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Helpful Forms

Adrienne offers psychotherapy services for individuals experiencing symptoms of depression, anxiety, disordered eating and relationship dissatisfaction. Adrienne also offers psychotherapy and guided self-help for individuals wanting to improve relationships, self-esteem and overall wellness.

Adrienne Benson M.Ed., RP

Helpful Forms & Worksheets

Starting therapy or guided self-help can be a difficult decision as the process of self-inquiry can bring up some difficult and/or long-buried emotions, thoughts and events.  The information provided below is designed to help you prepare for the process of therapy and to provide some basic tools/worksheets to get you started.

Helpful Forms: Basic information and administrative items to be reviewed and/or completed prior to beginning therapy or guided self-help.

Worksheets: Some typical and useful therapy tools to help you get started on your own or to supplement your therapy sessions.

Client Psychotherapy Intake Form Download

Authorization to Disclose Information Form Download

New Client Information Sheet Download

Online & Teletherapy Informed Consent Form Download

Growth Through Healthy Living

Frequently Asked Questions

Is medication a substitute for therapy?

In some cases a combination of medication and therapy is the right course of action. Working with your medical doctor you can determine what’s best for you. It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behaviour patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness.

Do you accept insurance? How does insurance work?

To determine if you have mental health coverage, the first thing you should do is check with your insurance carrier. Check your coverage carefully and find the answers to the following questions:

  • What are my mental health benefits?
  • What is the coverage amount per therapy session?
  • How many therapy sessions does my plan cover?
  • How much does my insurance pay for an out-of-network provider?
  • Is approval required from my primary care physician?

Is therapy confidential?

In general, the law protects the confidentiality of all communications between a client and psychotherapist. No information is disclosed without prior written permission from the client.

However, there are some exceptions required by law to this rule. Exceptions include:

  • Suspected child abuse or dependant adult or elder abuse. The therapist is required to report this to the appropriate authorities immediately.
  • If a client is threatening serious bodily harm to another person. The therapist is required to notify the police.
  • If a client intends to harm himself or herself. The therapist will make every effort to work with the individual to ensure their safety. However, if an individual does not cooperate, additional measures may need to be taken.