What is complex trauma?

Complex trauma isn't a single traumatic event that happened once. It's what occurs when you've lived through ongoing, inescapable harm—often starting in childhood or within relationships that were supposed to be safe. Sometimes this harm comes from systems that were meant to protect you: families, schools, churches, or other institutions. When safety, trust, and connection are consistently absent, it changes how your brain and body work. It affects how you see yourself, your sense of who you are, how you manage emotions, connect with others, focus, remember things, and make sense of your world.

What is the difference between PTSD and Complex PTSD?

In ICD-11, Complex PTSD is characterized as a variant of PTSD with additional and more severe symptoms. PTSD includes three core symptom clusters: re-experiencing the trauma in the present, avoidance of trauma reminders, and a heightened sense of current threat. Complex PTSD includes all the PTSD symptoms plus three additional Disturbances in Self-Organization: emotional dysregulation, negative self-concept with persistent feelings of worthlessness or shame, and interpersonal difficulties with trust and maintaining relationships. CPTSD is commonly associated with greater exposure to multiple interpersonal traumas earlier in life and exhibits higher functional impairment compared to PTSD.

What does complex trauma look like?

Complex trauma can affect nearly every aspect of life including emotional and mood-related symptoms like extreme mood shifts or chronic low self-esteem; relational patterns such as social isolation or fear of intimacy; behavioral responses including addictions or self-injury; sense of self issues like dissociation or feelings of hopelessness; cognitive difficulties with attention and focus; physical health problems including chronic pain; and impacts on meaning and belief systems including alienation from spirituality.

What insurance do you accept?

I accept the following Oregon Health Plan (OHP) Coordinated Care Organizations: Yamhill CCO, Trillium Community Health Plan, and Eastern Oregon CCO.

What is dissociation?

Dissociation is a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. It's a survival response where your mind creates distance from overwhelming experiences, emotions, or physical sensations. Dissociation might feel like being disconnected from your body or watching yourself from outside, losing time or having gaps in memory, feeling unreal or foggy, parts of yourself that feel separate or in conflict, numbness or feeling emotionally flat, or difficulty integrating memories and experiences into a coherent sense of who you are.

How long are therapy sessions?

Sessions are typically 45-60 minutes via phone or video through an electronic health record platform.

Privacy & HIPAA Policy | Josiah Erickson Counseling Oregon<br/>

Privacy policy.

Effective Date: December 16, 2024

THIS NOTICE DESCRIBES HOW YOUR PERSONAL HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. MY PLEDGE REGARDING HEALTH INFORMATION

I understand that health information about you and your healthcare is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records I maintain about you. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you and certain obligations I have regarding the use and disclosure of your health information.

I am required by law to:

Make sure that protected health information (“PHI”) that identifies you is kept private.

Give you this notice of my legal duties and privacy practices with respect to PHI about you.

Follow the terms of this Notice as it is currently in effect.

I can change the terms of this Notice, and such changes will apply to all PHI I have about you. The new Notice will be available upon request in my office and on my website.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

The following categories describe different ways that I use and disclose PHI without your permission. These uses and disclosures are more fully described below. Not every use or disclosure in a category is listed. However, this gives examples of the most common uses and disclosures.

Treatment: When and as appropriate, I may use or disclose your PHI to facilitate treatment or services, including disclosing your PHI to my supervisor in connection with my associate license or for the treatment activities of another health care provider involved in caring for you. For example, I may disclose your PHI to a licensed physician who treats you. Disclosures for treatment purposes may not be limited to the “minimum necessary” standard as defined in HIPAA because clinical social workers and other health care providers need access to the full medical and mental health record to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

Payment: When and as appropriate, I may use and disclose PHI about you to determine eligibility for certain insurance benefits, to facilitate payment for the treatment and services you receive from me, or to coordinate your coverage. I may share PHI with another entity to assist with a health claim or with a health plan to coordinate benefit payments.

Health Care Operations: When and as appropriate, I may use and disclose your PHI in connection with health care operations. For example, I may use PHI to conduct quality assessment, arrange legal services, conduct or arrange for a medical review, or for any other business management and general administrative activities.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose PHI in response to a court or administrative order. I may also disclose PHI about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION

Psychotherapy Notes. I keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your authorization unless the use or disclosure is:

For my use in treating you
For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling
For my use in defending myself in legal proceedings instituted by you
For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA
Required by law and the use or disclosure is limited to the requirements of such law
Required by law for certain health oversight activities pertaining to me
Required by a coroner or medical examiner who is performing duties authorized by law
Required to help avert a serious and imminent threat to the health and safety of others
Marketing Purposes. I will not use or disclose your PHI for marketing purposes.
Sale of PHI. I will not sell your PHI in the regular course of my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION

Subject to certain limitations in the law, I can use and disclose your PHI without your authorization for the following reasons:

When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law

For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety
For health oversight activities, including audits and investigations
For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain authorization from you before doing so
For law enforcement purposes, including reporting crimes occurring on my premises
To coroners or medical examiners, when such individuals are performing duties authorized by law
For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition; however, identifying information is generally redacted before such use
Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counterintelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions
For workers’ compensation purposes. Although my preference is to obtain an authorization from you, I may provide your PHI to comply with workers’ compensation laws
Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.

V. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI

The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.

The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.

The Right to Inspect and Copy Your PHI. Other than “psychotherapy notes,” you have the right to obtain an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost-based fee for doing so.

The Right to Request Disclosure of Your PHI. You have the right to request that I provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care. However, I may in emergency situations provide your PHI to a family member, friend, or other person that you indicate is involved in your care and the opportunity to obtain your consent may occur retroactively.

The Right to Receive a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request.

The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.

The Right to Receive a Paper or Electronic Copy of this Notice. You have the right receive a paper copy of this Notice, and you have the right to receive a copy of this notice by email. Even if you have agreed to receive this Notice via email, you also have the right to request a paper copy.

VI. WHAT TO DO IF YOU HAVE A PROBLEM WITH HOW YOUR PHI IS HANDLED OR IF YOU BELIEVE YOUR PRIVACY RIGHTS HAVE BEEN VIOLATED

If you have a problem with how your PHI has been handled, or if you believe your privacy rights have been violated, contact me. I will do my best to resolve any problems and do as you ask. You have the right to file a complaint with me, or with the Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington, DC 20201, or by calling 202-619-0257