How do I know if it’s a good therapeutic fit?

This question is why our free initial call is so important. Finding a therapist can be a monster of a task when you have to answer the same questions and share your heart and hopes with strangers repeatedly. I hope this hasn’t been your experience but I know it has been mine plenty over my own therapeutic journey. With this often being the case, I encourage you to really listen to yourself in these consultation calls you’re doing. How do you feel when we talk? Does your breath get shallow and chest tight, or are you able to sigh and let the guard down a little? When I explain my process and approach, does it make sense to you, seem useful and interesting to you? And do you feel confident that I’m equipped and knowledgable enough about your needs? Only you can say if it feels like a good fit for yourself, as is true for myself as I ask some of these same questions. So take the time that’s needed to feel that out. If we do end up working together and things start to feel off, annoying, frustrating, or any other not-so-goodnesses, let me know. Maybe it’s something we can change, and if not, let’s work together to find someone that feels better for you.

What should I expect in the first session?

All sessions begin with an overview of the logistics. I explain how confidentiality works, highlight important things to note in the paperwork, and check in about any questions you may have. I always like to begin sessions with a general check-in about where you’re at in the moment, which allows us to address what we can. For example, if you’re wildly stressed starting therapy, I want to know about that! Then we can both take a minute to breathe and shake it out, or whatever else it is that soothes you. After that, I like to ask some specific questions about what caring for you well looks like, including what I should look for to know when things might be going to fast or heading into some excessively stressful territory, and what are some of your known go-to tools we can keep in mind for bringing some comfort. If we have time, I will typically then go through some of my questions I have after reading through your paperwork, and the basics of learning about your life a bit. This, and the legal stuff, are why it’s important to complete your documents before our first session.

How are sessions structured?

Whether I’m working with you in couples therapy or individual, the first couple of sessions may look like some version of what I described in the first session expectations. I tend to take more of the lead in the first couple of sessions as I take time to inquire and learn your story. While I’m always continuing that process, once I’ve gotten a lay of the land, I really want to hand over the reins to you. If you like to have a specific structured check-in, we can work together to create that and use it at the beginning of every session. Otherwise, I try to go into every session ready to adapt to what you’d like to explore. You’re the boss here and in terms of content and what areas we spend time in, I’m going to follow your lead. That doesn’t mean you need to have an expansive agenda every time, but I really appreciate your active engagement with helping me understand what support you’re looking for.

Additional note: If I’m working with you as a couple, I generally meet with the two of you for a session or two, each of you one-on-one for a session or two, and then we come back together with all three of us. While I really prefer having a chance to speak one-on-one, this structure is flexible.

How long is each session?

50-minutes. If scheduling permits, I also offer double sessions which are 100-minutes, which we’d agree on in advance.

What are the costs of services?

For most clients, the fee for a 50-minute session is $185, $370 for a 100-minute session. I do have a limited number of low-fee spaces in my caseload, but typically have a waitlist for these.

How does this work with insurance?

I am not currently paneled with any insurance companies. Occasionally, some insurance companies offer their clients reimbursement for their psychotherapy. If this is something you’re interested in, I am able to provide a superbill for you, which is basically a detailed receipt that includes a diagnosis. Let me know if you’d like this option and I can arrange for these to be sent to you automatically.

What is a Good Faith Estimate?

The No-Surprises-Act’s Good Faith Estimates (GFE) are estimates of the expected fees you will pay for service, which are provided in your intake documentation. This estimate is the rate we have agreed you will be paying multiplied by how many sessions we share, which is a number that’s hard to predict. But I can assure you that I will notify you far in advance if rates change for any reason (which is rare) so you should never be caught by surprise.

Telehealth or in person? What if I’m out of town?

At this time, I am not offering any in-office treatment. I primarily conduct sessions virtually on a HIPAA-compliant telehealth platform, Simple Practice. However, if you are interested in ecotherapy and are able to travel to the Lake Stevens area, I also offer either walk-and-talk therapy or stationary ecotherapy at a small public beach in Lake Stevens.

Regarding out of town sessions, I am only able to see you when you are physically located in the state of Washington. This is because I am only licensed in this state, and as it is telehealth, I need to know where you are during each session should emergency services of any kind be required. While I am able to practice telehealth from anywhere in the world, I would be working outside of my scope of practice for anyone who is located beyond WA state lines, including short trips like vacations or work trips. If you know you’ll be out of town, just give me a heads up at least 24 hours in advance and we can reschedule or cancel, no problem.

How long will treatment take?

I would so love to provide you with a reliable answer to this question. I understand that when you’re hurting or feeling lost, the need to know when you’re going to find relief can feel so desperate. What that timeline looks like truly does differ for each person, as annoying as that answer is. You deserve to feel known in this process, which means I want to take the time that’s necessary for me to learn your story. You deserve intentional, individualized, and insightful treatment plans, which take time to develop as my understanding of you expands. And the process of therapy is rarely linear so the areas we may explore and find need for time with are hard to predict. What I can tell you is that I will always be open to your questions, your eagerness, and your ideas, and that I will do my very best to assist you in using your time in therapy well.

When are sessions offered? At what frequency?

I offer sessions on Tuesdays, Wednesdays, and Thursdays from mid-morning to early evening. Regarding frequency, I prefer to begin our work together meeting weekly so we’re able to develop our relationship and your comfort in sharing with me. However, I understand that financial and mental/emotional capacity concerns are real. Therefore, we collaborate on this decision and find something that works for us both/all of us.

How do diagnoses and medication prescriptions work here?

While I am technically able to provide most diagnoses within the DSM-V, I believe it is my ethical obligation to only do so for the diagnoses with which I am experienced and knowledgeable about. I am never able to provide medication, but if this is something of interest to you, I’m happy to do what I can to help you with referrals, as is true for any diagnoses I am uncomfortable providing.

Am I able to receive both relational and individual therapy with RSRT?

I see therapy as a really sacred place that is uniquely designed to hold you well. Because of this, I always want to keep my role in your life clear. If I am your couples therapist, I see your relationship as my primary client, as well as both partners, and I do my very best to minimize my biases. Therefore, any time spent one-on-one with one of you needs to be equal with the other, and the focus of our therapy is always the relationship. Transitioning to individual therapy with one of you is only permitted if we have permanently terminated our relationship as your couples therapist.

If I am seeing you for individual therapy, I will inevitably develop some level of bias towards your perspectives and needs. This means that I do not feel comfortable transitioning to any structure of relational therapy, as the imbalance would be too great between my original individual client and whichever relationship member they’d like to join our sessions.

TLDR; No, you are not able to receive both, just one or the other with me.

What is Ecotherapy?

Ecotherapy is a form of treatment that integrates nature into what is typically only talk-therapy. Ecotherapy includes a wide range of environments and activities, all based in the belief that we harbor an inherent need to convene with nature in order to experience wellness. Research in this area has provided evidence to suggest that time spent in nature can provide a multitude of benefits, such as increased self-esteem, reduced anxiety, improved client-therapist relationship, and many more. The forms of ecotherapy that I personally offer are walk-and-talk therapy, where our sessions are conducted while walking on a path, and stationary ecotherapy where we experience a seated session, as usual, but in an outdoor setting.

How can yoga be used in therapy?

How CAN’T yoga be used in therapy!? Sure, lots of ways, but big fan over here. With the added benefit of being a certified yoga instructor, I thoroughly enjoy getting creative with how we can integrate yoga. For an additional fee, I am able to create practices tailored to your needs, emotional/mental/and/or physical, that encompass our therapeutic work as well. We are also able to use some of my general practices a la carte as part of your regular session fee. We can use yoga to begin or end our sessions, to regulate in the middle of, or for really, any percentage of our time together during a 50-minute session. Yoga can be a method of integrating your body in healing, its postures and breath-work offering new lenses through which to process your experiences. No matter what we’re working on, I will always seek to connect you with the messages from your body, and use them to facilitate progress and an improved relationship with it. Yoga is a tool for that.