Results vary from person to person. Some people feel immediate shifts in a session, and more significant long-term change builds incrementally. Years of stress and related patterns were put into place over time. Similarly both time and space are needed to establish new patterns and behaviors as well as to restore and repair. While there are prescriptive and protocol-driven forms of short-term therapy available, lasting sustainable change requires attuned approaches tailored to each individual.

For example, benefits from a nine-month period are quite different from results after three years or more. A client at the end of a 6-9 month period, may have gained awareness of her patterns and valued having a neutral space to hear herself as well as receive feedback. Some clients feel better and transition here.

However, sometimes awareness of patterns isn’t yet enough to implement changes. At this point, I often hear clients say, “I see what my patterns are and I don’t know how to stop.” Therapy as an experience has its phases that trace natural processes of growth.

Like any story, there’s often a beginning, middle and end.

Therapy at the beginning is about addressing the pressing issues that prompted you to seek professional support. My approach in the initial phase is often stabilization. Major changes in an already destabilized or distressed state can be too much.

I often tell clients, “Now that you’re out of crisis, we can really look at what’s at the heart of the matter.” With greater stability and a foundation of support, deeper issues can be examined together. New behaviors and risks can be taken. Therapy can provide guidance, feedback and support while you’re experimenting. Some things you try will feel freeing. Other things might fall flat. Either way, you will have a trusted witness to guide you through. Of course, I paint this picture with broad brush strokes.

Each journey is unique. As trust and security are established over time with a practitioner, more can be explored. As initial goals and outcomes are fulfilled, new themes and directions for working together reveal themselves along the way. For instance, someone with an initial focus of wanting help with dating and finding a partner, now shares new difficulties with their spouse, wanting/having a family etc.  Others may start therapy after the loss of a loved one. There are so many different journeys in therapy.

Clients who spend perhaps several years in therapy might see their whole life changed: a greater sense of confidence, career growth as well as more satisfying, loving relationships. They may be quite happy and content. And, they may still want the supportive relationship of their trusted therapist.

Sessions are typically 45-50 minutes. I like a teeny bit of flexibility to adjust accordingly as we’re closing up our time together.

The beauty of a regular weekly appointment is that it’s your time. Even still, 45-50 minutes per week is not a lot of time. Nevertheless, you and I will build a relationship. You’ll find a rhythm: remembering things from our time together, looking forward to it, thinking about things through the week that you want to share.

The weekly commitment allows awareness and insights to be reinforced over time. As well, the regular frequency establishes consistency and provides the opportunity for a special relationship to grow between us.

I work with a limited amount of people at any given time so that I can give you my attention and presence.

However, I also know that things come up. For the way I operate my practice, it can be a challenge sometimes to find a different time from our regular appointment. Yet, I do my best given what I have to work with.

If you are unable to keep your scheduled appointment, please provide a minimum of 48 hours notice before your appointment time. If you do not cancel or ask to reschedule with sufficient advance notice, you will be responsible for the session fee. For a forgotten appointment with no notice (or no-show), you will be charged the practitioner’s full fee.

Clients who submit claims to insurance are personally responsible for fees related to late cancellations and not showing up for appointments. Insurance will not cover these incidents

Please take a look at Welcome Letter, or email me to schedule a time for a brief (~15 min) introductory call. I like to have the opportunity for both of us to get a feel for one another before meeting, and I’ll be happy to answer any of your questions.

• Do you need pre-approval for outpatient mental health services (or a referral before seeing a specialist)?
• What is your annual deductible? Have you met it yet? How much have you accumulated to date?
• Are medical and behavioral health integrated, or are they separate deductibles?
• Does your deductible follow the calendar year, or reset following a plan year?
• What percentage are you responsible for after meeting your deductible?
• How does your plan calculate the reimbursement rate for out-of-network services?
• What is your out-of-pocket maximum if any?
• Is there a limit to the number of sessions for outpatient mental health?
• How long do you have to submit a claim?

What do I need to know about my insurance benefits? from Mental Health America

What you need to know about mental health coverage from the American Psychological Association

Types of Out-of-Network Reimbursement from Fair Health Consumer

A Guide To Allowed Amounts by Rachel Norman, Better

Why do therapists charge so much? by Patrick Bryant, PsychCentral

Why is therapy so expensive? by Nicole Pajer, HuffPost

Working with a professional is an investment you choose, which can have lasting positive impacts on all areas of your life. Greater fulfillment, ease, happiness and vitality – while difficult to translate into monetary value – are just a few of the advantages of having professional support.