Professional Disclosure Statement

Jay Key
Office: < 336-334-4822 ext. 50272>
E-mail: <jwkey1@gtcc.edu>
Qualifications

BA Psychology: 2011; Wake Forest University

MA Counseling (STUDENT): Clinical Mental Health focus; Began Fall 2014; Estimated date of
completion Spring 2016
Estimated Licensure; Licensed Professional Counselor (LPC); Estimated time of completion
Spring 2019

Counseling Background

Counseling Orientation: My orientation is that of a Biopsychosocial model with elements of

Person Centered, Existential, Solution Focused, and Rational Emotive Behavior therapy.
What does this mean? First off it means that I believe counseling can and is effective and
empirically sound. Despite this there is no guarantee that counseling will work with every
person, and things may seem worse before they get better. However I believe that
counseling is a collaborative process that seeks to make clients the best they can be in
their areas of concern. And I believe that those areas of concern can stem from a wide
range of areas including biological, psychological, social, spiritual, and existential. The
way these areas are addressed ranges from client to client, but they often involve a
combination of self-reflection, goal setting, and references to other resources or
professionals.
Completed courses in: Counseling Theories, Research and Statistics, Professional Development,
Lifespan and Development, Basic Counseling Skills, Family Counseling, Cultures in Counseling,
Career Counseling, Counseling in Groups, Clinical Practicum, Clinical Mental Health
Counseling, Issues in Clinical Mental Health Counseling, Vienna Theorists, Appraisal
Procedures for Counselors, Advanced Counseling Skills and Crisis Management, Classification
of Mental and Emotional Disorders and Counseling Internship.
Current course work in: Addiction Counseling, Counseling Internship II, Professional, Ethical,
and Legal Issues in Counseling, Consultation and Program Development in Counseling, and
Professional Identity Capstone.
Safe Zone training completed: Feb 12, 2015
Populations served: Students and related others at Guildford Technical Community College
Services offered: Crisis Intervention, Personal Counseling, Study Skills, Community Resource
Referrals, Test Anxiety, Time Management, Screening & Assessment, Support Groups, and
Workshops.

Session Fees and Length of Service

Length of sessions will be approximately 50 minutes

Fees not included as part of the Guilford Technical Community College Counseling Center
system

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Use of Diagnosis
Some health insurance companies will reimburse clients for counseling services and some will not.
Because counseling at Guilford Technical Community College is free a diagnosis is not required.
Confidentiality
All communications during session becomes part of the clinical record, which is accessible to you upon
request. Anything you say will be kept strictly confidential as part of our counseling relationship with
the following exceptions:
A) Between myself and my supervisors at Guilford Technical Community College and Wake Forest
University as part of my status as a student to ensure your needs are met and that I am acting and
learning properly
B) I believe that you are a threat to harm yourself or others
C) I believe there is an instance of child, elderly, or vulnerable persons abuse and am required to
report it
D) You directly request that I disclose your information to someone else
E) Your records are subject to a subpoena by the courts. In the event of this occurring you will be
informed as soon as possible.
Complaints
Although clients are encouraged to discuss any concerns with me, you may file a complaint against me
with the organization below should you feel I am in violation of any of these codes of ethics. I abide by
the ACA Code of Ethics (http://www.counseling.org/Resources/aca-code-of-ethics.pdf).
North Carolina Board of Licensed Professional Counselors
P.O. Box 77819
Greensboro, NC 27417
Phone: 844-622-3572 or 336-217-6007
Fax: 336-217-9450
E-mail: Complaints@ncblpc.org

Acceptance of Terms
We agree to these terms and will abide by these guidelines.
Client: ___________________________________________________ Date: ___________
Counselor: ________________________________________________ Date: ___________