RAINIER BEHAVIORAL HEALTH
5909 Orchard Street West * Tacoma * WA * 98467
PH: 253-475-6021 / FX: 253-474-1871
Barry Anton, Ph.D., ABPPMarsha Cain, M.D. Ryan Coon, Psy. D.
E. Thomas Dowd, Ph.D., ABPP Amy Dwyer, LICW Natalie Glover, Ph.D.
Jodi Howell-Nagy, Ph.D.Vanessa Honn, Ph.D. George Jackson, M.D.
Kirstin Kirschner, M.D.Catherine Mulhall, M.S.W. Stephanie Munizza, LMFT, CDP.
Susan Poole, Ph.D.Thomas Roe, Psy. D. Emily Schoenfelder, M.S.W.
Fletcher Taylor, M.D. Trenton Williams, Ph.D. Alita Kathryn Markus, M.A., L.M.F.T.
Alita Kathryn Markus, M.A., L.M.F.T.
Washington State law requires that I share the following information with you and that you indicate you have been informed by signing one copy of this form. Please read the following information carefully. I welcome discussing any questions or concerns you may have regarding this agreement of my services.
CREDENTIALS: I hold a Master’s degree in Clinical Psychology with an emphasis in Marriage and Family Therapy from Pepperdine University (1995). I have worked in various agencies since 1992, including hospital settings, notably emergency psychiatry, from 2005-2017. I have been in private practice since 2006 seeing individuals, couples, families, and groups (adults, adolescents and children.) I am also an international Open Dialogue practitioner and trainer (see paragraph four in “current practice” section below.)
I have been a member of the California Association of Marriage and Family Therapists since 2004 and a member of the Washington State American Association of Marital and Family Therapists since 2017, when I moved to Tacoma from Santa Barbara, California. I was licensed by the State of the State of Washington as a Licensed Marriage and Family Therapist (LMFT#60785809) in 2017, and by the State of California as a Licensed Marriage and Family Therapist (LMFT #43665) in 20006. I ascribe and adhere to the Code of Ethics of the American Association of Marriage and Family Therapists and to the ethical and professional standards of the Washington State certification law.
CURRENT PRACTICE: I maintain a private practice treating individuals, couples, families, and groups. I am experienced with GLBTQ populations, adolescents, couples, family members of those with addictions, those with addictions themselves, those caregiving dying or ill family members, and those experiencing loss/grief/dying themselves. I especially love working with entire families/social networks who are concerned about someone experiencing an altered state/different reality (sometimes labeled “psychosis”).
I practice via open-ended conversation (i.e., dialogically), and I prefer working with multiple professionals in sessions. Every position in a family, couple, or greater social network has a voice and a perspective that is important and unique from all the others. Allowing and hearing all the voices is a tenet of dialogical practice. Conversations that emerge in therapy are infinite in possibility. We are relational and our engagement with the world is in endless motion. In dialogic practice, therapists practice holding “the space between”, i.e., the mystery and awe of people together creatively navigating through each dynamic relationship in their social and family context.
Dialogical therapists allow and promote a lot of mental space for new ideas to emerge, including silence, and prescribed reflecting segments within sessions, ideally co-facilitating with other professionals. The natural inner intelligence and capacity of each relationship and person to find its way is one premise I work from. We carefully witness, listen, and actively attend to what a family’s style is. Your goals and your strengths dictate the work done in therapy. Therapists help facilitate dialogue around the current, immediate needs of you and your family/social context.
I am an educator and trainer of psychotherapists and organizations in Open Dialogue, the public mental health model for treating psychosis and other mental health crises in Western Lapland, Finland. It has been studied and practiced there since the 1980’s. Open Dialogue is (1) inclusive (i.e., client-/family-/social network-centered,) (2) dialogic (listening and giving space to multiple positions and voices), (3) flexible and mobile (sessions vary in length, frequency, and locale adapted to the person and their extended support system), (4) promotes giving help as soon as possible in convenient settings, (5) encourages continuity of care (meaning that the same providers follow a case through), (6) tolerates uncertainty, and (7) expects that everyone (clients, providers, first-responders, the community) share responsibility. Philosophically, we treat people, not diagnoses. Many consumers and deliverers in mental health systems internationally have found it a relief to have learned about Open Dialogue, as it is evidence-based, cost-effective, integrative, and humanistic. Many countries are slowly adapting Open Dialogue to the way psychiatry is practiced. While the mental health system here in Tacoma does not replicate Western Lapland’s model, I seek to integrate Open Dialogue’s working principles and to partner with consumers and providers to apply what makes most sense to the mental health care delivery system, which always has room for change.
METHODS OF TREATMENT AND APPROACH TO THERAPY: You are the expert of you. Often patterns and behaviors appear for very good reason, whether new, maladaptive, or confusing, they can also be a sign of growth. Perhaps you are feeling what you are as a result of societal/systemic distress, or historical/familial trauma. Your current situation, just like in nature and in the seasons, could be a sign that something that is emerging inside of you needs space and attention. The only constant in life is change. The nervous system is constantly seeking balance between risk and safety. I have firm faith that you are exactly where you are supposed to be in that process, and one role I have as your professional counselor, is that of a compassionate seer.
I consider it a great honor and privilege to sit with people during times of grief/loss/change/wonder/difficulty. Relationships are often tremendous tools for pushing us where we’d never go alone. The scope of my license and practice is relationships, which includes your relationship to yourself, your relationship to your family, your relationship to your past/present/future, your relationship to your neighborhood and friends, your relationship to your world, and your relationship to what lies beyond that. Neuroscience research has finally caught up with ancient wisdom, that indeed, relationship is medicine.
I respect diversity in my practice. Your cultural and spiritual values/beliefs/interests are of utmost importance to me in our work.
With agreed upon consent from you and everyone present in a particular session, I sometimes videotape sessions to better my practice as a psychotherapist. We share each other’s work among professionals for educational purposes. I will not show videos without your explicit consent, and I will not reproduce them in any way.
You always have the right to request a change in treatment or to refuse treatment. It is essential that what we do together meet your needs. If you believe you are not getting the help you need, please voice your concerns. My clients are my best teachers for improving my work as a counselor. If we are unable to work out meeting your needs together to your satisfaction, I will assist you in finding another therapist.
CONFIDENTIALITY: Your permission is required for the exchange of information among professionals of your treatment team. I will not exchange or release information without your explicit consent. On occasion, I will consult with colleagues about my work with a particular client to gain feedback and suggestions about treatment. In no case will your name be given or unique information be used in such consultations. I find it most useful, when multiple professionals are involved in your care, so if there is a possibility of co-facilitating together with all persons present, I prefer that, for your benefit. That way you know what is discussed and multiple perspectives can be heard simultaneously. You are welcome to bring anyone you’d like to sessions to collaborate together.
APPOINTMENTS: Your appointment time is held exclusively for you. Please arrive on time. If you miss your appointment without proper cancellation (24 hours or more), you will be charged for the time. Insurance does not reimburse for missed sessions and you will be responsible for the full payment.
EMERGENCY CALLS: Call 911 or go to your nearest emergency room for medical emergencies, but in the case of a mental health emergency related to your care under me, when you call the Rainier Associates main number (253-475-6021) an answering service takes all emergency calls outside of regular business hours. They will attempt to locate me or the on-call therapist in the event of your emergency. My voicemail is not checked regularly so going through the answering service is the only safe way of getting either myself or the on-call therapist should the need arise.
BILLING AND PAYMENTS: Fee payment is your responsibility. Please keep current with your portion of the bill (the part not covered by insurance) each session or at the end of the month. If you are unable to manage this, please work out a payment arrangement in advance. Ultimately you are responsible for your account and are expected to pay your bill, whether insurance pays for a portion or not. A finance charge of 1% may be added to any balance not paid in 60 days after the charge is incurred. If 90 days passes without a payment, accounts may be sent to a collection agency. If you have questions about your account you may speak to me or someone in the billing office at any time.
INSURANCE: Be sure to check with your insurance company and our intake office to learn whether I am a provider for your plan. Inquire if your plan requires a preauthorization or a PCP referral, if you have a separate annual deductible for mental health and whether your mental health benefit has a maximum yearly number of sessions or a maximum yearly dollar amount. Our intake department can assist you with any of these questions. The billing department will submit claims to insurance companies. In order for this to occur you must complete the insurance portion of the “Patient Information” form attached to this office policy statement. They will need a copy of your insurance card.
CHANGES TO OFFICE POLICY: I will attempt to inform you of changes to these office policies as they may from time to time.
CONSENT FOR TREATMENT: I have read Alita Markus’s Office Policy Statement and understand it. I consent to therapy under the terms described above and understand I have the right to terminate treatment at any time. My signature below indicates I have received a copy of this agreement.
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Alita Kathryn Markus, M.A., L.M.F.T.