Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychologist and client, and the particular problems you bring forward. There are many different methods I may use to deal with the problems that you hope to address. Psychotherapy is not like a visit to a medical doctor. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home.
Psychotherapy can have both benefits and risks. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. But there are no guarantees of what you will experience.
Our first session or two involve an evaluation of your needs. By the end of the evaluation, I will be able to give you an overview of what our work will include and a treatment plan to follow, if you decide to continue with therapy. You should evaluate this information along with your opinion of whether you feel comfortable working with me. Therapy involves a large commitment of time, money, and energy, so you should be very careful about the therapist you select. If you have questions about my procedures, we should discuss them whenever they arise. If your doubts persist, I will be happy to help you set up a meeting with another mental health professional for a second opinion.
You might have been referred for an evaluation by a physician, a therapist, a teacher, an attorney, or employer, or you may have referred yourself. The first step is to get perfectly clear as to the purpose of the evaluation. Who will read the report? What will the results be used for? Once that is determined, I can select the appropriate tests and measures to use to answer the questions. The report will be written with both the purpose of the testing and the intended reader(s) clearly in mind. Psychological testing and forensic assessments are considerably more labor intensive than the initial evaluation for psychotherapy, and require significant amounts of time to complete and write up. Accordingly, my fee schedules for therapy and for other services differ.
I normally conduct a psychotherapy intake evaluation that will last at least 2 sessions (a session is 45-50 minutes). If possible, I like our first meeting to last about 1 ½ hours (a double session). Sometimes, this initial evaluation will take more time. During this initial time, we can both decide if I am the best person for you to work with to meet your treatment goals. If we decide to work together, I will usually schedule one 45-50 minute session per week at a time we agree on, although some sessions may be longer, more frequent or less frequent.
In some sense, treatment goes on as long as it goes on. More specifically, services will continue until:
Once a therapy appointment hour is scheduled, you will be expected to pay for it unless you provide at least 24 hours (1 day) advance notice of cancellation, unless we both agree that you were unable to attend due to circumstances beyond your control. Exceptions to this policy are what would generally be considered emergencies and would not include being very busy at work, or having a baby sitter “no show”, or just not feeling like coming in. If it is possible, I will try to find another time to reschedule the appointment, hopefully during the same week.
You may pay for therapy, testing, or forensic services using cash or check. All co-pays and payments are due at the time of the appointment and must be paid in full each session. If by the next visit you have not paid the amount owed, I reserve the right to hold off seeing you unless and until you have paid in full.
I charge this same fee for other professional services (pro-rated for periods of less than one hour) such as report writing, telephone conversations lasting longer than 5 minutes, attendance at meetings with other professionals you have authorized, preparation of records or treatment summaries, and the time spent performing any other service you may request of me.
Fees vary depending on the type of evaluation. Fees range from $2000 for a basic evaluation to several thousand for complex forensic (legal) cases. Fees will be determined on a case-by-case basis, depending on the referral questions. My policy is to collect at least 50% of the fee at the time of initial service and the balance before the report is delivered. If you have to cancel, please let me know at least 48 hours (2 days) in advance. If you cancel with less notice, or “no show,” you will be charged a flat fee of $350.
Because of the difficulty of legal involvement, I charge a minimum of $250 per hour for preparation and attendance at any legal proceeding. If therapy or testing is in connection with a legal case, I will ask you to sign a separate contract, specifying the specifics of my involvement.
Insurance carriers do not consider forensic services to be health-related and usually refuse any coverage. You will be asked to pay for forensic services prior to the service, either in full, or in the form of a to-be-agreed-upon retainer. If you have to cancel, please let me know at least 72 hours (3 days) in advance. If you cancel with less notice, or “no show” you will be charged a flat fee of $500. If you become involved in legal proceedings that require my participation, you will be expected to pay for my professional time even if I am called to testify by another party.
What should I know about insurance reimbursement?
If I am a participating provider with your carrier, I am required to file the insurance claims myself. If I do not participate with your plan, I will fill out forms and provide you with whatever assistance I can in helping you receive the benefits to which you are entitled; however, you (not your insurance company) are responsible for full payment of my fees.
It is very important that you find out exactly what mental health services your insurance policy covers. You should carefully read the section in your insurance coverage booklet that describes mental health services. If you have questions about the coverage, call your plan administrator. Of course I will provide you with whatever information I can based on my experience and will be happy to help you in understanding the information you receive from your insurance company. If it is necessary to clear confusion, I will be willing to call the company on your behalf.
Due to the rising costs of health care, insurance benefits have increasingly become more complex. It is sometimes difficult to determine exactly how much mental health coverage is available. Some “Managed Health Care” plans such as HMOs and PPOs may require approval for more therapy after a certain number of sessions. While a lot can be accomplished in short-term therapy, some patients feel that they need more services after insurance benefits end.
You should also be aware that most insurance companies require you to authorize me to provide them with a clinical diagnosis. Sometimes I have to provide additional clinical information such as treatment plans or summaries, or copies of the entire record. Such requests, fortunately, are fairly rare. I will let you know if such a request is made. This information will become part of the insurance company files and will probably be stored in a computer.
Though all insurance companies claim to keep such information confidential, I have no control over what they do with it once it is in their hands. In some cases, they may share the information with a national medical information databank. Note the numerous recent reports on the number of such databanks that have become compromised by hackers and others. For example, see the following link: Wsj.com/articles/health-insurer-anthem-hit-by-hackers-1423103720. This is a 2/4/15 Wall Street Journal article on the database hacking of tens of millions of customers of one of the largest health care insurers.
Once we have all of the information about your insurance coverage, we will discuss what we can expect to accomplish with the benefits that are available and what will happen if they run out before you feel ready to end our sessions. It is important to remember that you always have the right to pay for my services yourself to avoid the problems described above [unless prohibited by contract].
I’m often not immediately available by telephone, and don’t answer the phone when I am with a client. My phone is answered by voice mail that I monitor frequently. I will make every effort to return your call on the day you make it, with the exception of weekends and holidays. If you are hard to reach, please let me know some times you’ll be available. I usually respond to email on the same day. If you can’t reach me and feel that you can’t wait for me to return your call or email, please contact your family physician or the nearest emergency room and ask for the psychologist/mental health specialist on call. If I will be unavailable for an extended time I’ll provide you with the name of a colleague to contact, if necessary.