Here are the questions I most often hear and my answers:
1. “How long are your sessions?” I set aside 1.5 hours for new individual clients or couples. This allows plenty of time to connect, for me to understand what has brought you in, to assess if our goals for counseling match, and to see if my skills are the best fit for your particular needs. Follow-up sessions for individuals are usually 1 hour but can be longer if needed. Follow-up sessions for couples are always 1.0 hours.
2. “How many sessions will I have with you?” I will usually see individuals between 1-3 sessions, using a brief and very effective therapy called Rapid Resolution Therapy. Couples will vary, but can expect to be feeling better somewhere between session 10-12.
3. “What makes RRT so different than any other form of counseling?” In RRT we theorize that emotions originate in the subconscious mind, which works radically different than our conscious mind. There as an RRT therapist I language my sessions in a way that the subconscious mind understands so that the emotions are quickly transformed and change is immediate.
4. “What will it cost?” I charge per session versus per hour. For first sessions it is $180 and follow up sessions of Rapid Resolution Therapy are $120. Couples sessions are $180. The good news is that you will not be coming weekly for 1-2 years as in other forms therapy. I do not take insurance, EAP, or any other form of third party reimbursement. Payment is due at the time of your session.
5. “My wife (or husband) feels I am the problem and should be seen first. She (or he) will think about coming in only after I improve. Will you see me?” My experience as a couples therapist and, indeed, the best practices from the entire field of marriage and family therapy indicate it is better to start with both members of the couple from the first session. In this way the relationship becomes my client, and the alliance I have with each of you can be established without bias. I understand you may be calling me in the context of built up hurt or even distrust–you with your partner or from your partner towards you. But designating one person to come in for problems affecting both is almost never a good idea. Also, I will be screening for any significant individual issues that would indicate other forms of counseling need to come first. You wouldn’t take your car to the mechanic after recent stalling or break-downs but then tell him you only wanted him looking at the brakes, would you? Please let me help you get to the heart of whatever is troubling your relationship in the most efficient manner possible.
6. What do I need to read or do to prepare for seeing you? For people who have experienced trauma or any kind of disturbing life or relationship event, I figure they’ve done the hardest part by picking up the phone and showing up. Please come as you are. We will have everything we need right there as we collaborate on getting you feeling better even in the first session.
7. “What if I cannot afford it right now?” Much of the time, this is about a reluctance to spend money or, specifically, spending money on oneself. This is understandable and many folks are under other financial commitments. But consider that your mind and overall health is much more valuable than any piece of machinery or material possession you’ll ever own. Science is showing that the quality of our relationships and our perception of support and connection (or lack of it) affect productivity, the genesis of health problems, even our longevity. Just imagine you– tuned up, clear, coming from a place of peace, connection, and wisdom. How could you not be doing the best thing for those around you? I would suggest you are worth this investment and that together we can make sure it’s the best money you ever spent.
For those who are truly disadvantaged or have special circumstances, please call and let’s discuss it. I do give special consideration to veterans or those who have been through sexual violence.
8. “Why don’t you take insurance?” Please see my additional thoughts on this under Service-Rates and Insurance. I totally understand the need to use one’s insurance for surgeries and other major medical issues. I have and did. But when it comes to mental health insurance, consumers don’t generally understand the compromised position they are asking me to put them in. To get paid I have to give you a diagnosis of a mental disorder. Many of the life issues people bring into counseling don’t fit into these categories, but managed care insurance is running the show– to limit claim pay-outs by proving medical necessity. They will not pay for any kind of relationship therapy. They’ve defined therapy as only for individuals who have become symptomatic. Even if visit is held where family members are there, I have to prove the session mostly contained interventions focused on an ill individual. A diagnosis is necessary and goes onto your record and is automatically extracted into wider data bases. They claim to protect your confidentiality, but this cannot be guaranteed. The fact that multiple people at the insurance company see this information, what they do with it, and how it may be used in the future to deny you access to further insurance is out of my hands. Not to mention that decisions about the extent of therapy and whether it’s working or not are put in the hands of a third party, who knows neither of us, and is far removed from the immediate situation.
After awhile it dawned on me that I was being used as a go-between to manage costs, not care, and as an agent of all the ways the insurance companies protect themselves against exposure to the needs of covered members. All of this seems to undermine the safety of the therapeutic alliance by taking the necessary conditions– the confidentiality, trust, and collaboration that is at the heart of that alliance–out of the therapist’s hands.
If you still feel you must use your insurance, I totally understand and respect your decision. Your insurance carrier can direct you to other providers who will work with it.
