Disclosure

Richard W. Crandall MA, LCMHC, LADC, RCST, PTP

Master of Arts in Counseling

Registered Craniosacral Therapist

Polarity Therapy Professional
Licensed Clinical Mental Health Counselor Vermont Credential # 068.0061316
Licensed Alcohol and Drug Counselor Vermont Credential # 000419

International Certification Co-Occurring Mental Health-Substance Counselor

Business Location: PO Box 58 Burton House 289 Main St. Norwich, VT 05055
Email Crandall.LCMHC @comcast.net

Call or Fax 802-674-6661

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Professional Qualifications and Experience
My practice in counseling is reflective and client centered. It ranges from brief, solution-focused to in-depth, long-term work. In addition I am trained in motivational enhanced cognitive behavioral therapy, cognitive behavioral trauma therapy, mindfulness therapy and meditation. I have been in the field of co-occurring mental health and substance use disorders since 1988. I currently provide individual and family counseling to those effected by partner use of substances.  I am certified in motivational enhanced cognitive behavioral therapy. I am a licensed clinical mental health counselor and licensed alcohol and drug counselor in the State of Vermont.I graduated from Franklin Pierce University with a BS in General Studies (1991), and Union Institute and University with a Masters of Arts in Clinical Mental Health Counseling (2007). I have an International Certification to provide co-occuring substance and mental health counseling (2011).


I have holistic therapeutic bodywork training of 880 hours in Polarity Therapy from the Polarity Realization Institute (1994 to1997), training of 1250 hours in Craniosacral Therapy from the Wellness Institute (1999 to 2001) and spent an additional year (2003) assisting my teacher Roger Gilchrist in a Biodynamic Craniosacral Therapy Foundation course. I began my professional polarity practice in 1997 (RPP), changed polarity assiciations in 2015 and practice as a Registered Craniosacral Therapist (RCST) since 2001.   


Each two year period I complete a minimum of 40 continuing education credits for counseling and additional continuing education credits for  Craniosacral therapy. I am a member of the Vermont Mental Health Counselors Association, National Alcohol and Drug Abuse Counselors Association and Vermont Addiction Professional Association. In addition I am also a member of the  Biodynamic Craniosacral Therapy Association of North America and International Polarity Education Alliance. I am currently a member of the Associated Bodywork and Massage Professionals and Associated Psychotherapists of Vermont.


Confidentiality
In all but a few circumstances, the privacy and confidentiality of our work together is a privilege of yours and is protected by me, by the law, and by my profession’s ethical standards.  Exceptions are:
- You give me written permission to share information with another person.
- You are incapacitated or in imminent danger of harming yourself or others.
- You indicate evidence or possible exploitation of a minor, an elder or disabled person, in which case, I am mandated to report this to the State of Vermont.
- Your insurance claim requires a psychiatric diagnosis code.  This will become part of your permanent medical record.  Some managed care companies require written or telephone reviews of your treatment.
- Your records are subpoenaed by the court for legal proceedings.
- You make threats of violence to a person or property.  I have a duty to inform the authorities and any intended victim.
- When I need to discuss issues in professional supervision.

HIPPA-Privacy for Mental Health Records and Information Release for Billing Purposes
The Client acknowledges that Richard Warren Crandall has hired Erica Napsy, a medical billing specialist and bookkeeper. She is aware of and in compliance with confidentiality and HIPPA privacy regulations including keeping records safe in a secure location to which no one has access. The Client authorizes Richard Warren Crandall and Erica Napsy to contact the Client’s insurance company to discuss claims submitted for purposes of authorizing payment. The Client authorizes Richard Warren Crandall to share relevant information with the insurance company for the purpose of authorizing sessions.

Legal Issues
I am not an expert witness and do not agree to participate in any legal matters you may have. If I am subpoenaed to court on your behalf, I charge $2500.00 retainer and an hourly fee of $125 per hour in preparation, court time, travel time or for any other time I spend in regard to your case.

Counseling
In my private practice my intention is to provide a safe environment that allows the client to feel at ease and not judged. This form of reflective life process work allows 
the inner feelings to arise in the present moment from the mind or body which often leads to a healing process. 

Specifically my practice of Substance Use Counseling utilizes evidenced based  approaches of mindfulness and 12 step facilitation. Polarity Wellness counseling supports the client in his or her own healing process of enhancing a healthy life force, greater awareness and  expression of feelings that arise in the moment from the mind or body. Clients may be asked to complete homework of Polarity yoga or light stretching, journaling, and meditation to reduce social anxiety or substance use. Typically in  craniosacral therapy thoughts and feelings may be a brief update expressed before or after the session begins. However in Polarity 60 to 90 minutes can be utilized to examine the life process in greater detail and informs and  contributes to a more complete healing session.

Scheduling and Cancellations
Appointments  are usually 60 minutes. Appointments can  be  more if  you wish. If you need to cancel an appointment please notify me at least 24 hours in advance. If you give less than 24 hours notice of cancellation or if you no show for your counseling appointment I may refer you to someone else. There will be no cancellation fee for severe winter storms, sudden illness, or family emergencies. 


Fee Arrangement
Customary Counseling fee is $110 per hour cash or check, accepted if you do not have insurance I accept.

Therapeutic Bodywork either craniosacral or polarity fee is $70 per hour.

Therapeutic Bodywork Sessions are typically One Dollar per minute. A therapeutic bodywork session of 90 minutes is $85. Full payment(cash or check)is expected at the time of service unless other arrangements are made in advance. You are financially responsible for all charges rendered for service.


Insurance
BC+BS or Harvard Pilgam or Cigna is accepted for mental health counseling and substance abuse counseling. If you wish to submit your claim for craniosacral therapy Cigna has reimbursed in the past for treating PTSD. You would need to fill out your claim forms and send in the forms to your insurance provider. If you need my help filling out insurance I will do my best to help you. Insurance providers may reimburse you for bodywork. However, Preauthorization is recommended. Also Insurance may reimburse for polarity or craniosacral with (PCP/MD) doctors approval.  Your check or cash payment for therapeutic bodywork is expected at the end of each session.


Authorization of Treatment
Polarity or Craniosacral therapy services to minors and or those with legal guardians must be authorized by a parent or guardian.


If you are not satisfied with your therapeutic bodywork session I will offer your money back or a free session of therapeutic bodywork sessions.


Evaluation and Treatment Complaints
If at any time you feel dissatisfied with any aspect of our work together, please talk with me about it. This can be a very valuable part of our work together.

If you feel you have been treated unethically by me or any other therapist, and cannot resolve this problem, you can contact the licensing board of Professional Regulation, 109 State Street, Montpelier, Vermont 05609 or by phone 802-828-2390802-828-2390.


On the following page is a list of behaviors considered unethical by the mental health profession. The list may guide you in understanding your rights as a client.

Agreement
Your signature acknowledges that you have been given information regarding confidentiality, billing in keeping with HIPPA, scheduling/cancellation, fees, insurance, authorization for treatment, my professional qualifications and experience, a listing of actions that constitutes unprofessional conduct according to the Vermont Statutes, and the methods for making a consumer inquiry or filing a complaint with the office of Professional Regulations. Your signature also indicates your understanding and agreement to the above stated policy.

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Signature of Client  (Parent/Guardian)        Printed Name        Date

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Signature of therapist                    Date

* A list of actions that constitute unprofessional conduct are attached





 
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