Intake Forms
Jillian Smith M.A
619-261-6189
My coaching philosophy empowers individuals to navigate their grief by setting and achieving personal goals. I focus on practical strategies that foster resilience and promote personal growth.
Master of Arts Marriage and Family Therapy Alliant International University, San Diego, California 2008
Bachelor of Science, Psychology and Social Science Dowling College, Oakdale, New York 2003
INELDA- International End Of Life Doula Association INELDA End-Of-Life Training Class - 33 Hours, September 26, 2021
Chapter 4 “Individuals Seeking Non 12-Step Recovery.” T. Horvath, T, Ph.D., ABPP and J. Sokoloff, MFT. Registered Intern (2010). Alcoholism & Substance Abuse in Diverse Populations
The coaching fee is $500, billed monthly. Please note that payments are not set up as recurring transactions; each month will require a manual payment.
THERAPIST
Works with
• Clients who are having difficulty functioning or are dealing with observable dysfunctions (e.g., depression, anxiety, addictions, etc.).
• Clients dealing with current traumas or old pain and issues.
Approach
• Holds mandatory face-to-face sessions.
• Does not give advice or tell patient what to do.
• Helps with coping mechanisms to resolve old pain.
• Helps correct cognitive disorders.
• Teaches how to be less reactive by changing behaviors.
• Listens and reflects.
Client Relationship
• Strong boundaries, involving legal and ethical limits and guidelines.
• Client is not allowed to know therapist personally.
• Relationship totally related to client issues.
• May involve crisis or emergency.
Finances
• Client payment is made after each session; paid by client or insurance filed by therapist for third-party payment.
COACH
Works with
• Clients who have healthy lives and are designing their future based on a strong personal foundation.
• Clients who want more joy in life, who wish to double their income, get the most out of business or life pursuits, etc.
Approach
• Holds sessions by telephone, in office, or online.
• Gives advice in many forms, but only within their expertise (refers out for therapy).
• Introduces tools and new skills to assist the client in achieving selected goals.
• Helps clarify client’s values, matching those values to goals.
• Listens, reflects, and problem-solves.
• Does not allow for large amounts of negative time.
Client Relationship
• High level of ethics in place by ICF; stated and co-signed boundaries.
• Coach and client are equal partners in the process.
• Coach and client share information.
• Emergency or crisis not involved.
Finances
• Priced by the month; payment is made in advance for the month, not by the call or visit.
• Coach does not file for insurance reimbursement.
Coaching vs. Counseling
This document outlines the differences between Coaching and Counseling, ensuring you understand which service is right for you before beginning our work together.
By signing below, you acknowledge that you understand the key differences between Coaching and Counseling and that you are choosing Coaching for your needs.
Agreement to Coaching Process
Please sign your name and date below as a digital signature acknowledging the following agreement: I understand that I am a client for a coaching program, not for therapy.
My full name and date on this information means that I understand and accept that I am a client for a coaching program, not for therapy.
Fee Agreement Acknowledgement
In consideration of professional services rendered, I the undersigned, do hereby agree to the following payment arrangement with Jillian Smith M.A., I am responsible for a fee of $500.00 per month, $125.00 per hour. Electronic forms of payment are accepted. Payments are due monthly. I understand that I am solely responsible for the agreed upon fee. The coaching fee is $500, billed monthly. Please note that payments are not set up as recurring transactions; each month will require a manual payment. Not recurring payments.
24 Hour Cancellation Policy Acknowledgement
If you are unable to attend an appointment, we request that you provide at least 24 hours advanced notice to our office. Since we are unable to use this time for another client, please note that you will be billed for the entire cost of your scheduled appointment if it is not timely canceled, unless such cancellation is due to illness or an emergency. For cancellations made with less than 24-hour notice (unless due to illness or an emergency) or a scheduled appointment that is completely missed, you will be mailed a bill directly for the full session fee. We appreciate your help in keeping the office schedule running timely and efficiently.
My full name and date on this information means that I understand and accept that I acknowledge and accept the 24 Hour Cancellation Policy.