that said, the intention of my therapeutic methods is to improve your well-being. Through counseling, we can develop new coping skills, make behavioral changes, reduce symptoms of behavioral health disorders, improve the quality of your life, learn how to manage difficult emotions, learn to live in the present, and many more benefits. Together, we can maximize those benefits of therapy and apply those benefits to your life. Although, if you are experiencing physical pain or discomfort, I recommend you see a medical provider. Therapy sessions are not a replacement for medical treatment.

 

Telehealth Informed Consent 

Since my counseling services are telehealth-only, technology will be part of your counseling experience. Telehealth is the practice of delivering clinical health care services via technology-assisted media or other electronic means between a practitioner and a client who are located in two different locations. Telehealth, like counseling, comes with risks and benefits. Due to the nature of telehealth, there is always the possibility that unauthorized people may attempt to obtain your personal information.

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I will take every precaution to safeguard your information (e.g., HIPAA-compliant electronic communication, encrypted and HIPAA-compliant electronic health record, etc.) but cannot guarantee that unauthorized access to electronic communications will not occur. Please be advised to take precautions regarding authorized and unauthorized access to any technology used in counseling sessions. Be aware of any friends, family members, significant others, or coworkers who may have access to your computer, phone, or other technology used in your counseling sessions. You are responsible for choosing a location that is private for your telehealth counseling appointments, such as an unoccupied office or bedroom, empty parked car, or other unoccupied area. Furthermore, you are responsible for not driving or engaging in unsafe activity during your telehealth appointment. If you are unable to find a private location at the time of your appointment, or unable to refrain from engaging in unsafe activity during your appointment, I may need to cancel your session (resulting in a late-cancel fee).

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While there are risks, telehealth has many benefits, including improved access to care, convenience of meeting from a location of your choice (within Washington State), and the absence of travel or commute time. We can further discuss the benefits and risks of telehealth which may be personalized to you. By signing this document, you consent to participating in telehealth services. Please feel free to bring up questions or concerns about telehealth.

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Communication and Emergencies

If you need to contact me between sessions, please call or text (206) 337-9080 or email info@healingpowersoftherapy.com. I will return calls, texts, and messages within 48 business hours. Please note, however, that face-to-face sessions are often the most appropriate place for in-depth conversations, and I may encourage that we resume our conversation during our next scheduled session. Because I am not immediately available between sessions, I encourage you to contact the following crisis lines in the event of a mental or behavioral health crisis: 

King County 24-Hour Crisis Line: 1-866-4CRISIS 
National Suicide Prevention Lifeline: 800-273-8255
Crisis Text Line: Text HOME to 741-741 
If an emergency arises, please call 911 or visit your local emergency room.

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Notice of Privacy Practices

Session content, medical records, and all relevant materials to your treatment will be held confidential by me, apart from a few exceptions. These exceptions include: 

1. If you sign a release of information to have your session content released to a specific named person/people. 
2. For the purpose of coordinating care, referrals, and/or crisis response between me and a qualified provider responsible for your care. 
3. If the client is under 13 years of age, their parents have a right to their mental health treatment information. 
4. If I assess that you pose imminent threat to your own health or safety, such as threatening suicide or behaving in a manner in which there is a substantial risk of incurring serious harm. 
5. If you threaten or pose the risk of grave bodily harm or death to another person. 
6. If I have reasonable suspicion that you or another named victim is the perpetrator, observer, or actual victim of physical, emotional, or sexual abuse of children under the age of 18 years. 
7. Suspicions, as stated above, in the case of a vulnerable adult who may be subject to these abuses. 
8. Suspected neglect of children or vulnerable adults. 
9. If a court of law issues a legitimate subpoena for information stated on the subpoena. 
10. If you are in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert’s report to an attorney. 
11. If I use clerical assistants or billers who process your information and paperwork (Mindful Therapy Group processes your information for billing). 

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Due to the importance of your confidentiality and the issue of dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site. Although I appreciate therapeutic relationships, adding clients as friends or contacts can compromise our respective privacy and blur the boundaries of our therapeutic relationship. If you have questions or concerns, please feel free to bring them up when we meet. 

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As we will use electronic communication to exchange information, please know that I use Google Suite, a HIPAA-secure email platform with a Business Associate’s Agreement. I also use a phone.com plan that is HIPAA compliant under a Business Associate's Agreement. I also use AdvancedMD, a HIPAA-compliant electronic health record system, through Mindful Therapy Group. You have a right to request a copy of your medical records at any time, which should be provided within 15 working days of receiving the request (RCW 70.02.080).

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Client Rights and Responsibilities 

You have the right to refuse treatment and the right to choose a practitioner and treatment modality that best suits your needs. At the same time, if I feel your needs will be best met by another provider, I will make the appropriate referrals for you to receive better care elsewhere. 

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You also have a right to direct any complaints or concerns to the Department of Health. Additionally, you have the right to obtain a list or copy of acts of unprofessional conduct listed under RCW 18.130.180. The Department of Health may be contacted at: 

Health Systems Quality Assurance Complaint Intake 
(360) 236-4700 
HSQAComplaintIntake@doh.wa.gov  
P.O. Box 47857 
Olympia, WA 98504-7857

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Financial Responsibilities

Counseling services are an investment, both financially and emotionally, in your mental health and well-being. I make a time commitment exclusively for the therapeutic relationship. With that in mind, please note the following financial considerations. 

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Counseling sessions are 55 minutes long. My rate is $200 per counseling session. Payment is due in full at each session. If you would like to receive a statement for your co-insurance, rather than paying at the time of service, Mindful Therapy Group will do so at your request. You will be billed for any remaining balance. At this time, I accept Aetna, Cigna, Kaiser, Optum/United, PacificSource, Premera, and Regence/BCBS. Please check with your insurance company to verify your benefits.

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If you miss a session without cancelling, or cancel with less than 24 hours’ notice, you may be required to pay the late or canceled session fee of $100 (unless we both agree that you were unable to attend due to circumstances beyond your control). It is important to note that insurance companies do not provide reimbursement for canceled sessions, and you will be responsible for the cancellation fee. In addition, if you are late, your appointment will still need to end on time. If you are more than 15 minutes late, we will reschedule your appointment and you will be responsible for the cancellation fee. Please be advised that if you cancel two appointments without rescheduling, or have not attended an appointment within 60 days, I may close your file and you may resume services when you are ready. 

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Unpaid balances of $100 or greater will be turned over to a third-party collections agency after 120 days. Mindful Therapy Group will take care to preserve your privacy during this process, but your credit may be negatively affected. Mindful Therapy Group will assist in collections efforts and communicate with you by phone, email, and mail to resolve your balance. You can contact Mindful Therapy Group directly for issues with billing and financial responsibilities.

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“I authorize my provider, Samantha Powers, and Mindful Therapy Group to release information to the insurance carrier(s) listed and be paid directly by the insurance carrier(s) for services billed. I acknowledge that I am responsible for all charges not paid by my insurance companies, including copays, co-insurance, deductibles, insurance plan refusal to pay for failure to obtain authorization, and missed and late cancellation fees. If it becomes necessary to effect collections of any amount owed, the undersigned agrees to pay all costs and expenses, including reasonable attorney fees.

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My signature below is acknowledgement that I am the client or person authorized to consent for mental health treatment for the client and consent to services provided by Samantha Powers, that I have read and understand the disclosure information, and have received a copy of this disclosure form.”