[Torre M.

Shepker, MA]
[ Email: Shepker.counseling@gmail.com ]
[Fort Leonard Wood, Missouri 65473 ]

PROFESSIONAL DISCLOSURE STATEMENT

Qualifications

In 2008, I earned an Associate of Science in Behavioral Science from Georgia Military College. After completing a
psychology degree from Troy University in 2012, I sought to expand my knowledge. I did tremendous research and
enrolled in Wake Forest Universitys Counseling Program, a rigorous course load that has been identified as a top
counseling program in the nation. In 2015, I was inducted to Chi Sigma Iota, a counseling academic and professional
honor society, and I am also a member of the American School Counselor Association, Association for Play Therapy, and
the American Counseling Association. I have successfully completed 66 credit hours with a GPA of 3.8. On May 15, 2017,
my Master of Arts in Counseling was conferred, and I officially graduated.

In December of 2016, I attended a workshop at Missouri State University in which I received education and training for
Play Therapy Techniques in the amount of 6 continuing education credits (CEUs). The certificate is available to see upon
request.

I am actively pursuing licensure through completion of the PRAXIS Examination, which will grant me School Counseling
Licensure. Additionally, I am actively pursuing completion of the National Counselor Examination, which propels me
toward obtaining a Provisional Licensed Professional Counselor distinction. The completion of my degree allows me to
counsel under the supervision of a qualified supervisor.

Counseling Background

My focus lies within School Counseling, serving K-12 student populations, and I have spent one year at Partridge
Elementary School in Fort Leonard Wood, MO sharpening the my skills as a Professional School Counselor. Currently, I
have a particular theoretical interest in exploring Cognitive Behavioral Therapy, Child-Centered Therapy, and Play
Therapy. I also enjoy the implementation of a person-centered clinical atmosphere. Course highlights of my Master of
Arts in Counseling program include: Lifespan Development, Group Counseling, Cultures & Counseling, Basic & Advanced
Skills, Counseling Children, Consultation & Program Development, and Family Counseling.

Session Fees and Length of Service

As a Professional Counselor, services will be decided on a case by case basis. Length of service will begin at the onset of
the school year and continue until the end. If the needs of a client supersede my scope of practice, a professional
referral will be given to the client and/or parents/guardians [as appropriate], with great consideration being given to: (1)
the needs and preference of the client and (2) the expertise and abilities of community mental health professionals.

Use of Diagnosis
Professional Counselors do not conduct diagnoses alone. If a qualifying diagnosis is appropriate in your case, I will inform
you of the diagnosis before the qualified staff submits the appropriate documentation. Any diagnosis made will become
part of your permanent records.

Confidentiality

All of our communication becomes part of the clinical record, which is accessible to you upon request. I will keep
confidential anything you say as part of our counseling relationship, with the following exceptions: (a) you direct me in
writing to disclose information to someone else, (b) it is determined you are a danger to yourself or others (including
child or elder abuse), or (c) I am ordered by a court to disclose information.

Complaints

Although clients are encouraged to discuss any concerns with me, you may file a complaint against me with the
organization below should you feel I am in violation of any of these codes of ethics. I abide by the ACA Code of Ethics
(http://www.counseling.org/Resources/aca-code-of-ethics.pdf).

Missouri Committee for Professional Counselors Missouri Department of Elementary & Secondary
3605 Missouri Boulevard Education
P.O. Box 1335
Jefferson City, MO 65102-1335 Physical Address:
205 Jefferson St.
Telephone: 573.751.0018 Jefferson City, MO 65101
Fax: 573.751.0735 Telephone: 573-751-4212
TTY: 800.735.2966
Voice Relay: 800.735.2466
Mailing Address:
E-mail: profcounselor@pr.mo.gov P.O. Box 480
Jefferson City, MO
65102-0480

Acceptance of Terms

We agree to these terms and will abide by these guidelines.

Client: ___________________________________________________ Date: ___________

Parent/Guardian: __________________________________________ Date: ___________

Counselor: ________________________________________________ Date: ___________