What can I expect from our sessions?
In my approach, I use a combination of talk therapy and Brainspotting with somatic/mindfulness techniques. I generally tell clients that I use talk therapy for exploring and uncovering one’s patterns, while the Brainspotting is a method to help create deep shifts in our automatic emotional reactions. In my talk therapy interventions, I draw from Coherence Therapy, Emotionally Focused Therapy, Acceptance and Commitment Therapy (ACT), Internal Family Systems (IFS), Mindfulness, , and more.
As I often tell people, the progress that can be made through Brainspotting is significantly faster and more efficient than by doing talk therapy alone, because Brainspotting works with our physiology, which directly impacts our psychology. I use talk therapy interventions when more direction is needed, but I’ve generally found through experience that, ultimately, Brainspotting creates the deeper, lasting shifts that may be hard to reach in talk therapy alone.
For clients that like homework, I provide an activation/trigger worksheet where you will write down any moments throughout the week where you notice an emotional trigger. This helps to gain greater insight into one’s emotional, thought, behavioral and somatic (body-based) patterns that may have been otherwise unrecognized. This homework is particularly good for clients with anxiety and/or panic attacks, though it is a practice that everyone can benefit from.
I also work with dreams. So when I have clients who experience nightmares or reoccurring dreams, I will guide clients to explore all the meanings and associations of the different elements of the dream in order to gain greater insight and to help shift the emotional content from their subconscious that wants attention. I’ve also utilized Brainspotting in processing dream material since dreams originate from the same part of the brain (the subcortex) that Brainspotting helps us access. I’ve found overtime that working with dreams can be a more efficient way in working with old trauma and subconscious conditioning that are showing up in our waking life as anxiety, depression, panic attacks, etc.
Are sessions in person or online?
All of my sessions are done online via HIPAA compliant Zoom in order to ensure confidentiality and privacy. Therefore, I am able to see clients located anywhere in California. I generally recommend that clients meet with me via a computer or tablet, as sessions via cell phone tend to have more interruptions due to incoming calls and texts. However, I am flexible and able to accommodate if some weeks you can only meet via your phone for various reasons.
Will we meet every week or can we meet every other week?
In order to build momentum and gain the most out of therapy, I recommend meeting on a weekly basis. This helps me get to know you and it helps both of us gain insight into your habitual patterns.
Research shows that meeting less than weekly is less effective and that it is ultimately more costly in terms of money, time and energy spent overall.
When there is a longer break between sessions, the sessions become more of a summary of experiences rather than a focus on core issues. We ultimately end up spending the session attempting to “catch up” so we can try to get to the root of the issues, only to never really “catch up” and the core issues get overlooked.
How long will I be in therapy?
I understand that most people ask this due to money and budgeting. However, from an ethical standpoint, I don’t believe that I can (or should) state how many sessions would be required to meet goals. There are a lot of factors at play that impact the length of time that it takes for people to meet their goals — their history, the issues they’re wanting to work on, whether they’ve been to therapy before or not, unexpected life circumstances, and even the goals they’ve set for themselves. No two people are alike.
If one person meets their goals in 6 months while another takes 5 years, it doesn’t mean that there is something “wrong” with the one who took 5 years. It just means that those two people have very different histories and came to therapy with very different goals.
I cannot force a change in your physiological patterns in order to reduce anxiety or depression anymore than you can. You will make progress and heal at the pace that your brain and nervous system knows you are ready for, when you are ready for it. I’ve learned over time that the pressure we put on ourselves to create a certain outcome in a certain amount of time often creates a block in fostering lasting change.
I have some clients who I see for 3 or 6 months and then end because they got what they came for. For other clients, I see them for 2, 3, or 4 years before they feel ready to end. Some people I see for a year and then they stop and come back a year or 2 later for more work. It varies. There is no one “right” way. There are many “right” ways. It ultimately depends on your needs and life circumstances at the time.
If I have a client who has made a lot of progress and they feel stable, so they no longer need such in-depth work, we will begin fazing out by reducing our frequency of sessions from once a week to once every two weeks. The conversation to potentially reduce frequency can be brought up by either the client or myself.
What are your fees?
My fee is $250 per 50-minute session. If longer session times are requested, I would pro-rate the fee. Payments are made through a debit or credit card via IvyPay (a HIPAA compliant payment app for therapists). If you have an HSA or FSA, that can also work for payment.
I currently do not have any sliding scale availability. If you are seeking sliding scale, I generally recommend TherapyDen.com or OpenPathCollective.org.
I do have a 48 hour cancellation policy. So if you have to cancel in less than 48 hours, you will be charged the full cost of the session. If it was an emergency or sickness-related, I give clients the opportunity to make up for the session within 1 week of the cancellation. Of course, this is contingent on my own availability of that week.
Do you take insurance?
I am considered an out-of-network provider and I do NOT bill insurance.
However, if you have a PPO, I can provide you with a superbill, which is essentially an invoice showing the amount of money you’ve paid for therapy. You can then submit the superbill to your insurance company for the amount to either go towards your deductible or to be reimbursed a percentage of the cost. This depends on your insurance plan and the insurance company.
Please note that all superbills require a mental health diagnosis.
For more information, contact your health insurance provider.
What are my options in using insurance for therapy? Do I want to use insurance for therapy?
Figuring out the maze of insurance when it comes to getting access to psychotherapy can be messy and stressful. Here’s an outline of all the options that are available to you so you can determine which avenue is the best fit for you:
(1) Do you have an HMO or PPO?
HMO: Insurance will only cover in-network therapists (this generally includes people who have coverage through Medi-Cal or Medicare)
- Low cost for you
- Finding a therapist is fairly straightforward. For this option, you will contact your insurance company and find out which therapists are in-network. You then contact the therapist, schedule and you’re good to go!
- * For those with Kaiser, patients used to receive a referral for Magellan or Beacon and then find a therapist in those networks. As of 2020, Kaiser is now directly paneled with therapists so the process should be easier. However, as of late 2021, I have heard that Kaiser is generally pushing people into in-house, short-term group therapy. So in order to get a referral, you have to be very assertive in stating that you do not want group therapy and that you want a therapist you can see every week. If they ask why, you can tell them you’ve tried it in the past and know it doesn’t work for you. You also need to really emphasize to them your current mental health status and how much you need therapy in order to get a referral.
- You may not get to choose your therapist.
- Many therapists paneled with insurance companies are full (even if the insurance’s website states they’re taking new clients), so there are limited options and you may be placed on a long waitlist.
- Your insurance company dictates the treatment. Your insurance company has say over which issues, which approaches, and which therapists they will pay for and for how long. For example, with some insurance companies, you might be cut off after a certain number of sessions.
- To receive coverage for therapy, you’ll be required to have a mental health diagnosis, which will go on your medical health record.
PPO: Out-of-Network Options
- You have more choice over what kind of therapist you want to work with. You can find someone specialized in your issues or who has an approach that wouldn’t be covered if in-network.
- More options for session times.
- Easier to change therapists if either you or the therapist determine it isn’t the right fit.
- A mental health diagnosis is required on your superbill.
- You will need to pay for sessions out of pocket initially and then submit the superbill to get reimbursed or have it go towards your deductible, depending on your plan.
- It may take a while for the health insurance company to reimburse you, IF they decide to reimburse you.
- Your insurance company may decide to delay or reject your request for reimbursement for any reason. **However, there are companies out there who can now advocate for you with your insurance company to ensure that you do get reimbursed. One of those companies is The Superbill, who you can pay as little as $5/month to submit your superbills for you and do the busy work.
(2) Do you have an HSA or FSA card?
HSA and FSA cards are like debit cards that you can only use for medical expenses. Depending on your plan, therapy may be eligible. The benefit of using an HSA or FSA is that the accounts are pre-tax, so you save money over time. Here are the differences between the two:
- HSA (Health Savings Account) – It can be more difficult to apply for. However, it is not tied to your employment so you can take it wherever you go.
- FSA (Flexible Spending Account) – It is a “use it or lose it” system that is tied to your employment, but it is easier to apply for.
(3) Paying Out of Pocket (Private Pay)
- You can work with any therapist of your choosing.
- You can choose a therapist who is specialized in the issues you want support with.
- You can choose a therapist who uses modalities that are relatively new, alternative, or simply not covered by insurance (like Brainspotting).
- You don’t have a third party (ie, your insurance company) who is dictating your treatment, which makes it easier to collaborate with your therapist.
- No mental health diagnosis on your medical record, because no insurance company receives information about your therapy.
- Depending on your tax situation, you may be able to write off the money you spent on therapy as a medical expense at the end of the year.
- You’re the boss of your own treatment!
- It’s usually more expensive.