I do not take insurance directly. However, some of my clients choose to utilize their out-of-network (OON) insurance benefits and are reimbursed for a portion of their out of pocket costs. I am happy to provide you with the appropriate documentation, called a superbill, which you can submit to your insurance company for reimbursement.

OON benefits vary from company to company and plan to plan. The best way to determine what your insurance benefits would be for therapy is to call the number on the back of your insurance ID card and ask about “outpatient, out-of-network mental health benefits”.

There are a few factors to consider when thinking about using insurance for therapy.

The first is that insurance companies can and will limit the number of sessions that are covered. They may also request a treatment summary or copies of my therapy notes, which are records of our sessions together.

Additionally, if you choose to utilize your out-of-network benefits, I will be required to provide you with a mental health diagnosis (ex: Major Depressive Disorder, Adjustment Disorder, Generalized Anxiety Disorder, etc…) to prove “medical necessity” for therapy. This diagnosis may become part of your medical record, and result in you having a “pre-existiting condition.” I believe that therapy is an essential service that everyone could benefit from at some point in their lives, and that a requiring a diagnosis is a barrier to accessing good care.

If you have any additional questions about the use of insurance, I am happy to discuss this option with you during our call.

Outwardly, the consult call is our chance to co-determine if we are a good fit for working together. It safeguards both of us by ensuring I only take on clients that I can truly help. It is my opportunity to get to know you, and your opportunity to ask questions to help you make an informed decision about your mental health.

At a deeper level, the consult call serves as the beginning of our walk together. Sometimes, that walk only lasts the duration of the call! But very often it is much longer. Frequently, the consult call becomes the first point of contact in a process that ultimately changes both of our lives (hopefully for the good!)

All that is to say…the consult call, while low-stakes, should not be underestimated!

As far as what to expect, I am very informal during our initial call. I really just want to connect human to human, hear more about what’s going on in your life, and see how I might help. You can expect to feel like you’re talking to an old friend who is invested in your growth. There will be time enough for all that clinical stuff later! My best hope is that you leave our initial call feeling heard and hopeful.

I am a big believer in therapeutic fit. If, for whatever reason, one or both of us determine that you might be better served by another therapist, I am happy to provide referrals. I always ask that you take the evening and sleep on it so there is no pressure to make a decision on the call. I will follow up with you via email the next day to see if you’d like to move forward.

A few things you WON’T get on our consult call:

• peppered with interview-style questions

• diagnosed or labeled

• my attempts to pressure, convince, or otherwise sell you on my particular brand of therapy

Because I endeavor to tailor my approach to each individual I work with, it is difficult to describe a “typical” session. It’s helpful for me to envision my work as moving up and down a couple of continuums as necessary:

1) Client-Centered vs. Directive - I honor and appreciate my clients’ autonomy in utilizing the therapeutic space however they see fit. At the same time, I recognize that you may not be able to lead where you’ve never been before. I take a collaborative “co-pilot” approach, gently assuming and ceding the controls in accordance with your therapeutic goals.

2) Process Oriented vs Skill-Building - There will be many times in therapy where you’ll want space to process. By that I mean you’ll want to just talk, share incomplete thoughts, and figure out how you feel about something in the presence of a non-judgmental witness who can ask you questions and offer feedback. Other times, you’ll want the how-to: the words to say, the communication skill, the self-esteem practice, the daily ritual, or the new behavior. I have a deep respect for both of these modes, and together we can toggle between the two.

3) Science-Based vs. Heart-Centered - You may be wondering if therapy is an art or a science. The answer is…yes! As a clinician, I do my best to stay on top of the latest science and most effective evidence-based treatment strategies. I’ll often provide psychoeducation around what I think are exciting scientific findings that may guide our work and improve the quality of your life. At the same time, I maintain a profound respect for our shared humanity. I recognize that our condition as humans may not fit into neat little boxes. Despite my training and education, I never want to lose track of the simple fact that we are two humans in a room trying to make sense of life together. Thus I use science to guide my interventions while remaining firmly rooted in my heart.

As you might imagine, the answer to this question depends on many factors including:

• the severity and complexity of your presenting concern
• your own insight into what is creating the problem
• co-occurring mental health and medical conditions
• your previous mental health and medical history
• whether or not you require or could benefit from pharmacotherapy (medication management)
• your willingness and ability to make behavioral and lifestyle changes
• your social support systems (i.e. do your friends/family/culture support the changes you’re trying to make?)
• practical considerations like your ability to invest financially in mental health support and the amount of time you have outside of sessions to dedicate to your goals
• your own personal preferences
• and more!

I tend to think of my clients in terms of three groups:

1) Short-term, solution-oriented folks who want to work on a very specific problem. They get what they need in a few sessions or a few months.

2) Longer-term therapy clients who want to dig deep into longstanding patterns of thinking, feeling, or behaving. We’ll work together for several months up to a year or more before we say goodbye.

3) Long-term/ongoing clients who have incorporated therapy as part of their weekly/bi-weekly/monthly self-care. We meet on an indefinite basis as we walk through life together.

All relationships end! This is a difficult yet undeniable truth of our human condition, and the therapeutic relationship is no exception. Knowing this, I like to “begin with the end in mind.”

The clinical term for the conclusion of a therapeutic relationship is “termination.” In a “termination session,” we consolidate your therapeutic gains and develop a plan for “aftercare.” Then, I close your file, which means you are no longer an active client, and I open up your spot in my calendar for newcomers.

At a human level, it's a chance to say goodbye and reflect on what our time together has meant for both of us. This is sometimes hard, which is why many people opt out of doing it! And as an Irishman, I get it…But I hope that when you’re ready, we can bring our relationship to a meaningful end and be grateful for our walk together.

The most important thing to takeaway at this juncture is that you never need to be shy or self-conscious about bringing up termination. It’s a natural and expected part of the process. In fact, I’m always trying to work myself out of a job! I will always be happy to have that conversation with you.