School Counselor Disclosure/ Informed Consent Statement

Kristie M. Colpo
E-mail: Kristie.colpo@gmail.com

Background

I am a proud school counselor in the Greenville County School System. I hold a

Masters of Arts in Counseling, having successfully completed the CACREP (Council for
Accreditation of Counseling and Related Educational Programs) approved counseling
program with Wake Forest University.

In addition to the extensive coursework, my training included:

A 200-hour practicum at Bryson Elementary School in Simpsonville, SC.
A 600-hour Internship at Northwood Middle School in Taylors, SC.

Prior to my work in the helping profession, my professional training included an

M.S. in Physical Oceanography and Meteorology from the Naval Postgraduate School in
Monterey, CA. and a B.S. degree in Oceanography from the United States Naval
Academy in Annapolis, MD.

I have more than eleven years of informal counseling and leadership experience
as an active duty naval officer, including three years as a credentialed sexual assault
victim advocate for the Department of Defense. I continue to serve my community as a
counselor and my country as a Navy Reservist.

Experience Working with Children and Young Adults

I have experience working with children and young adults spanning from
Kindergarten to post-secondary developmental levels. Specifically, I have worked as a
substitute teacher in Greenville County, a varsity lacrosse coach at Hillcrest High School,
a volunteer lacrosse coach for the YMCA and Greenlight Lacrosse, and a Success Coach
at Greenville Technical College. I have worked with individuals and groups on issues
such as: sportsmanship, teamwork, exercising integrity, test anxiety, study skills,
organization skills, time management, prioritization, negotiating friendships, family
dynamics, relationship issues, major life changes, separation and divorce, identity
concerns, eating disorders, sexual assault prevention and response, as well as a host of
other concerns. My main modes of therapeutic intervention include Person-Centered
Therapy, Reality Therapy, Narrative Therapy, and Solution-Focused Therapy.

Confidentiality

What is said in counseling between the student (client) and the school counselor is
strictly confidential unless: 1) the client directs me verbally or in writing to disclose
information to someone else, 2) it is determined the client is a danger to himself or
herself or others, 3) the client discloses that he or she has been physically or sexually
abused, or 4) I am ordered by a court to disclose information. As a mandatory reporter,
disclosures involving alleged child abuse will be reported to the South Carolina
Department of Social Services in accordance with South Carolina State Law.

Although clients, and their guardians, are encouraged to discuss any concerns
with me, you may file a complaint against me with my supervisor listed below.

Counseling Relationship

The counseling services provided will be based on a relationship characterized by

trust and respect. The counselor and client will work together to both identify goals for
counseling and to move toward meeting those goals. The counseling sessions may
include an exploration of thoughts, feelings, personal history, communication styles,
attitudes and beliefs about self and others, and personal development needs. The school
counselor will receive supervision from the department chair of the school counseling
office.

Supervisor Information

Questions or comments regarding my counseling methods or the overall process

required for being a school counselor can be directed to myself or my counseling
supervisor, Ms. Elizabeth Hamer, Professional School Counselor, Northwood Middle
School.

Northwood Middle School

710 Ikes Road
Taylors, SC 29687
Phone: 864.355.7020
E-mail: ehamer@greenville.k12.sc.us

Acceptance of Terms

By signing below, the client or parent/legal guardian 1) acknowledges that he or she has
read the information above and has had any questions regarding its contents explained
and 2) agrees to allow counseling services to be provided.

Client: ________________________________________________ Date: ____________

Signature of parent/guardian:_____________________________ Date:____________

Counselor: _____________________________________________ Date: ____________