Frequently Asked Questions (FAQs)
What can I expect from our first therapy session?
In our first meeting, we will have several goals:
Confirm your identity. I will ask you to show me your government-issued photo identification, such as a driver's license or identification card.
Go over your "paperwork", including the informed consent agreement.
Address any questions about the informed consent agreement.
Clarify any questions I may have about your responses in the intake form or biopsychosocial interview form.
Complete any additional assessments that seem necessary based on your history.
Discuss safety protocols, login processes, and privacy issues.
Establish an emergency management plan.
Talk about how to get a hold of each other.
Get to know each other a bit.
Identify your goals for treatment.
This meeting will last for 60-120 minutes and will take place via video conferencing. I do not provide evaluations or initial sessions via telephone or chat.
How will I know if we are a good fit?
To some degree, you won't know until we work together for a bit. But it's important that you get a feel for who I am and how I do things before you commit to that first appointment, because if you're going to meet weekly with a therapist, it should be someone you have a good feeling about, have confidence in, and feel comfortable talking to. Research shows that the therapeutic relationship is the number one determinant of successful outcomes.
To help you make an informed choice, I've provided tons of information about who I am and how I work all over this website. Check out my about page, my description of services, my counseling policies and procedures, and the rest of the FAQs on this page. My policies and procedures spell out exactly how I do things, and my description of services talks about my clinical philosophies and my style in session.
If you are not sure if online therapy is right for you in terms of the technology involved, see my technology self-assessment screening to help you decide.
Do you take notes during sessions?
Many clients experience stress and anxiety when they see a therapist taking notes. If that's you, I'd like to address your concerns.
I do take notes during sessions. These notes serve multiple purposes:
Maintain an ethical standard of care.
Keep my mind focused on you instead of on remembering what I need to document.
Ensure accuracy in your session notes.
Please be assured that if you'd like me to share with you what I write in your session notes, I am happy to do so at any time. I believe in transparency when it comes to session notes. Per HIPAA guidelines, I document the minimum necessary to provide quality care. Documenting the minimum necessary protects your privacy and keeps session notes focused on facts, not judgements. Session notes might include statements such as: Client reported emotional distress. Client reported family conflict. Client reported progress in managing stress. I will document your mental status using a checklist that provides a moment-in-time impression of the outward appearance of your mental status. Session notes will also include the therapeutic interventions that I used during our session (i.e., strategies, trainings, materials), as well as plans for future sessions. Per HIPAA law, you have a right to view your session notes - just ask and I will make them available to you. Your rights to access your records are discussed in detail in the articles on my references page if you would like more information.
What can you tell me about your professional ethics?
I follow the codes of ethics of the American Mental Health Counselors Association (AMHCA), the American Counseling Association (ACA) and the National Board for Certified Counselors (NBCC). You can find the conduct and ethics policies and practices for my business on my counseling policies and procedures page.
What's the difference between counseling and therapy, or therapist versus counselor?
That depends on whom you talk to. I use the terms interchangeably. Many of my colleagues do as well. Some professionals gravitate toward the term counseling to avoid confusion with professions that also use the term therapy, such as physical or massage therapists. Other professionals favor the terms therapy or psychotherapy instead of counseling to avoid confusion with professions such as school counseling or career counseling. Some colleagues think of counseling as a short-term service and psychotherapy as a long-term service.
Another factor affecting how professionals refer to themselves is the difference in terms used by state licensing boards. Licensed clinicians who provide therapy/counseling have many titles. In Florida, we are called Psychotherapist, Licensed Mental Health Counselor (LMHC), Licensed Clinical Social Worker (LCSW), and Licensed Marriage and Family Therapist (LMFT). In addition to these titles, in other states you might also see the terms Licensed Professional Counselor (LPC), Licensed Clinical Professional Counselor (LCPC), Licensed Professional Clinical Counselor of Mental Health (LPCC), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Marriage and Family Counselor (LMFC), Licensed Clinical Marriage and Family Therapist (LCMFT), and Licensed Mental Health Practitioner (LMHP), to name a few. Practitioners with a doctoral degree in a counseling profession are called psychologists as opposed to psychotherapists.
I tend to favor the term counseling because my professional license and my national certification titles are Licensed Mental Health Counselor (LMHC) and National Certified Counselor (NCC). You will see the terms counseling, therapy, and psychotherapy on this website, and for the purposes of my practice, you may consider them synonymous.
What's the difference between mental health and mental illness?
The American Psychological Association has a handy online dictionary for terms like these. Here are their definitions:
a state of mind characterized by emotional well-being, good behavioral adjustment, relative freedom from anxiety and disabling symptoms, and a capacity to establish constructive relationships and cope with the ordinary demands and stresses of life. See also flourishing; normality.
Mental Disorder (aka Mental Illness)
any condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these. Such disorders cannot be accounted for solely by environmental circumstances and may involve physiological, genetic, chemical, social, and other factors. Specific classifications of mental disorders are elaborated in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (see DSM–IV–TR; DSM–5) and the World Health Organization’s International Classification of Diseases. Also called mental illness; psychiatric disorder; psychiatric illness; psychological disorder. See also psychopathology.
Take this mental health quiz to see how much you know, and read what the CDC has to say about mental health to learn more.
You do NOT need to be diagnosed with a mental disorder/illness/pathology to need or benefit from counseling. You would need a diagnosis if I were an insurance-based practice, because insurance reimbursement is driven by DSM diagnoses. That's one of the many reasons I chose to be a private pay practice (see elsewhere in my FAQs for other reasons).
Many people seek therapy for personal growth, enrichment, maintenance, and support, and do not necessarily meet the criteria for a formal diagnosis. Others seek therapy for those reasons and also meet the criteria for a formal diagnosis. Mental health is a fluid condition, and it travels up and down on the spectrum of what the APA calls normality (ugh; does anyone like the word normal???). Furthermore, your baseline mental health can look different from someone else's, and it can look different this year from what it used to look like for you at another point in your life. Let's not rush to diagnose. Let's agree on who you are and where you're at first.
The World Health Organization (WHO) explains that mental health is a fluid state of being.
"Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in. Mental health is a basic human right. And it is crucial to personal, community and socio-economic development.
"Mental health is more than the absence of mental disorders. It exists on a complex continuum, which is experienced differently from one person to the next, with varying degrees of difficulty and distress and potentially very different social and clinical outcomes.
"Mental health conditions include mental disorders and psychosocial disabilities as well as other mental states associated with significant distress, impairment in functioning, or risk of self-harm. People with mental health conditions are more likely to experience lower levels of mental well-being, but this is not always or necessarily the case."
You can read more about mental health on the World Health Organization website.
What does evidence-based mean?
Evidence-based treatments are therapeutic modalities and strategies that have shown to be effective in scientifically-designed research studies.
Practice-based evidence is another term of interest in therapy. This is what we call it when clinicians base their treatment strategies on the results they've seen in their work with clients. Some of the most well-known psychologists based their theories on practice-based evidence, such as Jean Piaget's theory of cognitive development, Freud's theory of psychodynamics, or Maslow's hierarchy of needs, all of which have had a dramatic impact on the field of psychology and on therapeutic modalities.
A good clinician relies on a combination of evidence-based practices, practice-based evidence, and craft to choose their therapeutic approach(es) and design personalized treatment plans for clients.
What's the proper term for telemental health therapy?
Ah, the terminology debate. There's an argument for or against just about every term. "Virtual" implies that something is not real. "Online" isn't associated with texting. "Digital" isn't associated with video conferencing. Web-based leaves out phone calls and text messaging. "Remote" and "distance" are applicable to therapy delivered via video conferencing, phone, and text messaging, but these terms are seldom used by therapists or clients. In the field, we use the terms telehealth, teletherapy, or telemental health therapy to refer to therapy delivered via telecommunications. You'll see all three of those terms on my website. I also use the term "online" because it's the term folks tend to search for when they are looking for therapy via distance.
Terms for therapy via telecommunications:
Telemental health therapy
Telemental health counseling
Why don't I see testimonials on your website?
We've grown accustomed to using reviews on shopping websites to help us decide if a product is right for us. It might be helpful to see testimonials about a therapist's services, but it is not ethical for us to post them - not according to our ethics codes. The solicitation of testimonials is in conflict with the several of the ethics codes of the therapeutic community, including the ethics codes of the American Counseling Association, the American Psychological Association, and the National Association of Social Workers.
Solicitation and posting of testimonials can be seen as 1) a violation of confidentiality, 2) self-serving, and 3) a way of pressuring clients when they are in a vulnerable position.
I will never pressure you to send me clients, and I will never ask you for a testimonial to post on my website. The best testimonial you can give a therapist is to refer others who need help, but I will never ask you to refer people. If you honor me with a referral, please keep in mind that due to client confidentiality, I will not be able to tell you if I was contacted by someone you referred to me. Even if they tell you that they reached out or started seeing me for therapy, I cannot confirm or deny this without their written permission.
Do I need to be tech savvy to use your counseling services?
You do not need to be a tech expert, or even be comfortable with the programs I use, but you do need to be willing to use them. I am happy to spend time acclimating you to the technology. But if you are tech-resistant or using apps to communicate causes you such anxiety that you will avoid scheduling or keeping sessions, please find a local counselor who provides in-person services and save your self the stress. If you are not willing to create and safely store passwords and passcodes, virtual counseling is going to compromise your security and privacy. If you are not willing to spend time learning how to use the programs I use to deliver services to you, either with my guidance or on your own, this practice is not the right fit for you. See my technology self-assessment screening for more detailed information.
What tech will I need?
For teletherapy to work smoothly, you will need, at minimum:
A computer and/or smart phone.
A reliable internet connection.
An email address you check regularly.
A free HIPAA-secure mobile app (I will send you a link for this).
The willingness to access communications and materials online.
The willingness to either use secure sign-on methods or sign a waiver to use unsecured methods.
The willingness to remit payment online through secure applications.
Please read my notice of privacy practices and my technology and security policies and procedures for detailed information about the apps I use, and visit my technology self-assessment screening to help you determine if teletherapy will work for you. To make things a little easier, I have tutorials on my tech trainings page that walk you through how the applications work.
Do you accept clients who live outside Florida?
Not at this time. I am currently licensed as a mental health counselor in the state of Florida only. Legally, I cannot work with you unless you are physically located in the state of Florida at the time of service. Even though we are working entirely online, the law prohibits me from providing therapy to clients outside the state of Florida. Please read my travel policy on my counseling policies and procedures page for more information. If you are located in another state and would like me to consider licensure in your state, please let me know by completing the corresponding form on my contact page.
Do you accommodate people with disabilities?
Please see my disability accommodations page for information about therapy accommodations for clients with disabilities. I am not a specialist in disability accommodations, but it is important to me to make adaptations when feasible.
Is there anyone you won't work with?
I do not work with clients under 18 years of age.
I do not work with clients whose diagnoses are outside the scope of my training and experience. My specialty areas are addiction recovery counseling, stress and anxiety help, and personal growth counseling.
I do not work with clients whose presentation indicates that they would be best served by treatment at an inpatient facility. This may be determined from the initial contact, but depending on the information provided, it may not be possible to determine until the initial evaluation has been completed. Some clients may develop the need for inpatient treatment during the course of counseling. If this becomes apparent, I will make an appropriate recommendation.
I do not work with clients who are looking for in-person sessions, or whose diagnosis or current circumstances make in-person therapy a better fit. My practice is 100% virtual.
I do not work with couples or offer family therapy where the family is the client. I do, however, strongly encourage family members to get involved in supporting their loved one’s treatment, and I will invite a family member to join you for your session if you and I agree that it would be helpful. In this context, family sessions should be considered collateral sessions, where the client is the individual in therapy and not the collateral. The collateral is a guest, and is there to support the client. Please note that I will not hold secrets for a collateral regarding information they offer regarding you and your case. Your family and friends should not expect phone, text, or email contact with me outside of sessions. If I am contacted by your family and friends outside of a collateral session, I will:
not respond at all unless I have a written release of information from you to speak with them.
respond in a limited manner according to the written release of information you provided specifically for that contact.
respond with “Per HIPAA law, I can neither confirm nor deny whether someone is or has been a client, or even if they have contacted me”.
not respond to voice mail messages from collaterals because it is my policy to limit calls to appointments only.
In keeping with the ethics and laws of the counseling profession, I cannot engage in a counseling role with you if:
We are friends.
We are family.
We are FB friends.
We have a past personal relationship.
You are located outside the state of Florida at the time of treatment.
How can I learn more about you?
Read my counseling services page, and check out my company vision, mission, and core values on my about page. Browse the rest of the website for more information about me and what I do.
Do you offer group therapy?
I set up groups when the need presents, and they differ in purpose and frequency. I offer group therapy when there are a number of clients who 1) have expressed an interest, and 2) are working toward the same task or processing the same concerns. I have a screening process to make sure group members are a good fit for the group's purpose and dynamic, and there is a separate informed consent process to ensure as much protection of confidentiality as possible.
Do you provide documentation for people with emotional support animals (ESAs)?
Please refer to my ESA letters request policy. If you are a potential client, the short answer is that I only consider writing ESA letters for clients who are actively on my caseload for at least three months, and only with an evaluation specifically for that purpose. Fees for the ESA evaluation are separate from regular session rates and are outlined in my ESA letters request policy.
Can I refer my friends and family to you?
Absolutely! I appreciate your referrals. But please be aware that due to confidentiality laws, I cannot tell you if they have engaged in services with me or not unless they have signed a release saying it's okay for me to share that information with you. If they have not, my answer will be, "Per HIPAA law, I cannot confirm or deny whether someone is or has been a client, or even if they have contacted me."
If I am seeing a client who has provided a release for me to speak with you, please be aware that:
A release of information is almost always specific to certain information and will probably limit the topics I can discuss with you.
I understand that sometimes, family and friends want to tell me about a loved one with the intent to help.
I will not hold secrets from a client for anyone who speaks to me regarding that client.
What does your logo mean?
What is instructional design and what does it have to do with therapy?
Instructional design is a job, a craft, an art, a science, and a field of study. Good instructional design involves closing a gap in performance. In counseling, that gap might be in knowledge, skill, attitude, or ability - sometimes all four. The purpose of instructional design is to produce measurable change that transfers from the learning environment — your therapy sessions — into the real world — your performance environment.
So what does that mean for you as a consumer of psychotherapy? It means that as your therapist, it is up to me to help you identify the problems in your life and then give you the tools to fix them. In instructional design language, it's my job to close the gaps in your life. I do that by using the basic components of what's know as the ADDIE process of instructional design, a process that informs most instructional design models used today across all industries. The ADDIE acronym stands for Analyze, Design, Develop, Implement, and Evaluate. This is what it looks like in therapy:
I assess your knowledge, attitudes, skills, and abilities.
Together, we figure out what needs changing and how best to make that happen.
I design a treatment plan that gives you options - different ways to work on changing the things are are negatively impacting your life.
I present you with a choice of activities to help you gain knowledge, understand how that knowledge helps or hinders you, instill habits and practices (aka coping skills) to give you more control over your life, and increase your capacity for independent self-management.
I measure the effectiveness of our work together and show you objective data on how much or how little you've progressed.
And it's my job to make that interesting, entertaining, relevant, and fulfilling.
What if I want to let you know about a company I represent?
If you are a marketing or outreach professional, please contact me via this form. Please do not send solicitation emails or texts, as that is just a quick way to get blocked. I'd much rather your introduce yourself through that form.
Do you offer a complimentary phone consultation so I can talk to you before scheduling psychotherapy?
Generally speaking, I do not. There are two reasons.
First, free phone consultations are often mistaken as an opportunity to take the therapeutic relationship for a test drive. That's not a realistic goal. You can't build trust in 15 minutes. You might get a good feeling from talking to a therapist, and they might make a positive impression on you. But if you're ready to unconditionally trust someone you've never met after a 15 minute phone call, then let me tell you - that's something you might want to work on in therapy. Trust comes with time and consistency.
The best way for you to determine if my services are a good fit for you is to look through my website, familiarize yourself with my clinical methods and philosophies on my counseling services page, about page, therapy services and fees, and start therapy page. In my policies and procedures, I've thoroughly described what you can expect from me, and what is expected from you as a client. I've given you a ton of information here, and I have probably addressed most of your concerns. If I haven't, please send me your questions via this form. As I've said often on this site, research shows that the therapeutic relationship is the most important determinant of success in therapy. If you decide to work with me, we will work together to establish that relationship. It will develop over time - not over a 15 minute phone call.
Second, when you commit to an appointment with a counselor, even a free consultation, you create a contract. You expect me to show up, and I expect you to show up. Your time is valuable, and so is mine. An exploratory phone call is similar to speed dating - there's no commitment from you, and no obligation. I am available for appointments when you are ready to make a commitment. You wouldn't want me to take your phone call without the willingness to work with you, would you? Well, same here.
My services are 100% online, and include substantial, meaningful psychoeducational content. Yes, we will spend a lot of time just talking. But I will also give you learning materials to work on between sessions. Sometimes, you'll get them all done. Sometimes you won't, and that's okay. But this practice is built on combining talk therapy with education and real world application. If you're interested in learning, I'm the therapist for you. If reading, watching videos, and interacting online are totally unappealing to you, then I can save you some time: My services are not a good fit for you.
If you are contacting me about instructional design services, practitioner materials, or continuing education, please use the relevant form on my contact page.
What hours do you work?
I schedule appointments seven days a week from 12pm-9pm ET (yes, that includes weekend evenings). This does not mean I am available nine hours a day, seven days a week. It means these are the hours during which I schedule appointments. Some time slots are for video sessions and other time slots are limited to phone or text sessions. Because I run a concierge service, I do not book appointments back-to-back. My schedule tends to book up a or more week in advance, so please keep that in mind if you've got a time preference.
I offer HIPAA-compliant video, phone, text messaging, and email therapy sessions. Video and phone sessions are synchronous. Text messaging and email messaging are asynchronous. You may occasionally get an immediate response to a text or email, but that will be unusual and should not be expected.Video
I schedule video therapy sessions Tuesdays, Thursdays, and Saturdays between 12pm and 8pm ET, pending availability, with the last video session starting no later than 7pm ET.Phone
I schedule phone therapy sessions seven days a week from 12pm-9pm ET, pending availability, with the last phone session starting no later than 8pm ET.Text or email messaging
There is no charge for text messaging or emails that are related to appointments, payments, or quick questions. texting for any other purpose is considered therapy and charges will apply per my fee schedule. I offer therapy via text messaging or email throughout the week from 12pm-9pm seven days/week. Fees for therapy via text messaging or email are calculated on a word count basis. This includes text/email messaging in both directions.Response times
Please see my therapy services and fees for details about response times and fees, and see my technology and security policies and procedures for a description of the technology used to keep these communications secure.
Do you offer weekend or evening appointments?
Yes to both. Please refer to the above FAQ about my hours.
What if I cannot make my scheduled appointment?
Please see my appointment and cancellation policies. You can find those policies on my therapy services and fees page.
How long is a session?
Video sessions are typically booked for one hour. One hour means 60 minutes - not 45-50 minutes. If you'd like to use less time, that's up to you, but you are charged based on what you booked. I offer additional time in fifteen minutes increments via video, phone, and text messaging if you'd like to go over the hour and the time is available. Please see my therapy services and fees page for all the details and feel free to send questions via this form.
Do you offer in-person appointments?
Nope. My practice is entirely online. Please see my online counseling services page to read about the benefits of online counseling. If you are a potential client and you are looking for an in-person provider, I have a few names in the Palm Beach County, Florida area I'd be happy to refer you to. Please reach out for those names using this form.
How do I schedule appointments?
You schedule appointments directly through me after you have completed the intake process. You can find the intake forms on both my start therapy page and my client forms page. I will ask your scheduling preferences on those forms. Once I've received your completed intake forms, I will text you a link to install a HIPAA-secure text messaging app so we can start a private, secure conversation. I will also send you an encrypted email that you can reply to securely. I will send appointment reminders, but you are responsible for keeping the appointments you schedule.
I strongly encourage you to communicate about appointments through secure texting or email - sometimes you will want to add a question about therapy, and keeping our communications on secure apps reduces the chance of a privacy breach.
Can I call you from the car for my therapy session?
If you schedule therapy during a work break or lack privacy at home, you may choose to sit in your car during therapy sessions. Please find a safe location to park and let me know where you are in case of an emergency. If you are in your car during our session, make sure you supply me with your ten digit local emergency number at the start of the session so I can call and send help if you are carjacked, hit by another driver, or experience a health emergency.
I ask that you do not drive during a therapy session. Therapy can be an emotional experience that distracts you from your vehicle, the road, and other drivers. Your risk of an accident increases when you are distracted while driving. If you're driving during a session, you take full responsibility for the risks and consequences.
How early/late can I call or text?
Current clients will receive an invitation to secure texting once the intake process is completed. If you're a current client, you should feel free to text at any hour - seriously. I really mean it. I keep my tech applications and device notifications on silent and check them throughout the day, so you don't have to worry about waking me or interrupting me. Just don't expect a response at any hour. Please see my therapy services and fees policies and procedures for details on my response times.
I do not answer calls except by appointment - no exceptions. You are free to leave a voicemail on my business phone at any hour. I will respond by email, so be sure to leave your email address. My business voice mail is HIPAA-compliant. All voice mails will be saved and stored per HIPAA regulations.
If you are not a current client, please contact me using the relevant form on my contact page.
Can I bring another person to my sessions?
In most cases, this is inappropriate and will result in termination of the session without refund. However, there are times when it may be helpful for me to talk to a supportive person in your life - either in our session or in a separate interview session. We have a term for support persons in this context. We call them collaterals.
Collaterals may be a client’s friends, family, legal team, or other healthcare professionals - basically anyone who is connected to the client and can provide insight or assistance with the therapeutic process. As the clinician, my role in a collateral session is to gather information and provide educational resources or clinical referrals when beneficial.
Collateral sessions should not be misconstrued as therapy for the collateral. Collaterals are not clients and are not protected independently of the client; the client holds the rights to confidentiality and the rights to access and transmit records of collateral sessions. Please note that I will not hold secrets for a collateral regarding information they offer regarding a client, nor will I keep from a client that someone contacted me about them.
Please note that I do not work with couples or offer family therapy where the family is the client. I do, however, strongly encourage family members to get involved in supporting their loved one’s treatment, and I will invite a family member to join you for your session if you and I agree that it would be helpful. In this context, family sessions should be considered collateral sessions, where the client is the individual in therapy and not the collateral. The collateral is a guest, and is there to support you, the client. Please see my therapy services and fees page for collateral session fees.
What should I do in an emergency?
To receive help immediately, please contact one of the national or community resources on the find immediate help page of my website.
If you experience an emergency during a session, we will follow the emergency management plan as discussed in my counseling policies and procedures.
Why do you ask me to complete the intake process before our first appointment?
This is my business model, and it serves several purposes:
It saves us time during your first session so you aren't spending money on us doing all that paperwork together.
It gives me an opportunity to review your needs and be as prepared as possible to jump right in during our first session.
It gives you the opportunity to ask informed questions before investing in therapy.
It gives you the chance to read how I do things and decide if I'm the right therapist for you.
It sets realistic and clear expectations.
It screens out anyone who isn't committed to starting therapy.
What if I don't want to go through all this to start therapy?
When do you charge me?
You are welcome to submit your payment when you schedule the appointment; it's the best way to hold the slot. You can make your payment quickly and easily on my payment page. I will also send an invoice to your email when you schedule. If you do not initiate the payment yourself, my policy is to charge your payment method just after you pass the cancellation window, which is 24 hours prior to the appointment for most clients, and 48 hours prior to the appointment if you have a history of repeated cancellations.
A cancellation is considered late if you cancel less than 24 hours prior to the scheduled appointment time. After three consecutive cancellations by the same client, the cancellation policy changes to 48 hours notice, and a cancellation will be considered late if you cancel less than 48 hours prior to the scheduled appointment time.
Please see my therapy services and fees page for information about base hourly rates, late cancellation fees, refunds or credits, fees for supplemental documentation, and fees for legal involvement, such as consultations with attorneys, depositions, and court fees.
Do you have a sliding fee scale?
Not at this time.
Do you take insurance?
No. This is a self-pay practice, otherwise known as private pay or direct pay. I am not an in-network provider, and I am not an out-of-network provider.
I do not take insurance, file insurance, or communicate with your insurance company. I do not provide superbills for you to submit for reimbursement. I do not accept assignment and I do not accept worker's compensation. I am strictly self pay.
I would love to work with you, but if you have insurance and plan to file an out-of-network claim, I am not the clinician for you. You need a therapist who provides superbills.
You are under no obligation to accept my policies; you have the option to work with a clinician who accepts your insurance or who provides superbills for out-of-network claims. Please see my find immediate help page for resources to help you locate a provider who can serve your needs, or contact your insurance carrier for a list of contracted providers.
Why not accept insurance?
Involving insurance would make it impossible to offer the features and benefits of a concierge practice. You can read about those benefits on my counseling services page. My business model does not accommodate the restrictions and administrative demands required when dealing with insurance. I want to spend my time working with my clients, not negotiating with insurance companies. Some of my services are not covered under the traditional medical model of treatment (e.g. therapy via texting or phone; psychoeducation via e-learning; collateral consultations).
Can someone else pay for my services?
Sure, but you will need to sign a release 1) allowing me to confirm for them that you are a client receiving therapy from me, and 2) agreeing that I can inform them of the dates, frequency, and duration of the sessions for which they are paying. They will sign an financial agreement for third party payors that authorizes the charges and acknowledges that they will not have access to any additional information about you or your treatment without your signed, written consent. Both the client who signs the informed consent agreement and the person who signs the financial responsibility agreement are financially responsible for all fees. This includes fees for services scheduled and received and fees associated with no shows and late cancellations.
If your parent or partner is paying for your treatment, the important thing to remember is that they care about you and want you to get well. That's why they are making this financial investment. It's up to you to communicate to them that for that to happen, you need the freedom to be open and honest with your therapist. If you need me to explain the limitations of confidentiality to your parents or partner, I can schedule a collateral session with them to discuss the boundaries around your treatment. Note that collateral sessions are fee-based sessions.
If I pay for someone else's services, can I be there during the session?
No one can be open and honest when they know they are being watched. Healing takes time, comfort, trust, and safety. So does change. Change has a flow, and that flow is disrupted when change in behavior feels like a performance instead of a natural evolution. Change in behavior stems from change in attitude, and inner work must be organic to be authentic.
It may be your intention to be supportive, and you may be coming from a place of love, but watching or listening to someone's therapy is not healthy. It's spying. It's impossible to feel safe when someone is spying on you. No matter who's doing the spying. The only people in the therapy session should be the therapist and the client(s).
An exception is something called a collateral session. This is not the same thing as a family session or a couples session. In the context of a collateral session, a client's support person(s) attends the therapy session but is not considered an additional client; they are present in a support capacity. The need for a collateral session is determined by the therapist and the client, not by the collateral, and is scheduled only when clinically useful. In that case, there is an informed consent process prior to booking the appointment so everyone is clear on priorities, expectations, and privacy considerations.
Please note that in the state of Florida, video or audio recording someone without their permission is a crime. It is the policy of this practice to press charges against anyone who records a session without express written permission.
If you contact me about a client who has provided a release for me to speak with you, please be aware that:
A release of information is almost always specific to certain information and will probably limit the topics I can discuss with you.
I understand that sometimes, family and friends want to tell me about a loved one with the intent to help. However, please be aware that I will not hold secrets from a client on your behalf. If you call to speak to me about a client, I will tell the client we spoke, and I will not hold the content of that conversation from the client.
If you plan to pay for someone else's services, please arrange for them to sign a release of information prior to contacting me. Once they provide this release, I will contact you via your preferred email. The client will provide your preferred email address on the release form, and I will send you a web-based fee agreement form to complete. You will be able to fill out this form on a computer or mobile device.
Why don't you accept insurance?
Involving insurance would make it impossible to offer the features and benefits of a concierge practice. You can read about those benefits on my counseling services page. Some of my services are not covered under the traditional medical model of treatment (e.g. therapy via texting or phone; psychoeducation via e-learning; collateral consultations). My business model does not accommodate the restrictions and administrative demands required when dealing with insurance. I want to spend my time working with my clients, not negotiating with insurance companies. More importantly, I am not a fan of the instantaneous diagnosis required by insurance companies to justify "meidcla necessity". I work from a wellness model. Wanting or needing therapy doesn't mean there's something wrong with you. It could also mean there's something wrong with your environment - now or in the past, and it could mean that you just want more out of life.
Confidentiality, Privacy, and Security Questions
What is HIPAA?
How do you protect my privacy?
Please see my notice of privacy practices and my technology and security policies and procedures for details. These policies discuss:
Safeguards I have in place to protect you
Safeguards you can put in place on your end
The applications I use and why I chose them
How I comply with HIPAA
Can I contact you to talk about my family member or friend who is one of your clients?
Not without a signed release of information from them. If you contact me and there is no release, my answer will be, "I appreciate your concern and your interest, but per HIPAA law, I cannot confirm or deny whether someone is or has been a client, or even if they have contacted me."
If I am seeing a client who has provided a release for me to speak with you, please be aware that:
A release of information is almost always specific to certain information and will probably limit the topics I can discuss with you.
I understand that sometimes, family and friends want to tell me about a loved one with the intent to help. However, please be aware that I will not hold secrets from a client on your behalf. If you call to speak to me about a client, I will tell the client we spoke, and I will not withhold the content of that conversation from the client.
How do you define recovery?
For current industry definitions of recovery from both addiction and mental health disorders, read the FAQs at the bottom of my addiction recovery specialty page. On that page, I also give you my take on recovery terminology as it relates to substance and behavioral addictions.
How do I find a recovery program?
Have a look at the "Which recovery program is right for me?" question in the FAQs on my addiction recovery page.