Do you take insurance?

While I can provide superbills for out-of-network reimbursement, I choose not to contract directly with any insurance companies. I want to provide the highest quality care possible, and inviting insurance into the relationship has some significant downsides.

First, dealing with insurance as a therapist is tedious and time-consuming. With decreased administrative overhead, I can offer much more responsiveness and flexibility to my clients outside of sessions. I also have more time outside of sessions to do the other parts of my job I love, like learning, creating, and connecting with other providers.

Second, insurance companies require that I quickly make, record, and share a formal DSM-5-TR diagnosis based primarily on symptoms. I think it is usually more helpful to think in holistic terms incorporating personal, cultural, and systemic contexts. When I do make a formal diagnosis, I make sure it is for a direct therapeutic benefit.

Third, working with insurance creates some unavoidable risks to privacy. Like therapists who take insurance, I document in compliance with all state and federal standards. However, for anything beyond these rules, I have a high degree of discretion over what I record and who can access it. Your insurance company cannot use, share, or mishandle information I do not send to them.

I understand that many prospective clients diligently pay their monthly premiums and want, or need, to make use of their benefits. Fortunately, there are many competent, compassionate therapists that choose to work with insurance companies. I am hopeful for a future in which every American who needs healthcare has access AND every provider is paid fairly for their labor and expertise.

Do you offer sliding scale?

I do not have any available sliding scale slots at this time. However, depending on your clinical needs and available social support, we may be able to keep costs down by prioritizing short-term stability, recruiting free family and community supports, and moving to every-other-week scheduling.

Something is definitely wrong, but I’m not sure what it is. Where would we even start?

It’s okay if you don’t know. Sometimes we need an outside perspective to get the full picture. Part of my job is helping you identify what you need and how to express it effectively.

Our intro session will include a loosely structured interview to get a “lay of the land,” including background on the major areas of your life and, basically, what it’s like to be you. I may also give you some small projects to work on between sessions to grow your self-awareness muscles.

It usually doesn’t take long to identify some basic themes, with some typically coming into view in the first session. Then, as we continue to meet, we’ll put together deeper patterns that emerge from your personal history, experiences, desires, ideas, and relationships.

Do I need to be abstinent from alcohol/drugs/pornography to work with you?

Not necessarily, though there are some important caveats. If you are asking this question, I assume that you are either curious about addiction, you know you want help, or you have a history of addiction and do not want help. For some people, moderating the target behavior is a realistic treatment goal. For others, there are underlying factors that cause the risks of moderation to far outweigh the potential benefits.

I follow a few guiding principles to make decisions in this area. Slips happen, and we can learn from them. If you remain honest, insightful, and motivated, they can be integrated into treatment to build better defenses for next time. On the other hand, when I treat someone I must always try to be helpful and always avoid being harmful. If I think the target behavior is preventing therapy from being effective, or that continuing to work with you is enabling things to get worse, we cannot keep doing the same thing.

How long are sessions? How often should we meet? And how many sessions will we need?

My schedule is set up in one-hour increments on the hour, though I ask that you please plan around a 55-minute session so that I can take a short break if my schedule is packed. If you would like a longer session or a half-day intensive integrating multiple modalities, please let me know. For established clients, I also offer 20-minute “check-in” phone calls.

I usually recommend starting with weekly appointments. Starting slowly may seem more economical, but there is a risk that if we don’t establish continuity and make some early progress, then you will be more likely to drop out and less likely to seek help in the future. Once we have a good working alliance and a sense of stability, we can then decide to scale back frequency. Or, if it becomes clear that more support is needed, we can increase at any time.

Remember, if the thing you want to change didn’t happen overnight, you may not be able to fix it overnight either. Similarly, progress that happens fast may revert fast without diligence and support. It is important to stay motivated and focused while also practicing patience.

Some clients like to commit to a certain time period, such as one year of individual therapy after finishing a higher level of care. While this definitely works, I prefer the “goals reached” mentality over “time served.” Some clients may gradually notice that there is less to talk about after moving from weekly, to bi-monthly, and then to monthly sessions. For others, an achievement like a new job, a new new educational program, or the resolution of a big relational conflict signals that it is time to graduate. In any case, we discuss treatment goals in session one and don’t stop checking in until the end of treatment.

My question is listed here. How can I contact you?

Call me, email me, or book a free consult. You can text me too, but please limit sensitive information as texting tends to be less secure. My practice is a one-man operation, so be assured that if you reach out, I will respond personally as soon as I am able.