FAQ

Frequently Asked Questions

I work with many clients who choose to use insurance and have a plan that covers out of network providers (PPO or POS). After careful thought, I have chosen not to be on any insurance panels.  While the primary benefit for clients when they use insurance is that more of the therapy fee is reimbursed, there are several significant issues I encourage clients to consider before opening up that process for themselves. Most importantly, all treatment you receive under insurance is kept in a central collective data base used by all insurance companies that is permanent and linked to you and an increasing number of other data bases of personal information. This may leave you open to very personal information being disclosed to others, either intentionally or unintentionally, such as the diagnosis and detailed therapy session content notes that insurance companies require of their contracted providers about their patients. As an out of network provider, I am required to provide only minimal information (just a diagnosis code), but even this is permanent, life-long information that will be associated with you.  I have had clients tell me that they had difficulty attaining affordable private health insurance coverage because even their extremely benign therapy diagnosis was seen as a pre-existing condition.  Some of this has been balanced by the Affordable Health Care Act, but it remains uncertain whether this policy will be a lasting protection against elevated insurance premiums for pre-existing conditions. The same is true about life insurance, where therapy may be seen as a pre-existing condition that would increase your rates and open up your therapy records for their review.  You may also want to determine whether your health insurance plan/company even covers the treatment you seek. For example, many insurance companies will not cover couples therapy. When people weigh out the one benefit of using insurance for therapy (financial) in contrast with the lifelong potential privacy issues and potential cost of increased insurance premiums, they often choose to go out of network or pay entirely out of pocket for therapy.

Yes, there is a tremendous difference between the two. Both are valuable and have their place. Counseling is more directive and instruction based. Peer or Lay counseling is mostly of this variety and very helpful for those who simply don’t know what they don’t know. The person is able to use the direction and new information and effect change. Other times people don’t do what they know and say they want to do and knowledge is not enough for the change. This is where the professional help of therapy is needed.

That is a great question and one that is misunderstood by many.  It gets confusing because anyone can call themselves a psychotherapist, therapist, or anything ‘psychological sounding’ regardless of whether they have had any credible training or licensure. So here are the basics to help you make the best choice for the help you need (for an in depth look, click here).

A psychiatrist is an M.D. who has taken a very cursory training in human behavior and whose role is typical to prescribe psychotropic medication. They are specialists in the human brain and behavior as it relates to organic, brain chemistry issues. Very rarely do they do the “talk therapy” that they did in days of old.  Most of the conversations they have with a client are to assess symptoms and address prescription medication needs.

A Marriage and Family Therapist (MFT) typically has a two-year masters degree in the mental health arena and are typically trained primarily in marital, child and family therapy. There are other masters level degrees in the mental health field, such as a Licensed Clinical Social Worker (LCSW), that similarly have a more limited scope of training.

Someone who calls themselves a “psychologist” must have a doctorate degree (2-3 years beyond a masters) and be licensed at the doctoral level with the state.  Their training includes that of an MFT and goes further to include comprehensive psychological theory, testing and a more broad and experienced exposure to the spectrum of conditions people need help with in therapy.  Those with a Psy.D. (versus a Ph.D.) have placed additional emphasis on their preparation for therapy with clients. The additional years invested in education, training and experience provide the most comprehensive scope of practice and a complete package for helping you.

Beyond these basic titles for those in the “people helping” field are a variety of other titles like pastoral counseling or the latest trend of Life Coaching. Training, if any, is considerably less and licensing or standardization often not needed.

As with all professional help, a degree is not the only thing to consider and ongoing education and training can help complete the picture for someone who did not receive it in school. This simply gives you a picture of what to consider when looking for a therapist who is prepared to help you with your situation. It may also help you understand why there would be a difference in fees between the various levels of professional titles.  When comparing therapists and making a decision, make sure you get the credentials and experience you pay for.

For your comparison, I have been in private practice for over 20 years as a licensed clinical psychologist (Psy.D) from a five year doctoral program that added an extra year to explore the integration of psychology with theology (an added bonus for Christian clients who value this aspect).

My goal always is to help people feel better and do better as quickly as possible. Often, people will come to me for help with an urgent or crisis situation. This first phase of therapy is shorter in time as some guidance, structure and counsel help them create a more stable life and they genuinely feel better and are doing better. Sometimes a crisis is the result of unavoidable live circumstances and just this initial phase of therapy is all that is needed. However, other times we discover that the crisis was often years in the making and that there are more foundational areas to address within to bring long-term stability. This is the part of therapy that takes longer as it involves deep beliefs that have long-standing roots and require more time to change and grow. The good news is that this change is much quicker than the length of time those problematic beliefs have been in place. I’ll sometimes say that therapy will take “Longer than you might wish, but shorter than you might expect.”

You can expect to be respected, listened to, empathized with, challenged, encouraged and partnered. Unfortunately, many of the media portrayals of therapy leave a person skeptical, fearful or unrealistic about the process of therapy. I hope you can gather from interacting with the content on this website that I’m a pretty normal person and the experience in therapy is more a partnership with a skilled partner. I believe that my approach to therapy is also best visualized as a word picture; you paddle and I’ll steer. You simply have to be yourself (fairly easy to do) and I’ll help you get a clearer reflection of who you are and how you do life. There is nothing magical or instant about this process, but the result of this investment in vulnerability is change, growth, and freedom and I would call this miraculous.

During the initial stages, therapy may be more directive as the problem symptoms are addressed. This if usually a big relief as the client feels hopeful again. Therapy then transitions to building and practicing the relational capacity that is often underdeveloped and the root of the problem symptoms. For example, a client came to me for help with
panic attacks and obsessive compulsive behavior. We were able to work on some relaxation and coping strategies that brought some relief, but it wasn’t until they learned to express their wants and need and had processed their deeply held sadness and anger that their panic attacks and the obsessive compulsive behavior stopped.

I will sometimes give suggestions of ways to put into practice some of the clients growing areas or give recommendations for books or social groups. The more chance a person has to see and interact and experience their areas of growth the more quickly they grow. More often I find client energized by the therapy experience and initiating their own challenges and growth between sessions. Some suggested readings can also be helpful by putting into words the kind of things we are addressing in therapy.

My standard rate for therapy is $190 per 50 minute session for those with once a week or fewer sessions.  For those wanting more than one session per week, the fee for therapy will be reduced based on the number of sessions.

Since therapy involves helping my clients to live in reality I realize that some people may not be able to afford the regular rate and in some cases, I am able to adjust the fee. More often there is confusion and sometimes mixed feelings about fees for therapy.  You are not paying for someone to care about you. That should be standard. You are paying for the competency and skill of the therapist, so I recommend finding the most credentialed and experienced therapist you can afford (read more about finding the right therapist) . If this were a life threatening surgery you would do anything you could to get the best doctor. As with most things in life, you get what you pay for.  Invest well in the process of therapy and yourself since the return on your investment is priceless, with a far-reaching impact on every aspect of your life and relationships.

The cost of a mediocre life is significant both in income lost, relationships marginalized and joy that is unreachable. For example, when you add up the cost of a failed marriage, from attorney fees, alimony, child support, stress time separated from loved ones, then therapy and a restored marriage are very cost effective. My clients frequently find themselves either excelling at their current jobs and getting promoted or getting hired at different jobs, making more money than therapy ever cost.

When looking for a therapist, consider their experience, level of education and training, licensure level, specialties and reputation in the community. Just because someone has a doctorate does not mean they are licensed (or even that their doctorate is in psychology) or that they have the years of experience and specialization that you need. Sometimes a bargain therapy fee is no bargain. This is your life, you are valuable and you deserve the best!

I enjoy working with people and realize not everyone may be able to afford my full fee.  Just as I volunteer my time and services in the community I also save room in my case load to adjust fees for those who carefully considered their budget and are not able to reduce their spending and expenses enough to cover the full fee, particularly those in the “people caring professions” like ministry or therapist/therapists in training.  Please contact me if you want to work together and would need a reduced fee. I keep careful record of the fund I use to support reduced fees and will know immediately what is available.

Below is my scheduling policy copied from the consent form of my intake paperwork.  I work a little differently than many therapists when it comes to missed or canceled sessions.  It’s my best attempt to balance and respect both our scheduling needs and to get the most benefit from therapy.  The concept for this policy is to offer increasing rescheduling flexibility with increased fee and more frequent sessions.  I’m eager to get you to your goals and find that this scheduling policy is something that really helps get the most out of the therapy process.  Special arrangements may be made for clients who work a rotating schedule or whose work requires 50% or more of travel time.

MISSED SESSIONS:

Missed sessions

I do not work on a 48 hour cancellation policy.  Session times and intervals are set at the start of our work and are recurring.  A cancelled session is considered a missed session. When you are not able to meet at your regular recurring time and we are unable to reschedule within seven days before or after, the session is considered missed.  In other words, you have a two week window to reschedule a regular session time that you are unable to attend without it being considered a missed session.  This means you are committed to your ongoing scheduled times, but may have the flexibility to reschedule a session free of extra charge even if you completely forgot or cancelled at the last minute.  Read the “FEE & SCHEDULE STRUCTURE” section to understand more about the differences in rescheduling based upon our fee agreement.

Missed sessions are rescheduled according to the terms below and only rescheduled once.  A rescheduled session is lost if it is not attended for any reason.  When a rescheduled session and a regularly scheduled session both fall on the same week, missing either of those sessions will be considered to be missing the rescheduled session.

If we are not able to reschedule a missed session according to the terms below, be aware that most insurance companies will not reimburse for missed sessions.

If I miss a scheduled session

The unexpected can happen for me as well.  If I must miss a scheduled session and you do not want to, or are not able to, reschedule the session, I will reduce your next monthly payment by your fee for that session and communicate to you that adjusted amount.

 Extra sessions

If you would like an extra session apart from the regular scheduled time, the fee for that session will be the same as your regular single session fee and collected at the time of the extra session.

Online scheduling

As an active client, you will be given credentials to view my schedule online and make appointment changes/requests as you need.

FEE & SCHEDULE STRUCTURE:

Consistent time in the therapy relationship gets you the best results, so I will typically set a regular weekly appointment time that is reserved for you. Special arrangements may be made for clients who work a rotating schedule or whose work requires 50% or more of travel time.

 The standard fee is $190 per 50 minute session.  I may be able to accommodate a request for reduced fees, but I ask that you please communicate with me before we meet to see if there is room for any adjustment. I keep careful track of the fund I use to adjust fees and will know what I’m able to do.  The fee for sessions will reduce with the number of visits per week as follows:

Once a week or less

For clients coming in once or less a week at my regular fee of $190 per 50 minute session, I will reschedule all missed sessions within the calendar year, even if you must cancel at the last minute.  I will keep track of your available missed sessions, but leave it to you to initiate rescheduling.  At the end of the calendar year, any unused missed sessions will expire.

Once a week or less with a reduced fee

If you’re coming in once a week or less and we have agreed on a reduced rate, there will be a number of missed sessions (as defined in the Missed Sessions section) that I will not reschedule for you in proportion to the discounted fee you are receiving.  In other words, because you are receiving the equivalent of a number of free sessions over a year with the reduced fee, I will reschedule any and all missed sessions only after you miss more than the free sessions allotted for the year.  Any unused sessions to reschedule will expire at the end of the year.  At the beginning of our work together I will calculate for you the number of free sessions specific to your fee with the following formula:

 (($190 – $your fee) x 46 weeks) ÷ 190 = number of free sessions per year

Multiple sessions per week

I enjoy working with clients more than once a week and find it produces an exponential rate of growth.  To reduce the cost of more frequent sessions, I will give you a number of free sessions every year.  Use all your sessions in a year and you will get the best value.  I give increasingly more free sessions the more often we meet each week.

*For two sessions per week, I will include 8 free sessions per year. This reduces the average fee per session to $173.

*For three sessions per week, I will include 20 free sessions per year. This reduces the average fee per session to $162.

*For four sessions per week, I will include 40 free sessions per year. This reduces the average fee per session to $148.

After missing (as defined in the Missed Sessions section) more than your allotted free sessions, all subsequent missed sessions are available to reschedule for the calendar year.  Any unused sessions to reschedule will expire at the end of the year.

That depends on some degree on how quickly you would like to achieve your goals for change. I see an exponential return for the amount of time spent in therapy. More time more often brings about change much more quickly and efficiently than the same amount of time over an extended period. I’m eager to see you feel better and do better as quickly as possible and more frequent visits or longer session times are a way to achieve that goal. Constraints on resources may be an issue, but I am willing to negotiate a compromise on those eager and invested in more frequent therapy sessions.

The field of psychology is finally coming around to realize that a comprehensive therapy experience must also include attention to the client’s spiritual life and beliefs. A person’s beliefs about the foundations of being and the meaning of life will be deeply intertwined with how they do life and relationships. With two years of theological education and ongoing thought about the interplay between a person’s psychology and spirituality, I am well positioned to support my clients as they sort through issues of faith. How issues of faith are addressed in therapy will vary with each individual’s preferences and I am happy to discuss what this would look like for you.

Psychotropic medication, like anti-depressants or mood stabilizers, have been a great help for some of my clients when there has been such a chemical imbalance that they are not able to take care of the basics in life or fully engage the therapy process. In such cases, I will provide a referral for an evaluation for medication and I am so grateful for the availability of effective modern medications that are more effective and have fewer possible side effects. Medication is rarely a substitute for therapy but can be a beneficial supplement to the process for some.

Yes, absolutely. I will always recommend that you tell me and coordinate such holistic approaches with any prescribing physician, but there are vitamins, supplements and other natural techniques that some clients have found to be very helpful. The human mind and body are so complex that to say only the medical community have the corner on truth for health and healing would be too simplistic. I continue to read and learn from a broad array of medical and holistic literature as I also consider sources of additional help for my clients.

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