Consumer's Guide to Mental Health

Your Rights, Your Voice: Why Informed Consent Matters in Mental Health Care with Scott Stolarick

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In this episode, Dr. Margo Jacquot of The Juniper Center sits down with Scott Stolarick to break down the role of informed consent in mental health care—and why it’s so essential for creating a safe, supportive experience. Together, they explore what informed consent really means, how it empowers clients to understand their options, and why having a clear voice in their care can make all the difference. Listeners will learn how informed consent helps build trust, strengthen the therapeutic relationship, and ensure that care is collaborative rather than confusing or overwhelming. Whether you’re new to therapy or looking to better understand your rights as a client, this episode offers clarity, reassurance, and practical insight into how informed consent lays the foundation for meaningful, effective care.

What You'll Learn:

  • The role of informed consent in building trust and strengthening the therapeutic relationship 
  • Why informed consent is essential for creating a safe, respectful therapy experience
  • What informed consent means in the context of mental health care
  • How understanding your rights as a client can increase comfort and confidence in treatment

Bio:

Scott is a licensed, trauma-informed psychotherapist who has been practicing in the state of Illinois for 33 years. He is an experienced administrator and clinical supervisor as well as a seasoned clinician. Scott has Management and Leadership Certifications from the University of Notre Dame and Cornell University. Scott is currently the owner of Mosaic Pathway Counseling in Gurnee, Illinois. Throughout the years, Scott has provided successful treatment planning for depression, anxiety, anger management, sexual abuse (victims and perpetrators), sexual addiction, substance abuse, marital discord, and family conflict, just to name a few. He is also a polished public speaker and has provided a variety of clinical workshops at the local and state levels.

Dr. Margo Jacquot is the award-winning founder and Chief Care Officer of The Juniper Center, one of the largest woman-owned counseling and therapy practices in the Chicago area. With over 20 years of experience, she specializes in trauma recovery, addiction treatment, and LGBTQ-affirming therapy. Dr. Jacquot is also the host of the "Mental Health Business Mentor" podcast, where she shares insights on running a successful mental health practice.

Connect with Dr. Margo Jacquot:

SPEAKER_01

Welcome to the Consumer's Guide to Mental Health. I'm your host, Dr. Margot Jacco. I'm a licensed clinical psychologist and have been in practice for, well, a few decades. During that time, I have come to see just how complicated the world of mental health and finding resources can be. So many different types of treatments, so many different types of insurance to navigate. This podcast will break that down for you. Understanding treatment options and navigating insurance to exploring resources and real-world strategies. Each episode gives you practical insights to support your mental well-being. Let's get started. Hi everyone. Thanks for joining us. Lovely to have you here. If you're a first-time listener, wonderful to have you. If you're back again, wonderful to have you as well. This is the Consumer's Guide to Mental Health, and I'm Dr. Margot Jacco. I'm a clinical psychologist in the Chicago area. And this podcast is for anyone who's wanting to learn about anything to do with mental health. So today we have a guest who has been on a different podcast that I am a part of, and I'm thrilled to have him back again. Let me tell you about our guest today. Today we are talking to Scott Stelleric. He is a licensed trauma-informed psychotherapist who's been practicing in the state of Illinois for 33 years. We discovered we're about half an hour apart. He's an experienced administrator and clinical supervisor as well as a seasoned clinician. Scott has management and leadership certifications from the University of Notre Dame and Cornell University. Scott is currently the owner of Mosaic Pathway Counseling in Gurney, Illinois. Throughout the years, Scott has provided successful treatment planning for depression, anxiety, anger management, sexual abuse, victims and perpetrators, sexual addiction, substance abuse, marital discord, and family conflict, just to name a few. He's also a polished public speaker and has provided a variety of clinical workshops at the local and state levels. Welcome, Scott Stelleric. Thank you for being here today.

SPEAKER_00

Well, thank you for having me back. I'm very appreciative.

SPEAKER_01

Well, I appreciate you donating your time. This is a podcast for people who just are curious about mental health. And so I think any of us that are doing this, we're donating some time to help people understand our field. So thank you for doing that.

SPEAKER_00

So pleasure.

SPEAKER_01

Today we're talking about, in addition to some other things, but informed consent essentially. And can you just explain what we are talking about when we're talking about informed consent?

SPEAKER_00

Sure, yes. Informed consent is in a brief definition, just understanding thoroughly what you're about to become involved in. Many people who venture out into therapy to try it, either individually, couples or families, many have not tried it before and are very, you know, curious about it and have a feel that and a belief that it can do right by them, but it doesn't mean that they fully understand it. So I think the informed consent goes to many levels of the process, talking about the therapist's role, the client's role, you know, if there's a teenager involved, what exactly is passed along if parents inquire and what isn't. So primarily what to expect. And for me, I talk about my style and how I go about developing rapport and gathering information. So I want to make sure that they fully understand the journey.

SPEAKER_01

Yeah, it's just what it sounds like. You are giving your consent and it's a signed piece of paper that the therapist and the client have discussed and said, this is what you can expect, to use your words. This is what you're in for, this is how I work, this is what I do. I want you to understand that. So why is it such an a fundamental, important part of what we might consider as clinicians, ethical therapy, ethical treatment and mental health?

SPEAKER_00

Sure. Yeah, it's a big part of it, the part of it, you know, foundationally. There are one of the reasons it's such an important component is I think just the respect of the client and the earning of their trust by telling them what this is and how it will play out and what to expect as it plays out. And also confidentiality limits that exist. Not everyone knows that. Occasionally you'll get a client who is also a mandated reporter, so they know a little bit about confidentiality limits, but talking about exceptions to confidentiality is important as well, not just in terms of a piece of paper and reading and signing, but also discussing child abuse and neglect, duty to warn, elder abuse, things of that nature are important to cover, especially if you're dealing with a minor and that minor has parents or guardians who are involved in the process. They want to know the lay of the land, especially if they have not done this before. You know, I liken it to anybody who goes to a doctor's office for the first time, and you kind of want to know what to expect. And when you don't, it's nerve-wracking enough, I think, to go see a doctor, but to know kind of the expectation of what is going to occur is always helpful. I think many times we find ourselves in situations, and we've all been there, where you're filling out a new patient questionnaire and going through all the labor associated with that. And you go into the appointment and the assistant, the PA, the nurse, whomever it happens to be, asks you those questions again. And then I think when you're actually with the provider, it's not uncommon for them to come at it for a third time if you're not expecting that kind of redundancy, which I think is just maybe a process of being thorough, it can be frustrating. I think it's good to make that known. I have clients, as I'm sure you do and others, fill out, you know, client information and client history forms. And what I will do with them is basically say up front that I have not read the material you've submitted yet. And the reason I have not read that yet is because I want to formulate my own fresh interpretation without any bias coming in that has been written by you or a parent or anyone else. But after we talk today, I will go to that and read it as part of my social history gathering as well. So, and the reason I say that is to avoid that frustration with gee, I already told wrote this down on my form. Why are you asking me again? You know, kind of things. So I want to be transparent about that and you know, kind of get off on the right foot and allow the opportunity to ask questions and clarify.

SPEAKER_01

Which is wonderful. So, however, the provider chooses to use the information or use the process, the idea is let's just be transparent. Let's tell people what's happening. Right. So, your informed consent is here is what you can expect, here's how I work. To your point, you were talking about mandated reporting child abuse, reporting elder abuse, limits of confidentiality, which I bet you there are a lot of folks who don't realize there are actually limits to confidentiality. And they come into treatment. And guess what? If somebody hasn't disclosed that, then they feel very betrayed. Like, what do you mean you're gonna call the authorities on me? Why would you do that? So, what are some of the limits to confidentiality that a therapist ought to be talking about on the front end?

SPEAKER_00

I think the main ones refer to, you know, first and foremost, child abuse and neglect. And I kind of explain how that would work using, you know, physical abuse examples, neglect examples, disclosures of sexual abuse. And we talk about how experiences like that cannot be, you know, kept under wraps, that if something like that did occur, it has to be reported to child welfare. And even if the alleged abuser is not officially in a caretaking role, I think it's just good form to notify child services and they can then tell you whether it's a yay or nay, but you've done it. I think that's first and foremost. Elder abuse is also kind of it falls under that category as well, as it pertains to a person caring for an elderly family member. If that elderly family member is the identified patient or client, or if they're involved as a family, or if they're not involved, but they're in the household and someone admits that they've harmed them or they've, you know, withheld treatments from them or food, those are important things to discuss as confidentiality limits. Duty to warn if someone says that they have credible intent to leave your meeting and go inflict an act of harm upon another person. You have an obligation to notify authorities of this. Now, people say things in jest all the time, but it's always important to firmly and closely examine what it is they're saying. And if someone is, you know, really committed to a statement that they make, you have to report that to the local authorities. And just as it relates to these examples I've given, not all clinicians feel the need to do this, and they don't have to theoretically, but I will share with my clients that I reported. I'm not going to duck that or hide from that. I'm not going to pretend like you know, it happened and I'm mystified by it in session. And so oftentimes I will call with a person, with them present, so that we all know what happens. And if that injures or severs the relationship from that point forward, it does. And that's, you know, uh a byproduct of the ethical considerations. Another one that doesn't get talked about a lot too is collusion. I do a lot of couple therapy. And as part of that couples therapy, I will break off and do an individual session with each person to gather social history information. And before I do that, we talk about what collusion is and how a therapist cannot participate in acts of collusion. And an example of that could be if I'm sitting down with one of one person in a couple, husband, wife, boyfriend, girlfriend, same-sex relationship, doesn't matter. And the one person says, I'm so glad that I have you alone because I really have to tell you something about so-and-so, and that I don't want him to know about, or this, you can't enter into that because then it's just what the statement is it's collusion, and you're now forming a connection with one person, if essentially against another. And that could become very fragmented if your client is indeed the couple. So collusion is important to discuss when talking about relational work with people. Another example is when working with minors. Guardians or parents are entitled to know how things are going in therapy with their kid or the person that they're responsible for. And I talk at the very beginning about just that mom and dad, or whoever the legal guardians of that particular minor are, they have the right to call and say, hey, how are things going? What's been going on? And when they do, with the minor there, I say, This is the kind of update I would give to them. And I would be very general. I would say something to the effect of Johnny is participating, is becoming more engaged as we progress, and is talking about things that, in my opinion, are very important and relevant to the treatment plan, as opposed to saying, you know, he really can't stand his dad, and I just want you to know that it's not one of those deals, or he experimented with the pot. And I just wanted to let you know that. Now, if substance use is injurious, if it's happening to a degree to which it's risky and hazardous, then I have a conversation with that miner about bringing it to their parents' attention. So I think it's important to go into all this on the front end because the risk of betrayal runs high if a consumer, a client does not know any of this. Exactly.

SPEAKER_01

Yeah, Scott, though you what a beautiful job. I mean, you covered a lot of territory there. And folks who are listening, the Illinois mental health law, I think all of us are familiar with HIPAA. You know, we have HIPAA privacy, but the Illinois mental health law, at least in our state, supersedes the HIPAA regulations. And that's true in any state. Whatever is the most stringent are the rules we have to follow. And so we are what are called mandated reporters. By law, we have to follow certain guidelines or we are out of compliance. So things like reporting if somebody's gonna go hurt somebody. And you mentioned child abuse. It's not if you tell your therapist, boy, 30 years ago somebody abused me, unless they're still in charge of children. By and large, that's not what we're talking about. We're talking about somebody who could actively hurt a child right now, or you were you are a child, you're a minor. That's a different story. We don't call about adults on adults. That's not it. But these are all things that we are mandated to report because it's about the welfare of society, and that's part of what we're the guardians of. The one thing you didn't touch on, Scott, is what do you do if somebody tells you they're suicidal?

SPEAKER_00

Oh, thank you. Yeah, very important one. I think uh a disclosure of uh ideations of self-harm have to be thoroughly assessed, discussed. And if indeed the person is feeling this way and has verbalized a plan, the important thing is to facilitate a higher level of care and additional assessment for higher level of care, I should say. And in the case of a minor, that would be involving parents that would be talking about the situation in detail and facilitating a referral to a local emergency room to do additional assessment so that that person can be protected from essentially from themselves. So that's very important to go into if somebody uh discloses that and you want to get really detailed information. If somebody says, I feel like harming myself, and you ask, okay, is that a a current feeling? Are you feeling that at this point in time? Well, no, but I felt it yesterday. I don't feel it today. I kind of had it come and go yesterday. That's different, it's noteworthy, but different from I feel it right now. I feel it intensely, and when I get home, I think I'm gonna do X and Y to follow through on this ideation I have. So very, very serious, and you know, one that you want to be part of involving higher care levels, if it's deemed a credible statement. And that gets into muddy waters too, because if you have, let's say, an adult client who has a long history of verbalizing ideations with no follow-through, you obviously have to take it seriously, but you also have to apply a larger context. And so my rule of thumb is you know, err on the side of caution always. And if someone happens to say it every time they're in your office, then every time they're in your office, they're going to experience the routine, so to speak, that it would become to flag that behavior and bring it to the attention of those who can assess for higher care level.

SPEAKER_01

Mm-hmm. Absolutely. And you know, nobody's got a crystal ball, right? Yours works as well as mine does. Mine rolls all off my desk all the time. I never know where it is. We can't know if somebody means it right now or not, or if they're serious about it or not. And people feel things very intensely in the moment. So our job isn't to be mind readers, folks, right? I mean, you may come in and say to your therapist, I feel like killing my, I'm so sick of this lifetime. Your therapist has to then, doesn't mean anybody's gonna pick up the phone right at that moment and call 911 and say, get here, toot sweet, we've got to get this person out of here. That's not it. Our goal, our job is to protect people, right? Always in whatever the circumstance is. We take the oath when we're getting our degree is conferred upon us, right? We sign something as licensed professionals to help protect folks. So that's really what we're about. So I think these are just things that are really good for people to understand. There are limits to that confidentiality, Scott. You've done a really nice job of describing what those are and what might happen and what the therapist's behavior might be like. So, and again, all of this is to help people feel more empowered, to help them feel safer in therapy. But what questions should someone ask their therapist or whoever the provider is, to ensure that they understand the informed care process? Because again, we might be telling them all this and they're saying, yeah, yeah, yeah, I've got my story to tell you. Let's go. But what kinds of questions might be wise for people to ask? Like assuming this is a part of the process, not just something to be ticked off from the checkbox.

SPEAKER_00

I think one question would be, you know, is everything I say in here private? You know, that's a good question to lead with. And I think that opens the door wide for a clinician to say, well, hopefully most of what you say, if not all, is private. But here are some exceptions to that. And let me go through that with you. And I think, or what do I do if I want you to talk to my last therapist? Then we'll talk about releases of information. So that would be kind of a good lead-in question that I don't think is asked enough. And you know, I think if someone asks that it really opens the door to a thorough informed consent conversation that should be happening anyway. But if it doesn't, that's a really important, you know, objective. I I think another good question is, you know, how what is your style? How do you go about this? Uh, do you come from a certain orientation? Are you eclectic in your approach? Do you have any specialties? No, a lot of this, you know, if clinicians have a social media or website presence can be touched on that way, but I always encourage it anyway, you know. Essentially for clients to do an interview of the therapist, you know, it doesn't happen enough. So I think uh that's a good consumer move to have is for individuals to interview the clinician, if you will.

SPEAKER_01

Right. And if a therapist won't spend a little bit of time, it could be five minutes, ten minutes, fifteen minutes, answering a few questions, folks, I might move on to the next person. And some folks will say, Well, my time isn't free. Well, you know, I shouldn't have to, uh, you know, this is a personal preference. I've done this my whole career, which spans a few decades. I'm always happy to hop on with somebody, as I think, Scott, you indicated you were as well, and just be able to ask some questions of the clinician. Here, tell me a little bit about yourself, how you work. And I make it a time-limited thing. Because boy, sometimes people can get on and that can be, you know, half an hour, an hour. We have 10 minutes. What can I tell you in 10 minutes? That I think is very fair. You know, you don't have to meet live and in person to do that. But I think it's a great idea. Do a little bit of an interview. Be an informed consumer. Make sure that this person understands how many people like me have you treated before? How many people who have experienced childhood neglect have you worked with before? And you know, how do you tend to work with folks like that? So I think that's a great suggestion to do an interview, and it is really okay to ask for that. And if somebody says they won't, you might want to consider moving on to the next person who will be more accommodating, my two cents. So how does this help people advocate for themselves in therapy, Scott? And thank you. I'm glad you agreed with that. I'm glad we're on the same page. But how does informed consent help people advocate for themselves then?

SPEAKER_00

In my personal opinion, it's immediate empowerment. Oftentimes when someone is seeking out therapy, it's because there's a lack of that existing healthy empowerment in their lives. And certainly not always the case, but it's the case enough to really know how important this informed consent piece is. So I think it's starting off by letting that person know that they are important enough to know the lay of the land and the rules, and that you are open to explaining those rules. And if something is not understood clearly that you're happy to go back to it and discuss it. So it really paves the path of trust and empowerment. And those are just very foundational elements when you start therapy. You have to be able to trust the person you're sitting across from.

SPEAKER_01

Absolutely. Bottom line, that word trust. I'm glad you said that because that really is the point of informed consent. In part, it helps create that sense of trust. And this, you know, we were kind of toying with what are we going to call this podcast, the client's guide, the patient's guide, that, you know, it was the consumer's guide. Why? Because when I think of myself as a consumer, I think of myself as having certain rights that I might not if I go into a doctor's office. I might think, oh, the doctor's busy. Can I ask questions? Do I that? No, you folks are the consumer. You have a right and potentially a responsibility to yourself or your loved ones to come to in advance make sure this is the right process for you, the right person for you. And you know what, Scott? I personally think if somebody has come to see me and I check in with them after the first, second, third, like the first several sessions, are we get are you getting what you came for? Does this feel like the right fit for you? No harm, no foul. If you say I'm not the person for you. And we really can be that kind of open, you know, have that kind of open process with them so that people don't have to feel bad, like, I don't want to hurt your feelings. Boy, this I was hoping somebody would be more cognitive behavioral and you're more process oriented or whatever. There's no harm, no foul. And if we've done a good job in our informed consent, hopefully we don't even have to do that. So yeah, I'm sorry.

SPEAKER_00

Well, and I think just real quickly, I think it's as clinicians, it's a privilege when clients come to see us. And and it's I think we have an obligation to act accordingly when you have a privilege of being let into someone's world.

SPEAKER_01

That's right. Oh, well said. It is a privilege to be let into someone's world. And if we can hold therapy as a therapist with that kind of reverence, not me walking around with a white coat. I don't even own a white coat, not me being the expert. I have expertise, but this is a process between the two of us where you get to ask questions, I ask questions, you ask questions. It's a partnership of sorts that really creates that environment of trust. So, Scott, what would the top three suggestions be that you would give to our listeners if they're going to start therapy and they are curious at all about this whole idea of trust and informed consent?

SPEAKER_00

Well, I think first and foremost, I think, you know, do your homework. I think psychologytoday.com is a wonderful resource to search for providers. And the reason I say that is it gives you a whole host of information, background and what insurance is accepted, style, availability, even a photo or a video if you want to get a feel that way. So do your homework front end. And I think the questions that I had asked or I had mentioned that people ask or should ask at the beginning, I think they should do. I think you want to know, you want to interview the clinician. You want to go in and know that this is a right fit. And you want to know that the relationship is collaborative and that you have a voice to verbalize discomfort, or if you felt like something was discussed that you really weren't in the mood to discuss, or if you felt guided towards something you didn't want to go toward, that's important too. So I don't know if that's three things, but definitely those would be points I would recommend because sometimes people just go hit the ground running, and maybe they're five sessions in and realize, you know, this just this isn't working, you know.

SPEAKER_01

Yep. And change does take time, but to your point, if after five sessions it feels wrong, like this isn't, we're not getting each other, this isn't the approach I was looking for to expect change, right? That does take time. But to your point, people kind of have a gut feeling of, oh, we're really clicking or we're not. So those are great suggestions, Scott. Thank you so very much for sharing your wisdom with us today. Scott Stelleric of Mosaic Pathway Counseling in Gurney, Illinois. If people would like to get a hold of you or learn more about you, how can they do so?

SPEAKER_00

I think the easiest way is just to go to the website, which is www.mosaicpathway counseling, all one word dot org, and they can find out pretty much anything that they want to know. It covers style intervention. I put pictures of what my office looks like on there. So it's a little bit of a uh desensitizing option. There's a video, there's a little bit about what I do outside the office for my spare time. So that's a kind of one-stop shop, is how it's designed to really give a consumer a view of what they're getting into and whether they feel it's a fit or not.

SPEAKER_01

Wonderful. And folks, that's those are great things to have on a website. And it just gives you a much better window into what you're going to find when you're interviewing a therapist. And I hope you will do so. So, Scott Stoleric, thank you so much for being here. All of you who have been listening, thank you for joining us. I hope you'll join us again next time. Be well. Thanks for listening to the Consumer's Guide to Mental Health with Dr. Margot Jaco. That's me. If you found today's conversation helpful, please be sure to subscribe so you won't miss future episodes. For more resources and information, check out the links in the show notes. And remember, mental health is health, and you deserve access to the support you need. Until next time, take good care of yourself and be well.