Mark E. Williams M.A. LCMHC
186 White Street, South Burlington, VT 05403
802 865 4883  markewilliams@gmail.com

Please read and sign:
This form is required by the State of Vermont, to insure that all clients know their rights.



Purpose of Counseling:
A. To learn new ways of dealing with
people.
B. To learn to make better decisions.
C. To learn to put decisions into action.
D. To support grief.
E. To overcome discouragement and to be
more encouraging.
F. To form healthier relationships.
G. To find better mentors.


Responsibilities
A. You will be asked to set your own goals,
and to commit to a counseling program
until you have reached your goals. Your
counselor will guide you; you will do the
work.
B. Attend each session and be on time.
C. When stopping counseling you are asked
to give one week’s notice. The last
session will be used to say goodbye, sum
up, and to look at the possibility you
may be stopping because you have hit a
difficult spot.


Canceling a session: If you need to cancel an
appointment, please do so by the evening before your appointment and you will not be
charged for the missed appointment. Otherwise, if you miss an appointment you owe half of the
expected payment. (Health insurance does not pay for missed appointments.)


Pay for each session as you go,
at the beginning of each session, unless you negotiate
other terms. Each session is 45 minutes; couples
and family counseling is 50 minutes. The last five minutes is used for wrapping up, and scheduling the next appointment. Phone calls are billed at your regular fee (divided by 45 minutes). Most phone calls are not paid for by health insurance.


A. Mark is mildly allergic to aftershave, cologne and perfume.
B. Young children cannot be left unattended in the waiting room. Bringing young children into the therapy session with you usually interferes with counseling unless the child is the focus of the therapy.
C. The waiting room (White St.) is difficult to make soundproof, so please have family members wait in the car, if possible.
D. No eating or answering cell phones during
   counseling.


Counseling: You do not have to take part in
any counseling exercise with which you do not feel comfortable. The counseling may include:
A. Taking a life history.
B. Role-plays
C. Imagining what you felt like as a child.
D. Talking about emotions and reactions
you experience in the counseling
session.
E. information and education.
F. Homework.


Confidentiality: Everything you say in
counseling is completely confidential, except:
A. Child abuse is required to be reported to
the State.
B. If someone’s life is in danger the
counselor has the duty to warn that
person.
C. If your life is in danger the counselor
may notify appropriate people.
D. If you sign a release to give information
to a medical doctor or for some other
reason.
E. Insurance billing and authorizations.
F. When the counseling is professionally
supervised.


Your counselor cannot socialize with you
while you are in counseling. This is to keep the
counseling uncomplicated.

Mark is not a forensic counselor, and does not do assessments for court.


Risks:
A. Painful emotions are sometimes
experienced in counseling. These
experiences are often valuable.
B. As a person learns to relate in new ways,
he/she starts acting in new ways toward
his/her spouse, parents, employer,
employees, fellow-workers, children and
friends. Some of these people will enjoy
the changes, others will be upset by the
changes.
C. Counseling is a process and cannot be
measured by how one feels at the end of
a particular session. It is like building a
house or hiking up a mountain: it is the
end result that counts. Although it is
impossible to give a specific number of
weeks needed to solve a particular
problem, you may ask for an estimate and a
brief counseling plan.
D. Counseling is a relationship between
you and your counselor. As you work on
your relationship with your counselor, so
you are working on your relationships
with everyone in your life.


State of Vermont required information
 (#11 through 13):
Mark Williams holds a Master’s degree from Vermont College (1990) in Psychology and Religion, and has been licensed by the State of Vermont as a Mental Health Counselor since 1994. Mark worked part-time as a pastoral counselor for the South Burlington Church of Christ, 330 Dorset St. (1986-1990, supervised 18 months by William Saxby). He worked in private practice from 1991 to the present (supervised from 92-94 by David Sokol): 177 Pearl St., Burlington, 1991-94; 22 Patchen Rd., So. Burl., 1994-97; 186 White St., S0. Burl., 1997-present; 1091 Fairfax Rd., St. Albans, 1996-present; 1759 Rt 7, Ferrisburgh, 2000-2009.
Mark uses an eclectic approach including: cognitive-behavioral for anxiety, brief therapy, pastoral, developmental, Object Relations for early childhood issues, Gestalt, Family Systems, Prolonged Exposure Therapy for trauma, Assertiveness Training, and Transactional Analysis.
He specializes in: depression recovery, sexual abuse recovery, men’s issues, anger management, couple counseling, sexual dysfunctions, parenting issues, and play therapy.


If you have a consumer inquiry or a complaint about a mental health counselor, contact:  Office of Professional Regulation, National Life Building, North FL2, Montpelier, VT 05620-3402

Your counselor is required to use Professional Conduct.
Unprofessional Conduct (par. 3271, Laws and Rules for Clinical Mental Health Counselors) includes:
A. Fraudulent or deceptive procuring or use of a license.
B. Willfully making or filing false reports or records in the practice of clinical mental health counseling, willfully impeding or obstructing the proper making or filing of reports or records, or willfully failing to file the proper reports or records.
C. Using dishonest or misleading advertising.
D. Exercising undue influence on or taking improper advantage of a person using counseling ‘services, or promoting the sale of services or goods in a manner which exploits a person for the financial gain of a practitioner or a third party.
E. Failing to comply with statutes governing the practice of clinical mental health counseling.
F. Conviction of a crime that evinces an unfitness to practice mental health counseling.
G. Failing to make available to succeeding health care professionals or institutions, upon written request of a person using clinical mental health counseling services, copies of that person’s records in the possession or under
the control of the clinical mental health counselor.
H. Practicing clinical mental health counseling when medically or psychologically unfit to do so.
I. Misusing a title in professional activity.
J. Conduct which evidences unfitness to practice clinical mental health counseling.
K. Gross or repeated malpractice.
L. Engaging in sexual conduct with a client, or with the immediate family member of a client, with whom the licensee has had a professional relationship within the previous two years.
M. Harassing, intimidating or abusing a client.
N. Entering into an additional relationship with a client, supervisee, research participant or student that might impair the licensed clinical mental health counselor’s objectivity or otherwise interfere with the clinical mental health counselor’s professional obligations.
O. Independently practicing outside or beyond a clinical mental health counselor’s area of training, experience or competence without appropriate supervision.

"A heart at peace gives life to the body”

I have read the above Information: