Therapist Names, Credentials, and Phone Numbers:
- Ambra R. Born, Psy.D. (Clinical Psychology), Licensed Psychologist, 720-347-8836 (Tuesday, Wednesday, Thursday)
- Loraine Fishman, Psy.D. (Clinical Psychology), Licensed Psychologist, 720-507-9036 (Monday, Tuesday, Wednesday)
- Kelsey Kuperman, Ph.D. (Counseling Psychology), Postdoctoral Candidate, 720-588-8760, (Monday, Tuesday, Wednesday)
- Juanita Torres, Psy.D. (Clinical Psychology), Postdoctoral Candidate, 720-263-1184, (Monday, Tuesday, Wednesday)
- Sarah Gillingham, Psy.D. (Counseling Psychology), Licensed Psychologist, 720-347-8769 (Tuesday)
- Cody Weeks, Ph.D. (Clinical Psychology) Postdoctoal Candidate, 720-504-6709, (Monday, Tuesday, Wednesday)
- Tal Ginsburg, M.A. (Clinical Psychology), Postdoctoral Candidate, 720-598-2596 (Monday, Tuesday, Wednesday)
- Corey Petit, M.A. (Clinical Psychology) (Monday, Tuesday, Wednesday)
- Alissa Wolsky, M.A. (Clinical Psychology) (Monday, Tuesday, Wednesday)
- Jasmine Cervantes, M.A. (Clinical Psychology) (Monday, Tuesday, Wednesday)
- Aislin Guajardo, M.A. (Clinical Psychology) (Monday, Tuesday, Wednesday)
- Sandra T. Mann, PsyD, PLLC (Clinical Psychology) (Tuesday, Wednesday, Thursday)
- Kortnee S. Nelson, M.A. (Clinical Psychology) (Monday, Tuesday)
Business Addresses: 13611 E. 104th Ave, Ste 100, Commerce City, CO 80022
Business Phone: (720) 347-8769 Reaching HOPE main line
Business Email: info@reachinghope.org
Email is not a confidential form of communication and Reaching HOPE cannot ensure confidentiality or receipt in a timely manner; therefore, email should never be used to seek support for clinical or crisis/emergency situations.
Crisis: I understand Reaching HOPE does not have a 24 hour crisis line and in the event of an emergency, I will call Colorado Crisis and Support Line at (844) 493-8255.
Training of Mental Health Professionals:
The practice of licensed or registered persons in the field of psychotherapy is regulated by the Mental Health Licensing Section of the Division of Registrations. The Board of Psychology Examiners can be reached at 1560 Broadway, Ste 1350, Denver, Colorado 80202, (303) 894-7800. As to the regulatory requirements applicable to mental health professionals:
LICENSED PSYCHOLOGIST must hold a doctorate degree in psychology, have one year of post-doctoral supervision, and pass both the Examination for the Professional Practice of Psychology and the Jurisprudence Examination. A Psychologist Candidate must hold the necessary licensing degree and be in the process of completing the required supervision and examinations for licensure.
Licensed Clinical Social Worker, Licensed Marriage and Family Therapist, and Licensed Professional Counselor must hold a masters degree in their profession and have two years of post-masters supervision. A Marriage and Family Therapist Candidate and a Licensed Professional Counselor Candidate must hold the necessary licensing degree and be in the process of completing the required supervision for licensure.
Licensed Social Worker must hold a masters degree in social work.
Licensed Addiction Counselor must have a clinical masters degree and meet the CAC III requirements.
Certified Addiction Counselor I (CAC I) must be a high school graduate, and complete required training hours and 1000 hours of supervised experience. A CAC II must complete additional required training hours and 2,000 hours of supervised experience. A CAC III must have a bachelors degree in behavioral health, and complete additional required training hours and 2,000 hours of supervised experience.
Registered Psychotherapist is registered with the State Board of Registered Psychotherapists, is not licensed or certified, and no degree, training or experience is required.
Confidentiality: I understand that, generally speaking, the information provided by and to me during therapy sessions is legally confidential and cannot be released without my consent, except as required by law. There are exceptions to this confidentiality, some of which are listed in section 12-43-218, as well as other exceptions in Colorado and Federal law. In general, the exceptions include a "threat of serious harm to yourself or others" as in the case of child abuse, suicide, homicide, and grave disability; under a court order; or in response to any legal action taken by you against this agency. If a legal exception arises during therapy, if feasible, I will be informed accordingly. If you participate in group therapy, it is necessary for you to agree to protect and respect the privacy of other group members by not sharing personal information, including the names of other group members, with people outside of the group. You may expect other group members to show the same respect for your confidentiality.
As a client, you have the right to:
- Receive treatment only if you or your legal guardian give consent by signing this disclosure.
- Terminate treatment at Reaching HOPE at any time.
- Not be discriminated against, but rather be treated with respect and dignity.
- Actively participate with your treatment provider in creating a plan for your care.
- To include other people you think would be helpful to you in creating your care plan.
- Refuse treatment unless you are court-ordered to receive services and be informed of consequence of your refusal.
- To be represented by your guardian, if you are unable to fully participate in your treatment decisions.
- Receive written notification and request a second opinion if you disagree with your provider's decision to reduce or discontinue your services, or deny you services.
- Receive written information about Reaching HOPE's services, providers, and the fee structure.
- Be safe in therapy; in a professional relationship, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies the licensee, registrant or certificate holder.
- Complain about our services at any time without retaliation.
Follow-up: I understand that Reaching HOPE may contact me after termination of treatment to gather information needed for follow-up, program evaluation, and collection of unpaid debts.
Destruction of Records: I understand that the clinical records from this treatment episode may be destroyed if no further treatment is rendered within 7 years of the date of termination of this episode. Any person who alleges that a mental professional has violated the licensing laws related to the maintenance of records of a client eighteen years of age or older, must file a complaint or other notice with the licensing board within 7 years after the person discovered or reasonably should have discovered this. Pursuant to law, this practice will maintain records for a period of 7 years commencing on the date of termination of services or on the date of last contact with the client, whichever is later.
Animal Assisted Therapy: I understand that Reaching HOPE offers Animal Assisted Therapy (AAT) with dogs registered with Delta Society. I have the right to refuse this service at any time. I understand that while AA T therapy dogs have undergone training and testing to ensure safety around all people, these are animals and as such can be unpredictable; therefore, I agree to assume the risk of any injury or illness resulting from my interactions with AAT partners. I agree to be responsible for my own actions and respectful of the animals.
Supervision and Consultation: I understand that Reaching HOPE staff discuss all Reaching HOPE cases together to ensure best client care. I understand that all staff are receiving supervision by Drs. Austin and Born, licensed psychologists employed at Reaching HOPE. All discussion are confidential.
Consent to Email/Text Communication:
I understand that if I consent to communicate by email/text messages, I attest to the following:
- It is my request to use email/text. Any decision by either me or Reaching HOPE staff to stop the use of email/text will be respected.
- I understand normal text message rates may apply and will not be reimbursed by Reaching HOPE.
- I am responsible for notifying Reaching HOPE of any changes in email addresses, mobile numbers, or lost mobile devices as soon as possible.
- Email/Text communications are not secure and as such, confidentiality cannot be guaranteed.
- No therapeutic services will be provided via email/text communications.
- No emails/texts with urgent messages will be sent. Text/email will not be regularly monitored and is not intended for crisis purposes.
- I understand that email/text communications may be referenced or summarized in my chart and will be available for review by individuals authorized to access my health information.
- I understand the conditions above and have been made aware of the associated risk with regard to data protection.