Professional Disclosure

Professional Disclosure Statement
Allison Lopez adlcounseling@gmail.com 407-308-0322
Welcome!
I am glad you have selected me as your counselor. I know that you may have a lot of
questions about how counseling works and what to expect. This document is to
provide you with information regarding my background, about our professional
relationship and about how the counseling process works. It will also inform you
about State and Federal Laws and your rights. If you have questions that are not
addressed in this document, please feel free to ask me!
Qualifications, Experience and Counseling Style:
I have completed a BA in Cultural Anthropology at University of South Florida and am

completing my Masters in Counseling at Wake Forest University. I am not yet a
Licensed Mental Health Counselor. Instead, I am seeing you as an intern at Real Life
Church and am being supervised by licensed professionals at this location and by
professors at my University. Supervisor contact information is available by request and
if you have any further questions about my education and experience, please feel free
to ask.
My counseling experience includes individual counseling for depression, anxiety,

dealing with rejection, regret, grief, forgiveness, life changes/transitions, anger
management, spiritual issues, setting boundaries, divorce, marriage counseling,
family, adolescent and childrens issues, adolescent counseling, bipolar personality
disorder, borderline personality disorder, obsessive compulsive disorder, and group
counseling.
I have an eclectic approach to counseling derived from person-centered therapy,

cognitive-behavioral therapy, and emotion focused therapy. My relationship with God
and my understanding of Biblical Scripture provides a foundation underneath these
theoretical approaches. However, you may choose whether or not you would like to
incorporate the use of the Scriptures and Christian practices like prayer into your
therapy. Your therapy will be individualized to you and what you feel comfortable with.
Confidentiality:
Our verbal communication and clinical records are strictly confidential except for: a)
information shared with my site and university supervisors, b) information you and/or
you child or children report about physical or sexual abuse; then, by Florida State
Law, I am obligated to report this to the Department of Children and Family Services,
c) where you sign a release of information to have specific information shared and d) if
you provide information that informs me that you are in danger of harming yourself or
others e) information necessary for case supervision or consultation and f) or when
required by law. If an emergency situation for which you or your child feels immediate
attention is necessary, you or your childs guardians understand that they are to
contact the emergency services in the community (911) for those services. I will follow
up those emergency services with standard counseling and support for you, your child
and/or your family.
Nature of Counseling:
Counseling is a collaborative effort that calls both counselor and client to work
together to identify areas in your life that are causing you distress and to explore
possible causes and solutions together. I see my role as a facilitator in the ongoing
process of helping you to understand, heal, and/or change troubling emotions,
thoughts, and behaviors. Often, this means you and I may talk about your past and
present experiences to uncover possible sources of your distress. It is important to be
aware that exploring past experiences and coming to grips with where you find
yourself now may be at times uncomfortable or even painful for you or your child.
However, through the counseling process, gaining insight and healing from painful
experiences can lead to healthier relationships as well as a healthier sense of self-
worth in the present.
Number of Counseling Sessions and Session Times
You might be wondering how long your will need to come to counseling in order to
accomplish your goals. Unfortunately, that can be a difficult question to answer since
every person is different. To give you a general timeline, I usually work with clients to
set goals for 8-12 week time periods. After we reach the end of that time period, you
and I will talk about how you are progressing toward meeting your goals in counseling
and whether or not you would like to continue.
You and I will work together to identify your counseling goals during your first few
sessions. After we have spoken, I will be able to give you a better idea of what your
projected time period in counseling is likely to be.
Each of your sessions with me will last for 50 minutes. Part of your responsibilities in
our counseling relationship are to arrive to your appointments on time and to give
yourself adequate time outside of counseling to complete any homework you may be
given.
Because there is high demand at Real Life Church for counseling, you may be
placed back on the waiting list if you miss more than one appointment,
consistently arrive late or consistently do not complete your homework.
During our first and second session, you will be asked to complete a number of
assessments. These assessments will help me to 1) learn more about you and your
background 2) identify your personality strengths, experiential strengths, spiritual
preferences and strengths, existing coping skills, environmental factors and social
support systems 3) identify areas of growth, clarify what your concerns are and
identify environmental factors that may be contributing to the problems you would like
to solve. You have a right to access any information I obtain through these
assessments. I will do my best to help you understand what each assessment is for
and what your results from each assessment are.
Contact In Between Appointments
Because I am often in session during the day, I may not be able to answer phone calls.
The best way to contact me and ensure a quick response is via text or email. I will
respond within 24 business hours (excluding holidays and weekends). If you have an
emergency, please call 911 or one of the numbers listed under community resources.
Community Resources
Suicide Hotline
24 hours / 7 days
Community Crisis Line

(407) 425-2624
Teen Hotline
(407) 841-7413
Mental Health
If you or a family member is in crisis due to a mental health crisis, please call 911 and
request the assistance of a CIT Officer or contact Aspire Health Partners at (407) 875-
3700.
Adult Substance Abuse Services

If you or a family member is in crisis due to substance abuse, please call 911 and
request the assistance of a CIT Officer or contact the Aspire Health Partners at (407)
245-0012.
Domestic Abuse
For immediate assistance, please call the Florida Domestic Violence Hotline at 800-
500-1119, TDD at 800-621-4202 or the Harbor House 24 Hour Hotline at 407-886-
2856.
Homeless Services
If you are homeless, please contact one of the service providers listed below.
Homeless Services Network of Central Florida at (407) 893-0133.

Healthcare for the Homeless at (407) 428-5751.
Heart of Florida United Way at 211.

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Professional Disclosure Statement

Allison Lopez adlcounseling@gmail.com 407-308-0322

Qualifications, Experience and Counseling Style:

I have completed a BA in Cultural Anthropology at University of South Florida and am

My counseling experience includes individual counseling for depression, anxiety,

I have an eclectic approach to counseling derived from person-centered therapy,

Number of Counseling Sessions and Session Times

Contact In Between Appointments

Community Crisis Line

Adult Substance Abuse Services

Homeless Services Network of Central Florida at (407) 893-0133.

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