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Psychotherapist Employment Contract - DOC

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					                               Oregon State ADR Provider Roster
                                  Statement of Qualifications

                         Section #1: ADR Provider Contact Information & Languages

Last Name           Baker                                 First Name         Deborah
Company Name        Lakewood Counseling and Mediation

Business Address    543 Third St, Suite C-12

City                Lake Oswego                              State           OR

Zip Code            97034                                    Phone           503-697-3484

E-mail              DeborahBakerMA@aol.com                   Fax #           503-697-0704

Web Site                                                     Languages       English
                                                             Spoken

                                        Section #2: Provider Overview
           The following section provides a brief overview of the provider’s experience and qualifications

Deborah Baker is an experienced mediator and psychotherapist specializing in marriage and family
therapy. As a part of her private practice, she has been contracted by the Department of Human Services
to provide mediation for open adoptions, open guardianships, and other family issues, including parenting
and visitation planning. Some of the open adoption/guardianship agreements have been between family
members, including grandparents who planned to raise their grandchildren. Agreements for extended
birth family members and the adoptive parents or guardians have also been mediated. She has facilitated
numerous Family Decision Meetings for DHS to identify families' needs, set up services and support
resources to meet these needs, and establish reunification and transition plans for the children to be
returned to their parents' custody. She has provided mediation to develop pre- and post-divorce parenting
and visitation plans. Additionally, she has been contracted by DHS to provide marital and family
counseling to families who have come to the attention of protective services for threat of harm, abuse, or
neglect, with the goal of improving family functioning so that the children might be safely returned to their
parents' care.


Deborah believes in providing respectful and supportive mediation that creates a safe and comfortable
setting and accesses people's strengths to assist them in productively discussing difficult topics,
articulating their interests, creating new options, and resolving conflicts. Her twenty-five years as a
marriage and family therapist give her the skills and experience to assist people in handling their intense
emotions and reactions so that agreements can be successfully made as well as to help them build
rapport and establish ongoing, trusting relationships. Because Deborah has worked with a diverse
population, she can set a respectful tone and help people address and overcome their concerns and/or
conflicts about differences.
                            Section #3 Services Offered, Case Experience and Rates
                                                                 # of cases                        Other charges or rate
                                                                                   Rate per
                  Type of Service Offered                        (range) the                     structures for this type of
                                                                                    hour
                                                                provider has                           service, if any
                                                                    done
   Mediation involving two to five parties                     more than 100        100.00

   Large group mediation or facilitation (six or more          more than 100        100.00
parties.)
   Mediation or facilitation of workplace conflicts               BLANK              00.00

   Litigation Settlement Mediation                                BLANK              00.00

   Neutral Evaluation                                             BLANK              00.00

   Public Policy Mediation or Facilitation                        BLANK              00.00

   Other ADR related Services Pre- & post-divorce                  51-100           100.00
parenting & visitation plans, family reunification
   Other ADR related Services                                     BLANK              00.00

   Other ADR related Services                                     BLANK              00.00


Section #4: Does the Provider charge travel expenses to provide services in your area?

                                                                     Available to work in this     Available to work in this
                     County or County Area                            area without charging       area but will charge travel
                                                                        travel expenses.                  expenses
1 Clatsop, Columbia, Tillamook – Counties

2 Washington, Multnomah – Counties

3 Polk, Marion, Yamhill – Counties

4 Lincoln, Benton, Linn – Counties

5 Lane – County

6 Douglas – County

7 Coos, Curry – Counties

8 Josephine, Jackson – Counties

9 Hood River, Wasco, Sherman, Gilliam, Wheeler – Counties

10 Jefferson, Crook, Deschutes – Counties

11 Lake, Klamath – Counties

12 Morrow, Umatilla - Counties

13 Wallowa, Union, Grant, Baker – Counties

14 Harney, Malheur – Counties

15 Clackamas – County




                   Baker, Deborah                  Oregon State ADR Roster Provide Data Form     Page 2 of 12
                                 SECTION #5: Relevant Formal Education
               Provider’s relevant formal education (e.g., AA, BA, graduate degree or certificate, etc)

1978: MA in Counseling Psychology, University of Oregon
1972: BA in Psychology and Sociology, University of Illinois




                                  SECTION #6: Relevant Work Experience
Provider’s paid or volunteer work experience that contributed to his or her process (e.g., mediation) or substantive
                                        (subject matter) expertise or skills.
2000 - present: Open adoption mediation, contract with Department of Human Services (Adoption
Services) to mediate cooperative post-adoption agreements between the adoptive and birth parent(s).

2000 - present: Mediation, private practice, specializing in family mediations including open adoption,
open guardianship, pre- and post-divorce parenting plans, and visitation plans

2000 - 2004: Family mediation, contract with DHS to provide mediation for open adoptions with birth
family members other than the birth parents, parenting and visitation plans for family members, and open
guardianship

1998 - 2003:      Family Decision Meeting facilitation for Clackamas County Department of Human Services

1985 - present:    Psychotherapy private practice specializing in marriage and family therapy

1984 - present: Contract with the Department of Human Services to provide marriage and family therapy,
conduct family evaluations, facilitate Family Decision Meetings, provide clinical supervision, and
administer the Intensive Family Services Program in Clackamas County.



    Section #7: Standards the Provider Subscribes to and Professional Licenses Held

   Oregon Mediation Association Core Standards of Mediation Practice, April 23, 2005
  (http://www.mediate.com/oma/pg61.cfm )
   Association for Conflict Resolution, Model Standards of Conduct for Mediators, 2005 revisions.
  (http://www.acrnet.org/pdfs/ModelStandardsofConductforMediatorsfinal05.pdf)
   Model Standards of Practice for Family and Divorce Mediation developed by the Symposium on Standards of
  Practice, August 2000 (http://www.afccnet.org/pdfs/modelstandards.pdf )
   International Association for Public Participation (IAP2), Code of Ethics for Public Participation Practitioners
  (See http://www.iap2.org/displaycommon.cfm?an=1&subarticlenbr=8)
   Other professional standards that the provider subscribes to: Oregon Psychological Association, American
Association for Marriage and Family Therapists, National Certified Counselors


   Oregon State Bar #
   Other professional licenses: Licensed Marriage and Family Therapist T0103, Licensed Professional
  Counselor C0168


               Baker, Deborah                Oregon State ADR Roster Provide Data Form     Page 3 of 12
                      Section #8: Provider’s Specialized Areas of Expertise
                  Area of Expertise                                    Sub Specialty          Areas of expertise
               Business and Finance                                          General
                                                              Investment and Finance
                                               Patents or Intellectual Property Rights
                         Civil Rights                                      Civil Rights
                          Consumer           All Types, Consumer-Merchant Disputes
                                                             Assistive Technologies
                                                     Vehicle Sales, Service or Repair
                            Cultural       Cross Cultural, Ethnicity, or Related Fields
                          Education                                         Education
                                                                    Special Education

                      Environmental                   Agricultural Exceptions (goal 2)
                                                                           Agriculture
                                                          Air, Land and Water Quality
                                                                               Coastal
                                                      Endangered Species or Wildlife
                                                                               Energy
                                                                              Forestry
                                             Hazardous Materials and Environmental
                                                     Other Natural Resource Related
                                                         Water Resources, Wetlands

        Governmental and Regulatory     Government-to-Government (e.g., state-tribal)
                                                               Professional Licensing
                                                                        Public Utilities
                                        Child Dependency and Permanency Planning
                    Human Services
                                                                      (Adoption)
                                                                        Disability
                                             Family Services, including Service Plans
                                                                          Health Care
                                                                      Senior Services
                                                                       Social Services
                                                             Vocational Rehabilitation
                                                              Public Assistance - AFS
                        International                                     International
                                                     Collective Bargaining and Labor
              Labor and Employment
                                         General Employment and Human Resources
                                                              Workers’ Compensation
                                                   Workplace Interpersonal Disputes
           Torts or Insurance Claims                        Torts or Insurance Claims
                                              Construction Industry & Contracts, Civil
Transportation, Housing and Land Use
                                                                        Engineering
                                                                    Eminent Domain
                                                                    General Planning
                                                                 Growth Management
                                                                              Housing
                                                                             Land Use
                                                                              Railroad
                                                                        Real Property


            Baker, Deborah                Oregon State ADR Roster Provide Data Form        Page 4 of 12
                                              Siting Controversial Projects or Facilitates

                                    Section #9: ADR Related Training

Part A. Basic Mediation Training
   The Provider attended a basic mediation training course of at least 30 hours, comparable to the basic
mediation curriculum specified in section 3.2 of the Oregon Judicial Department Court-Connected Mediator
Qualifications Rules.

Course Name             Negotiation & Mediation            Year                              2000


Course provider,        PSU, Alison Taylor Ph.D            Length (hrs)                      32.00
trainer or sponsor

Part B - Mediation, Facilitation or ADR related training the provider RECEIVED in addition to the mediation training
described above.


ADVANCED SPECIALIZED CHILD WELFARE MEDIATION TRAINING, Jeane Etter, PhD (22 hours) 2000
BASIC MEDIATION, Jon Townsend (5 hours) 2000
HIGH RISK FAMILIES IN MEDIATION, Hugh McIsaac, Chris McIsaac, and Bealisa Sydlik, Oregon Mediation
Association (3 hours) 2000
CREATING PARENTING PLANS, Linda Scher, JD, Oregon Mediation Association (3 hours) 2000
WHEN ADOPTIONS GO AWRY, Rick Delaney, PhD, Portland State University School of Extended Studies
(4.5 hours) 2000
HOT ISSUES IN OREGON ADOPTION, ADOPTION RIGHTS, TECHNOLOGY, LAW, AND ETHICS, Various
presenters, Professional Development Network (6 hours) 2000
TEAM DECISION MAKING, Portland State School of Social Work (4.25 hours) 2001


Part C - Mediation, Facilitation or ADR related training the Provider CONDUCTED (includes a brief course name or
description and the year attended and approximate length of the course).


None




               Baker, Deborah                Oregon State ADR Roster Provide Data Form         Page 5 of 12
                         Section #10: ADR-Related Panels, Organizations or Programs
  The following section lists the provider’s experience on ADR-related panels, organizations or programs, if any.

                                  ADR Panel, Organization or Program Experience #1

                                                                                     Lead mediator or facilitator
Name of program,            Department of Human             Primary ADR
panel or organization       Services, Child Welfare,        Provider role on
                            Adoptions Unit                  this panel or
                                                            program

                                                            The date (year
                            Provide open adoption
Brief description of                                        only) of the             2009
                            mediation services as
the organization,                                           Provider’s most
                            outlined in OAR 413-120-
program or panel’s                                          recent involvement
                            0600-0635
function and the                                            with this panel or
Provider’s role in it.                                      program
                                                            Approximate total #      Total hours (if less than 100) =
Program Contact             Gail Schelle                    of case hours as an
Person                                                      ADR Provider in                 at least 100 hrs
                                                            this organization,
                                                            panel or program                at least 200 hrs

# of cases, by type,        100+ Mediation(2-5 parties)
that the ADR                      Large group facilitation or mediation (6 or more parties)
Provider conducted
                                  Mediation or facilitation of workplace conflicts
as part of this panel
or program                        Litigation Settlement Mediation
experience.                       Neutral Evaluation of Legal Disputes
                                  Public Policy Mediation or Facilitation

                                 ADR Panel, Organization or Program Experience #2

                                                                                     Lead mediator or facilitator
Name of program,            Department of Human             Primary ADR
panel or organization       Services, Child Welfare,        Provider role on
                            Clackamas County                this panel or
                            Branch                          program


                            Facilitate Family Decision
Brief description of                                        The date (year           2003
                            Meetings for families
the organization,                                           only) of the
                            involved with DHS
program or panel’s                                          Provider’s most
function and the                                            recent involvement
Providers role in it.                                       with this panel or
                                                            program
                                                                                     Total hours (if less than 100) =
Program Contact             Cindy Eisenmeyer                Approximate total #
Person                                                      of case hours as an             at least 100 hrs
                                                            ADR Provider in
                                                            this panel or                   at least 200 hrs
                                                            program
# of cases, by type,        60 Mediation (2-5 parties)
that the ADR provider       140 Large group facilitation or mediation (6 or more parties)
conducted as part of
                                  Mediation or facilitation of workplace conflicts
this panel or program
experience.                       Litigation Settlement Mediation
                                  Neutral Evaluation of Legal Disputes
                                  Public Policy Mediation or Facilitation


                 Baker, Deborah                 Oregon State ADR Roster Provide Data Form          Page 6 of 12
                          Section #10: ADR Panel, Organization or Program Experience #3

                                                                                    Lead mediator or facilitator
Name of program,          Department of Human              Primary ADR
panel or organization     Services, Child Welfare -        Provider role on
                          General Mediation                this panel or
                          Contract                         program


                          Provide mediation to
Brief description of                                       The date (year           2003
                          families for parenting &
the organization,                                          only) of the
                          visitation, guardianship,
program or panel’s                                         Provider’s most
                          grandparent contact, and
function and the                                           recent involvement
                          other family issues
Providers role in it.                                      with this panel or
                                                           program.
                                                                                    Total hours (if less than 100) =
Program Contact           Gail Schelle                     Approximate total #
Person                                                     of case hours as an             at least 100 hrs
                                                           ADR Provider in
                                                           this panel or                   at least 200 hrs
                                                           program
# of cases, by type,      30+ Mediation(2-5 parties)
that the ADR provider          Large group facilitation or mediation (6 or more parties)
conducted as part of
                               Mediation or facilitation of workplace conflicts
this panel or program
experience.                    Litigation Settlement Mediation
                               Neutral Evaluation of Legal Disputes
                               Public Policy Mediation or Facilitation

                             Section #11: Specific Case or Project Experience
               The following section describes the provider’s experience with specific cases or projects.

                                                         Case #1
Case/project name         OPEN ADOPTION MEDIATION WITH ADOPTIVE PARENT & BIRTH GRANDPARENTS

Description:              Mediation between the birth maternal grandparents, who were not chosen as the adoptive
                          resource, and the prospective, gay, adoptive father to develop a post-adoption
                          communication agreement outlining how the grandparents would have contact with the
                          two grandchildren and the adoptive parent once the adoption was finalized. The process
                          of mediation assisted the grandparents and adoptive father to overcome some significant
                          apprehension and begin the process of building a trusting, positive relationship that was in
                          the children's best interest.

Role                      Lead mediator or facilitator

Case Contact              Donna Thomas, DHS caseworker; Gaile Schelle

Category of ADR               Mediation (2-5 parties)                             Year                           2005
experience that               Large group facilitation or mediation (6 or
applies to this case or       more parties)
project.
                              Mediation or facilitation of workplace
                              conflicts




                 Baker, Deborah                Oregon State ADR Roster Provide Data Form          Page 7 of 12
                              Litigation Settlement Mediation
                                                                                  # of case                   19
                              Neutral Evaluation of Legal Disputes                hours
                              Public Policy Mediation or Facilitation
                              Other


                      Section #11: Specific Case or Project Experience - Case #2
Case/project name         OPEN GUARDIANSHIP MEDIATION BETWEEN BIRTH PARENT & GUARDIANS

Description:              Mediation between the birth father and the prospective guardians (husband and wife) to
                          develop a post-guardianship communication agreement outlining how the birth father
                          would have contact with the two female children and the guardians once the guardianship
                          was finalized.




Role                      Lead mediator or facilitator
Case Contact              Danielle Santilli-Day, DHS caseworker
Category of ADR                                                                    Year                       2008
experience that               Mediation (2-5 parties)
applies to this case or       Large group facilitation or mediation (6 or
project.                      more parties)
                              Mediation or facilitation of workplace conflicts
                              Litigation Settlement Mediation
                                                                                   # of case                   9
                              Neutral Evaluation of Legal Disputes                 hours
                              Public Policy Mediation or Facilitation
                              Other


                      Section #11: Specific Case or Project Experience - Case #3
Case/project name         FAMILY DECISION MEETING

Description:              Facilitated a meeting for DHS that included the parent, several foster parents, the
                          maternal grandparents, the family therapist, the children's individual therapists, the CASA,
                          and the DHS caseworker to review the progress of all family members, develop a plan for
                          answering the children's questions, specify a plan for returning the children home, develop
                          an appropriate transition plan for all the children, and create a support system for the
                          mother.




Role                      Lead mediator or facilitator
Case Contact              Marcy Cady, DHS caseworker; Chuck Dunn
Category of ADR               Mediation (2-5 parties)                              Year                       2000
experience that
applies to this case or       Large group facilitation or mediation (6 or
project.                      more parties)
                              Mediation or facilitation of workplace conflicts


                Baker, Deborah                 Oregon State ADR Roster Provide Data Form       Page 8 of 12
                              Litigation Settlement Mediation                      # of case                   2
                              Neutral Evaluation of Legal Disputes                 hours
                              Public Policy Mediation or Facilitation
                              Other


                      Section #11: Specific Case or Project Experience - Case #4
Case/project name         OPEN ADOPTION MEDIATION WITH THE BIRTH MOTHER & ADOPTIVE PARENTS

Description:              Mediation occurred between the birth mother and the adoptive parents, who were the birth
                          mother's own mother and stepfather, to decide how the birth mother would have contact
                          with the child and the adoptive parents once the adoption was finalized. Concerns
                          included the relationship between the daughter and her parents as well as the relationship
                          between the daughter's boyfriend and her parents, which could negatively impact the
                          child. Although the family issues were not resolved in the context of mediation, a plan
                          was developed to work around the issues so that the interactions could be positively
                          structured.



Role                      Lead mediator or facilitator
Case Contact              Chris Dref, DHS caseworker; Gaile Schelle

Category of ADR                                                                    Year                       2009
experience that               Mediation (2-5 parties)
applies to this case or       Large group facilitation or mediation (6 or
project.                      more parties)
                              Mediation or facilitation of workplace conflicts
                              Litigation Settlement Mediation
                                                                                   # of case                  14
                              Neutral Evaluation of Legal Disputes                 hours
                              Public Policy Mediation or Facilitation
                              Other


                      Section #11: Specific Case or Project Experience - Case #5
Case/project name         OPEN ADOPTION MEDIATION WITH THE BIRTH FATHER & ADOPTIVE PARENTS

Description:              Mediation between the birth father and the prospective adoptive parents to decide how the
                          birth father would have contact with the child and adoptive parents once the adoption was
                          finalized. The birth father and adoptive father met for the first time and developed a
                          relationship during the course of mediation. A plan was developed for the birth father to
                          have drug-free contact with the child.




Role                      Lead mediator or facilitator

Case Contact              Shari Clark, DHS Caseworker; Gail Schelle




                Baker, Deborah                 Oregon State ADR Roster Provide Data Form       Page 9 of 12
Category of ADR                                                                   Year                        2008
experience that               Mediation (2-5 parties)
applies to this case or       Large group facilitation or mediation (6 or
project.                      more parties)
                              Mediation or facilitation of workplace conflicts
                              Litigation Settlement Mediation
                                                                                  # of case                   13.6
                              Neutral Evaluation of Legal Disputes                hours
                              Public Policy Mediation or Facilitation
                              Other


                      Section #11: Specific Case or Project Experience - Case #6
Case/project name         FAMILY DECISION MEETING

Description:              Facilitated a family decision meeting for DHS that included the father, foster parents,
                          maternal grandmother, children's individual therapists, father's attorney, the father's DHS
                          caseworker, the children's DHS caseworker, and an intern from Clackamas County Mental
                          Health. The purpose of the meeting was to develop a plan for the children to move to
                          Sisters, Oregon, with the foster parents, clarify and plan visitation times with the father, set
                          up ongoing counseling for the children, and identify and address other needs of the
                          children.



Role                      Lead mediator or facilitator

Case Contact              Carrie Nash, DHS caseworker

Category of ADR               Mediation (2-5 parties)                             Year                        2001
experience that               Large group facilitation or mediation (6 or
applies to this case or       more parties)
project.                      Mediation or facilitation of workplace conflicts
                              Litigation Settlement Mediation
                              Neutral Evaluation of Legal Disputes                # of case                    2
                              Public Policy Mediation or Facilitation             hours
                              Other



                      Section #11: Specific Case or Project Experience - Case #7
Case/project name         FAMILY DECISION MEETING

Description:              Facilitated a Family Decision Meeting involving the mother, the father of one of the
                          children, one of the children, the occupational specialist, a staff member of Volunteers of
                          America, a friend of the mother's. the maternal grandmother, the ETBS caseworker, the
                          Self-Sufficiency worker, the child's therapist, the mother's cousin, and the DHS
                          caseworker. The goal of the meeting was to identify and address the family's needs so
                          that the children could be safely returned to their mother's custody. Services were set up
                          to assist and support the family members, and a transition plan was developed to return
                          the children home.


Role                      Lead mediator or facilitator

Case Contact              Mina Maldonado, DHS caseworker

               Baker, Deborah                 Oregon State ADR Roster Provide Data Form       Page 10 of 12
Category of ADR                                                                   Year                        2002
experience that               Mediation (2-5 parties)
applies to this case or       Large group facilitation or mediation (6 or
project.                      more parties)
                              Mediation or facilitation of workplace conflicts
                              Litigation Settlement Mediation
                                                                                  # of case                    2
                              Neutral Evaluation of Legal Disputes                hours
                              Public Policy Mediation or Facilitation
                              Other


                      Section #11: Specific Case or Project Experience - Case #8
Case/project name         POST-DIVORCE PARENTING PLAN

Description:              Mediated between parents who were in conflict after a contentious divorce to assist them
                          in developing a workable parenting plan, including which home each child would reside in,
                          which schools the children would attend, how the academic expenses would be covered,
                          and how a workable visitation plan/schedule could be set up and followed. Additionally,
                          the relationships between both parents and the children were improved and various
                          specific co-parenting issues pertaining to each individual child were resolved.




Role                      Lead mediator or facilitator

Case Contact              Deborah Baker, Private Practice

Category of ADR                                                                   Year                        2007
experience that               Mediation (2-5 parties)
applies to this case or       Large group facilitation or mediation (6 or
project.                      more parties)
                              Mediation or facilitation of workplace conflicts
                              Litigation Settlement Mediation
                                                                                  # of case                   20
                              Neutral Evaluation of Legal Disputes                hours
                              Public Policy Mediation or Facilitation
                              Other


                      Section #11: Specific Case or Project Experience - Case #9
Case/project name         MEDIATION FOR POST-ADOPTION

Description:              See Case # 1,4, & 5    I have mediated over 100 cases for open adoptions since 2000.




Role                      Lead mediator or facilitator

Case Contact              Gail Schelle

               Baker, Deborah                 Oregon State ADR Roster Provide Data Form       Page 11 of 12
Category of ADR                                                               Year                        2009
experience that           Mediation (2-5 parties)
applies to this case or   Large group facilitation or mediation (6 or
project.                  more parties)
                          Mediation or facilitation of workplace conflicts
                          Litigation Settlement Mediation
                                                                              # of case                   1000
                          Neutral Evaluation of Legal Disputes                hours
                          Public Policy Mediation or Facilitation
                          Other




               Baker, Deborah             Oregon State ADR Roster Provide Data Form       Page 12 of 12

				
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