b. Therapy FAQ A Better Life Counseling Service

Once people make the decision to look for a therapist, they often have some frequently asked questions. I have listed and responded to some of them below. If you would like to know more, or if you have other questions, please feel free to contact me at: 206.706.2694 or 360.239.4564.

What is the difference between talking about my problems with a friend and talking with a therapist?

This is a question I struggled with myself when I was a therapy client years ago. I think the systemic concept of “homeostasis” is one of several answers to this question. Supportive friends are one of the most enriching aspects of our lives. They are an important part of the system that each of us lives within. A natural aspect of any system (be it the circulatory system in your body or a specific human community) is that it tends to return to homeostasis. A different way of saying this is that systems or groups (by natural law) try to stay as they are. Often at a very unconscious level, your friends and family need you to stay the same. You have a specific role in the group that they depend upon you to fill. Change creates anxiety for them. A therapist is trained to hold a safe space for you and help you make lasting personal and communal change in spite of nature’s urge toward homeostasis. The fact that your therapist is not a part of your family or friendship system is key in helping you to make lasting and productive change in your life.

How long will therapy take?

This is a question that is impossible for your therapist to answer. That has to do with at least two things: 1. Each person is a unique individual, and 2. “Healing” means different things to different people. How long therapy takes will depend in part on what you want from it. Some approaches (such as Solution-Focused therapy) help you change the surface behaviors that you have and are relatively quick. Other approaches work at a deep level, helping you to heal old trauma and take real control over your life. The kind of therapy I do is called Internal Family Systems therapy. In doing this work with me, you will ultimately have such a good understanding of yourself that you can become your own therapist.

How often will I need to visit my therapist?

I find that it usually works well for my clients to see me for an hour a week to start. An exception would be anyone experiencing trauma in the present. In that case we might meet several times a week initially. After about a month my clients and I then evaluate what the schedule should look like. It varies depending on what works for my clients. Many continue weekly, some come every other week, some couples see me together one week and individually the next week.

How much will it cost?

In our area the rate for a therapist ranges from $150 to $50 for 55 to 60 minutes.

Because therapy is going to be an important, life changing, experience for you – I offer a free half-hour initial meeting. You should be able to meet with as many therapists as you would like to before deciding who is the best fit for you. To help with that, many of us offer free or reduced fees for the initial evaluation.

My regular fee is $90 for a 60-minute session. This fee stays the same even if more people attend the session (such as your partner or children or parents). This is a reduced rate for my services because I do not accept insurance. I also offer a sliding scale, based on income. Because of the nature of Internal Family Systems work, I do see couples together and individually as the need arises. I will often adjust the rate for the individual sessions in that case, so that the work can still remain affordable. As my client, you may also have a free telephone consult with me for up to 10 minutes each week. Any time beyond that will be prorated based on the regular hourly fee we have agreed to. Most people find that 10 minutes is more that adequate. An exception to my hourly fee structure is my rate for group therapy. That fee is $25 per person for 90 minutes when the group is six people or more. I also provide workshops to the community. These fees vary (if there is a fee at all) and will be advertised. My workshops are educational rather than therapeutic in nature.

Why don’t all therapists take insurance?

I believe the reasons I do not accept insurance are similar to those of other therapists. One reason is that by not doing so I save the cost of hiring a billing firm and can pass that savings on to you by having a lower rate. In addition, therapy is an activity in which commitment is extremely important and may even speed the healing process. In our society when you pay for something out of pocket, you tend to take it more seriously. It is just the nature of being human. Also, I want the complete freedom to work with you the way I think is best for you. Insurance companies can sometimes create a barrier to a therapist’s work. For instance, an insurance company might force me to give you a diagnostic label or not offer you a sliding scale. I prefer to have the decisions about how we will work together to be solely between you and me.

I have some secrets I’ve never told anyone. How do I know it will really be confidential?

It is a very important ethical standard for all mental health therapists that we keep what our clients tell us confidential. There are several legal exceptions to this that you should know about. Therapists are sometimes required to report if you are planning on committing a “crime or harmful act,” if a minor has a crime committed against them (such as abuse), or if we are given a subpoena by a court of law. It is also legal to disclose information to very specific people when a therapist has a written release from the client to do so. I think it is better for therapy clients if this release has a time limit on it.

When you first make a service contract with a therapist in Washington State, they need to give you a copy of your rights under law as a counseling or hypnotherapy client and a “disclosure statement” that describes their background as a therapist. For more information on this you can contact the Department of Health, Health Professions Quality Assurance Division, PO Box 47869, Olympia, WA 98504-7869. You can also reach them by calling 360.753.1761.

What if I need medications?

Prescription medications can only be given by individuals with medical training, such as allopathic and naturopath doctors, certain nurses and psychiatrists. Medication management is typically their focus, as opposed to counseling. For this reason, those of us with a Master’s degree or a non-medical Ph.D. (like a psychologist) would typically work in partnership with your doctor if you need certain medications. In this case, we get a written release from you to talk to your doctor before doing so.

I live in a small town. What if I run into my therapist in public?

It can be jarring to run into your therapist in public without an advance plan. This is something I discuss with my clients in the first session. Typically, I will wait for you to acknowledge me first and it is completely your choice whether you acknowledge me or not. It is also not necessary to introduce me to the people with you unless you want to. I will not introduce you to whomever I am with. If we do greet each other, I find it works best to keep our interaction fairly brief. All of this helps to keep our sessions feeling safe for you.

What if I don’t have anything to talk about since the last session?

Internal Family Systems work is not at all dependent upon you having a current problem or upset. Anything that comes up in a session is generally a great pathway to something that a part of you needs to tell us. I find that some of the best sessions happen for people when there is no planned topic of discussion.

I hope this FAQ helped you. Please call me at 206.706.2694 or 360.239.4564 if you have other questions. If you get my voicemail message - I am typically able to return messages within 48 hours or sooner.