+ How do I know if a therapist has specific training, current certifications, and proper licenses?

Each state and district has a process for licensing therapists. The licensing rules dictate what courses are required and how many hours of supervised experience the therapist must have before practicing independently.

In theory the licensing boards also make sure that each therapist has the required number of continuing education units but since this is largely an honor system, it might be more relevant to simply ask the therapist what type of continuing education they have received in the past 2 years. Every therapist is required to take ethics training so if they don't mention ethics you should be wary. Any other continuing education topics will likely tell you what type of therapy or topics are of interest to that therapist.

A web search of the mental health licensing boards in your state should provide you with either an online license search or a way to contact the appropriate licensing board to verify that the professional holds an active license in good standing. Keep in mind that in most states there are separate licensing boards for each profession: marriage and family therapists, licensed professional counselors, social workers, addictions counselors, and psychologists.

Most certifications are managed by a national or international association. For example, the EMDR International Association (EMDRIA) is the certifying body for EMDR therapists. A search of the certifying association's website should yield a list of currently certified therapists for that specialty.

+ How do I know if a therapist provides the type of therapy well-suited for my goals and challenges?

While few therapists will give you free therapy time, you can usually ask a therapist in general terms how they work with people who have symptoms and concerns similar to yours and how often they work with those types of clients.

If you feel very comfortable with the therapist but have concerns about their lack of expertise on your issue, you might ask them how they would proceed if the therapy seems to be stuck. A good therapist will have a supervisor, mentor, or peer consultation group that can help them brainstorm how to proceed when therapy stalls.

+ What format of counseling do I need?

If you are concerned about a close relationship and are not sure whether individual or couples/family format would be best, you should talk to the therapist to talk through the pros and cons.

Keep in mind that if you are considering couples or family therapy it is usually best for the therapist to meet everyone involved at the first session in order to get a good understanding of the situation and evaluate whether there are individual issues that should be addressed first.

The decision about individual versus group therapy is largely personal and many people engage in both simultaneously. A therapist might recommend group therapy for various reasons - to provide help within a specific budget, to give you a safe place to work through social awkwardness or anxieties, to get to know others who have similar experiences, or to learn skills that apply mostly to group interactions.

+ How long is each session?

Most appointments are 50 minutes in duration.

+ How often do I need to come in?

New clients attend once a week or every other week. Once life is more stable, session frequency often decreases to about once every 4-6 weeks for accountability and relapse prevention.

+ Do you work with individuals, families, or couples?

I work with all three. I work with individuals (17 years old and up), premarital and married couples, and families (parent/ adult child, adult sibling issues, family trauma recovery). In general, I only work with children under 17 years old if they are attending as part of a family trauma treatment.

+ How do you incorporate Christian faith?

This depends on the issue being discussed. For some clients the faith component is exploring the carriers that prevent the client from inviting God into a particular area of life. For other clients the focus is on developing spiritual disciplines such as Bible reading, prayer, and community involvement. For yet others, it is about developing or re-establishing trust in God after being betrayed by people or feeling angry that God did not intervene in a particular situation.

Watch this video to learn more.

+ What if I’m not a Christian?

We can still work together. Spiritual matters are often an important part of how we view and cope with challenges in our lives, but not every counselor will ask about or invite that type of discussion. I am open to talking about spiritual matters regardless of your faith background. Similarly, if you do not want to talk about your spiritual beliefs, we can focus on other topics.

+ What is EMDR?

EMDR stands for eye-movement desensitization and reprocessing. It can be helpful for a variety of issues including anxiety, past trauma, poor self-esteem, etc. Visit the EMDR International Association to learn more.

+ Do I have to do EMDR?

No, you don’t have to do EMDR. EMDR is a collaborative therapy, so if either you or I do not feel like EMDR is the right approach for a particular session or for the topic at hand then we will use other methods. In general I will be conceptualizing your story from the perspective of negative beliefs or self-talk, automatic reactions, and patterned behavior. Both Cognitive-Behavioral Therapy (CBT) and EMDR can address the underlying patterns that perpetuate discomfort, anxiety, and distress. Some clients work all the way through an issue just with CBT while others might use mostly CBT with just a session or two of EMDR to get unstuck, and some clients work mostly in EMDR with just a few CBT sessions.

As a side note, there are a few topics (e.g. grief, transitions, etc) that do not fit as neatly with CBT or EMDR, so we may use standard talk therapy (cathartic discussion), Narrative therapy, or Family Systems Therapy in order to address those topics.

+ How much does it cost?

• $210 per 50-minute session

• $300 per 75-minute session (limited availability)

Cash, checks, HSA debit cards, and all major credit cards are accepted.

+ Can I use my insurance?

You are welcome to submit your paid invoices to your insurance company for out of network reimbursement.

Tricare clients: I am a preferred provider so you should receive some reimbursement through this process.

If you wish to do advanced research, contact your insurance company and ask the following questions:

• Do I have any out of network benefits for in-office mental health services?

• Do I have an out-of-network deductible?

• What is the allowed amount for CPT code 90834?

• What percentage of the allowed amount will I be reimbursed?

You may use an HSA/FSA debit card to pay for counseling even if your insurance company does not provide reimbursement.

+ Will you bill my insurance for me?

The short answer is No. Directly billing your insurance creates many dilemmas:

• You are giving power to a third-party which sets its own rules about when, whether, and how much to pay for services. You are also accepting the risk that they may decide that you do not need therapy and choose not to pay at all.

• Honesty in diagnosing often results in insurance denying payment.

• People who pay for their counseling out of pocket (even on a sliding scale) are often more motivated and invested in the therapeutic process and thus have better outcomes.

• Insurance verification and billing takes time away from treatment planning, consultation, continuing education, and collaboration (these are things your counselor should be doing between therapy sessions in order to ensure a high quality of care).

• Because insurance rates often barely cover the basic costs of doing business, the therapist must see a large number of clients every week to have a liveable wage and this quickly leads to exhaustion and burn-out.

• When insurance denies claims the billing issues often negatively impact the therapist/client relationship.



Work with Angela