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Just Mind 2019 Disclosure Agreement
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Declaration of Practices and Procedures for Just Mind

We are pleased that you have chosen Just Mind to fulfill your counseling needs. This document gives you the answers to questions that people often have when entering a counseling relationship. Please discuss with us any questions or concerns you have about this information.


Counseling Relationship

We respect the uniqueness of each individual and this is a core of our beliefs. We work to help build an environment based on trust and warmth in which you may choose to examine and change patterns of behavior that may not be working for you. We would like this experience to be one that is reflective and in which you learn more about yourself. We believe all clients have the capacity to change their own problems, but assistance sometimes helps. Counseling is a collaborative process, and you will gain the most benefits by being an active, honest participant.

Qualifications and Area of Expertise

Qualifications, years of experience, and areas of expertise vary by each therapist at our practice. Please see our website, talk with our scheduling coordinators, or ask your therapist if you have questions about his or her specific background and areas of experience. All providers have a master's degree or doctorate in a mental health field. Their licenses may range from LCSW, LPC, LMFT, or Ph.D.

Fees and Appointments

Fees for therapy vary by provider depending on their years of experience. Our fee ranges are explained in more detail on our website, and our scheduling coordinators will discuss your agreed ­upon fee before your first appointment with a therapist. Please talk with your therapist or our scheduling coordinators if you have questions about fee rates.

If you have phone calls with your therapist, the first 15 minutes are free. 15­-30 minute phone calls may be billed at the rate of one half of a session; 30­-45+ minutes will be billed at a full session rate.

If your therapy work requires your therapist to spend time coordinating with other resources or care providers (teachers, doctors, etc.), your therapist may bill you for time over 15 minutes.

If a claim is denied for payment by your insurance company, you will be responsible for any balance owed. This is standard practice with any medical office.

If your therapy work requires your therapist to spend time in court, there is a separate fee structure of $250 per hour (including preparation for court, time in court, testimony, and travel time), and a minimum of a half day’s time (4 hours) will be billed one week in advance as a non­refundable deposit.

Cancellation Policy

There is no charge for missed or canceled appointments when 24 hours notice is given. Our standard policy is that you will be charged for the full session if you do not cancel 24 hours in advance. However, we understand that sometimes unforeseen emergencies, unexpected illness, or dangerous weather conditions may arise, and your therapist may take special circumstances into account.

Code of Conduct

All of our therapists are required by Texas state law to adhere to Ethics standards for Licensed Professional Counselors, Licensed Clinical Social Workers, Licensed Marriage Family Therapists, and Licensed Psychologists.

Privileged Communication

The relationship between the counselor and the client is considered by law as confidential and will be held in strict confidence. All records kept by the counselor are confidential. Exceptions to privileged communication exist if it pertains to child abuse, injuring oneself, or intent to harm someone else. The law requires the counselor in these exceptions to inform the appropriate authorities.

If you choose to communicate with your therapist by email or text messages, please be aware that messages can be intercepted or accidentally sent to other parties. To maintain privacy, please keep messaging focused on scheduling.


We cannot guarantee that your therapist will be available to you in an emergency. If you are in crisis, please call 911, or you may also call the Crisis Helpline (512­472­HELP).

Client Responsibilities

The counseling process is a cooperative effort on the part of the client and the counselor. For the process to work, the client needs to be motivated to change and be responsible for his or her behavior and feelings. Clients are expected to be honest with the counselor and work toward resolving problems for which help was sought. Ultimately, the responsibility for setting and accomplishing any specific goal in counseling rests with the client. The client needs to recognize that meaningful change is never an easy task, and at times, could be difficult, painful, and threatening as well as rewarding. It is also important to recognize that as a result of the

counseling process, the client may realize that additional issues exist which may not have surfaced prior to the onset of the counseling relationship.

I have read and understand the above Declaration of Practices and Procedures.

_________________________________________                        _______________________

        Client’s signature                                                        Date