Frequently Asked Questions
Initial Contacts and First Sessions
I think I might be interested in meeting with you, but I’m not sure. What should I do?
Please give me a call. With every prospective new client, I offer a brief screening call so we both can get a general sense of whether we might be a good match for working together. At the end of that call, either of us might decide that your needs might best be served by someone else. If I get a strong sense of that, it’s my ethical obligation not to offer to see you. If either of us believes the match isn’t right, I am happy to offer other referrals when possible.
What will the first sessions be like?
Like any time you seek treatment of any sort, good psychotherapy needs to begin with a thorough assessment. I’ll ask lots of questions about the concerns and symptoms bringing you in, but will also want to know your history, your current support system and cultural context, what helps you and does not help you, and many other things. I will be paying attention to whether I believe I can be helpful to you. I also encourage you to be thinking about that too. Like I mentioned about the initial phone call—if either of us believes I’m not suited to help you, I will provide referrals if I can.
How long will therapy take?
I’m not going to lie to you. My honest answer is: it depends. The strategies I use are of course part of that. But there are a lot of other factors that make a difference too. Unlike some other forms of treatment, where the focus is almost exclusively on what the provider does, success in counseling/psychotherapy depends on your goals, your openness to new ideas and experiences, your motivation, and so on. Therapy is usually most helpful when clients spend time reflecting on the things we discuss between sessions, and if we are talking about specific skills, practicing them. Talking with loved ones and journaling can also move things along. But I ask that you have patience. With some clients who have very limited goals and feel they’ve met them quickly, we've only met a handful of times. With other clients it takes considerably longer. Throughout therapy we will check in on your progress toward your goals, and I might have you take periodic questionnaires that will allow us to gauge symptom improvement.
I'd like to meet with you in person. Can we schedule an appointment that way?
I welcome clients who prefer to meet in person.
If you have any symptoms of COVID-19 (fever, loss of smell/taste, congestion/respiratory concerns) or for that matter, any other communicable disease, please contact me so we can reschedule or meet via telehealth.
I'm not sure about teletherapy. Can you describe it?
I completed a certification in teletherapy prior to the COVID-19 pandemic, but had only met with a handful of clients that way, so I was nervous about taking my entire practice online. However, I've been impressed by how well therapy translates online. I am careful to select platforms that are encrypted and HIPAA compliant, so it's pretty safe, though online there are never any guarantees. There are also times when the connection is variable, so that does affect the work. There are benefits too though: most people find it easier to work sessions into their schedule since there's no commute time.
Information about Therapy
What's Acceptance and Commitment Therapy?
Sometimes it seems like we are completely immersed in our discomfort, but when we truly look inside, we recognize that we're actually pushing against these feelings--by being preoccupied with issues of fairness, or how it should be, or or how we just can't stand it. To avoid those uncomfortable feelings, we do things that also wind up making us avoid what's most important to us--for example, if we drink away our feelings, we also lose touch with meaningful contact with our friends, family and partner. ACT emphasizes awareness and acceptance of patterns of emotion and thought. At the same time, ACT encourages the awareness of one's values--what's most important to the individual--as a way of motivating us to move beyond the discomfort and take risks in a positive way, rather than get stuck in cycles of avoiding then becoming overwhelmed by the pain.
What's Cognitive Behavioral Therapy?
CBT suggests that when we're upset about something, sometimes the problem is more how we are interpreting things than the things themselves. For example, if you didn't get a job, you might say things to yourself such as, "I'm such a loser--I'll never get a good job." That's a pretty depressing and anxiety producing thought, right? CBT aims to help people be more aware of their thought patterns and to try to change them to make them more realistic and less troublesome.
What is EMDR Therapy?
Eye Movement Desensitization and Reprocessing Therapy, otherwise known as EMDR Therapy, is an evidence-based form of treatment for psychological conditions resulting from upsetting life events. When a very upsetting life event occurs, it may get locked into memory along with the feelings, thoughts, and sensations that were happening at the time, rather than being fully processed by the brain. Those thoughts, feelings and sensations can then recur at unexpected times, and/or cause cyclical patterns of thinking and behavior that don’t ultimately serve the person’s goals and values. EMDR is a form of treatment that taps into the brain’s natural ability to process upsetting events by revisiting them cognitively while engaging in various activities guided by the therapist (usually eye movements), that activate both sides of the brain. Unlike other forms of treatment that target the impact of traumatic events, “homework” is not required and the client does not need to fully discuss the upsetting events if they prefer not to do so. More information about EMDR Therapy is available at https://www.emdria.org/about-emdr-therapy/.
What is Interpersonal/Dynamic Therapy?
Interpersonal and dynamic therapies focus on how we develop images of ourselves and others through early and repeated life experiences. We wind up replaying patterns in our relationships that aren't aligned with what we truly want. These approaches to treatment emphasize becoming aware of these patterns in order to learn different ways of interacting with ourselves and others.
These therapies seem really different. I'm confused. Do I need to do all of that?
I practice what's called Integrative therapy. This means that depending on the individual, I might emphasize different techniques. Factors influencing those choices include the client's approach to the world and goals, what's worked and not for that person, the evidence for different approaches, and my own experience and instincts from having practiced for over two decades. I borrow most frequently from the approaches above, and with most people I use aspects of each at different points in the therapy. I also draw from Dialectical Behavioral Therapy skills, and use Prolonged Exposure or Cognitive Processing Therapy when appropriate.
Mindfulness and Meditation
You mention that you like mindfulness based approaches. What does that mean?
A lot of people are confused about what mindfulness is, and some people are even a little scared of it. Mindfulness approaches include meditation, but also yoga, mindful walking, mindful eating, contemplative prayer, and other strategies. The concept of mindfulness basically means that you pay attention to what you do, when you are doing it. If you’re washing dishes, you pay attention to the warmth of the water, the smell of the suds, etc. If you’re walking around the neighborhood, you pay attention to the sensations in your body, the feeling of the sun on your skin, and what you see and smell. If you’re eating, you pay attention to the taste of the food, the smells, the sensation of your jaw chewing. In our society we are often told we should multitask, but that often results in our doing a halfway job at a lot of things, while our lives pass us by. I don't usually use mindfulness to try to take away difficult thoughts and feelings. Instead, I incorporate mindfulness strategies as a very useful way to clarify these thoughts and feelings and to deal with them rather than to try to make them not be there.
I’ve tried to meditate before, and I’m really bad at it. What do you suggest?
First--not every mindfulness practice is meditation, and it isn't necessary to meditate to obtain benefits from mindfulness. That said, learning to meditate can be very helpful for many people. Lots of people believe that if they’re doing it "right," meditation is a quick process that, should result in their becoming instantly relaxed and completely focused. I thought this too when I started learning about it. Actually, meditation is simply the process of refocusing again and again whenever your mind wanders.
There is a lot of research about the benefits of meditation, but one thing that isn't often considered is that we can individualize it. If you have specific religious beliefs, those can be incorporated into meditation to make it a more profound experience for you. If you are completely secular, no problem—there is no need to be religious for meditation to be helpful.
Starting to meditate can be really hard and I find that it’s usually best to start with an app or guided meditations. I frequently guide clients through meditations in session, but there are also a lot of great apps and websites to help with that. I have a list of helpful resources on this site, but it’s not exhaustive. Feel free to look around and if you find something great, please share it with me!
Fees, Insurance and Payment
What are your fees?
My fees are $207 per session, or whatever my contracted rate is with your health insurance company. I am in network and accepting referrals from Cigna, Aetna, and Lyra Behavioral Health. Many clients choose not to use insurance for various reasons, and I also see clients who are private pay only.
I have a different insurance and I’d like to use it. What does that mean for me?
If you wish to use another insurance and have a PPO plan, I ask that you pay my fee up front, and I will either generate an electronic claim to your insurance company as a courtesy, or will generate a monthly “superbill” for you to submit to your insurance. Your insurance company will likely reimburse you for a portion of the cost of sessions, and that portion is likely to be lower than if you were to see an in network provider. If you have an HMO plan, you will probably not be eligible to receive any reimbursement for the cost of sessions with me, so if that’s important to you, you should consider reaching out to another provider who is in network. I am not able to verify insurance benefits for insurance companies I don't have a relationship with. However, before you meet with me or another provider, I strongly encourage clients to do so themselves as well.
I want to ask my insurance company for information about my coverage for psychological services, but I don’t know what to ask them. Can you help?
Sure! Here are a list of questions that will likely be helpful:
-What is my coverage for outpatient mental or behavioral health office visits?
-What is your coverage for seeing a provider who is in network? Out of network?
-Do I need a referral from my doctor to use these benefits?
-Is there a deductible I will need to pay before accessing my benefits?
-Once the deductible is paid, what will my copay be?
-If my provider believes there is medical need for services, is there any session limit?
What forms of payment do you accept?
If possible I prefer cash or check, but also accept credit card payment using a system called Ivy Pay. If you wish to pay in that way, I will walk you through it in the first session.