Art Therapy, Transpersonal Art AS HeAling + Transformational Guide
Individual Art Therapy: $110.00/50 minutes
Family Art Therapy: $130.00/50 minutes
Transformational Guide: $130.00/50 minutes (session packages)
Portfolio and Art Therapy Path Consultation: $65.00/50 minutes (1:1)
Supervision 1:1 or Group (4 minimum): 65.00/50 minutes
Amy K. Leiter LPC, ATR-BC in order to provide accurate and current information, and to comply with Colorado State law, offers the following disclosure to you:
I. General Information
MA in transpersonal counseling psychology and art therapy; Naropa University, 2014
I am a licensed professional counselor candidate in the state of Colorado. (CO Permit #LPCC.0014191) and Board Certified Art Therapist (ATCB #: 17-115)
I am a registered Art Therapist and have completed my clinical hours to be registered as a licensed professional counselor with Jessica Whitesel, a licensed as a professional counselor in the state of Colorado. (CO License #4578), I am waiting to take the National Counselors exam to complete my licensure requirements in the State of Colorado.
II. Client Rights and Important Information
The Colorado Department of Regulatory Agencies has the general responsibility of regulating the practice of licensed psychologists, licensed clinical social workers, licensed professional counselors, licensed marriage and family therapists, certified school psychologists, and unlicensed psychotherapists.
Mental Health Regulations
The practice of licensed or registered persons in the field of psychotherapy is regulated by the Mental Health Licensing Section of the Department of Regulatory Agencies. The Department of Regulatory Agencies, Mental Health Section, is located at 1560 Broadway, Suite 880, Denver, Colorado 80202, (303) 894-7800.
The regulatory requirements applicable to mental health professionals are as follows: A registered psychotherapist is a psychotherapist listed in the state’s database and is authorized by law 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 a registration from the state. Certified Addiction Counselor I (CAC I) must be a high school graduate, complete required training hours and 1,000 hours of supervised experience. A CAC II must complete additional required training hours and 2,000 hours of supervised experience. A CAC III must have a bachelor’s degree in behavioral health, complete additional required training hours and 2,000 hours of supervised experience. A licensed Addiction Counselor must have a clinical master’s degree and meet the CAC III requirements. A licensed Social Worker must hold a master’s degree in social work. A psychologist Candidate, a Marriage and Family Therapist Candidate, and a Licensed Professional Counselor Candidate must hold the necessary licensing degree and be in the process of completing the required supervision for licensure. A licensed Clinical Social Worker, a Licensed Marriage and Family Therapist, and a Licensed Professional Counselor must hold a master’s degree in their profession and have two years of post-masters supervision. A licensed Psychologist must hold a doctorate degree in psychology and have one year of post-doctoral supervision.
The Department of Regulatory Agencies regulates the practice of both licensed and unlicensed persons in the field of psychotherapy. The address is: State Grievance Board, 1560 Broadway, Suite 1350, Denver, CO 80202; Phone: (303) 894-7800.
As a Client of AMY LEITER:
• Art Therapy and Process: You are entitled to information about the methods of clinical counseling and art therapy; the techniques used; the duration of therapy, if known; and the fee structure.
• You are entitled to seek a second opinion from another therapist or may terminate therapeutic services at any time.
• Dual Relationships: Although our sessions may be very intimate psychologically, it is important to discuss that we have a professional relationship rather than a social one and I need to stay within the rules regarding dual relationships set forth by our professional ethics board. While I am seeing you for therapy, you will be best served if our relationship stays professional and that our sessions concentrate exclusively on your goals and concerns for your life. It is important for you to remember that you are experiencing me in the professional relationship. Due to the professional nature of our relationship, I am unable to attend social gatherings, accept gifts, or relate to you in any way other than in the professional context of our therapy sessions.
My approach to therapy is informed by a variety of models and therapeutic philosophies. These include a humanistic, Jungian, psychodynamic, and client-centered orientation, using talk therapy and art therapy. I use a variety of methods and techniques drawn from mindfulness practice, attachment theory, and cognitive-behavioral approaches in working with individuals, families, and groups. Generally, my therapeutic approach involves looking at underlying issues with the aim of personal transformation and freer, more creative living. Length of therapy varies, depending on the nature of the problem and what the client wants from therapy. Some issues may be resolved within a few sessions, while deep level change often takes time. No one can guarantee the outcome of therapy, and often how well therapy works depends on the fit between client, therapist, and therapeutic model. Please feel free to discuss with me at any time your goals for therapy and any thoughts you have about the work we are doing together. If at any point you would like to try another approach, please feel free to talk with me about this and I will be happy to provide appropriate referrals.
My fee for Therapy is $110 for individual sessions of 50 minutes and $165 for 80 minutes. The cancellation policy is a minimum of 24 hours notice of cancellation. The client is responsible for the fee for the full hour of a canceled session unless he or she provides notice of cancellation at least 24 hours before the scheduled session. In cases of genuine emergency session fees will be waived by the therapist. At this time, we do not accept insurance reimbursement. However, we can provide receipt for out of network reimbursement.
• You are responsible for payment at time of service, no running balances will be accommodated.
• You are responsible for paying full cost for sessions not cancelled within 24 hours of scheduled time.
• You agree that therapist can use the credit card information on file to charge for missed sessions that are not cancelled within 24 hours of scheduled time.
• Out-of-network insurance reimbursement is the responsibility of the client, though we are happy to provide an invoice if desired.
• There will be no charge for occasional phone consultation of a brief and necessary nature. If phone calls exceed 15 minutes you are responsible for paying for this service. These conversations will be billed in 15-minute increments at $35/hr.
Disclosure Regarding Litigation
• In the event that you are involved in divorce, custody or other litigation it is understood that my role as a therapist is not to make recommendations to the court regarding custody or parenting issues. By signing this Disclosure Statement you agree not to subpoena me to court for testimony or for disclosure of treatment information in such litigation. You also agree not to request that I write any reports to the court or your attorney in order to make recommendations regarding custody or parenting issues.
• The Colorado Department of Regulatory Agencies has the general responsibility of regulating the practice of psychotherapists. The agency within the department that has specific responsibility over licensed and unlicensed psychotherapists is the Department of RegulatoryAgencies, Mental Health Section, 1560 Broadway Suite 1350, Denver, Colorado 80202, (303) 894-7766.
• I assure you that my services will be rendered in a professional manner consistent with accepted ethical standards. Please note that it is impossible to guarantee any specific results regarding your counseling goals. However, we will work together to achieve the best possible results for you.
• My practice provides outpatient, non-emergency psychotherapy services by appointment only. If I determine that your case is beyond my level of competence or outside the scope of my practice, I have a legal and ethical responsibility to refer, terminate services or consult with another professional. If you are experiencing an emergency situation, you will immediately call 911 or immediately admit yourself to the emergency room at a local hospital. By signing this consent form, you understand the scope of my practice and will follow the emergency procedures.
I (the client) have read and understand the preceding information regarding my rights as a client and consent to receiving counseling services from Amy K. Leiter ATR, LPCC. I understand that this agreement is not binding and I am free to terminate counseling at any time.
Cancellations & Refunds
I request a minimum of 24 hours notice of cancellation. The client is responsible for the fee of a canceled session unless he or she provides notice of cancellation at least 24 hours before the scheduled session. In cases of genuine emergency, session fees will be waived by the therapist. At this time, I do not accept insurance reimbursement. However, I can provide receipt for out of network reimbursement. If at any point you have questions about any aspect of therapy with me, please do not hesitate to ask.
For Packages and Studios no refund will be provided once the second session is complete.