Professional Disclosure Statement

 
 

Caitlin Keitel, BSW, Mapof

New Paradigm Process Therapy & Consulting

(802) 595-1876, E-mail: caitlin.keitel@gmail.com

Types of Counseling: New Paradigm Process Therapy & Consulting offers a variety of support services to individuals, couples, families and groups. These include therapeutic support unavailable in the mainstream psycho-medical treatment model, as well as consulting services for organizations seeking conflict transformation and healthy workplace cultures. NPPTC uses the facilitation techniques of Process Oriented Psychology and Leadership, within a social equity and anti-racist framework. NPPTC is an alternative way forward, through personal, historical, and cultural traumas and conflicts. Conflict may include, but is not limited to: relationship issues; social oppression; internalized oppression; thoughts of suicide; surviving the suicide of a loved one; death, grief, and loss; activist burnout; mental health conditions; physical illness, chronic pain, and acute symptoms; sexual trauma; any form of abuse, past and present; existential and philosophical suffering; life transitions; behavioral addictions; and more.

Methods: I am trained in the Process Oriented Psychology paradigm, which allows me to work with the whole person, and the deeper, meaningful patterns of their lifetime. I employ interventions that serve to externalize the polarities of conflict, in order to name and  bring awareness to the client’s internal experience. Building upon the client’s new awareness, I use role-play, earth-based meditation, sensory-grounded experience, and creative movement to invite new insights and fluid ways of dealing with painful situations. I believe that through greater awareness, one develops greater choice. My therapy style also acknowledges the significant impact of the social, historical, and political contexts in which we live. I am available to see clients on a weekly or bi-weekly basis.  


Fees: All fees are based on a 60 minute session. Fees: sliding scale between $60.00 and $100.00. A fee of $25.00 is charged for all sessions that are not canceled with 24-hour notice. In cases where there is less than 24-hour notice, call me immediately. If you can be rescheduled within the same week, you will not be charged the missed session fee.


I agree to pay $______________________ per session, payable at the beginning of each session.

Confidentiality: Whatever is said in your counseling sessions is confidential with the following exceptions: I am legally required to report suspected physical, sexual abuse and neglect of children or elders; serious threat of harm to yourself or others: if ordered by courts to testify or to provide treatment records; if you have signed a release of information form authorizing me to share relevant information with someone, like a doctor or teacher; confidential clinical supervision, with extreme caution taken to protect your anonymity and not reveal any identifying details.

Office Hours and Crisis Response: My practice hours are Monday-Saturday, and vary week to week. I am available throughout the week by email. Please give me 48-72 hours to respond. I am not able to offer crisis counseling in between sessions. If you feel that you are in immediate need of mental health treatment, you are advised to call the county mental health center in the community in which you reside.

Experience: I am a new practitioner of Process Work, receiving my MAPOF in June 2019. I studied at the Process Work Institute in Portland, OR, and continue to see clients at the River’s Way Community Clinic. I worked for the previous five years as a community-based social worker in Portland, invested in the development of grassroots movements for economic justice, affordable housing, good food access, and racial equity.

Education/Affiliations:

  • Process Work Institute of Portland Graduate School: Master of Process Oriented Facilitation

  • Rivers Way Community Clinic: Community therapist

  • Portland State University: Bachelors of Arts in Social Work

Professionalism: As a practicing Process Work therapist I will uphold the Ethical Principles and Standards of the Process Work Institute (PWI). Several PWI faculty, including Susan Kocen, MPW, provide ongoing supervision of my practice and skill development.


As a client of New Paradigm Process Therapy & Consulting you have the following rights:

  • To examine public records maintained by PWI and to have PWI confirm credentials of the therapist;

  • To view the complete Ethical Principles and Standards on the PWI website (http://www.processwork.edu/about-pwi/ethical-principles-and-standards-for-process-workers/);

  • To report complaints to the Ethics Committee using the Ethics Complaint Form (http://www.processwork.edu/ethics-complaint-procedure/);

  • To be informed of the cost of professional services before receiving the services;

  • To be assured of privacy and confidentiality while receiving services as defined by rule and law, including the following exceptions:  1)  Reporting suspected child abuse; 2)  Reporting imminent danger to client or others; 3) Reporting information required in court proceedings or by client's insurance company, or other relevant agencies; 4) Providing information concerning therapist case consultation or supervision; and 5) Defending claims brought by client against therapist;

  • To be free from being the object of discrimination on the basis of race, religion, gender, or other unlawful category while receiving services.

You  may  contact  the  Process Work Institute at 2049 NW Hoyt St, Portland, OR 97209 Telephone: 503.223.8188

I acknowledge that I received the Professional Disclosure Statement from my therapist Caitlin Keitel, BSW, MAPOF. I consent to treatment under these conditions.


Client Signature: /

Therapist Signature: /

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