Professional Disclosure Statement for Johanne Toussaint - Resident Intern, Therapist
Counselor’s Professional Disclosure and Client’s Informed Consent
BACKGROUND OF CLINICIAN/EDUCATION AND CREDENTIALS
I am pursuing a Masters degree in Clinical Mental Health Counseling (CMHC) from Liberty University in Lynchburg, VA. I received a Bachelor of Business Administration, Finance degree from Georgia State University in Atlanta, GA in 2012. I am a certified PREPARE-ENRICH facilitator, SYMBIS (September 2025), and New 5 Love Languages (September 2025) assessment facilitator. I am also a Ramsey Master Financial Coach, and a Financial Peace University Coordinator.
COUNSELING APPROACH
My clinical interests include working with individuals experiencing anxiety, depression, stress, relationship concerns, intimate partner abuse, domestic violence, and major life transitions. I integrate evidence-based approaches such as cognitive-behavioral therapy (CBT), person-centered therapy, and mindfulness-based practices while tailoring my work to meet the unique needs, backgrounds, and strengths of each client. I view counseling as a collaborative process and strives to empower clients to build resilience, discover healthier coping strategies, and move toward personal growth and healing.
CLIENT POPULATION
I will agree to meet with a potential client regardless of age, color, culture, disability, ethnic group, gender, race, religion, sexual orientation, marital status or socio-economic status. I may decline meeting with a client if I feel, in my professional opinion, that I cannot help them or if they would be better served with the services of another professional. If a referral elsewhere is needed, I will provide information regarding services for the client’s consideration.
CONFIDENTIALITY
I regard the information you share with me with great respect. All information that you share with me including notes and records as well as assessment results are confidential and will not be released to any outside person or agency without your written authorization and consent.
The following are circumstances in which I cannot guarantee confidentiality, either legally or ethically:
- If there is abuse (potential or actual) of children, persons with disabilities, and/or senior
2. If disclosure is required to prevent clear and imminent danger to yourself and/or others.
3. If mandated by a court of law.
In order to improve my clinical skills and obtain additional training I may audio/video record counseling sessions. These sessions may be discussed with and reviewed by a licensed professional counselor supervisor. Confidentiality concerning such recordings are considered the same as the counseling sessions themselves. Following the feedback of my supervisor(s) the recordings will be destroyed.
SESSION FEES AND LENGTH OF SERVICE
I can assure you that my services will be provided in a professional manner and will be consistent with accepted ethical standards. After we decide on the frequency of appointments (generally once a week) and the appointment time, I will reserve this time for you. Sessions are usually 45 – 50 minutes long. The length of treatment varies depending on the therapist, the client (s) and the nature of the problems. Typically treatment will last 8-12 sessions for relatively specific problems but may be longer or shorter depending upon the nature of treatment.
The leadership of Soul Care PLLC determines the counseling fee structure. Clients may use their insurance if applicable. Please note that your insurance company may require information regarding diagnosis, symptoms, treatment goals and methods. Any diagnosis provided to your insurance company becomes a part of your permanent medical record. Please understand that you, the client, are fully responsible for payment of fees for services provided regardless of any insurance coverage you may have. Counseling fees are accepted in the form of cash, check, debit and/or credit card(s). Please note that if your check is returned for insufficient funds, you will be responsible for the bank charges incurred. Cancellation of appointments must be made 24 hours prior to your appointment. If the appointment is not canceled within this time period or if you do not show up for your appointment, you will be charged a $35 missed appointment fee.
IN CASE OF EMERGENCY
If you have an urgent situation that you feel needs immediate support, please contact one of the following: your primary care physician, the nearest hospital emergency room or call 911.
INSURANCE PROCEDURE \ USE OF DIAGNOSIS
Some health insurance companies will reimburse clients for counseling services and some will not. In addition, most will require that a diagnosis of a mental-health condition and indicate that you must have an “illness” before they will agree to reimburse you. Some conditions for which people seek counseling do not qualify for reimbursement. If a qualifying diagnosis is appropriate in your case, I will inform you of the diagnosis before we submit the diagnosis to the health insurance company. Any diagnosis made will become part of your permanent insurance records.
SOCIAL MEDIA AND ELECTRONIC COMMUNICATION
Social Media is neither private nor confidential. Therefore, I will not seek out or accept “friend” requests or “follow” any current or former client on any social media platform. With this being said, I will not engage you in any public forums over the Internet, because to do so could blur the professional nature of our relationship and could compromise the privacy that I seek to guard. Electronic communications (E-mail, texting (SMS), etc.) are not encrypted or secure and may not be received in a timely manner. The best method is to contact the office or the phone number given.
THERAPIST’S RESPONSIBILITY
As a professional, I will uphold and abide by the standards of the American Counseling Association and the North Carolina LPC Board code of ethics. Our relationship is a professional one. Our contact will be limited to the sessions you arrange with me. You will be best served while I am seeing you for counseling if our relationship stays strictly professional and if our sessions concentrate exclusively on your concerns.You may learn more about me as we work together, but it is important for you to remember that you are experiencing me as a professional therapist.
CLIENT’S RESPONSIBILITY
The beginning sessions involve understanding your situation so that together we can develop specific, realistic goals, methods to accomplish them and the approximate length of time needed. It is important for you to be as open and honest with me as possible and work toward the goals we have agreed upon. The majority of the counseling session will consist of you talking about the issues you present and employing methods that can help make a positive difference in your life. This requires effort and active involvement on your part to understand and change your thoughts, feelings and behaviors. It will include work in and out of the counseling sessions and may include homework assignments, self-observation and practicing new behaviors. It is important for you to attend all of your scheduled appointments on time.
COMPLAINTS
Although clients are encouraged to discuss any concerns with me, you may file a complaint against me with the organization below should you feel Iam in violation of any of these codes of ethics. I abide by the ACA Code of Ethics (http://www.counseling.org/Resources/aca-code-of-ethics.pdf).
North Carolina Board of Licensed Clinical Mental Health Counselors
P.O. Box 77819
Greensboro, NC 27417
Phone: 844-622-3572or 336-217-6007
Fax: 336-217-9450
E-mail: [email protected]
