Frequently Asked Questions

Your first session will focus on the main reasons that you are considering therapy and have decided to meet with me. We will discuss the background of your problems, what you have tried previously to handle your concerns, and what you hope to change or specific goals with which you would like help. We will also talk about your history, family background, support system and other aspects of your life. This information will help me better understand your strengths, experiences and difficulties, and begin to identify how best I might be able to help.

We will be together for 50 minutes. By the time we have finished our first meeting, I will share some impressions with you, we will talk about how well our perspectives fit. We may also begin to talk about some things that we can do together to address your goals or difficulties. I aim to use the time in such a way that you will be in a position to decide if you would like to do some work with me. Accomplishing this sometimes requires more than a single meeting.

Whenever possible, you will be encouraged to complete a questionnaire in advance so that we can use this first hour to your greatest benefit. I will mail the questionnaire to you by post or email, whichever you prefer. Or you may wish to come to this initial meeting earlier than our scheduled time to complete the questionnaire as well as some additional paperwork in the office. Please plan to arrive at least 15 minute before your first session with me to provide insurance information and to complete other paperwork. (I recommend coming 30 minutes ahead if you also plan to do the questionnaire itself in the waiting room.) In this way, we can have the full time together to discuss your situation and the work you are coming to do.

The conversations you have with me with be kept in the strictest confidence and, under Washington state law, are protected by legal privilege. In most cases, the matters you share with me in sessions will remain private from disclosure to anyone without your written authorization.

There are a number of circumstances when I will ask you to consider granting consent for me to collaborate with other professionals involved in your care. If, for example, you are using medications that would effect your emotional and psychological wellbeing or have a medical condition that effects your psychological or cognitive function, I will make such a request. Should you have a history of severe psychological difficulty or currently are facing a significant medical health problem, I may similarly ask collaborate with other professionals.

You and I will discuss such communication or disclosure carefully and thoughtfully. You will have every opportunity to raise questions and consider together the significance of disclosure before you decide how to proceed.

In some very rare cases—where safety is a considerable risk—I have made such collaboration a requirement before accepting a person for therapy. Fortunately, that is very atypical and I go to great lengths, in these circumstances too, to be collaborative.

Please see the related section titled, “How much information does my insurance receive?”

Confidentiality is addressed by the American Psychological Association’s code of ethics and by the federal Health Insurance Portability and Accountability Act (HIPAA) and Privacy Rule.

I believe it is your right and very important to discuss confidentiality, your legal rights and the situations in which information may be disclosed so that you are fully informed. Please feel free to ask questions and to raise other concerns during any of our meetings.

Some people are involved in legal, court or divorce proceedings that have implications for your privacy. If you are, please let me know at the outset so that we can discuss how your privacy will be affected and so that you can make informed choices. Should such circumstance emerge at a later date, please inform me as soon possible or as soon as you anticipate this occurring.

If you need to reach me between sessions, please telephone (360.524.3616) during regular business hours. Leave a message and I will return your call at my first opportunity.

In the event of an urgent matter that cannot wait until our appointment or in the case of a true emergency outside of office hours, please telephone and leave me a detailed message. I will return all urgent calls as soon as I receive the message. Please make certain to include your phone number(s) ensuring that I can contact you if I am not in the office as well as enough information so that I understand the urgency of your situation. It is helpful to let me know how late at night I can return your call, after which time I will call the following morning.  I return all non-urgent calls (scheduling, administrative, payment, etc) the next business day.

When I am on vacation or anticipate being unavailable, I make arrangements for how I can be reached or I have a colleague available to you in the event of an emergency. In either case, information will be available from the receptionist and on my voicemail. I will return all non-urgent calls the first day back from vacation.

If I have not returned your emergency call as quickly as you need, contact your physician (or psychiatrist), or 911. Be advised, your insurance may require you follow specific directions concerning emergency room visits. Please inform yourself of any limitations or steps directed by your policy.

Therapy Fees

The initial assessment session is $250.

Therapy sessions are $225.

Administrative charges

I charge my hourly fee for other professional services (ie: reports, record reviews, treatment summaries, evaluation letters, consultations) that you may need or that you request of me. The charge is pro-rated by the amount of time actually involved. Insurance does not cover administrative and documentation time, they are paid out of pocket.

I do not charge for occasional letters communicating treatment information with other health professionals. If letters and consultations with your other health providers become frequent or highly involved, I will charge my pro-rated hourly fee.

Contact between sessions

I charge my hourly fee, pro-rated, for telephone contact lasting MORE THAN 15 MINUTES between appointments. Under certain circumstances, a treatment plan may include limitations on the amount or duration of contact between sessions.  If such a limitation becomes relevant, we will discuss it in session so that you understand how it fits with our work and treatment, and my professional rationale for doing so.

Discussing financial matters

Finances and financial matters are appropriate topics in therapy. There may be instances in which it is essential to discuss fees and payment arrangements. I am always open to discussing my fee, financial arrangements, your ability to afford therapy or unusual financial hardship in session.

Payment responsibility

Please be prepared to pay the portion of your fee for which you are responsible (deductible, co-insurance, copays or the full fee if that is our agreement) at the time of your session. I accept cash, checks, credit and debit cards. If you choose to pay using a credit card, the 3% bank expense associated with their use is an added surcharge. It is my policy to request a credit card on file in the event of an unpaid, past due account. Charges to your credit card are made only AFTER the account is past due or when you specifically request we do so.

Most health insurance provides some coverage for mental health treatment. I participate in a select number of insurance panels.

• Regence Blue Cross/Blue Shield
• Aetna
• Pacific Source
• Moda
• Out of network

Insurance websites are not accurately maintained lists of professionals who accept their coverage. Please do not hesitate to speak with me for clarification.

I do not participate in any health maintenance organizations (HMO) panels, nor in any Medicare and Medicaid. These would be out of network services.

Nearly all policies now have co-insurance, co-pays or a self pay portion of the fee that are paid by the client. Some policies have a deductible (a set dollar amount) that applies to mental health care and must be paid by the client before the insurance benefit begins to cover any portion of your sessions.  These deductibles usually renew annually.

You are responsible for fees incurred for psychotherapy. If you have insurance for which I am a participating psychologist, the insurance will pay me directly for their portion of my fee based on the specific health coverage benefit you have. You will be responsible to pay the deductible and copay or co-insurance. Insurance policies vary as to how much mental health treatment is included, and the amount that they reimburse. I will not know the exact amount for which you are responsible in advance since it is based on many different factors at the insurance company.

Your insurance company expects you to be familiar with your benefit. Given the complex language used by insurance companies to describe your coverage and out of pocket expenses, I encourage you to contact your insurance member services department (the member services number on your insurance card) and to ask about your specific insurance benefit.

It may be helpful to ask the coverage your benefit provides for two specific CPT service codes: the initial assessment session(s), CPT 90791 and psychotherapy sessions, CPT 90837. In that way, you are best informed as you make decisions about your therapy.

I will work closely with you to understand your coverage, and to update you as the insurance company provides reimbursement. We will also discuss your goals and therapy needs in the context of the insurance benefit so that you can make informed decisions about the work we do together.

Many traditional indemnity insurance plans reimburse you for part or all of the cost of treatment with a therapist of your choice. If you have an insurance for which I am not participating and your benefit includes ‘out of network’ coverage, our office will submit to your insurance on your behalf. You will be responsible for payment of the difference between my full fee and that portion reimbursed by your insurance.

Many professionals, including myself, require having a credit card on file as the reimbursements amounts vary by policy and benefit, or in the event of an unpaid, overdue balance. Unless you specifically instruct me to automatically bill your portion of your fee to your credit card, I will charge your credit card ONLY AFTER the account is past due or on specific instances when you choose that form of payment. If you choose to pay using a credit card, the 3% bank expense associated with their use is an added surcharge. I make every effort to communicate transparently with you about financial matters and to discuss charges with you during your sessions. 

Cancellations must be made by telephone. Please do not cancel or change your appointment by email or text message, as you will remain responsible for the full fee.

If you do not provide this notice for your cancellation or absence, regardless of the reason, you are responsible to pay my fee. I utilize the time of your call either recorded by the receptionist or the time of your voice message as the basis for the full business day notice. In this way you are assured you have provided sufficient notice and will not be charged.

Please note that insurance carriers do not reimburse missed appointments or late cancellations. They are paid out of pocket.

It is important for you to understand that whenever you use your insurance to pay for mental health or medical care, the insurance company has the right to information about you. Companies vary in the questions they ask, the amount of documentation they require, their access to your records and the frequency with which I will have to justify your therapy to them.

I make every effort to preserve your privacy in the medical record while documenting the information both required legally and to secure insurance reimbursement. Your insurance company will expect you to be aware that they reimburse for ‘medically necessary’ services. They may also require you to telephone yourself to request pre-authorization for mental health care. Once I have your consent, I will file claims for your therapy. I do not, however, obtain pre-authorization on your behalf.

Over the years, many of my clients have chosen to pay for therapy out of pocket because this ensures maximal privacy and confidentiality. When you make arrangements directly with me about payment, you have maximum control of whom may access your records. In that circumstance, you control what we discuss and how long we work, factors that your insurance company and benefit may influence whenever you utilize insurance. As a general policy, it is my practice to discuss disclosure of your private information in advance.

I have earned a Diploma in Clinical Psychology from the American Board of Professional Psychology (ABPP).

The American Board of Professional Psychology (ABPP) exam is the only evaluation that assesses a psychologist’s clinical competence and ethical practice. The examination focuses on actual clinical skills and effectiveness. It is neither a credential review like the National Register nor a test of academic knowledge like the licensing exam. I have demonstrated my work, ability, skill and expertise to a panel of nationally recognized psychologists who reviewed multiple videos of my work with people and who then administered me a rigorous oral exam.

Board certification in clinical psychology connotes specialty competency, and it is the only board certification recognized by the 156,000-member American Psychological Association or the National Register of Psychologists. Only 1300 psychologists in the US have board certification in clinical psychology.