Located in Charleston, South Carolina.
Pastoral Christian Counseling Agreement
You must be 21 years of age or over in order to purchase a Christian Pastoral Counseling session here at Soul Clinic. In order to be fully informed about the Christian Pastoral Counseling you will be receiving, please read through this following agreement, fill out the consent form, including today’s date, checkmark what applies to you, then sign your first and last name in the black box the bottom.
This form must be signed and the intake form must be completed and returned before we are able to proceed with your session.
***(Note to couples: Each individual should fill out their own form.)
The goal of Christian Pastoral Counseling is to help an individual think biblically about their current struggles in the context of a confidential, caring environment.
A Christian Pastoral counselor relies on Scripture as the sole authority for the way in which we conduct ourselves.
Guided by biblical principals, the Pastoral counselor role is to utilize guided questioning, empathetic support, problem-solving, reflection/reading assignments, encouragement, and prayer. In addition to that the Pastoral Counselor must provide wise, biblical and faith-filled counsel to those who are hurting and in need.
We also focus on the person’s thought process and how it may be influenced by past events. We address the root cause and core issues of current problems so that lasting change and personal growth may occur.
What Our Christian Pastoral Counseling Sessions Provide:
Focus on present problems and situations
Specific situations or behaviors
Short term (for a period of weeks and up to 6 months)
Action and behavior focused
Guidance, support, and education to help people identify and find their own solutions to current problems
All interactions which take place in the setting of pastoral counseling are considered confidential. This includes requests by telephone, all interactions with this pastoral counselor, any scheduling or appointment notes, all session content records, and any progress notes that I take during your sessions. I will not even verify that you are a client. You may choose to give me permission in writing to release any or specific information about you to any person or agency that you designate.
Limits to this Agreement
If I learn of or believe that there is physical or sexual abuse or neglect of any person under 18 years of age, I must report this information to county child protection services.
If I learn of or believe that an elderly person or disabled person is being abused or neglected, I must file a report with the appropriate state agency that handles elder abuse.
If I learn of or believe that you are threatening serious harm to another person, I am obligated to report this. This can be in the form of telling the person whom you have threatened, contacting the police or requesting hospitalization.
If there is evidence that you are a danger to yourself and I believe that you are likely to kill yourself unless protective measures are taken, I will be obligated to seek emergency services for you or to contact family members or others who can help provide protection.
Your Rights As A Client
1. You are entitled to information about any methods of Christian Pastoral counseling, techniques.
2. You have the right to end counseling at any time without any moral, legal or financial obligations.
3. You have the right to expect confidentiality within the limits described.
4. You have the right to authorize your counselor to consult with a professional about your biblical counseling sessions in writing.
Contacting Soul Clinic Christian Counseling Services
To schedule an appointment, please email us: email@example.com or call our office at (843) 608-9884
For all emergencies, or if you are in crisis, please call 911, or go to your local emergency room.
Before you schedule a counseling session, you must acknowledge that you have read the aforementioned and agree to the terms by check-marking the boxes below and signing your first and last name in the black box below.
Also, please fill out the attached contact form, which must include your first and last name, email address, phone number with any questions or concerns or the date and time you would like to schedule your session and we will email a reply to you at our earliest convenience.
I have read and discussed the above information. I understand the nature and limits of confidentiality.
Once You Have Completed, Signed and Submitted the Form Above, You May Now Schedule an Online Counseling Session.