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Karen Osborne-Rowland
828 -768-5440
2 South Main St.
Weaverville, NC 28787

 Therapeutic Orientation:

I work primarily with teens, adults, and families experiencing difficulties around developmental and adjustment issues. Issues that often need to be addressed include:

  • ADHD symptoms and challenges 
  • Body image and sexual identity
  • Family relationships and communication challenges
  • Grief and loss
  • Major life transitions
  • Peer relationships and peer pressure
  • Struggles for independence and autonomy
  • Trauma and PTSD
  • Understanding and managing stress
  • Your individual needs and concerns

I am mindful of the strong emotions that develop around personal developmental issues. I encourage my clients to identify and express those feelings, and to begin to understand their personal frames of reference.  I help clients and families to define what is important to them, to find their own strengths, and to look for ways in which those strengths can be used to address the area(s) of concern.  I generally use a practical approach, focusing on the development of short and long-term goals, examining the potential consequences of various courses of action, and asking the client to look at what has and has not worked in the past. We will also likely explore past experiences and how they have shaped current perspectives and challenges. In the course of our work together, in addition to talking, we may use journaling and readings, as well as play therapy, games, and art activities for fully engaging in the therapeutic process and relationship. On occasion, there may be an issue which I feel will be more appropriately addressed by a specialist, such as a psychiatrist or medical doctor. If that should occur, a referral will be recommended.  While I cannot guarantee the services of other individuals or agencies, every precaution will be taken to direct you toward those with high standards of professional conduct.

Therapy is a relationship that works in part because of clearly defined rights and responsibilities held by each person. This frame helps to create the safety to take risks and the support to become empowered to change. As a client in psychotherapy, you have certain rights that are important for you to know about because this is your therapy, whose goal is your well-being. There are also certain limitations to those rights that you should be aware of. As a therapist, I have corresponding responsibilities to you.  


I. Confidentiality  

With the exception of certain specific exceptions described below, you have the absolute right to the confidentiality of your therapy. I cannot and will not tell anyone else what you have told me, or even that you are in therapy with me, without your prior written permission. I will always act so as to protect your privacy even if you do release me in writing to share information about you. You may direct me to share information with whomever you chose, and you can change your mind and revoke that permission at any time. You may request anyone you wish to attend a therapy session with you.

You are also protected under the provisions of the Federal Health Insurance Portability and Accountability Act (HIPAA). This law insures the confidentiality of all electronic transmission of information about you. Whenever I transmit information about you electronically (for example, sending bills or faxing information), it will be done with special safeguards to insure confidentiality.

If you elect to communicate with me by email at some point in our work together, please be aware that email is not completely confidential. All emails are retained in the logs of your or my Internet service provider. While under normal circumstances no one looks at these logs, they are, in theory, available to be read by the system administrator(s) of the Internet service provider. Any email I receive from you, and any responses that I send to you, may be printed out and kept in your treatment record.

The following are legal exceptions to your right to confidentiality. I would inform you of any time when I think I will have to put these into effect.

1. If I have good reason to believe that you will harm another person, I must attempt to inform that person and warn him/her of your intentions. I must also contact the police and ask them to protect your intended victim.

2.  If I have good reason to believe that you are abusing or neglecting a child or vulnerable adult, or if you give me information about someone else who is doing this, I must inform Child Protective Services and/or Adult Protective Services.

3.  If I believe that you are in imminent danger of harming yourself, I may legally break confidentiality and call the police or the county crisis team. I am not obligated to do this, and would explore all other options with you before I took this step. If at that point you were unwilling to take steps to guarantee your safety, I would take additional steps to do so.  

II.  Emotional Risks and Consequences

Therapy has potential emotional risks. Approaching feelings or thoughts that you have tried not to think about for a long time may be painful. Making changes in your beliefs or behaviors can be scary, and sometimes disruptive to the relationships you already have. You may find your relationship with me to be a source of strong feelings. It is important that you consider carefully whether these risks are worth the benefits to you of changing. Most people who take these risks find that therapy is helpful. 

III: Ending Therapy

You normally will be the one who decides therapy will end, with some exceptions. If I am not, in my judgment, able to help you because of the kind of problem you have or because my training and skills are, in my judgment, not appropriate, I will inform you of this fact and refer you to another therapist who may meet your needs. If I feel verbally or physically threatened I reserve the right to end our work together.  If I terminate you from therapy, I will offer you referrals to other sources of care, but cannot guarantee that they will accept you for therapy.

IV. Record-keeping   

I keep very brief records, noting that you have been here, what interventions happened in session, and the topics we discussed. If you prefer that I keep no records, you must give me a written request to this effect for your file and I will only note that you attended therapy in the record. Under the provisions of the Health Care Information Act of 1992, you have the right to a copy of your file at any time, giving me the chance to print it out from my computer. You have the right to request that I correct any errors in your file. You have the right to request that I make a copy of your file available to any other health care provider at your written request. I maintain your records in a secure location.

V. Diagnosis

If a third party such as an insurance company is paying for part of your bill, I am normally required to give a diagnosis to that third party in order to be paid. Diagnoses are technical terms that describe the nature of your problems and something about whether they are short-term or long-term problems. If I do use a diagnosis, I will discuss it with you. All of the diagnoses come from a book titled the DSM-5, which I will openly share with you if you so chose.

VI. Other Responsibilities

When I plan to be away from my practice, I will tell you well in advance of any lengthy absence and give you the name and phone number of the therapist who will be covering my practice during my time away. I am available for brief between-session phone calls during normal business hours. If you are experiencing an emergency when I am unavailable you are encouraged to call 911 or go to your local Emergency Room for assistance. I have the responsibility to answer any of your questions about anything that happens in therapy. I'm always willing to discuss how and why I've decided to do what I'm doing, and to look at alternatives that might work better. You can feel free to ask me to try something that you think will be helpful. You can ask me about my training for working with your concerns, and can request that I refer you to someone else if you decide I'm not the right therapist for you. You are free to leave therapy at any time.


I. Timeliness

You are responsible for coming to your session on time and at the time we have scheduled. Sessions last for 55 minutes. If you are late, we will end on time and not run over. If I am late I will extend the time so that you have your full session. If you miss a session without canceling, or cancel with less than twenty-four hours notice, I ask that you pay for that session at our next regularly scheduled meeting. I cannot bill these sessions to your insurance. The exceptions to this rule are if you would endanger yourself by attempting to come (for instance, driving on icy roads), you are ill, or you have an emergency.

II. Payment 

You are responsible for paying for your session weekly unless we have made other firm arrangements in advance.

III. Insurance Information 

If you have insurance, you are responsible for providing me with the information I need to send in your bill. You must arrange for any pre- authorizations necessary. I will bill directly to your insurance company via electronic means for you on a regular basis. You must provide me with any forms, completely filled out as needed, your complete insurance identification information, and the complete address of the insurance company. If a check is mailed to you, you are responsible for paying me that amount at the time of our next appointment. If the insurance over-pays me, I will credit it to your account or refund it to you if you would prefer that. 

IV. Managed Mental Health Care

If your therapy is being paid for in full or in part by a managed care firm, there are usually further limitations to your rights as a client imposed by the contract of the managed care firm. These may include their decision to limit the number of sessions available to you, to decide the time period within which you must complete your therapy with me, or to require that you to seek a medication consult if their reviewing professional deems it appropriate. They may also decide that you must see another therapist in their network rather than me, if I am not on their list. Such firms also usually require some sort of detailed reports of your progress in therapy, and, on occasion, copies of your case file.  I do not have control over any aspect of their rules. However, I will do all that I can to maximize the benefits you receive by filing necessary forms and gaining required authorizations for treatment, and assist you in advocating with the MC company as needed. 

V. Complaints

If you're unhappy with what's happening in therapy, I hope you'll talk about it with me so that I can respond to your concerns. I will take such criticism seriously, and with care and respect. If you believe that I've been unwilling to listen and respond, or that I have behaved unethically, you can complain about my behavior to

The North Carolina Board Of Licensed Professional Counselors           
P.O. Box 77819      
Greensboro, NC   27417
Phone: 844-622-3572    336-217-6007 

You are also free to discuss your complaints about me with anyone you wish, and do not have any responsibility to maintain confidentiality about what I do that you don't like, since you are the person who has the right to decide what you want kept confidential.

With great respect and concern for your well-being,

Karen Osborne-Rowland
Fax:  828-658-0615