What do therapy sessions look like?

Sessions are 50 minutes long and usually scheduled weekly but there may be circumstances where we decide to meet more or less frequently. Most sessions will be in-person but telehealth options may be available on a case-by-case basis. The first few sessions will involve getting to know each other and evaluation of your needs. After a few sessions, I’ll be able to offer you some recommendations and a treatment plan for therapy.

I use psychodynamic therapy, which is a kind of talk therapy where we work together to help you better understand your thoughts and feelings, how you relate to people, and how your past experiences contribute to your present and future. We talk openly about how things are going in our therapy relationship. I also use other therapy approaches when indicated such as dialectical behavior therapy and cognitive behavior therapy. Please see Services for more information about my therapy approach.

When and where are therapy appointments?

I am available for Friday daytime appointments. In-person appointments are available at the Richmond area office and telehealth appointments may be available throughout the state on a case-by-case basis. Telehealth is not appropriate or effective for every client and every situation. We can discuss telehealth’s appropriateness during your consultation or in the initial appointment. Please see the telehealth policy for more information.

How long do I have to be in therapy?

The first few sessions involve evaluation of your needs and will allow us to develop a treatment plan which we’ll discuss. Since the therapy process is highly individualized, your treatment plan will be specific to you, and we will regularly discuss your progress towards your therapy goals. Clients often find that they need more intensive therapy at first, but may need less frequent sessions later in treatment or may end treatment with the option of returning at any time.

What if I don’t want to continue therapy?

You have the right to end therapy at any time and I am ethically obligated to end therapy if I believe it is no longer helping you or is harmful. I am happy to refer you to another therapist in these situations. A final termination session is recommended before ending therapy. Therapy involves a large commitment of time, money, and energy so you should be very careful about the therapist you select. If you have questions or concerns about the therapy process, it is very important that you bring them up in treatment as they arise.

Why don’t you take insurance?

I am not in-network with any insurance companies. This means that you and I are in total control of the therapy process without any possible interference from a third-party like an insurance company. That keeps things more private and confidential, and it means that we can decide what kind of therapy to do, how often to meet, and how long therapy is needed for. Research shows that people do better in therapy if they are investing in it- financially and emotionally. This also allows me to spend more of my time helping clients rather than dealing with insurance companies.

I’m under 18. Will you tell my parents everything I say?

Therapy is most effective when a trusting relationship exists between the therapist and the client. This is particularly true for adolescents who are naturally developing a greater sense of independence and autonomy. When the client is a minor, I will work with the client and their parents to establish expectations for privacy at the beginning of treatment. It is my policy to provide parents with general information about their child’s treatment, but not to share specific information the child has disclosed without the child’s consent. However, there are some circumstances in which I would need to disclose information about a child without their consent including serious risk-taking behavior and threats to themselves or someone else.

How much does therapy cost?

Individual and couples therapy sessions are $150.00. Please see Services for updated fees and Policies for the payment policy. Payment is due at each session. Cash, personal checks, credit cards, and FSA/HSA cards are acceptable methods of payment. You will be provided with a Good Faith Estimate at the beginning of treatment showing the cost of services that are reasonably expected in a given time frame and this will be continually updated as treatment progresses.

Do you take insurance?

The practice does not accept insurance at this time. If you wish to use an insurance policy for services, it is your responsibility to contact your insurance company to inquire about specific coverage for out-of-network benefits for mental health services. Please note that most insurance companies require a psychiatric diagnosis in order to reimburse for mental health counseling and this diagnosis will become part of your permanent insurance records. I can be an out-of-network provider with any insurance plans that provide out-of-network coverage. I can provide a superbill for you to mail to your insurance company for possible reimbursement. Please see Policies for more information.

Can I call you in an emergency?

I cannot provide 24-hour on-call emergency services. Should you have a mental health emergency, please go to your nearest hospital emergency room, call 911, or use one of these other crisis resources.

What are the risks and benefits to therapy?

Therapy has both benefits and risks. Therapy involves discussing uncomfortable things and may raise unpleasant feelings such as anger, sadness, and anxiety. Sometimes people find that they feel worse before they feel better. However, research has consistently demonstrated that therapy is effective. Most people find that therapy helps stabilize their mood, understand themselves better, have healthier relationships, and cope with stress. We will establish goals for therapy, but I cannot guarantee any specific results. The best outcomes are produced when you are open and honest, and when you work actively towards your goals in between sessions.

Can I email you?

You are welcome to email me for administrative purposes (see Email Communication policy). That means that email exchanges should be limited to things like setting and changing appointments, billing matters, and other related issues. Please do not email me about clinical matters because it is not the most secure mode of communication. If you need to discuss a clinical matter, please call or wait to discuss it during the next session. The telephone or face-to-face context is a much more secure mode of communication.

I’m still on the fence about coming to therapy. What should I do?

I offer a free, no-obligation 20-minute phone consultation. This is a time where we can talk more about what you’re struggling with and whether I’m a good fit or not. You can book a consultation by phone or email.

What if I have another question that isn’t answered here?

Feel free to contact me by email or phone if you have additional questions. Please keep in mind that email is not a secure mode of communication (see above and Email Communication policy) so if your question involves sensitive or personal information, calling would be preferable.