What to Expect from a Therapy Session
Sessions typically last 45 to 90 minutes. (Some couples find that setting aside several hours is preferable to juggling schedules just for a one hour session.) During the first meeting we will talk about the issues that have brought you into counseling. We will start to get an idea of what we can accomplish together. It is also a time for us to decide if we are well matched for working together and to explain the counseling process, answer any questions, and go over important details such as confidentiality, scheduling, etc.
Sessions are payable with cash, check, debit or medical savings account cards. Sessions are 53 minutes in length. I do not bill insurance companies for services, but I can help you seek reimbursement if you have that benefit available.
Some insurance companies will reimburse you for sessions with an “out of network” therapist. In those cases, I can provide you with the documentation that may allow you to get some or all of the cost of the session from your insurance company. Be aware that most policies do not cover marriage counseling, but some cover shorter “family counseling” sessions in order to treat a member of the couple for a diagnosed mental illness.
Late Cancellation Policy
Our session time is important to me. I reserve that time for you and plan my schedule around it. If I don’t have a convenient time slot available, you can ask to be put on my waiting list. The policy is a required 24 hours notice prior to a cancellation or half the regular fee is charged for the session. I occasionally waive this for unforeseen emergencies such as extreme weather or a sudden onset illness. I will also waive the fee if I am able to fill that time by scheduling someone on my waiting list. If I have an emergency, I will contact you as soon as possible to reschedule. For new clients, I also require 24 hours notice of cancellation or there is a charge for the missed session before a new one can be set.
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Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.
Frequently Asked Questions
Can I talk to you first?
Yes, I am available by phone for a consultation. That way I can hear what’s going on with you and give you an idea of how I might be able to help. It will also help us determine if counseling with me is the best option, or if I can suggest different resources for you.
How long does counseling take?
For marriage counseling, it often takes at least 6-8 sessions to really get a sense of improvement, and a few more to solidify progress. However, the range can be pretty wide depending on so many factors. I’ve seen couples feel much, much better in two sessions, and others who make a more long term commitment to work on more entrenched patterns. For individual counseling, again the range is very wide, but again some people feel better after just a couple of sessions, while others have been known to come for a year or two of regular sessions to overcome more difficult problems or patterns. The main point is not how long it takes, but how important the goal is. Living life in a painful relationship can make a day feel like a year. Putting off therapy increases the difficulty and the time it takes to improve. Ideally you should plan to come in as a couple once or twice a week to keep the momentum going and the focus on progress!
How do I know if I really need a therapist?
Almost anyone can benefit from therapy. People usually go when they sense things aren’t getting better on their own or it’s interfering with life. An increasing number of people are realizing that waiting until the problem is absolutely terrible is not a good plan. If you want to improve your life or your relationship, therapy is a great way to get there. The sooner you go, the greater the chances for success.
Does counseling really work?
In most cases, yes! This may be the best kept secret around. It is so rewarding to see how much better people can get through counseling. A lot of times they express surprise about it, as if they didn’t really expect it to help. Frequently over the years I’ve had people tell me they wish they would have come to counseling years ago. Success depends on many things, including finding the right person at the right time. But for many people, counseling absolutely makes a big difference. Sometimes a better life is about having the courage to try something new.
How can I commit to this when I don’t have time?
Good question. Between jobs, kids, commutes, chores and everything else, it can be hard to imagine setting aside regular time for therapy. I do offer telephone or online options for people who just can’t get to my office without too much disruption. Sometimes you may not realize how much of a time-suck your problems have become, so in a way investing the time to get better at solving them can really be worth it. For some people, it’s easier to take time off and come in more often to get through problems faster. Others spread it out, coming in before work, after work, or even at lunch. Most workplaces have policies that account for medical visits, and working on your emotional health is incredibly important.
I don’t want to be put on medicine. Will I be pressured to?
First of all, I am not licensed to prescribe medicine. I do work with clients who are on antidepressants or other medications, and I often suggest checking with your doctor if I believe it is a good idea. But I also know that some people avoid going to counseling because they may have heard they’ll be put on medication and they don’t want that. I understand. That’s why my focus is to help people to look at all of the many, many reasons they are struggling and to try to find ways to help get relief.
I have seen people feel much better after working with me in therapy without any medication. Those who choose pharmaceutical options also find it helpful to have counseling sessions as well. Outcome studies strongly suggest that combining medication with talk therapy can bring better and longer lasting results. There are many different ways to address your concerns, and I will not pressure you to seek a solution that does not fit for you.
Do I have to commit to a certain number of sessions or a certain time slot?
Nope. It’s important for you to decide what you want as you go along. Even if you love my approach, my skills, and my coffee, you may have a big project that comes up at work, or a bad flu bug that goes through everyone in the house. I maintain a flexible attitude for each client, and each session as we plan what will work. When I talk about commitment, I’m talking about a mindset. Therapy works the best when you really want things to get better enough to stick with the process. Having said that, many of my clients choose to carve out a regular time and day so they know they can count on my availability, and so they can plan their weeks more easily. For those who don’t choose a regularly recurring spot, that could mean you wind up having to wait a few weeks to get in.
Are you going to ask me all about my childhood and blame my parents for everything?
Therapy has a mixed reputation, and some of it is deserved. For decades we have been honing and improving the art and science of helping people to overcome emotional pain, mental illness and relationship problems. That accumulated wisdom has led to some incredible expertise and proven results, over time. Yes, I will probably ask about your past. I will want to know about your family. But I don’t place blame and I don’t see value in stewing in old hurts. I am present and future focused in order to help my clients make the most of their one and only life.
Is it worth the expense?
What is the value to you of overcoming this problem? Is it something you want to keep living with? Counseling is an investment — in yourself as well as in your life. Through therapy you will be better equipped to cope and adjust to life’s challenges. It can help you build a a more satisfying and happy life. In this way, when you face future life transitions, you’ll already have the tools to navigate your way through it, making it less scary and stressful. I think about it like physical illness. If you kept getting sick, would you seek out a doctor to help you get well again and look into prevention? Most people would find a way. Your emotional and mental health are crucial parts of you that are necessary to care for in whatever ways you need. It makes sense not to just live with the pain, when you can find a way to lessen and eliminate it.
I see that you don’t take insurance. What if I can’t afford the fee?
There are less expensive, even greatly reduced fee options in the community and I can help you find them if necessary. I don’t take insurance for many reasons, including the fact that many of my clients don’t want to have a mental health diagnosis going on their medical record. (Some people have health insurance that will still reimburse them for some or all of the cost of seeing me as an “out of network therapist.) If you have the feeling I’m the counselor for you, then sometimes planning ahead can allow you to make the investment in yourself. Some people choose to come less often to spread out the cost. Others decide to change financial priorities, temporarily, to make an investment in a better future. Only you know what your options are, and what the stakes are for you. Call me for a free consultation if you are still deciding.
What if bringing up all this stuff makes it worse?
That is a great question. Sometimes talking about painful issues does make it feel worse, temporarily. With couples especially, I find that things can feel pretty heightened and tense. This is not always the case. Many clients feel immediately better when they can talk things out with a neutral party. But for those who find it hard at times, all I can say is that you have these emotions and problems anyway. Because they feel worse temporarily doesn’t mean they ARE worse. I will help bring a sense of neutrality and calm, take things as fast or as slowly as you would like, and help you finally feel more free of what may have been holding you back for years.
What is the first session like?
In the first session I will ask you more about what brings you to counseling. This is your chance to sort out exactly what is going wrong and why, and also how you want your life to look. More importantly, it’s a chance for you to get to know what it’s like to work with me. You can ask any questions that come up, and get a sense for what kinds of things I ask. I will explain to you what I think is going on and what might help. I will talk to you about my methods, a timetable, and any perceptions I have about how things can improve for you.
It’s important for you to decide for yourself whether it feels right, or if you want me to help you find a better fit. Occasionally I find that a client has an issue that I don’t have expertise in, and I might recommend a colleague or other resources.
What if I don’t know what’s wrong?
This is not all that uncommon. Sometimes a person can just know things “aren’t right” or they are feeling down, or anxious, but they have no idea why. For many people, therapy begins with way more questions than answers. But just knowing that you want things to feel better is valuable information. I will work with you to go from there.
Can my marriage be saved?
That is up to each of you. Yes, sometimes one person can make enough difference to turn things around. Other times, there may be a serious enough issue that growth is blocked. For instance, if someone has an active addiction, that can block progress. If there is a competing emotional attachment such as an affair, that can get in the way. Or if there is abuse, I will make a referral for individual counseling before couples counseling can be of any help. Safety is a higher concern in these instances. But if there is no active addiction, affair, or abuse, the chances of your relationship improving go up. Now we can begin to really address the underlying patterns and find ways to help you feel much more connected and happy.
There was an affair. Now what?
If the affair is truly over, this can be the very best time for couples counseling. As painful as it is, infidelity has a way of bringing problems to the forefront so that things can drastically improve. There are many steps to the process, and each couple is different. However, an affair can serve as a wake up call that many couples have found makes them stronger than they ever were before. By getting counseling after an affair, you can get great value from the pain you’ve had to go through. You can address things that probably have needed to be addressed for a long time. Or you can work through the mysteries and the doubts and the pain of it all together instead of in your neutral corners. More importantly, you can begin to join together to build a sense of security about the future.
My partner doesn’t think we need counseling, but I do.
That probably puts you in the majority. The squeaky wheel gets the grease. I would recommend making an appointment, inviting your partner, and then coming alone if necessary. You can check out my blog on this for more details.
We’ve done therapy before and it didn’t work. Why try again?
Because I’m not your other therapist, for one! I have my approach, which might be the one that works for you. If your relationship, your sense of well-being, your happiness are important to you, you don’t have to take “no” for an answer. A second opinion (or third, or fourth) might just be the one that helps get you what you’ve been looking for. I have had a lot of people tell me they are surprised by the difference between me and their last therapist. I have been told, multiple times, that one session with me accomplished more than months with someone else. My guess is, it really has a lot to do with finding the right fit. When you find the right therapist for YOU, you will do best.
What about evenings or weekends?
I offer very limited slots for couples-only sessions in the evenings and on weekends. For individual sessions, I am available from 9-5 during the workweek. Couples who want longer blocks of time, or “marathon” sessions, can take advantage of occasional Saturday hours. For busy couples who want to accomplish a lot without stretching the process out over many weeks or months, I sometimes block out an evening or a weekend day.
I’m on the fence. Can you provide any more info that would be helpful?
I will be happy to answer any questions you have by email or by phone. Sometimes just having the chance to hear a person’s voice and get a brief sense of who they are can help you make the decision. Another option would be to come to one session and get a feel for what it’s like. That will tell you a lot about the therapy experience, what it will be like working with me, and to get some insight into your problem.
I called for a session and they told me you were full! What now?
I know how frustrating it can be to find a good option for counseling and find out the timing was wrong and the schedule is full. I do not normally keep a waiting list for new clients beyond a few weeks. This is because I know there are so many caring and skilled therapists available who can be of tremendous help right now. Sometimes putting off help can turn into not getting the help at all. I know that family, friends, your insurance company, and of course the web (including the psychology today website) can be a source of options for finding the right therapist. I often make specific suggestions as well, depending on your particular concern.
What else can I do, between sessions or prior to starting therapy, to get help?
There are many resources for help right now. Check out this page for a start.
Call 217-290-2478 x55 for a free 20 minute consultation, or: