EXPECTATIONS OF THERAPY 

 

The ultimate goal of a therapy is to graduate from counseling and use skills on your own.

I believe that change occurs through the combination of a collaborative and mutually respectful relationship, as well as through therapeutic intervention. I approach counseling from an integrative model based on the your needs and the nature of your presenting issues. I work with a variety of therapeutic modalities, including Eye Movement Desensitization and Reprocessing Therapy (EMDR), Brainspotting, and Cognitive Behavioral Therapy. For more information on these modalities, see “Services and Fees.”

I work with clients of all ages and backgrounds in multiple formats including individual, groups, and families.

Trauma and therapy can affect all members of a family. For this reason, I strongly encourage clients to bring in their significant other, family members, or closest support person(s) for at least one session to gain a better understanding of what my client’s family system perceives and to give these support members some information and guidance on how best to support my client in their therapeutic process. When you attend a session as a support (or “Collateral”), you are not considered a client or part of the treatment process. I can receive information from you about my client, but cannot respond to you without their express, written consent. Any information a collateral shares with me about my client will be shared with my client.
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Counseling is not meant to be an ongoing, lengthy process. Rather, it is ideal for people to attend counseling and gain skills to manage their own challenges, then come back for ‘touch up’ sessions every so often.
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Depending on the issues with which you are struggling, counseling can be as brief as 6-8 sessions, or as long as several years for many people with chronic and severe trauma symptoms.
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Counseling is like any other endeavor you choose to begin. You will get as much out of it as you put in. My expectation is that you will attend weekly, or every other week until you are able to use skills on your own, then drop in for “tune ups” as needed in the future.

INSURANCE vs SELF-PAY

Why choose self-pay?

 

Many people choose to pay for services out of pocket for a variety of reasons, including privacy.

 

Insurances authorize strict 45-53 minute sessions. Trauma and couple’s work requires a skilled balance of building trust, doing difficult work, and stabilization. One hour simply is not enough time for most sessions.

 

Self-pay allows you to schedule in blocks of 1-3 hours, with 2 hours being the the standard. This gives us plenty of time to let you catch me up on your week, do intensive work, then ground you so that you never leave the office feeling rushed and raw from the session.

 

Insurance companies require a medical diagnosis to authorize services, regardless of your reason for seeking counseling.

 

Mental health diagnoses can be used to make determinations about life or health insurance premiums. Many life insurances now ask if you’ve ever been diagnosed with a mental health disorder, such as anxiety or depression. Insurance companies can review your treatment and life circumstances when determining whether or not to continue covering treatment. They can also decide how many sessions you can have, how frequently you can attend, whether or not they will pay for ongoing treatment, and how long sessions can last.

 

Most insurances do not cover phone or video sessions. Self-pay allows you this option.

 

When considering cost of treatment, you can spend over $100 per session in copays / co-insurance fees, with a “talk therapist” who may have to see you for an extensive period of time with minimal results, or you can make an investment in your well-being and get results quickly with someone who has invested time and dedication in advanced trainings and modalities with proven results.  

 

We make returning phone calls and emails a priority if there is a need to get a hold of your therapist in between sessions, so you never have to play ‘phone tag,’ or wait for days or weeks to hear back. We offer support outside of sessions because stressors don’t wait for appointments. We keep our caseloads down to a manageable size so that no one ever has to wait weeks to get an appointment.

 

We go above and beyond for our clients to ensure the best quality care and counseling experience.

 

Can I be reimbursed by my insurance?

 

Many services can be reimbursed by your insurance if you have “Out of Network Benefits.” If we don’t take your insurance, we can provide you with a ‘Superbill,’ which you can submit for direct reimbursement from your insurance provider.

WHAT TYPES OF PROVIDERS ARE THERE?

There are different types of providers in the mental health field who perform different services. Their licenses depend on their level of education and training. Many people find this confusing.
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MD (Doctor of Medicine):

Someone who has completed medical school. Psychiatrists hold MD degrees, have specialized training in psychiatric conditions and medications, and can prescribe medication, perform assessments and evaluations, and diagnose.
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PNP (Psychiatric Nurse Practitioner):

Someone who has completed a Master’s Degree in nursing and can prescribe medication. A PNPhas specialized training in psychiatric conditions and medication. They often do not perform assessments or evaluations, but can diagnose and sometimes also offer counseling.
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PhD (Doctor of Philosophy) and PsyD (Doctor of Psychology):

Someone who has completed a Doctoral program. These providers are often addressed as “Dr.” but cannot prescribe medication. They often are trained in assessments and evaluations, can diagnose and often offer counseling.

LCSW (Licensed Clinical Social Worker):

Someone who has completed a Master’s degree in social work (MSW). An MSW program focuses on a broad spectrum of issues and includes extensive training in advocacy, social justice, diagnostics, and person-in-environgment. LCSWs cannot prescribe medication. They can diagnose, counsel, advocate, work in public policy positions or management and work in hospital settings.

LMFT (Licensed Marriage and Family Therapist):

Someone who has completed a Master’s degree in Marriage and Family Therapy (MFT). MFT’s are trained from a systemic perspective which means they work with individuals, couples, and families from the perspective of understanding how the client, or clients, are interacting with their environment and the relationships in their life. MFT’s approach treatment from the mindset of “context is key,” the more we can build an understanding of the relationships in your life, the easier it will become to identify ways to create and maintain lasting change.  LMFTs cannot prescribe medication. They can counsel, as well as work in a variety of settings.
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LPC (Licensed Professional Counselor):

Someone who has completed a Master’s degree in counseling (MC). LPCs cannot prescribe medication. They can counsel, as well as work in a variety of settings.
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LCSW, LMFT and an LPC have undergone national testing, had years of clinical supervision, and have been required to log over 3,200 hours of client contact before being able to practice independently.

State Licensure: ​

All the levels of licensure listed above are governed by their respective Boards in the state of Arizona. You can easily look up any person who holds a license on their respective website (specific to their Board) and search for any disciplinary action against that provider, or to verify that their license is recent and in good standing. All providers are required to attend continuing education to maintain their licenses.

To verify licensure and search for Board actions or complaints for LMFT, LCSW, and LPC, visit www.AZBBHE and click on “Verifications.”

WHY DO PROVIDERS CHARGE FOR NO-SHOW AND LATE CANCELATIONS?

 

Many providers will charge a no-show or late cancellation fee if an appointment is missed. Often, it is the full cost of a self-pay session.

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While this may appear punitive to the person being charged, and can even look unreasonable to them, there is a reason for this:

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Imagine showing up to your job for work as scheduled and being told by your boss, “We’re only going to pay you for 6 of the 8 hours you’re going to be here today. You can take a break, catch up on work, or even nap for the other two hours.” That may seem like a bonus moment until it’s time to collect your paycheck. You were promised 8 hours of work. You showed up for 8 hours of your day. But you were only paid for 6. Sure, you may have gotten things done or taken a small break, but you also can’t count on income this way or rely on your own budget because you are at the mercy of someone else’s decision to fulfill their promise of paid work to you on any given day.

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Imagine a second scenario: You have the option of working at one of two potential jobs today. Both pay equally. You select one option and this person cancels on you without enough time for you to take the second job. Now you have missed out on income and can’t fill that slot with any way of producing income. You were ready and available to work, and took a job in good faith. But the other party decided to change the plans without adequate notice to you. You still have bills to pay and responsibilities to take care of, but because someone else changed their mind and you didn’t have enough time to make other arrangements, you are missing out on income.

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Providers make a commitment to you when they schedule you. We hold a slot specifically for you and no one else. We don’t book other people in your time slot, and try not to cancel at the last minute when you’ve made arrangements to come. Emergencies always come up. That’s a given. But missed appointments create a loss of income for providers, who are in a unique position in that we cannot bill insurance for hours someone did not show up, unlike companies who can pay sick time to you or pay you whether you are working or daydreaming during your shift.

Please consider the impact that late cancelations and no-shows can have on someone who committed to holding a time slot for you, and only you.

When you book an appointment, that hour is a product that usually cannot be re-used, returned or replaced.

If another client can be booked into the slot, we waive these fees. If not, there is an expectation that the hour will be paid in full to the clinician.

If you have any questions about late cancel and no-show fees, please feel free to talk to your provider.

LOW COST / FREE COUNSELING

Counseling can be costly. No one should have to forgo services due to financial constraints. For this reason, I suggest the following resources for low-cost or free services if you are experiencing difficulty affording the cost of counseling….

Low-Cost / Free Counseling

Counseling can be costly. No one should have to forgo services due to financial constraints. For this reason, I suggest the following resources for low-cost or free services if you are experiencing difficulty affording the cost of counseling:

  • Arizona State University offers counseling to the community for $80 per semester. Click HERE for more information.

  • University of Phoenix offers free counseling to the community. Click HERE for more information.

  • Franciscan Renewal Center offers individual, family, and couple’s counseling for the price of a donation and “no one is turned away due to lack of funds or income. For more information, click HERE.

  • Open Path helps with finding affordable, in-office psychotherapy between $30 and $60 per session (between $30 and $80 for couples & family sessions). For more information, click HERE.

  • For more information on free or low-cost services, click HERE.

REFLECTIVE LISTENING

“Most people do not listen with the intent to understand; they listen with the intent to reply.”

― Stephen R. Covey, The 7 Habits of Highly Effective People

 

GOAL:

To be able to hear each other and not end up in a shouting match to be understood; to see that a message is actually received. We take the time to address a letter and put a stamp on it and emotional communication requires the same care and thoughtfulness.

 

SPEAKER:

  • THINK BEFORE YOU SPEAK- Exactly what do you want to convey?
  • Use “I” statements:
    • “I feel (EMOTION) about/ when (EVENT/ THING/ ACTION) because (how it affects you).
    • Example: “I feel frustrated when dishes are left on the counter because it feels like I’m expected to do them myself.”
    • Emotion =/= thought. Example: “I feel you don’t care about my needs.” Instead: “I feel sad because my needs don’t appear to be considered.”
  • BE BRIEF. Too many words confuses a listener and your message can get lost.
  • “YOU” Do not use the word “you” as it elicits defensiveness. Stick with YOUR feelings, events, situations. Example: “I feel disrespected when dishes are left on the counter” rather than “When YOU leave dishes on the counter…”
  • Avoid: Attacks       all-or-nothing     ‘always’     ‘never’
  • Clarify for the listener if need be
  • Stick with original message (no sand-bagging/ bringing up other things)

LISTENER:

  • LISTEN before you speak
  • Notice tone, body language, emotion coming from speaker
  • DO NOT RESPOND. DO NOT RESPOND. DO NOT RESPOND.
    • (It is your turn to only listen and allow the speaker feel heard. You will have your chance to be heard when the speaker feels heard)
  • BUT Avoid using “but” as it is dismissive of what speaker said.
  • Reflect back how you understood the message; not the actual words
    • Example: Lauren’s husband asks “Are you going to the gym today,” Lauren might say “I’m hearing you say I’m fat and need to work out.”
  • Allow speaker to clarify if you did not hear the message as they intended it.
  • Reflect back the underlying message you hear the speaker giving you, including emotions, thoughts, body language
    • “You are saying ___________________.”
    • “I am hearing ______________________.”
    • What I heard you say is ______________.”
  • Reflect back the emotion you are hearing from the speaker
  • “You feel ___________________ because ___________________.”
  • When the speaker feels heard and lets you know you have received the message as they intended it, you become the speaker and the speaker becomes the listener.