Historically, the difference between counseling and therapy (psychotherapy) was the length and depth of care offered. Counseling provided more targeted solution-focused short-term care while therapy provided more in-depth long-term care.

Today, many counselors and therapists are trained to offer both short-term and long-term care, so the terms "counselor" and "therapist" are used fairly interchangeably. Presently, the technical difference between "counselor" and "therapist" is the licensure a provider holds (i.e. Licensed Marriage and Family Therapist vs. Licensed Professional Counselor).

In Oregon, once a counselor graduates with their master's degree, they can apply to be a Professional Counselor Associate (LPC-A). Professional Counselor Associates need to work under clinical supervision, which supports clinical decision making and client safety.

In order to become fully licensed as a Licensed Professional Counselor (LPC), a provider need to complete an additional 1900 direct client hours, which generally takes people around 2 years after graduating and working full-time to complete. 

I don't.

Absolutely! Counseling is a collaborative process and we can explore potential goals that align with potential interests and capacity.

These are some questions that could be valuable for you to think about:

-What insurances do counselors work with (if applicable) and do their schedules align with your availability?
-Is there a particular therapeutic modality or modalities (i.e. EMDR, CBT, etc.) that you'd like your counselor to be trained or certified in and use in sessions?
-Do you like a counselor that is more hands-off and goes with the flow, or more directive (i.e. pausing to check in, redirecting, structured sessions, etc.)?
-Do you want a counselor that is more direct with you and able to challenge you at times?
-Do you want someone that has a particular education, level of experience, identity or identities, cultural background, or specialty they work with?
-What is your relationship with giving feedback? No counselor is perfect and it may be valuable at times to check in about the care you're receiving to see if the provider is open to meeting your request(s).
-What comes to mind when thinking about what could help you feel comfortable when working with a counselor?

As a counselor and human, I care deeply about your safety and comfort, especially in the current world we're living in.

While counseling is widely confidential and honors your privacy, there are some limitations to confidentiality:  

-As an associate counselor, I am required to work under the supervision of a clinical supervisor. I consult with her about client care, and she reviews and approves all my clinical documentation, as it's under her name and license.
-If we are working with insurance, insurance companies will be reading my clinical documentation. However, I take HIPAA's health privacy "Minimum Necessary" requirement very seriously and only document what is absolutely necessary.
-If there is imminent danger to a client or others (not ideation but serious foreseeable harm or death by suicide or homicide).
-If confidential information from our sessions would help facilitate treatment of a medical emergency.
-If I am issued a court-mandated subpoena, I'd be legally required to release information.
-If a client brings a legal claim against me, I may need to release confidential information to the extent necessary to defend myself in that legal matter.

Clients can request to see their clinical notes and can always ask me to omit certain details from my notes if they don't want certain things documented in their health records. 

This is one of the most challenging aspects of my job, but I try to approach this aspect of the work with as much transparency, intentionality, and both systems- and trauma-informed care as possible.

As a health care professional in the state of Oregon, I am legally required to report disclosed or suspected abuse or neglect of:

-Minors (any person under 18)
-Elderly individuals (people 65 and over)
-Vulnerable adults (adults who live with intellectual, developmental, physical, or mental health conditions or cognitive impairments)

Everyone is explicitly told this information during the informed consent process of onboarding. Another way I try to support clients is if people are bordering on sharing information in session that could lead to a mandatory report, I'll pause them (when I'm able to catch it in time) to remind them of my legal reporting obligations and check in about what they'd like to share or if they'd like to take a step back (figuratively).

Lastly, if a mandatory report does need to be made based on something a client disclosed during session, I approach this process with as much collaboration as possible, as there are multiple ways to go about this process. 

In Oregon, clients 14 and older can legally consent to their own outpatient counseling.

However, Oregon law also states that counselors are generally expected to involve the minor's parents or caregivers before services end unless:

-The parents refuse involvement

-There are clear clinical indications that parent involvement is not appropriate;

-The minor was sexually abused by a parent; or

-The minor meets one of the statutory definitions of emancipation.

As my associate counseling licensure is through the state of Oregon, I am only able to work with clients who are physically in the state of Oregon during counseling sessions. This also means that if you live in Oregon but travel outside of Oregon during our normal session time(s), we will need to reschedule or skip a week(s), due to Oregon's counseling licensure guidelines. 

It depends on what you're looking for. Many services (i.e. emotional support animal, disability accommodations, etc.) may require established care, since these requests tend to be more successful when there's a history of distress and treatment to support them. Feel free to reach out and let's discuss the specifics. I have experience writing letters, completing referrals, and supporting with care coordination and advocacy to help clients meet their needs across various pillars of their life.

Health care in the U.S. is steeped in a problematic history that has and continues to create harm and additional barriers, particularly for those with marginalized identities. While I am not perfect, I strive to practice from a space of integrity and transparency, with systemic oppression, equity, and accessibility top of mind. I ask about previous experiences with health providers, explore what kind of care may feel the most safe and affirming, and adjust throughout care as needed.

I also practice counseling from a place of cultural humility. This means that while I work to build foundational knowledge, I never assume I know everything about a culture, identity, or group of people, and I understand people are not monolithic. It also means acknowledging my position of power as a counselor, centering clients as the experts of their own, and being a lifelong learner (including unlearning).