Photograph by Jim Madden

 

Q: How does therapy work?

A: Therapy is an intentionally-created safe, nurturing, and supportive space for you and I to talk together about anything and everything that is important to you. Each time we see each other, we will meet for 50 minutes. Research shows that therapy works best when the client and the therapist are a "good fit" for working together, regardless of how many years of education or training in specific techniques the therapist has. In essence, this means that we can co-create a trusting relationship where you feel as comfortable as possible to share your concerns, fears, anxiety, mistakes, and shame without feeling criticized, judged, or misunderstood. Therapy is also a place to share your joys and celebrate your successes. When looking for a good fit with a therapist, think about what it would be like to: talk about your feelings, explore your past, brainstorm solutions to problems, experiment with new ways to talk with others, learn new skills, and plan your future. In my experience, a good fit is occurring when it is comfortable enough to talk openly with, sit quietly and reflect, cry as needed, and laugh together. Some clients will know within the first visit if it's a good fit or not; most know by 6 sessions.

 

Q: How often do we need to meet?

A: The general rule for frequency of sessions is meeting once a week. For clients with acute distress and active crisis, we may decide that it is helpful to meet more frequently, from twice a week or even as often as every day, until the crisis has passed. Once the goals of therapy have been initially met/achieved, it is not uncommon for us to decide to meet every-other-week for ongoing maintenance and support. Meeting less often than that (e.g., once per month) is generally advised against.

 

Q: How long does therapy last?

A: Therapy can both be brief or long-term. Brief therapy tends to be short, anywhere from 3 to 6 months of weekly meetings. This kind of therapy is most useful for resolving immediate crises such as grief, unexpected unemployment, an unexpected change in relationships, learning of a chronic health problem, the death of a loved one, etc.

Long term therapy tends to continue for a year of at-least weekly sessions, and in some cases, for more than a year depending on the goals you wish to work toward. This type of therapy works best toward resolving more chronic problems such as depression, anxiety, trauma, relationship difficulties, longstanding workplace challenges, addiction, and the like. Some benefits of longer-term work are:

1) an increased understanding about who you are, and why you have chosen to think, feel, act, and relate to others as you have thus far

2) learn how you can choose to be different now and for the future

3) recognize "red flags" and avoid situations and people that have previously caused you pain

4) develop new tools and healthier coping strategies for dealing with crises, losses, and times of extreme strain and distress

When we first meet, it is helpful if you have a sense of the time frame you'd like to spend in therapy and share that with me. In some cases, the timeframe we initially thought we would work together may change as we continue to understand and refine your goals for your treatment and personal development.

 
Q: Can I really talk about ANYTHING in session?

A: Therapy is one of the very few places in the world where you can indeed feel free to share anything and everything that is of concern to you. In our very first meeting we will review and discuss the few limitations to confidentiality the state requires of therapists, but other than this small handful of specific exceptions, everything else you choose to share in therapy will remain between you and the therapist.

Therapy actually works best when you take risks: tell me the truth about what you are really feeling, thinking, remembering, or experiencing in the moment. Be honest with yourself and with me about things you've never allowed yourself to say aloud. Feel free to ask any question that pops into your mind. Tell me how you see me or feel about our work, especially if there's something you feel stuck or unhappy about. I commit to responding to you respectfully and honestly about what we're doing in our work.

 

Q: Do you accept insurance?

A: I am not a within-network provider of any insurance company. As such, I do not bill any insurance directly for my services. However, I am happy to provide you with a Superbill at the end of each month for you to submit to others for reimbursement.

If we decide to work together, there are a number of ways which you might be able to receive reimbursement for my session fees:
a) Your insurance may reimburse you in part, or in full after you meet a certain deductible amount, for the work we do together. This works for some HMO insurance companies, and most PPO insurance companies as an out-of-network provider. The only way you can determine this is for you to call your insurance company directly and ask about their reimbursement for mental health services.

b) Many employers offer Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA) as pre-tax savings accounts for you to use to cover out-of-pocket medical expenses. Therapy is covered as an expense under both HSA and FSA.

c) If you have either a HSA or FSA, you can also use these to fund either the deductible and/or the out-of-pocket expenses your insurance won't cover.

 

Q: Why don't you accept insurance?

A: Most people think the fee you pay for therapy is only for the 50 minutes of face-time we spend together meeting and talking. When we meet, I treat each client and each session as a custom fit - designed intentionally and specifically for YOU - to respond to your concerns and work toward achieving your specific goals. Toward that end, between sessions I regularly think about what we have talked about together, often do additional reading and research on the latest evidence-based practices to optimally resolve your problems, brainstorm potential questions and follow-up on themes for our next visit, generate exercises as needed for us to try out in session (or have you do on your own between sessions), and come prepared to session with books and resources for you to explore as additional support in our work when relevant. Every minute I interact with insurance companies is one less minute I spend thinking specifically about you and preparing for our next session. Meeting with you I very much enjoy; working with insurance companies, not so much :-)

 

Q: What are your fees?

A: When we first talk by phone, we will discuss the fee for therapy. You are responsible for paying for the session each time we meet, on an hourly basis. You can choose to make payments either by check, cash, or credit card. In some instances, a sliding scale may be used during times of financial difficulty.

 

Q: What are your hours?

A: I keep regular office hours both during the daytime and in the evenings, Monday through Friday. I do not see clients on Saturdays or Sundays, except in extreme emergencies on an as-needed basis.

 

Q: What if I need to cancel an appointment?

A: You will need to contact me 24 hours in advance of your scheduled appointment to avoid being charged for a missed session. I will respond and confirm that I have received your cancellation the same day I receive it. If I do not respond to you, I did not receive the cancellation notice.

 

Q: What should I do if I have an emergency?

A: If it is a life-threatening emergency: call 911, or go to the nearest hospital emergency room IMMEDIATELY. If your life is not in immediate danger, please utilize the emergency protocol we will have discussed the very first time we meet for a session.