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Associate Licensed Professional Counselor (ALPC

Brittany Glaser
I am currently pursuing a licensure as an Associate Licensed Professional Counselor in Georgia. I am
also simultaneously working towards receiving my Master of Counseling and Master of Divinity at
Wake Forest University and will graduate with both degrees in May 2016. In my affiliation with the
Wake Forest counseling program, I am qualified to counsel under the supervision of a program faculty
member. My formal education has prepared me to counsel individual adults, adolescents, and children;
groups; couples; parents; and families.
Counseling Background
For my internship, I am at Salem College’s Counseling Center and directly supervised by Dr. Jack
Locicero. I will also be supervised by Dr. Erin Binkley at Wake Forest University who will review
session tapes and advise me throughout my internship. While at Salem, I will provide individual as well
as group counseling under supervision. I will also work with the other counseling intern to provide
programing surrounding wellness and mental health for the students on campus.
For my practicum, I was at Meadowlark Middle School and was directly supervised by Kim Mickey.
When there, I served the middle school population in that setting. In my practicum, I offered individual
counseling and group counseling while under supervision. I also assisted in other school counseling
endeavors and responsibilities, such as registration.
In my master’s program and under supervision, I have practiced counseling skills with classmates,
counseled several clients, and led counseling groups.
I will keep confidential anything you say as part of our counseling relationship, with the following
exceptions: (a) you direct me in writing to disclose information to someone else, (b) it is determined
you are a danger to yourself or others (including child or elder abuse), or (c) I am ordered by a court to
disclose information.
Nature of Counseling:
I believe that each person has the inner capacity to grow, thrive, and pursue wellness. In counseling, I
will work with you to help you find your own meaning and truth. Together we will work to understand
your story, the elements of that story that have been keeping you from thriving, and reframe those parts
in ways that will be life-giving and meaningful.
I believe in the power of acceptance as part of that reframing and I will work with you in your journey
towards embracing yourself as you are without judgment. In sessions we will continually work to
identify your strengths and find ways to both build them up and use them to help cope with daily

My main hope in counseling is for you to find wholeness, health, and self-acceptance.
Although clients are encouraged to discuss any concerns with me, you may file a complaint against me
with the organization below should you feel I am in violation of any of these codes of ethics. I abide by
the ACA Code of Ethics (
North Carolina Board of Licensed Professional Counselors
P.O. Box 77819
Greensboro, NC 27417
Phone: 844-622-3572 or 336-217-6007
Fax: 336-217-9450

Acceptance of Terms
We agree to these terms and will abide by these guidelines.
Client: ___________________________________________________ Date: ___________
Counselor: ________________________________________________ Date: ___________