This is the public version of the mandatory disclosure statement clients receive and sign by the second session, per C.R.S. § 12-245-216.
Sagelight Counseling
Tyler Marshall, MA, LPCC
Business address: [pending — open item]
Business phone: 720-514-9227
1. Levels of regulation under the Mental Health Practice Act
Mental health professionals in Colorado are regulated at several levels under the Mental Health Practice Act (C.R.S. § 12-245-101 et seq.). The differences are:
- A Registered Psychotherapist is a psychotherapist listed in the State's database and authorized to practice psychotherapy in Colorado, but is not licensed by the state and is not required to satisfy any standardized educational or testing requirements to obtain registration from the state.
- A Certified Addiction Counselor I (CAC I) must be a high school graduate or equivalent, complete required training hours, and complete 1,000 hours of supervised experience.
- A Certified Addiction Counselor II (CAC II) must meet the CAC I requirements and complete additional training hours, 2,000 additional hours of supervised experience, and pass a national exam.
- A Certified Addiction Counselor III (CAC III) must hold a bachelor's degree in behavioral health, meet the CAC II requirements, and complete additional training hours, 2,000 additional hours of supervised experience, and pass a national exam.
- A Licensed Addiction Counselor must hold a clinical master's degree, meet the CAC III requirements, and pass a national exam.
- A Licensed Social Worker must hold a master's degree from a graduate school of social work and pass a social work exam.
- A Licensed Clinical Social Worker must hold a master's or doctoral degree from a graduate school of social work, practice as a social worker for at least two years, and pass a social work exam.
- A Psychologist Candidate, a Marriage and Family Therapist Candidate, and a Licensed Professional Counselor Candidate must hold the necessary licensing degree and be completing the required supervision for licensure.
- A Licensed Marriage and Family Therapist must hold a master's or doctoral degree in marriage and family counseling, have at least two years of post-master's or one year of post-doctoral practice, and pass an exam in marriage and family therapy.
- A Licensed Professional Counselor must hold a master's or doctoral degree in professional counseling, have at least two years of post-master's or one year of post-doctoral practice, and pass an exam in professional counseling.
- A Licensed Psychologist must hold a doctoral degree in psychology, have one year of post-doctoral supervision, and pass an exam in psychology.
2. My credentials
I am a Licensed Professional Counselor Candidate (LPCC) registered with the Colorado Department of Regulatory Agencies, license number LPCC.________ (pending DORA issuance). I hold a Master of Arts in Counseling from Regis University. As an LPCC, I have completed the necessary licensing degree and am completing the supervised practice required for full licensure as a Licensed Professional Counselor. I practice under the clinical supervision of Kerri Ann Hernandez, LPC (Colorado license LPC.0019431).
3. Regulating board
The practice of licensed or registered persons in the field of psychotherapy is regulated by the Mental Health Licensing Section of the Division of Professions and Occupations. The State Board of Licensed Professional Counselor Examiners can be reached at 1560 Broadway, Suite 1350, Denver, CO 80202, (303) 894-7800.
4. Your right to information about therapy
You are entitled to receive information about the methods of therapy I use, the techniques used in your treatment, the duration of therapy (if known), and the fee structure. My primary approaches are Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), motivational interviewing, and parts and inner child work. Fees, the session length, and the cancellation policy are listed on the FAQ page and reviewed during the free consult.
5. Your right to a second opinion and to terminate
You may seek a second opinion from another therapist at any time, and you may terminate therapy at any time.
6. Sexual intimacy is never appropriate
In a professional therapeutic relationship, sexual intimacy is never appropriate and should be reported to the State Board of Licensed Professional Counselor Examiners at the address above.
7. Confidentiality
The information you provide during therapy sessions is legally confidential under Colorado law, except as provided in C.R.S. § 12-245-220 and certain legal exceptions that will be identified to you if any such situation arises during therapy. Standard exceptions include reasonable suspicion of abuse or neglect of a child, at-risk adult, or vulnerable person; imminent danger to yourself or to identifiable others; a court order requiring disclosure; and the supervision relationship described in this statement. Routine clinical consultation with my supervisor is part of my LPCC practice and is covered by the same confidentiality protections.
Acknowledgment
Clients receive a signable version of this statement in the intake packet before the second session, per Colorado law. By signing it there, you acknowledge that you have read this statement and understand your rights as a client.