Allow Me to Introduce Myself

Della Woods, LPC, NCC

PO Box 1372

Hood River, Oregon 97031

della@wildsidetherapyllc.com

Phone: +1 (509) 637-9031

Fax: (888) 388-1690

Philosophy: The moment when you no longer know what to do, perhaps that is the moment when your real work is about to begin. It’s important for you to know that all of us humans get stuck in life. Many times in fact.

But when that little voice inside our head tells us we’re not good enough or worthy enough to have a better life, that's when we get ourselves into trouble. And it can be tough to have perspective on a difficult situation without some outside help.

I can help you skillfully untangle the confusion, identify blind spots, heal the emotional wounding, all in order to make the deep and profound change you desire in your life. Together, we’ll work to unbury your authentic self from past expectations placed upon you.

I am a safe and supportive guide to help you through a journey of self-exploration and growth, to break out of stuck patterns, and explore who you would like to become. It is an absolute honor to guide clients towards more clarity, connectedness, and satisfaction with their lives.

Our sessions are free of judgment and your time to regain a sense of true empowerment.

Therapeutic Approach: As the mind and body are a system that work in unison, I utilize both cognitive-behavioral and somatic therapeutic evidence-based practices in my work. While working together, I may draw upon the following evidence-based therapeutic modalities:

Acceptance and Commitment Therapy

Person-Centered Therapy

Cognitive-Behavioral Therapy

Mindfulness-Based Therapy

Formal Education and Training: I hold a master’s degree in Clinical Mental Health Counseling from Southern Oregon University and am a Nationally Certified Counselor. Major coursework included Advanced Human Development with an emphasis on adolescent adjustment, Multicultural Mental Health, Ethics, and Counseling Theory.

As a Licensed Professional Counselor with the Oregon Board of Licensed Professional Counselors and Therapists (Board), I abide by its Code of Ethics.

Fees: I charge $185 per session. Please inquire about which insurances I am currently in-network with. If using out-of-network benefits, I provide superbills to clients for each session to receive reimbursement for therapy fees from their insurance.

As a client of an Oregon Board Licensed Professional Counselor, you have the following rights:

• To expect that a licensee has met the qualifications of training and experience required by state law;

• To examine public records maintained by the Board and to have the Board confirm credentials of a licensee;

• To obtain a copy of the Code of Ethics;

• To report complaints to the Board;

• To be informed of the cost of professional services before receiving the services;

• To be assured of privacy and confidentiality while receiving services as defined by rule or law, with the following exceptions: 1) Reporting suspected child abuse; 2) Reporting imminent danger to you or others; 3) Reporting information required in court proceedings or by your insurance company, or other relevant agencies; 4) Providing information concerning licensee case consultation or supervision; and 5) Defending claims brought by you against me; and

• To be free from being the object of discrimination on any basis listed in the Code of Ethics while receiving services.

You may contact the Board of Licensed Professional Counselors and Therapists at:

3218 Pringle Rd SE, #120, Salem, OR 97302-6312 │ Telephone: (503) 378-5499

Email: lpct.board@mhra.oregon.gov

Additional information about this licensee is available on the Board’s website:

www.oregon.gov/OBLPCT.

APPOINTMENTS AND CANCELLATIONS Please remember to cancel or reschedule 48 hours in advance. I understand emergencies happen. Cancellation fees are an unfortunate occurrence to keep my practice running. You will be charged 50% of the appointment fee if cancellation is less than 48 hours. You will be responsible for the entire fee if cancellation is less than 24 hours.

The standard meeting time for psychotherapy is 50 minutes. It is up to you, however, to determine the length of time of your sessions. Requests to change the 50-minute session needs to be discussed with the therapist in order for time to be scheduled in advance.

A $10.00 service charge will be charged for any checks returned for any reason for special handling.

Cancellations and re-scheduled sessions will be subject to a full charge if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time.

SESSION ETIQUETTE

Start and end the session on time.

Cell phones are on “silent” and not a distraction from the session.

Clients are in a quiet and private space so they can fully engage in therapy.

TELEPHONE ACCESSIBILITY If you need to contact me between sessions, please leave a message on my voicemail. I am often not immediately available; however, I will attempt to return your call within 24 hours. If a true emergency situation arises, please call 911 or any local emergency room.

SOCIAL MEDIA AND TELECOMMUNICATION

Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.

ELECTRONIC COMMUNICATION

I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.

Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of California. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your therapist chose to use information technology for some or all of your treatment, you need to understand that:

(1) You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled.

(2) All existing confidentiality protections are equally applicable.

(3) Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee.

(4) Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.

(5) There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs. Effective therapy is often facilitated when the therapist gathers within a session or a series of sessions, a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information, and experiences. When using information technology in therapy services, potential risks include, but are not limited to the therapist's inability to make visual and olfactory observations of clinically or therapeutically potentially relevant issues such as: your physical condition including deformities, apparent height and weight, body type, attractiveness relative to social and cultural norms or standards, gait and motor coordination, posture, work speed, any noteworthy mannerism or gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact (including any changes in the previously listed issues), sex, chronological and apparent age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what he or she would consider important information, that you may not recognize as significant to present verbally the therapist.

REQUESTING THERAPIST TO TESTIFY IN COURT

Please know before entering into a therapeutic contract with me that I reserve the right to refuse to testify in court on behalf of my clients. If circumstances urge my testimony, I charge a fee of $300, plus my hourly rate for any court-related work. This fee is not covered by your insurance.

MINORS

If you are a minor, your parents may be legally entitled to some information about your therapy. I will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential.

TERMINATION

Ending relationships can be difficult. Therefore, it is important to have a termination process to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment after appropriate discussion with you and a termination process if I determine that the psychotherapy is not being effectively used or if you are in default on payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified psychotherapists to treat you. You may also choose someone on your own or from another referral source.

Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, I must consider the professional relationship discontinued.

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.