Disclosure of Supervision and Limits of Confidentiality

    Abigail Billings, Psy.D., LPCC
    ​
    Lisabeth Babson, Ph.D.

    Dr. Lisabeth Babson, a psychologist licensed in the State of Ohio, supervises the psychological work provided by the individual noted above. The supervisor provides supervision of psychological services requiring supervision as dictated by the Board of Psychology. The supervisor noted above maintains responsibility, as set forth by the Ohio Board of Psychology, for the work provided by the supervisee.  All information obtained by the supervisee noted above is subject to limits of confidentiality under Duty to Report Suspected Injury or Neglect of a Child (ORC sec 2151.421), Suspected Abuse of Adult (ORC 5101.61), Believed Abuse of MR/DD vulnerable adult (ORC 5123.61), and Knowledge/Belief of Domestic Violence/Abuse in Client Records (ORC 2921.22). We may release and/or obtain information without your written consent if we suspect that a child under 18 years of age and/or an intellectually disabled, developmentally disabled, or physically impaired child under 21 years of age has experienced or may face a threat of experiencing any physical, sexual, or mental injury, disability, or condition. We may release/obtain information if we reasonably believe that abuse or neglect of a child has occurred or will occur. As 'mandated reporters', we may be required to file a report with children's protective services (e.g., FCCS, NYAP), a local board of developmental disabilities, or an adult protective service agency such as the Department of Job and Family Services. We may be required to provide additional information if requested by these or other agencies. If we reasonably believe that the client presents a clear and substantial risk of imminent serious harm to him/herself, we must report that information to the appropriate public authorities. If a client poses a risk to another individual and/or property, then we may notify the individual who is at risk and/or the appropriate public authorities. If we believe that the client has been the victim of domestic violence, we may note that knowledge or belief and the basis for it in the record. We will make every attempt to limit disclosure of sensitive information. Please feel free to ask us any questions about the limits of your confidentiality. The supervisor can be reached at 614-706-7548 and is located at 132 Dorchester Square Suite 100 Westerville, Ohio.  The supervisor is available to meet upon your request. By signing below, I acknowledge the Disclosure of Supervision.
    Lisabeth Babson, Ph.D., Abigail Billings, Psy.D., LPCC
    Supervisor, Supervisee
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