Eric K. Mason, MA, MS, PhD Candidate
Licensed Professional Counselor (LPC)
Licensed Clinical Addictions Specialist (LCAS)
Certified Rehabilitation Counselor (CRC)
Internationally Certified Advanced Drug & Alcohol Counselor (ICAADC)
Certified Master Substance Abuse Therapist (CMSAT)
Member Singapore Psychological Society (MSPS)
Member American Psychological Association
Member American Counseling Association
203 TT Building
Soi 81 Sukhumvit
Wattana, Bangkok 10110
Ph: +66 (0) 80-60-999-76
Client Disclosure Statement
Thank you for choosing me as your counselor or consultant. This form is meant to inform you about my credentials and background, as well as to ensure that you understand our professional relationship.
I earned a MS in Addiction and Mental Health Clinical Counseling in 2009 from East Carolina University. In addition, I have a MA in International and Cultural Studies, as well as BA’s in Psychology and German. I am currently completing a PhD in Counseling Psychology at Assumption University in Bangkok. I have completed all course work for the PhD and passed the qualifying exams. I am in the process of completing the dissertation.
I am a Certified a Rehabilitation Counselor (CRC #00110985), a Licensed Clinical Addictions Specialist (LCAS #1661), a Licensed Professional Counselor (LPC #7660), an Internationally Certified Advanced Drug and Alcohol Counselor (ICAADC #206201), and a Full Member of the Singapore Psychological Society (MSPS). My licensures are verifiable at the following websites: www.ncsappb.org and www.ncblpc.org I have worked in the mental health and addiction filed for about 10 years.
Counseling Services Offered and Theoretical Approaches
People can make better decisions if they have enough information and understanding about how counseling works. Here are some aspects of counseling as I perceive and practice them:
Counseling requires your active involvement, including efforts to change any self-defeating thoughts, feelings, and behaviors. You will be asked to work both in and out of counseling sessions. There are no instant, painless, or passive cures. In short, there are no “magic pills.” Instead, you will work on improving yourself through homework assignments and other therapeutic techniques. Most likely, you will be asked to work on improving stress management, belief systems, relationships, and your general lifestyle, if counseling is to be successful. Change may be relatively easy at times; however, more often change will take much effort, time, and persistence. It is not uncommon that some psychological and behavior patterns have been reinforced for 20 to 30 years and will not change with insight alone. These entrenched behavior patterns and ways of thinking will usually require much focused time and effort.
It is important that you are upfront about the reasons you have sought out counseling. Although counselors and psychologists may possess a great amount of insight into the human mind, they are not mind readers. Issues that people may have a hard time talking about include sexuality, infidelity, abuse, and drug addiction. Most mental health professionals with any amount of experience will not be caught off guard by any of these issues. In short, no topics are off limits and please feel free to discuss any of your concerns.
I utilize an eclectic counseling approach, which is a mix of different approaches. Mostly, I rely on Person-Centered Therapy, Motivational Interviewing, Cognitive-Behavioral Therapy, Solution Focused Therapy, and Narrative Therapy. These are all well established, researched, and respected therapies.
I provide counseling services to adolescents and adults with general mental health concerns, rehabilitation needs, substance use disorders or addictions, relationship problems, vocational concerns, as well as those in need of general supportive counseling.
In addition, I am qualified to administer various types of psychological tests for assessment and diagnostics purposes. For example, this includes comprehensive assessments for ADHD and/or other psychological disorders, as well as to assess overall functioning in general.
Mental health counseling and therapy can involve both benefits and risks. Potential benefits include becoming free from self-defeating, and self-destructive behaviors, developing more satisfying relationships with other people, becoming happier, and living a healthier lifestyle. Risks may include experiencing uncomfortable feelings or difficulties with friends and family members during the counseling and/or rehabilitation process. Personal growth often involves change. Sometimes changing the way we usually function or relate to others involves considerable stress. Major life changes like divorce and changing jobs or careers, although stressful in the short-term, may be the conclusion you arrive at as a result of professional counseling in order to actualize your long-tem mental health or career potential. For example, an outcome of counseling may not be to keep a dysfunctional marriage together at all costs. Sometimes it is in the best interests of both spouses and other family members to separate.
When people enter into counseling, they may receive a diagnosis when appropriate. Diagnoses are not meant to be judgmental or to reflect upon you, negatively. They are simply a short-hand method clinicians use to describe a group of symptoms that one may be experiencing.
I regard the information you share with me with the greatest respect. I want us to be as clear as possible about how this information will be handled. Generally, I will not tell anyone what you tell me. The privacy and confidentiality of our conservations and my records will be held confidentially according to my profession’s ethical standards in all but a few circumstances. These circumstances are as follows: (1) If I believe you intend to harm yourself or another person; (2) If I believe a child or elderly person has been or may be abused or neglected; (3) In rare circumstances, a judge may order professional counselors to release information. (4) I may share information with my supervisor (for clinical advice); however, your name will not be associated with such information. I will ask your permission and ask you to sign a consent form before any information is released. Otherwise, I will not tell anyone anything about your treatment, diagnosis, history, or even that you are a client, without your full knowledge and, usually, a signed “Release of Information Form.”
Explanations of Dual Relationships
Although our sessions may be very intimate psychologically, it is important to remember that we have a professional relationship rather than a social one. Our contact will be limited to sessions you arrange with me. Please do not invite me to social gatherings, offer me gifts, or ask me to relate to you in any other way than the professional context of our counseling sessions. You will be best served while I am seeing you for counseling and therapy if our relationship stays strictly professional and if our sessions concentrate exclusively on your concerns. You will learn a great deal about me as we work together during your counseling experience. However, it is important to remember that you are experiencing me in my professional role.
Length of Sessions
I assure that my services will be rendered in a professional manner consistent with accepted ethical standards. Sessions are 60 to 75 minutes in duration. If you are unable to keep an appointment, please call to cancel or reschedule at least 24 hours in advance. Please note that it is impossible to guarantee any specific results regarding your counseling goals. Often, counseling and treatment goals change with increased understanding. Your counseling, treatment, or rehabilitation goals will likely be modified throughout the counseling process. However, counseling and rehabilitation goals will always be your goals. Together we will work to achieve the best possible results for you.
Individual sessions are 3000 Baht for a session and 7500 Baht for three sessions (if you pay in advance for three sessions). There is no charge for an initial consultation by phone or email. The costs of psychological assessments vary. Please contact me for details. Please notify me 24 hours in advance if you are unable to attend an appointment. Failure to do so will result in 1000 Baht fee for each missed appointment. Please note that prepaid sessions expire after eight weeks. Please make use of your prepaid sessions within that time period.
If you are dissatisfied with any aspect of our work, please inform me immediately. This will make our work together more efficient and effective.
If you have any questions, feel free to ask. Please sign and date this form.
Counselor’s Signature Date Client’s Signature Date
Eric K. Mason , MA, MS, LPC, LCAS, CRC, ICAADC, MSPS