Professional Disclosure Statement
David Bolton, M.Ed., LCMHC
6626 Gordon Rd.
Wilmington, NC 28411
910-765-1003
Dbolton88@gmail.com
I am a North Carolina Licensed Clinical Mental Health Counselor License #906. I received my master’s degree in counseling in August of 1988 from the University of North Carolina Greensboro and have been practicing continuously since that time. I have been in private practice since 1998 and first began work in the mental health field in 1982. I have also been trained as a clinical supervisor.
Experience
I have a wide range of clinical experiences. In 1982 I began work in a mental health center working with substance abuse clients suffering from addiction and mental health issues. I then worked for Guilford County Social Services with adolescents and children; I worked at Youth Focus, Inc., supervising group homes for troubled youth, and foster home placements and their staff supervision; Project Safe Place a program for runaway youth; Individual and group counseling with 7-17-year-old youth as well as family counseling with parents of these youth for over 13 years. Later, I specialized in the treatment of sexualized youth performing evaluations for court and counseling for those individuals and their families.
As I continued in private practice I began to work with probation and parole clients charged with sexual crimes, performing evaluations, individual and group counseling. This led me into learning and receiving extensive training in the treatment of sexual abuse, domestic abuse, post-traumatic stress disorder, and the trauma related to incarceration. For three years I worked extensively with Federal Probation to treat and clinically supervise parolees returning to civilian life, providing individual and group counseling, as well as clinical recommendations for these individuals.
During this time, my practice Triad Behavioral Resources became licensed with the State of North Carolina in Guilford County as a Domestic Abuser Treatment Program and worked with individuals charged with domestic abuse crimes.
Around this time, I began working with veterans suffering from PTSD and conducted a study in conjunction with the David Lynch Foundation, demonstrating the effectiveness of transcendental meditation on counseling to reduce the symptoms of trauma. I continued my training and practice of cognitive behavioral therapy with a wide array of clients and clinical issues, including addictions, PTSD, depression, anxiety, sexual and physical abuse as well as mood disorders.
I have collaborated extensively with psychiatrists and other medical practitioners in my private practice and have provided medical counseling for clients and utilized psychiatric services to assist clients in stabilizing their behavior and improving their lives.
In 2003, my brother passed away from issues related to alcoholism and drug addiction. This life experience prompted me to shift the focus of my clinical practice by starting a Medication Assisted Treatment Program for opiate addicts using the medication buprenorphine. My clinical practice has refined its clinical interventions by combining individual, group and family counseling to address the systemic problems associated with opiate and alcohol addiction. Our practice also uses drug testing to monitor effectiveness and compliance with our Medication Assisted Treatment Program. We work extensively with individuals seeking treatment for opiate and alcohol addictions and I specifically treat mental health issues associated with the recovery from addiction. I am not a substance abuse counselor; however, I am knowledgeable about addictions and my focus is on the treatment of mental health concerns that arise from addiction.
Counseling Orientation and Approach
My theoretical orientation is based in cognitive behavioral therapy. I also draw from gestalt training, existential therapy and psychodynamic training. Sessions with me will involve identifying your strengths and building on those skill sets. My role in our sessions will be to assist you in identifying areas where you will develop a working plan that positively alters how you experience your life and the choices you make. My role is to assist you in improving relationships that you identify as important, and to raise your overall functioning and well-being in a way that is built to last over time. You may have questions about medications or other medical treatments. I am not a medical doctor, but I can offer information based on literature and clinical experience with other patients who have experienced similar issues. I will always refer you to your treating physician to answer specific questions I am not qualified to answer. In addition, I will, at your request and permission notify your treating physician regarding your concerns, your progress and other pertinent clinical issues that will improve your treatment outcomes.
Fees and Insurance
It is my responsibility to inform you that as a part of your clinical record, I will document our interactions together with some impressions of how we are proceeding, goals and outcomes expected, but I will not release any documentation or any part of your record without your expressed consent. See below in Confidentiality regarding exceptions to this rule.
Individual sessions are typically 30 minutes to one hour. Group sessions are typically one hour. Intake sessions can last anywhere from 50 minutes to 90 minutes. I do file insurance claims for you and am a cash fee for service provider. My initial fee for intake is $175, and $125 for follow up counseling sessions of 30 – 60 minutes in length. If our sessions exceed the allotted time, you will be billed additionally for every quarter hour above the hourly rate. For instance, if we work for 75 minutes at $125 per hour, your session will be $156.25, adding an additional $31.25 per quarter hour. If you are using insurance, you are responsible for any copays or deductibles applicable to your plan.
We do not offer a sliding fee scale. Cash pay services are to be paid at the time of service. We accept cash, debit and credit card. We do not accept checks. Copays are also due at time of service.
Confidentiality
Our sessions are confidential in nature. There are only a few exceptions that require me by law to break confidentiality. One exception is when a crime has been committed on the premises or against a member of the staff. Other exceptions are explained below.
Most of our conversation in counseling sessions and the information revealed there is completely confidential, but there are the following exceptions: (1) I am bound by law to report to appropriate authorities if you appear to be a danger to yourself or to someone else, or if you disclose that you have abused, neglected, or exploited a child or an elderly or disabled person. (2) I will disclose information if I am forced by the court to do so, after appropriate protests have been exhausted. (A subpoena and a court order are required.) (3) I will disclose information to others if you request, in writing, that I do so. In all cases only the minimal amount of information necessary will be disclosed.
In the case of family or group therapy, confidentiality cannot be assured because the group members’ behavior cannot be controlled. However, clients will be discharged from the program if it is clear that they have broken confidentiality.
Though we keep records, they are for our own use. We will release information if you sign a release for us to share your information with someone or an agency. Part of that record is at least one diagnosis (depressive disorder, for example). If you choose to release this information, the diagnosis (or diagnoses) may negatively affect whether you can get health insurance, life insurance, or some licenses. Any diagnosis made could become part of your permanent insurance records.
Complaints
If you wish to file a complaint against me with the North Carolina Board of Licensed Mental Health Counselors, you may do so by placing that complaint in writing and sending it to the NCBLCMH at this address: North Carolina Board of Licensed Clinical Mental Health Counselors, 2-C Terrace Way, Greensboro, NC 27403. According to the American Counseling Association’s Ethical Guidelines, you should attempt to resolve your complaint with the counselor directly. If this is not successful, you may place your concerns in writing, citing the ACA ethical codes you believe to have been broken, and submit along with a completed NCBLPC Complaint Form to the board. (The ACA Code of Ethics, the Complaint form and the complaint procedures are available at the following website:
Ncblpc.org) The board will assign your complaint a number so no names will be known to anyone but the board attorney, administrator, and ethics chair. Once the complaint has been received, notification is sent to the counselor against which the complaint was filed allowing him or her to respond to the alleged charges. If necessary, the board will investigate the complaint and issue a ruling after gathering all information.
David Bolton, M.Ed., LCMHC