NC Disclosure

PROFESSIONAL DISCLOSURE STATEMENT

DENNIS MENDLESON, M.S., L.P.C.C.-S.

Masters of Science, Mental Health Counseling                                                   Wright State University, Dayton, Ohio, 1986

Advanced Clinical Hypnotherapist                                                                                 The Wellness Institute, Issaquah, Washington, 2010

Licensed Professional Counslor                                                                                             North Carolina License Number 8352

Licensed Professional Clinical Counselor                                                                   Ohio License Number E2213-S

Welcome. I began working in the counseling field 32 years ago. I received my Master’s Degree in Mental Health Counseling in 1986, and my independent counseling license in 1996. I have extensive experience working in various counseling settings, including inpatient, residential and outpatient agencies. I have supervised other licensed and unlicensed clinicians throughout my career. In 1998 I began using hypnosis, helping people with various problems. I counsel pre-teenagers, adolescents, and adults, and I work with individuals, couples and families. I provide individual counseling, marriage counseling, couples counseling, and family counseling, in an open minded, non-judgmental setting. I help my clients work through marriage, family, and relationship problems, anxiety, stress, grief, and sexual issues.

Using hypnotherapy, I help individuals toward deeper spiritual connections, smoking cessation, weight loss, traumatic past issues, anxiety, stress, and grief.

I work with those who are struggling with anxiety disorders, depression or difficulties with mood, those having problems with emotional and/or behavioral difficulties and those who have concerns with sexual or gender identity. 

 I am currently pursuing licensure as a Licensed Professional Counselor in the State of North Carolina.

 Services:

 Length of Session, Fees, and Sliding Fee Schedule:

 Initial Intake Sessions (70 – 90 minutes)                              $125.00

Ongoing counseling sessions (50 – 60 minutes)                  $90.00

Hypnotherapy sessions (70 – 90 minutes)                             $125.00

Licensed Professionals in the Counseling Field                    $75.00

Full Time Students                                                                           $60.00

 Reducing or sliding these fees is available on a case-by-case basis.

____________________                                                                           _______________

Fee Agreed Upon                                                                                            Date

Fees are payable at the end of each session by check or cash. Please have your check made out to ‘Dennis Mendleson’. If you need to cancel your session, please do so within 24 hours of the time of your appointment, otherwise you will be charged the full session fee.

I do work with Humana Insurance Company. If you are going to use this insurance, please bring your card with you to the initial session. I will copy the card and bill the Insurance Company for services. Health insurance companies require that I provide them with a mental health diagnosis before they reimburse for services. Any diagnosis may become part of your permanent record. 

I believe counseling is a very individualized service – I have a Brief/Solution Focused approach to counseling, and hypnosis can be a very effective tool, reducing your time in therapy. I am very familiar with and work with people using Cognitive Behavioral Therapy.

You have taken an important step toward reaching your goals. I offer my insight and support in a non-judgmental setting.

 Before making your decision to see me for counseling, please read the information below – it is part of the standards of practice in the State of North Carolina. It is designed to provide you information about my credentials, the types of services I offer, and your rights as a client in therapy.

 Confidentiality

 Everything you share with me is confidential. I tell no one unless you provide me with a written release for me to do so. There are exceptions to this – if you convince me that:

You’re going to harm yourself

You’re going to harm someone else

You are abusing a child

You are abusing an elderly person

I am presented with a court order

 Whenever possible I will ask you to sign a release of information.

 Complaint Procedures

 If you are unhappy with any part of your counseling experience, please inform me so I may address your concerns and we can make a decision about how to best proceed; whether to continue counseling with me or a referral to another counselor.

If you feel that I have treated you unethically or unfairly and you do not feel we can resolve the problem, please feel free to contact:

 North Carolina Board of Licensed Professional Counselors

P.O. Box 1369

Garner, North Carolina 27529-1369

(919)-661-0820

 Feel free to discuss any questions or concerns you may have about entering into counseling with me. Please sign and date below that you have read and understand the above information and that you voluntarily agree to enter into counseling services.