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Consent Form

​INFORMED CONSENT FOR PROFESSIONAL COUNSELING & COACHING SERVICES

Shawn McBride, MA, LCPC
The Couples Counseling & Coaching Center, LLC

Shawn McBride Therapy, LLC

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Description of Practice

Shawn McBride, MA, LCPC is licensed in the State of Maryland (License # LCPC-13229) and provides professional counseling, pastoral counseling, and coaching services through The Couples Counseling & Coaching Center, LLC and Shawn McBride Therapy, LLC. He is solely responsible for your clinical care.

Services offered include, but are not limited to:

  • Individual counseling

  • Couples counseling

  • Pastoral counseling and coaching

  • Caregiver support

  • Assessments and specialized therapeutic modalities

Clients located outside of Maryland receive services under a coaching framework.

If you have questions or concerns about any aspect of your treatment, you are encouraged to discuss them directly with Shawn.

 

Your Rights as a Client

You have the right to:

  • Ask questions about any therapeutic or coaching methods used.

  • Decline any technique or approach.

  • End therapy at any time without moral, legal, or financial obligations beyond what has already been accrued.

  • Return to therapy at any time.

  • Review your records upon request.

  • Authorize release of your records to any person or agency you designate.

  • Request limitations on how your protected health information is used.

  • Receive confidential communications through alternative means.

  • Be treated with respect, competence, and professionalism at all times.

  • Speak openly with your therapist about concerns, complaints, or disagreements.

  • Expect that your privacy and confidentiality will be protected within legal limits.

Your therapist also has the right to terminate the therapeutic relationship if clinically appropriate or necessary.

 

General Information

1. Appointments

Sessions are 55 minutes and may occur weekly, bi-weekly, or as mutually determined.

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2. Missed Appointments

Cancellations must be made 24 hours in advance (Friday by 5:00 p.m. for Monday appointments).
Late cancellations or missed sessions are billed at the full session fee, payable before the next appointment.

After three late-cancelled or missed sessions, the therapist reserves the right to terminate treatment.

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3. Phone Calls & Emergencies

All calls go to voicemail and will be returned within 24 hours (excluding weekends).
In a crisis or life-threatening emergency, do NOT call the office—call 911 or go to the nearest emergency room.

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4. Referrals

Shawn does not provide hospitalization services. If inpatient or psychiatric evaluation is needed, appropriate referrals will be made.

 

5. Confidentiality & Its Limits

All information shared in therapy is confidential except in circumstances required by law, including:

A. Risk of harm to yourself or others
B. Suspected abuse or neglect of a child, elderly adult, or vulnerable individual
C. Court orders requiring release of records
D. Other legal or ethical exceptions as defined by Maryland law

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Fees & Payment Policies

  • 55-minute session: $330

  • 3-Session Package: $995

  • 3-Hour Intensive: $1,497

  • Premarital Counseling Package: $1,997

  • 6-Month Programs: $3,800

Fees are the same for counseling, therapy, or coaching.
Payment is due at each session.
Accepted forms of payment include credit card, HSA, and FSA.

The Couples Counseling & Coaching Center does not bill insurance.
Superbills may be provided upon request.

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Psychological Evaluations

Clients needing psychological testing will be referred to an outside licensed psychologist. Those providers bill separately.

 

Termination of Treatment

Termination occurs when:

  • Your goals have been met

  • Attendance becomes inconsistent

  • Another provider would better meet your needs

  • You do not follow mutually agreed-upon treatment plans

  • Fees are not paid

  • Safety, violence, litigious behavior, or ethical concerns arise

  • The therapeutic relationship becomes compromised

Your therapist will never terminate treatment to pursue any form of personal, business, supervisory, or social relationship with you.

 

Initial & Ongoing Assessment

Assessment begins in the first session and continues throughout treatment. If another therapist or specialist would better serve your needs, appropriate referrals will be made.

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Benefits & Risks of Therapy

Therapy can lead to meaningful growth, clarity, improved relationships, and emotional healing. However, it may also involve:

  • Discomfort

  • Emotional intensity

  • Exploration of difficult memories

  • Temporary increases in stress or conflict

  • Unanticipated changes in relationships

No outcome or specific result can be guaranteed.

Clients may develop strong emotions toward the therapist; these will be addressed ethically and professionally. Sexual or inappropriate behavior is never permitted and is strictly unethical.

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Minors

Confidentiality for minors (ages 13 and under in Maryland) follows state laws and will be reviewed with parents/guardians during intake.

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Custody & Visitation Cases

This practice does not conduct custody evaluations and cannot provide recommendations regarding custody or visitation.

 

No-Secrets Policy (Couples & Families)

When treating a couple or family as a unit, the treatment unit—not the individual—is considered the client. Information shared individually may be disclosed to the full treatment unit if clinically necessary. This policy protects the integrity of treatment and prevents conflicts of interest.

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Communication (Text, Email, Phone)

Texting and email may be used solely for scheduling or logistical communication.
Therapy is not conducted via text, email, or phone.

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Firearms

This practice is a weapon-free zone. No firearms or weapons of any kind are permitted.

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Financial Responsibility Agreement

By engaging in services, you accept full responsibility for all fees and agree to remit payment as outlined. Fees may increase at any time without prior notice.

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Informed Consent Agreement

By making an appointment, you acknowledge that you have read, understand, and agree to all terms in this Informed Consent. A copy will be provided upon request.

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