Creating a professional disclosure statement

After reviewing information about the professional disclosure statement in your text, Orientation to the Counseling Profession, complete an Internet search for the professional disclosure statements described in this unit’s studies.

Now, imagine that you are a fully licensed independent counselor working in the specialization you aspire to, and create a professional disclosure statement of your own. Include general headings such as:

• Contact Information.
• Education and Experience.
• Credentials.
• Description of Practice.
• Fee Scale.
• Client Responsibilities.
• Limits to Confidentiality and Emergency Protocols.
• Complaint Procedure.

You may also use the professional disclosure statement you created in the media activity, Creating a Professional Counseling Disclosure Statement.

Post a copy of your professional disclosure statement in the discussion area for peer and instructor feedback. You will refine this statement many times through the years; this will be your first draft.

Response Guidelines

Respond to a learner who has posted a disclosure statement that differs from yours and note the differences. What can you incorporate from his or her statement that can help strengthen the content of your statement?

Review other learners’ professional disclosure statements for ideas on how you could improve your own. Use the feedback you obtain from your peers and your professor to polish the professional disclosure statement that you are preparing for the Unit 4 assignment, Practice Plan.

Learning Components

This activity will help you achieve the following learning components:

• Compare examples of professional disclosures/contract statement to notice how laws, ethical guidelines, licenses, and professional credentials are noted.
• Identify a professional counseling disclosure statement, meeting ethical and legal standards, that discloses credentials, licenses, and certifications.
• Locate Web sites for counselors in your area, and search for professional disclosure statements (sometimes called treatment contracts or counselor-client contracts) on these Web sites.