Frequently Asked Questions About Counseling in WA

Sessions are 50-minutes. We start with a few minutes to connect and check in, then spend 30-40 minutes digging in deeper or doing a therapeutic activity, we spend the last 5-10 minutes summarizing our work together, making a plan for any homework or reflection before we meet again, and confirming your next appointment.

During the consultation call we cover any questions you didn’t find answers to here in these FAQs. We briefly discuss your reason for seeking therapy at this time. I answer any questions about fees and insurance. And if we both feel good about it, we schedule a regular time for you to come in for therapy weekly or biweekly. You will provide a credit card to secure your first appointment. We book your first appointment!

After the consultation call and prior to the first session you will receive an email link to my secure online portal. You will log into the portal and complete an intake packet that has my policies, procedures, and informed consent. It is important that you take some time to read through these.

Your completion of these documents confirms your intake appointment. If the documents are not completed 48 hours prior to your appointment, it will be cancelled and you can reschedule it once the forms are complete. Your credit card will be billed 48 hours before your first appointment to confirm your appointment. You will not receive a refund, exchange, or transfer for this fee.

Before your intake appointment you will also be provided with a variety of questionnaires and self-assessments. Most of these take just a few minutes to complete and you are welcome to fill out as much or as little as you feel comfortable completing before we meet. These will help expedite our work together so that we can get started on therapy in the first session!

Note: Any forms requiring your signature (or e-signature) are required. Any forms without a signature requirement are optional.

During the first session we briefly review all of the documents you read and signed, and I answer any questions you may have about any of them. We go over the results of any assessments you completed. We create your first goal for counseling -a vision of what you hope life will look like if therapy is successful- and we start to sketch a brief history of who you are and what your life has been like up to today..

We end the first session with a review of what we did, any insights gained, what we plan to do before we meet again, and a confirmation of your next appointment.

This is a complex question which—in true therapist style—has me curious about the source of the question. Do you think you need counseling? Did someone tell you you need counseling? Is this about financial reimbursement? (Insurance coverage often requires “medical necessity” i.e. “need” for counseling)

In my practice the “need” for counseling shows up when one of many possible things occurs:

-you notice your own mental health is declining and this is affecting your own wellbeing, your relationships, or your stability in work and/or life.. This may be shown in an increase in a variety of symptoms such as anxiety, sleeplessness, inability to focus, poor health or hygiene habits, short temper, more arguments or difficulty maintaining relationships, feelings of hopelessness, and much more.

-others are telling you or showing you that you need counseling. Not the ideal way to find out, but sometimes (and often) it is the way it occurs. It may be a friend or family member, or in more extreme situations an employer, judge, safety officer, or mental health professional

-you want to improve your mental health, gain insight about how you became who you are, be proactive in changing your personal or family legacy, overcome relational or situational traumas, learn better ways of coping, live your best life, or any other number of reasons.

What do you think? Do you need (or want) counseling right now?

You will come to counseling once or twice per week for 50-minutes. For best results a minimum of weekly appointments is required. You will experience more intensive treatment and accelerated results if you come in twice per week.

Your personal reasons for seeking counseling will factor into this answer. Taking this into consideration, I like to provide 1-3 months of weekly counseling with short breaks in between for you to reflect on the changes you see as a result of therapy and the effectiveness of our work together.

You may stop therapy at any time, but are encouraged to commit to a 1-3 month block with a review or discharge session scheduled a few weeks after a therapy block.

Some clients with acute concerns achieve optimal results in as little as 5 weeks. Clients with pervasive or persistent concerns may benefit from as many as 40 sessions over 12 months. On average 3 to 6 months of weekly or twice weekly sessions can produce effective outcomes for most clients (12-24 sessions).

My goal is for my clients to receive most of the benefits of counseling as quickly as possible and in less than 12 months. Clients who wish to continue counseling past 12 months usually do so on an as needed basis or if something unexpected in life comes up. Ideally you end counseling with the skills, insights, and personality development to be able to maintain your optimal mental health without much more than occasional, optional “check ups”.

It is possible to live a mentally healthy and enlightened life without continuous therapy for years on end. Modern approaches and theories validate that mentally healthy, trained minds are very resilient, so once the mind achieves mental health, maintenance can be done relatively automatically and easily.

Sessions are $375 per 50-minutes and may be eligible for insurance reimbursement or HSA benefits.

I also offer a reduced cash rate of $150/session for up to 12 sessions per calendar year.

Each insurance provider and benefits package is different so this is a question you need to ask your patient representative (see more questions below).

I can provide you with receipts for possible insurance reimbursement.

You may wish to contact your insurance provider to find out what your deductibles are and if there are limitations or requirements for you to access any mental health benefits. Sometimes deductibles are high enough that you receive little benefit from using an in-network provider based on the cost of therapy. There may also be mental health specific deductibles, or limited access to who you can see, for how long, how often, and what treatments are used.

You may want to ask the following questions of your insurance provider to know what your coverage is:

1. Is my insurance benefit an HMO or PPO? (HMOs required you to use only in-network providers)

2. What is my annual deductible? Is there a mental health deductible?

3. What is my co-pay? Number of allowable appointments? Allowable frequency of appointments?

4. Which CPT codes are approved for my insurance benefits? (I primarily use 90791, 90834, 90837, and 90846)

5. Can I have a list of approved providers? [Call to see if any are accepting new clients. Sometimes ‘phantom providers’ exist, meaning you can’t find someone who you can actually get in to see.]

6. Do I need a referral from my medical doctor or a pre-authorization for a therapy referral?

7. What percentage of the therapy fee is reimbursed if I use an out-of-network provider? [You may have to pay a portion out of pocket and it is good to know that amount in advance].

Most importantly, while it can make sense to want to use your insurance benefits, paying for your mental health out of pocket can have great rewards and perks too. Including some of the following:

1. More privacy and autonomy over your mental health care

2. The good feeling of investing your income into something that can impact and change the trajectory of all other areas of your life: yourself, your health, and your ways of thinking, feeling, and interacting.

3. A budget line item that, once counseling is complete, can move into other areas of wellness and self care, or personal growth and development.

Don’t let insurance benefits (or lack of them) stop you from taking care of your mental health and achieving optimal mental wellbeing.

Evening and weekend appointments are scheduled on an as needed basis. They are full fee ($375)

Most clients prefer online therapy. I use Telehealth by Simple Practice as my secure online portal. You are encouraged to find a quiet, safe and private place for therapy. People use their office, bedroom, car, closet, back yard, etc. It is important that your have ample battery power, an excellent internet connection, and privacy for the appointment.

Occasionally clients will want to come into the office for therapy. I hold limited in-office sessions in my downtown Tacoma office if therapeutically appropriate.

I also offer “walk and talk” therapy in Olympia on occasion with well-established clients, if therapeutically appropriate.

I primarily provide counseling for women who want to be more empowered, find more joy in life, heal from emotional or relational wounds, and have more fulfilling relationships. We work together to reconnect you to your intuition and internal wisdom, learn or refresh skills to reach outwardly and inwardly for support when life is challenging, and heal past traumatic experiences and limiting beliefs.

My clients often come in experiencing increased stress, tearfulness or anger, low self confidence, low motivation, increasing panic attacks or anxiety, overwhelm or depression, loneliness or disconnectedness, traumatic experiences and difficult relationships.

Through our work you learn to love and accept yourself as you are, listen to your wants and needs, empower yourself to have the life, relationships, and goals for optimal mental wellbeing, and embrace the relationship you have with your intuition. You may learn to communicate more effectively, establish healthy boundaries, and choose healthy relationships.

I provide LGBTQIA+ affirming care .

I also have lived experience in the Mormon (Latter Day Saint) faith and provide therapy to anyone seeking a counselor with understanding of these beliefs or faith transition to or from this belief system and culture.

I work with men, couples, families, and children/teens on a case by case basis.

My primary concern is for your wellbeing. I want therapy to work for you so that you can achieve optimal mental health. I check in each session to see how therapy is working for you, and we hold a special session every 5-10 weeks to review our work and determine if we want to continue, stop, or if you would benefit from a different approach or therapist. If it is not working for you, please let me know.

It is also important to know that sometimes therapy can get pretty uncomfortable when it is working! Sometimes clients want to stop just as things are starting to change. I may remind you of this, and encourage you to continue, but you have the right to stop or start therapy at any time with or without notice. For your own benefit and the option to continue in the future, I recommend that you let me know if you want to stop, or if any concerns arise that are impacting your engagement.

The “therapeutic container” is an important part of the ritual and routine of therapy. Additionally, other clients have their therapy time scheduled before or after your appointment or your therapist has other commitments to their time, so it is important to be mindful of the time scheduled for your session and practice prioritizing the goals of the session. I will help you with this through prompts and reminders if needed, and maintaining firm boundaries around time and expectations..

Clients who have difficulty holding the time boundary may be therapeutically advised to consider having multiple sessions in a week or may be referred externally for more intensive treatment.

Group therapy is another way to modify treatment if more time or support is needed or wanted. It can be a wonderful precursor, augmentation, or post script to individual therapy which can produce faster outcomes, and may be recommended as part of your individual treatment plan.

Group therapy is a very effective therapy model that can stand alone, prepare, augment, or transition individual therapy.

Ask me more about this if you ever want to hear about the history, positive effects, and benefits of group therapy. I’m a big fan of this model for: effectiveness, affordability, and the powerful acceleration it can have on therapeutic growth.

I have some standard groups that I put through my rotation, and also enjoy offering limited group offerings based on the needs of my clients and my community.

My groups are always developing and evolving; some are structured, some not, some are open and some are closed.

My standard groups are:

Women’s Building Trusting Relationships Group offers safe space for women to connect through shared experiences, practice vulnerability, and build healthy and trusting relationships and communication with other women. Ultimately increasing their skills and base of social supports, a key factor in mental wellbeing.

Coping Skills for Anxiety and Depression. This is a ‘psychoeducation’ group, or a group that feels kind of like a class where you learn some information about anxiety and depression, and practice skills that are known to help reduce these symptoms. This group is intended to build effective coping skills.

The intention of both of these groups combined is that you learn the basic foundations of mental health which are: effective coping skills and supportive relationships. These foundations have been demonstrated to be factors that reduce mental health symptoms. They are not intended to resolve the deeper reasons for mental health symptoms, so it’s important to do individual or other group therapies to get to the roots, but they do offer some relief from symptoms and offer emotional space and increased capacity to address the deeper issues (vital for any progress in therapy to actually occur.)

The best way to learn more about my groups including my group schedule, upcoming groups, dates, times, fees, etc. is to fill out my contact form. You will receive updates of any group information. Additionally, I have a group page that I make “live” when I am offering groups. If you don’t see it, fill out the contact form and I will connect with you about group offerings.

There are many resources available about mental health counseling, therapy, and wellbeing. I contribute to these free resources in the form of my blog (on my website) and in various social media outlets, workshops, and public speaking events. I encourage you find resources that work for you and take proactive care of your mental health.

If you find that the free resources aren’t enough or your relationships or mental health continues to decline, it is important to consider getting connected to a mental health professional who can provide targeted, professional help. The sooner the better!