Becoming, Inc.
Caring Christian solutions to life's tough problems

Program Information

 1.  You will be asked to sign a release of liability form that makes clear that my training is in theology.  I have a B.A. in Religion from Baylor University and a M.Div. from Southwestern Baptist Theological Seminary in Ft. Worth.  In addition, I did one semester of clinical training through New Orleans Baptist Theological Seminary.  In that program, the clinical work was done through the chaplain's office at Rusk State Hospital, Rusk, Texas.

 2. You must understand that even though I consider our sessions to be religious in nature and are more like a confessional, I am bound by certain laws of the state.  In spite of our agreement of confidentially, I am required by law (and by good counseling practice) to report certain things to authorities and/or to bring other people into our relationship.

I cannot promise confidentially in any situation where you might hurt yourself or others.

If you refuse my advice to consult with other professionals or with medical  specialists, I cannot continue the relationship.  While I would not want to reject you, I am not God and cannot be responsible for your life or do you the disservice of continuing a relationship in which you refuse to consult qualified professionals.  In extreme cases where your health is involved, I reserve the right to contact members of your family to make them aware that you are refusing my recommendations.

I cannot respect confidentiality regarding a crime.  If you have committed a crime, are currently involved in a crime, or are planning a crime, I cannot be a party to that crime.  If you will go to the authorities, I will not abandon you  merely because you are in trouble or have done something wrong.

If I become aware of any case of current physical or sexual abuse, I am required by law to report such to the authorities. 

 3.  Certain problems are beyond my experience and training.  For that reason I may on occasion ask you to consult with others.  This should not be taken as rejection on my part, but should be taken as concern for you.  In most situations we can continue our counseling relationship if you so desire.

 4.  In order to discipline myself to honor confidentiality in our relationship, I will ask  you to sign a release form that authorizes me to consult with others on your behalf if I feel a need to do so at some point in our relationship.

 5.  In order to discipline myself not to share or appear to share your story in my speaking or writing, I will ask you to sign a release form before I tell your story.  Always be aware of others to whom you are talking about your problem, for they may be telling your story.  Also, while we all assume our situation is unique, others often face similar problems.  If I ever give a hypothetical situation that reminds you of your situation, please give me the benefit of the doubt.  Many people share similar problems and situations.

 6.  You are expected to take all prescription medication.  Nothing in our program shall ever be construed to suggest that you should not follow the directions given by other professionals.

I have read and understand these conditions of confidentially.  I agree to enter the counseling relationship under these conditions.

____________________________________  ___________________
             signature                                                    date


Main Menu
Client Forms Index