FAQ

Can I use my insurance?

Not right now, sorry!  In order to devote more bandwidth to my clients and my practice, I’m not accepting new insurance clients at the moment.  I may return to accepting certain insurances in the future, however.  If you’d like to be notified if/when I’m able to accept your plan, just join my wait list and include your insurance on the form.

For clients with out-of-network benefits, I’m happy to provide “superbills” (i.e. special insurance-friendly receipts).  However, please keep in mind that if you use your out-of-network benefits, your insurance company may demand to view your records at any time.

Why Pay privately for Therapy if I have insurance?

Overwhelmingly, clients tell me they chose to pay privately because they simply could not find the therapist they were looking for within their limited insurance network.

Many folks searching for a therapist don’t realize that (according to one national survey, at least) over a third of U.S. therapists don’t accept any insurance plans at all. A more casual survey of directories in major U.S. cities will show that in some, the majority of therapists don’t take insurance. Among those who accept at least one plan, how many accept your specific plan? How many of those therapists happen to specialize in your issue or diagnosis? How many of those specialists have openings within the next 6 months? If you’re very, very lucky (and have excellent insurance) that number may be more than zero.

And I sincerely hope it is! Honestly, I use my own insurance whenever I reasonably can, and if you can find the care you need in-network, please feel free to use that discount! Unfortunately, most insurance plans limit their members’ options significantly, and some still refer members to “ghost listings,” listings for therapists who left the network (or died) years ago, but who still look good on paper. Most insurance companies can provide you with a list of in-network therapists, but even if those listings are mostly real, you may have no way of knowing who has openings, except by contacting each one individually. Since most therapists nowadays don’t even keep wait lists (I’m weird, apparently), this can sometimes mean calling dozens of therapists a week for many weeks (according to folks who call me).

If you’re looking for a generalist, or if you’re willing to try several therapists to find the right fit, then I strongly encourage you to try to find care within your insurance network first. However, more experienced therapists are much less likely to accept insurance, as are therapists with specialized training or in-demand experience. So if you’ve been looking for a long time and haven’t found what you need yet, it may be time to consider widening your search. Many non-insurance therapists are able to offer reduced fee openings or sliding scale rates, and others may even have reserved slots for clients who are in their target population. Open Path Collective also has a directory of therapists who are able to accept lower rates.

In addition to the scarcity of qualified in-network therapists with openings, there are other issues that come with using insurance. For example, insurance typically does not cover phone sessions or text-based support at all, and some insurance plans even refuse to cover full length sessions for most diagnoses and members. Some plans have limits on how many sessions can be used per benefit period, or may have high deductibles and/or copays that make the “discount” less helpful than anticipated. Some clients also have privacy concerns about using insurance, and may want to limit the number of people who have access to their private health information.

Lastly, but perhaps most importantly, therapists accepting insurance are typically required to diagnose you after your very first session.  Yes, you read that right.  If you’ve been to counseling before and used your insurance, you’ve likely been diagnosed with a mental health disorder, even if your therapist didn’t share this with you!  But what if you don’t want a clinical label on your medical record? What if you just don’t want to have to get diagnosed with a disorder in order to get help?  This is just one of many reasons clients may choose to pay privately for counseling rather than using their insurance benefits.

Don’t get me wrong, insurance can be a great option for many!  If your insurance network has good coverage and includes therapists who are the right fit for your needs, have availability when you’re free, and are geographically accessible to you, then you should absolutely consider taking advantage of that discount.  However, if you find yourself compromising your own healthcare or privacy needs just to meet the “needs” of your insurance company, it may be time to reprioritize.

do you remember me? i was a client when you worked at ____…

Long time no see! I’d love to work with you again, and I’ll prioritize you on my wait list if possible. If you’re unable to afford my current fees, please use this form to request a reduced fee, or contact me directly to discuss other options.

Online?  So I can meet with you from ANYWHERE???

Sorry to be a bummer, but no. Unfortunately, licensing for mental health professionals in the U.S. is still regulated on a state-by-state basis. I hold active licenses in both Texas and Illinois, so I can see clients who are currently located in either of these states. To be clear: this has nothing to do with your official address or your state of residence: you have to actually be sitting in one of these two states for us to work together. You can travel in-state within Texas and/or Illinois and I can continue to work with you, but if you leave the state for any reason, we’ll need to pause our work until your return.
 

Okay fine, but as long as I’m in-state I can meet with you from anywhere (my office, my car, the park, the bathroom), right?

With text-based support, you can reach out from anywhere you like within the state!  If you’re in a public place, I recommend being aware of people around you for your own privacy’s sake, of course (e.g. someone reading over your shoulder in a crowded coffee shop).

For video or phone sessions, you’ll need a private place to meet, even if you “don’t care” about your own privacy.  “Private” usually means a room with a door that closes, but more importantly it means there are no humans nearby who might overhear.  Your dogs, cats, and other animals are fine (unless perhaps you have a parrot who repeats things).

Walking around outside during a phone/video session may sound like a good idea, but with wind, traffic, and passersby, you will end up having to yell for me to hear you, which makes it distinctly less private. Please don’t try this! Same goes with the bathroom… It’s echo-ey and kinda gross. Let’s not go there.

what if my connection drops during a video session?

Although relatively rare, this does sometimes happen Usually it’s because of client-side tech issues, I’m afraid (like being too far from your router, using a mobile network, or having one billion tabs open). I’m happy to help you troubleshoot to the best of my ability, and there are usually several things we can do to improve your connection. However, if you have ongoing connectivity issues, we may want to try a different secure video service (I have several backup options, all of which are HIPAA-secure).

If for whatever reason our video session is interrupted, please wait for at least two minutes while I try to reconnect us, and check Spruce (or your preferred contact method) because I’m probably messaging you! If we can’t reconnect by video (or if the connection keeps dropping), we can also finish up our session via phone, or even live-chat if you prefer.

What kinds of clients do you accept?

Good question!

I currently only accept clients 18 years and older; I honestly don’t even have the paperwork for minors, so this isn’t negotiable.

I will not support intentional weight loss as a treatment goal, though I can support health-oriented goals around nutrition, body movement, and/or improving one’s relationship with food.

I do not see clients who need treatment for an active eating disorder, or who need initial treatment for OCD. To be clear: I do see plenty of folks who have already received an effective treatment for OCD (like ERP) or an eating disorder, and whose OCD/eating disorder symptoms are currently in remission or stable. I may refer you out for assessment or additional treatment if needed.

If you’re experiencing psychosis, severe dissociative symptoms, mania, homicidality, potentially lethal forms of self-harm, or frequent psychiatric hospitalizations, I would encourage you to consider seeing someone in-office for the additional grounding experience of being present in the same space. Additionally, I’d encourage you to find someone who specializes in your specific concern, since specialized treatments can often be life changing for many folks with the above symptoms, and non-expert care can be discouraging or even damaging in some cases.

who do you typically work with?

I typically work with adult clients who’ve been in therapy at least once before, but who either need a new approach or just want to up their game. I do see first-timers as well, just not often.

The clients most psyched to work with me also typically check one or more of the following boxes:

1. Neurodivergent (especially ADHD and Autism)

2. Nerd, geek, or gamer (especially D&Ders)

3. Spoonie (i.e. chronic or invisible diseases/disabilities)

4. Trauma survivor (especially medical trauma)

5. Queer and/or TGNC (e.g. ace/aro, demi, gray, pan, etc.)

To be clear, this is not a list of requirements; just an informal venn diagram of my current caseload. If this list sounds like friends of yours, you may feel especially at home here! If you recoiled in horror when reading this list… Well, then I might not be the droid you’re looking for.

what if i miss a session?

No problem; I keep several extra slots open every week for flexible rescheduling, even at the last minute! You can also cancel with zero guilt (and zero questions).

Unlike many therapists, I don’t lecture or punish clients for cancelling. You’re an adult, and it’s YOUR time and money to spend how you choose! There’s no need to feel ashamed, make excuses, or explain yourself, and I don’t discharge clients just for missing a few sessions

If you know in advance that you’ll be missing a scheduled session, please let me know as soon as possible so I can offer that time to another client. If you notify me at least 48 hours in advance of your appointment’s start time, there’s no fee (no-shows and later cancellations that aren’t made up are charged a fee to reduce the loss of income).

Notifying me when you’re missing a session is always helpful because it allows me to offer that session to other clients who might need flexibility that week. Hopefully some day someone else will do you the same favor!

do you write letters for emotional support animals?

I am willing to consider writing an ESA housing letter for an established client who meets the requirements, but generally will not do so until the therapeutic relationship has been firmly established and I am able to assess the client’s symptoms and needs over time (usually several months of regular attendance/participation). I will not write letters for specific or multiple animals, as this type of assessment is too far beyond my scope of practice (and isn’t required for most ESA exemptions). That said, I strongly recommend that clients seeking an ESA letter find a therapist who specializes in this if they can.

Any other questions?

Please contact me here for any further questions, or reach out (non-securely at your own risk) via email. I will answer your question in the format of your choosing (email, phone, text) but won’t bug you after that or send you any spam :)