FAQs (Frequently Asked Questions)

I’ve tried to make the process easy with an online non-clinical intake form, but also personal.  I make sure we speak by phone before meeting, with me answering all of your questions. Only after we’ve had that chance to talk will I personally secure your first appointment.

It depends mostly on the time(s) of day you are available. 1-3P is the most open block of time in my practice; 4-6P is the most in-demand. If you are able to come in at 1PM or 2PM I can likely see you within a week’s time. If you set up your first appointment at those times, even if it isn’t very convenient, we can meet sooner. And, I can bring you into my scheduling ‘system’, so that future appointments that fit your life can be easily made.

To help make our schedules fit together more successfully, I typically keep two appointments scheduled with each client. After your first appointment, if you wish to schedule future appointments, we will arrange the next two. Usually the second appointment is 0ne to three weeks out, when my schedule is a bit less crowded, so it’s easier to get the time and day you prefer.

At the end of each appointment, I access my online schedule of appointments, re-confirm the next appointment we made last time, and then set the new one, what I call the “forward appointment”. This system allows us to verbally and visually confirm – in the office – every appointment twice. That’s why I rely on what’s in the online schedule when there’s any scheduling problem.

By continuing that way of scheduling, it’s usually easier to get the appointment time you want. And, if you have to cancel any next appointment, we do not have to suddenly get your next one set up. If you must cancel without adequate (48 hour) notice, or if you do not appear, having the next appointment already scheduled qualifies you to pay only 75% of the regular cancellation fee.

My scheduling system sends out two reminders, via e-mail and/or text. If you decide to cancel, you must send me an e-mail, text or voice mail to that effect. I do require a 48 business hour (this excludes weekends) period in which to cancel or reschedule an appointment. This is not a flexible policy; it does not take into account specific reasons for waivers. Cancellation fees are also reduced to 75% of the amount I normally receive. If a cancelled appointment is rescheduled within the same week, a $25 fee is applied.

When you (re-)schedule via e-mail or text, your appointment is only confirmed when you’ve received a reply message from me that says “Confirmed”.

The answer(s) are: yes, and no. I’ll explain the confusion people are facing;  A starting point is the list of “covered procedures” maintained by the American Medical Association, called CPT (Current Procedural Terminology) codes. The list is used by the insurance industry.

If you call your insurance carrier (let’s say, Premera Blue Cross/Blue Shield)  and ask whether “couples therapy” is covered, they look it up in the list of your plan’s “covered procedures”.There is no official procedure entitled ‘Couples Therapy”, so you will be told that it is not covered. It is highly unlikely that you will be told that the most similar procedure, “Family Therapy with member present” could be covered. Or that the widely accepted CPT procedure code 90837 (or the briefer 90834) explicitly includes family member presence.

{INote that the term “family” is defined for insurance purposes by legal marriage. In formal terms, relationship therapy for unmarried partners is ineligible for insurance coverage – unless a domestic partnership has been declared.}

Even if you were told these things, insurance carriers have historically interpreted the procedure in a limited way, so as to fit a basic rule of the larger medical model: there’s only one “identified” patient. It holds that the treatment focus must be on that individual’s diagnosis, no matter which other family member is attending therapy.  It follows from this interpretation that the same two family members (including spouses) should not attend more than a few appointments together, beyond what’s needed for basic assessment purposes. The medical model of treatment does not theoretically recognize couples or family treatment, only individual assessment.

In my office, I advocate for clients understanding and properly using their benefits. I frequently work with relationship clients for 80 minute appointments. This length of appointment is not covered by any insurance carrier. Therefore, I use my private fee schedule. However, I always have you review and understand your benefit. There are often alternatives that allow for some coverage of your visits.

My office’s financial policies seek to be as accountable, private, confidential, accurate, safe and responsive as possible.

When you secure your first appointment with a credit or debit account, the terms you’ve agreed to in the intake form allow me to use that account information to collect either private or insurance-related (co-payments, deductibles and co-insurance) amounts.

For a typical appointment covered by insurance, I collect the “patient responsibility” amount (co-payment, deductible or co-insurance) when I receive my copy of the claim voucher (EOB) from the carrier, That’s about two weeks after the appointment. I deduct the exact amount.

If we have a private or sliding scale payment arrangement in place, I would use the credit/debit or checking account on file (encrypted/password protected) to deduct amounts due.

I use the account you provide me to reimburse my office for appointments where the client does not appear, or cancels the appointment with less than 48 hours notice. Exceptions to the fee for no-show or late cancellation are addressed on a case-by-case basis.

I can produce statements of various kinds, including for health savings accounts, as needed by the client. I do not send out monthly statements by US Mail.

In a word, no. Medication prescription is not in the licensed scope of practice for LICSWs (or LMHCs or LMFTs either). Only MDs and ARNPs are legally able to prescribe in the State of Washington.

If you are using medication, I bring you the familiarity and support that comes from spending many hours on this subject with hundreds of clients. The longer, more frequent appointments for therapy, compared to brief follow-ups with MDs, allow my clients a greater ability to understand and evaluate the effects of their medications. We talk about a wide range of medication-related issues. Yet I am careful not to advise on various medical subjects that only physicians and specially trained ARNPs are qualified to discuss.

There are circumstances where a first individual appointment should occur, such as when IPV (intimate partner violence) has occurred. Starting with individual appointments sometimes “eases in” the relationship therapy, but not always. If we start couples therapy with an individual appointment, then usually I want the next appointment to be for the other partner individually. But it’s usually preferable to see relationship partners interact in my office, as soon as possible. After that, individual appointments are fairly common.

I have long maintained a policy for individual therapy appointments during the course of couples or relationship work. Most often, after I have seen a relationship client once or twice, I set up individual appointments to go over personal, family, social and sexual histories

I offer a 10-15 min. phone or Zoom call that does not obligate you in any way. During the call you can if you wish briefly summarize why you want to begin this work so that we’re both clear that my training, experience and approach – as described on this website -fit well enough together. If you have a question specifically related to what you’ve read, please ask about it. I do not engage discussions about psychological theories, or more than a general summary about how I typically begin working with my clients. I rarely if ever share more personal information than I publish on this site. I am happy to provide information about the cost of this work, how insurance generally works. If you are seeking individual therapy but are also interested in the possibility that I might work with you as a relationship client, I’m happy to discuss that.

EAP stands for Employee Assistance Program. Many companies offer it as an employee benefit. It is not part of health insurance, yet many EAPS are managed by a division of health insurance carriers. EAPs are meant to assist employees with personal or work-related problems (including mental health and substance abuse), and to be used before health insurance. Many therapists, including myself, see clients using EAP benefits.

You can receive an overall assessment and referrals to other professionals, if needed. In most cases, you can use your insurance to continue to work with me, after we’ve made an appropriate use of EAP covered appointments. EAPs also offer many “work-life balance” services, including legal, financial, healthcare, child and eldercare, etc.

You can (and should) set up an account on your health insurance carrier’s website so that you know what your benefit is. All of the sites allow you to monitor claims, which I recommend as part of knowing and managing your healthcare. For work with me, you are seeking info on your “outpatient mental health benefit”. If you have any questions after reviewing your carrier’s site, call your carrier’s customer service. And you must call them if your benefit requires pre-authorization before you can begin working with an outpatient therapist.

That’s most often needed when your health insurance carrier has subcontracted the administration of its mental health benefit to a separate utilization management vendor.  On the card there’s often a group of corporate logos symbols from these vendors (including pharmacy.)