Counseling vs. Psychotherapy vs. Psychiatry


Counseling is best for addressing symptoms, gaining tools and resources for a particular issue, and support (includes productive venting). Tends to be time limited. Rarely addresses the underlying core issue. Helpful.


Psychotherapy dives underneath the symptoms to find the root or the crack in the foundation. Then, seeks to repair the crack so everything else will work better.


Psychiatry, in our present world, is for medication. While psychiatrists once provided both therapy and medication, it is less common now. No medication is prescribed at this practice. Medication can provide a reduction in symptoms to allow therapy to work better. Nutrition, vitamin, and hormone balancing can be extremely helpful, as well. Referrals provided, as needed. 



What do I need to know ?




Risks of Psychotherapy


Primary risk? You might get better. Your life might work. It is not always possible to know the domino effect of handling life differently. What is best for you may cause struggle in a family member, friend, or work situation. I can assist in helping you provide a good transition for everyone. However, just as a nurse must clean out an infected wound in order to heal properly, initial time in therapy can prove painful. The goal is to pace the process to afford healing at the best rate for your life and circumstances. 



Location, hours, and a form to send initial questions or schedule an appointment are in the further drop down menu on this tab.


Session length is typically 50 minutes. Session time includes scheduling and payment. Extended 90 minute sessions are available, as well as, 3 hour intensives for couples. Group sessions are 90 minutes.


Cost ranges from $50 - $400. I maintain 2 pro-bono slots, reduced fees for students, and am considerate with temporary hardship. Cash, check, debit, credit accepted. HSA and FSA cards are accepted as long as the card includes a symbol for a primary credit card agency. Insurance addressed below. 


How soon can I/we make an appointment? You can typically expect to have an appointment within 10 days. If at certain peak times it is not possible to schedule within 2 weeks, I will assist with finding a next option. Even if you are not ready to schedule, I am glad to answer basic questions about the therapy/counseling process. 


Do you have a cancellation policy? Unless previously discussed, the full session rate is charged for cancellations less than 24 weekday hours from the scheduled appointment (i.e. Monday appointments must be cancelled by the appointment time on Friday). The reason does not change the policy. A time commitment is made to you and is held exclusively for you! On the rare occasion I cancel with less than 24 hours notice, I will provide a voucher for a free late cancellation for you to use in the future. 


How often do I need to come in?


How often depends on whether you are in crisis, need to heal, or are seeking personal growth. Generally speaking, I meet with individuals and couples once a week. Every other week is a common practice, as well, especially if you are alternating with group therapy. Maintenance clients might come in twice a year to power through a particular situation. Your therapist can be added to your support system like your CPA, attorney, family doctor, or personal trainer. 


What are the benefits of self-pay?


Privacy Stays Intact

Insurance providers require a certain level of intrusion.


Your insurance can request records at any time or require a “file review” to determine further care. Often this assessment is by a non-medical professional.


Your information is sent to the Medical Information Bureau (MIB). Qualifying for current or future life, health, disability, or long-term care insurance may be affected.


Diagnosis not required

A diagnosis is required for care with insurance (both for in-network and out-of-network coverage). While understandable, not all situations warrant a diagnosis. All situations require a framework for care, but not all symptoms/situations have the intensity level and duration of time required by a diagnosis.


Using Out of Network benefits does require diagnosis and a record of your care in the MIB. I am glad to provide a Superbill to submit to apply to your Out of Network plan – no problem. And, please ask me about Better and Patch - 2 companies I am starting to work with in 2019 to help patient's actually use and seek reimbursement using Out of Network benefits. 


Flexibility of Care

Incorporating research, making tailored recommendations, coordinating with other providers, providing Telehealth/encrypted online video, and activity development between sessions is possible.


Avoid Questionable Payment Practices 

When a therapist seeks verification of your insurance, even through a medical biller, the information provided about your coverage under your plan often changes. This should not happen since you agree to a deductible and amount of coverage for services. Self pay provides clarity of session rates.


A practice called “recoupments.” Multiple years after your care, when you think back on your time fondly - yet in the distance, the insurance provider can state they made a mistake approving already provided services. The therapist is required to return funds. Technically, the client/patient should be billed for these fees. The last time this happened it had been 2 years since the services were provided. I have never required former/current clients to pay for past services and do not support recoupment practices.


Sample fees: Group therapy is an increasing focus of this practice due to its effectiveness. Insurance, as of 2016, has raised copays to $25-55 while they pay $0 or $1 for group therapy.


Protect Your Quality of Care During the years of working with insurance, the behind-the-scenes care to maintain awareness of (sometimes daily) insurance plan changes took a medical biller and hours of tracking. Isn’t this a “necessary evil” to provide low cost care? Possibly, but once it crosses a certain time boundary it affects the quality of care provided. I would rather not hire additional staff that raises out of pocket rates, provide additional low fee options, work with you during times of hardship, and provide extra pro-bono assistance. 


Your Time is a Priority Therapists do not triple or quadruple book appointment times like M.D.s have done to account for insurance practices. And, therapists rarely keep a client waiting more than 5 minutes (on a bad day). Instead, I prefer to maintain a calendar that helps you schedule at your ideal time and assist you in ways that provide relief quicker.



You're allowed to go therapist shopping!


There is no need to feel locked in once you choose someone to see for an initial session. Finding the best fit is important. And, you won't fully know until you meet the person. The right person will make you feel just a little uncomfortable. That edge will help you change your life.