Dr. Heidi McLain, PhD
Happy Heart Counseling
Happy Heart Foundation, Inc.
3575 E. Valley Parkway ~ Escondido, CA 92027
760-715-0550
The following is intended to provide important information to you regarding your child’s counseling. Please read the entire document carefully and be sure to ask me any questions related to this agreement, my qualifications, or your child’s counseling before acknowledging it with your signature below.
Information About the Counselor
My PhD is in Clinical Christian Counseling. I have additional certification in the areas of Group Counseling, Child & Adolescent Counseling, Substance Abuse & Addiction. I am an Ordained Minister in good standing through United Christian Faith Ministries, and practice counseling under the authority and following the Code of Ethical Standards and mandates of the National Christian Counselors Association as a Pastoral Counselor, Advanced Certified. I hold a valid business license in Escondido, and am a counselor, but not a Psychologist or licensed as a Marriage & Family Therapist (MFT), nor do I practice as a State licensed "Therapist."
Risks and Benefits
Counseling for children can have benefits and risks. Since counseling often involves discussing unpleasant aspects of one’s life, your child may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness and helplessness. Working through difficult emotions can sometimes lead to an increase in difficult behaviors before the child is able to utilize new skills or fully integrate their experiences. On the other hand, counseling has been shown to have benefits. There are no guarantees of how a child will respond. Children are unique beings that sometimes require assistance and support in order to grow and develop to their fullest potential. Counseling can also serve to strengthen a child’s sense of self and to gain mastery over their world or their “problems.” Counseling also provides the child with an opportunity to express him/herself in a safe way.
Parents: Please do not leave the office while your child is with the counselor unless discussed with your counselor. Your presence may be necessary during your child's visit.
Confidentiality
Counselors who work with children have the difficult task of protecting the child's right to privacy while at the same time respecting the parent or guardian's right to information. Counseling is most effective when a trusting relationship exists between the counselor and the child. Privacy is especially important in securing and maintaining that trust. In my practice, I provide individual counseling to children and ensure the caregiver/parent is involved in the process through consultation with them. At times, the parent/caregiver may even participate in the sessions. However, to ensure a child’s privacy, I will not provide detailed information to the parent/caregiver regarding what the child shared unless the child gives approval. Instead, general themes, ideas and recommendations will be provided as well as support and encouragement to the parent/caregiver. It may be necessary to refer your child to another mental health professional with more specialized skills, and if so, I will share that information with you.
Giving Consent
When you give consent for your child to receive counseling, you are acknowledging that you have reviewed and fully understand this Agreement, you have read or discussed any terms with the counselor that were unclear, and have had all questions with regard to its terms and conditions answered to your satisfaction. You agree to abide by the terms and conditions of this Agreement and consent for your child named below to participate in counseling. Moreover, you agree to hold the Counselor free and harmless from any claims, demands, or suits for damages from any injury or complications whatsoever, save negligence, that may result from such counseling.
Revoking Consent
Both you and your child may end the counseling relationship at any time, without penalty or prejudice. While free to discontinue services at any time, it is preferable to have a closing session or phone call, to ensure the child understands that counseling is ending and to provide an appropriate closure to the experience. You may also have the right to refuse or discuss modifications of any of my counseling techniques or suggestions that you believe may not be helpful.
Acknowledgment and Consent
By entering your name below, you are indicating that you read and understood this consent form and that any questions you had about this consent form were answered to your satisfaction.
Consent for Counseling of a Minor
This is to certify that I/we give permission for my/our child (listed above) to obtain counseling from Dr. Heidi McLain, PhD.
California state law mandates the reporting of suspected child abuse, including physical abuse, sexual abuse, unlawful sexual intercourse, neglect, emotional and psychological abuse. All actual and suspected acts of child abuse will be reported to the appropriate agency.
The consent of both parents will be sought, except when one parent has sole legal (not just physical) custody. You may be asked to provide a copy of the most recent custody order.
This consent form is in effect until 12 months after consent is given.
Consent can be revoked at any time.