FAQ

Common Questions

When should you seek counseling?

From childhood through late adulthood, there are certain times when we may need help addressing problems and issues that cause us emotional distress or make us feel overwhelmed. When you are experiencing these types of difficulties, you may benefit from the assistance of an experienced, trained professional. Professional counselors offer the caring, expert assistance that we often need during these stressful times. A counselor can help you identify your problems and assist you in finding the best ways to cope with the situation by changing behaviors that contribute to the problem or by finding constructive ways to deal with a situation that is beyond your personal control. Professional counselors offer help in addressing many situations that cause emotional stress, including, but not limited to:

• anxiety, depression, and other mental and emotional problems and disorders

• family and relationship issues

• substance abuse and other addictions

• sexual abuse and domestic violence

• eating disorders

• career change and job stress

• social and emotional difficulties related to disability and illness

• adopting to life transitions

• the death of a loved one

"Good indicators of when you should seek counseling are when you're having difficulties at work, your ability to concentrate is diminished or when your level of pain becomes uncomfortable," says Dr. Gail Robinson, past president of the American Counseling Association. "However, you don't want to wait until the pain becomes unbearable or you're at the end of your rope."

"If someone is questioning if they should go into counseling that is probably the best indicator that they should," says Dr. William King, a mental health counselor in private practice in Indianapolis, Indiana. "You should trust your instincts."

Joyce Breasure, past president of the American Counseling Association and a professional counselor who has been in private practice for more than 20 years, recommends counseling when you:

• Spend 5 out of 7 days feeling unhappy

• Regularly cannot sleep at night

• Are taking care of a parent or a child and the idea crosses your mind that you may want to hit that person

• Place an elder in a nursing home or in alternative care

• Have lost someone or something (such as a job)

• Have a chronic or acute medical illness

• Can no longer prioritize what is most important in your life

• Feel that you can no longer manage your stress

"If you're not playing some, working some, and learning some, then you're out of balance. There's a potential for some problems," Breasure says.

Robinson points out you don't have to be "sick" to benefit from counseling. "Counseling is more than a treatment of mental illness," she says. "Some difficult issues we face in life are part of normal development. Sometimes it's helpful to see what you're going through is quite normal."

What is professional counseling?

Professional counselors work with individuals, families, groups and organizations. Counseling is a collaborative effort between the counselor and client. Professional counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health. Through counseling you examine the behaviors, thoughts and feelings that are causing difficulties in your life. You learn effective ways to deal with your problems by building upon personal strengths. A professional counselor will encourage your personal growth and development in ways that foster your interest and welfare.

Who are professional counselors?

Licensed professional counselors provide quality mental health and substance abuse care to millions of Americans. Professional counselors have a master's or doctoral degree in counseling or a related field which included an internship and coursework in human behavior and development, effective counseling strategies, ethical practice, and other core knowledge areas.

Over 80,000 professional counselors are licensed in 48 states as well as the District of Columbia. State licensure typically requires a master's or doctoral degree, two to three years of supervised clinical experience, and the passage of an examination. In states without licensure or certification laws, professional counselors are certified by the National Board for Certified Counselors (NBCC). Participation in continuing education is often required for the renewal of a license or certification.

Professional counselors adhere to a code of ethics that protects the confidentiality of the counseling relationship; prohibits discrimination and requires understanding of and respect for diverse cultural backgrounds; and mandates that professional counselors put the needs and welfare of clients before all others in their practice.

How can therapy help me?

A number of benefits are available from participating in therapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that counselors can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:

• Attaining a better understanding of yourself, your goals and values

• Developing skills for improving your relationships

• Finding resolution to the issues or concerns that led you to seek therapy

• Learning new ways to cope with stress and anxiety

• Managing anger, grief, depression, and other emotional pressures

• Improving communications and listening skills

• Changing old behavior patterns and developing new ones

• Discovering new ways to solve problems in your family or marriage

• Improving your self-esteem and boosting self-confidence

Do I really need therapy? I can usually handle my problems.

Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you're at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.

Why do people go to therapy and how do I know if it is right for me?

People have many different motivations for coming to psychotherapy. Some may be going through a major life transition (unemployment, divorce, new job, etc.), or are not handling stressful circumstances well. Some people need assistance managing a range of other issues such as low self-esteem, depression, anxiety, addictions, relationship problems, spiritual conflicts and creative blocks. Therapy can help provide some much needed encouragement and help with skills to get them through these periods. Others may be at a point where they are ready to learn more about themselves or want to be more effective with their goals in life. In short, people seeking psychotherapy are ready to meet the challenges in their lives and ready to make changes in their lives.

What is therapy like?

Because each person has different issues and goals for therapy, therapy will be different depending on the individual. In general, you can expect to discuss the current events happening in your life, your personal history relevant to your issue, and report progress (or any new insights gained) from the previous therapy session. Depending on your specific needs, therapy can be short-term, for a specific issue, or longer-term, to deal with more difficult patterns or your desire for more personal development. Either way, it is most common to schedule regular sessions with your therapist (usually weekly). It is important to understand that you will get more results from therapy if you actively participate in the process. The ultimate purpose of therapy is to help you bring what you learn in session back into your life. Therefore, beyond the work you do in therapy sessions, your therapist may suggest some things you can do outside of therapy to support your process - such as reading a pertinent book, journaling on specific topics, noting particular behaviors or taking action on your goals. People seeking psychotherapy are ready to make positive changes in their lives, are open to new perspectives and take responsibility for their lives.

What about medication vs. psychotherapy?

It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness. Working with your medical doctor you can determine what's best for you, and in some cases a combination of medication and therapy is the right course of action.

Do you take insurance, and how does that work?

To determine if you have mental health coverage through your insurance carrier, the first thing you should do is call them. Check your coverage carefully and make sure you understand their answers. Some helpful questions you can ask them:

• What are my mental health benefits?

• What is the coverage amount per therapy session?

• How many therapy sessions does my plan cover?

• How much does my insurance pay for an out-of-network provider?

• Is approval required from my primary care physician?

Does what we talk about in therapy remain confidential?

Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office. Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone. This is called “Informed Consent”. Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your Physician, Naturopath, Attorney), but by law your therapist cannot release this information without obtaining your written permission. However, state law and professional ethics require therapists to maintain confidentiality except for the following situations:

• Suspected past or present abuse or neglect of children, adults, and elders to the authorities, including Child Protection and law enforcement, based on information provided by the client or collateral sources.

• If the therapist has reason to suspect the client is seriously in danger of harming him/herself or has threatened to harm another person.

Privacy Policy

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. MY PLEDGE REGARDING HEALTH INFORMATION:

I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

• Make sure that protected health information (“PHI”) that identifies you is kept private.

• Give you this notice of my legal duties and privacy practices with respect to health information.

• Follow the terms of the notice that is currently in effect.

• I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your person health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

1. Psychotherapy Notes. I do keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:

2. a. For my use in treating you.
   b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.
   c. For my use in defending myself in legal proceedings instituted by you.
   d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
   e. Required by law and the use or disclosure is limited to the requirements of such law.
   f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
   g. Required by a coroner who is performing duties authorized by law.
   h. Required to help avert a serious threat to the health and safety of others.

3. Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI for marketing purposes.

4. Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course of my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION. Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:

1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.

3. For health oversight activities, including audits and investigations.

4. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.

5. For law enforcement purposes, including reporting crimes occurring on my premises.

6. To coroners or medical examiners, when such individuals are performing duties authorized by law.

7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.

8. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.

9. For workers' compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers' compensation laws.

10. Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

1. Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.

2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

3. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.

4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost based fee for doing so.

5. The Right to Get a List of the Disclosures I Have Made.You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost based fee for each additional request.

6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.

7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.

EFFECTIVE DATE OF THIS NOTICE

This notice went into effect on September 20, 2013