You’ve got questions?

I am located in rural Idaho. I am currently licensed to practice in Idaho, Texas, Arizona, Florida and South Carolina. You may visit the various state boards to look up the status of my license. Through the brand-new Counseling Compact, I can easily become registered to practice in the state you live, so please just ask me about it. All my therapy takes place online.

It’s so easy! You simply need a device, a stable Internet connection and privacy. Once you are scheduled, I will send you a video link for our telehealth session. Both our cameras and audio will be all the time, and we meet without other people in the room. You will get automated reminders of our meeting 24 hours before, and you may cancel or reschedule at that time. I do have a cancellation policy, thank you for understanding.

I do not. If we happen to be in the same geographic location, we may decide together if a meeting is appropriate.

My current fee per 50-minute session is $150. My DBT group fees are $50 per meeting. If you attend both individual and group meetings in one week, the combined fee is discounted to $150. During intake you consent in writing for me to place your credit card on file and you will be charged after each session. I am always flexible in helping you keep therapy affordable, but payment is a condition for services.

Our first appointment serves a few purposes: 1) for us both to determine whether we will work well together, 2) for me to determine whether this level of care is appropriate for you, and 3) to obtain some baseline measures of your mood, trauma and other indicators.

We should always start therapy with the end in mind. That’s good thing for you. Therapy is not intended as a lasting relationship, since it can become unhelpful to stay in therapy too long. You will be in therapy with me for 12 weeks, although you are always free to end therapy at any time. If you completed 12 weeks, we will evaluate your progress and decide together on continuance or an appropriate referral.

A Good Faith Estimate is a formal, written notice of the fees you can expect for therapy so that you are not surprised by a huge bill! In my case, the estimate is that you will pay $150 per weekly session for the duration of a year, unless we have to meet more (or less) frequently, and longer ) or shorter than that. My fees only change every few years and then I give you ample notice in advance.

You are right, paying out of pocket for therapy is a significant expense! I thought it may be helpful to give you an idea what goes into my fee at a one-person, online, private practice.

1. Getting started: Before you can enter a counseling program, you need an undergraduate degree and this may have required a student loan. My counseling program lasted four years and was funded by more student loans, about $50 000. The graduate program included 700 hours (about ten months) of unpaid work at a community mental health agency. I then had to pay for a professional exam, an associate license, and start work at the lowest pay rate in the industry for the supervision years. Due to COVID and relocations, my supervision took almost four years, during which I had to pay for weekly supervision as if in therapy myself.

2. Costs of a private practice: working from home reduces many overhead expenses, but it requires an initial capital layout. Professional equipment and furniture are required. Ongoing expenses include monthly utilities, pro rata mortgage costs, subscription to an electronic patient portal and virtual delivery service, google business service for HIPAA protected email, online banking, website subscription, therapy database marketing as well as tax accounting services. Any clinician must also carry the costs of applying for and maintaining licensure, obtaining records, maintaining professional indemnity insurance and ensuring annual continuing education credits in training.

3. Training: I do an inordinate amount of training. That is what makes me better at my job. High-end training is expensive because it compensates expert trainers for decades of clinical experience. EMDR, DBT, IFS, Ego State and Clinical Hypnosis trainings are all multi-stage trainings with individual or group consultation hours after the actual training. I belong to multiple consultation teams where I meet face-to-face with an expert for an hour each week or month. (I also buy more books on therapy than I have place to store.) These trainings and consultations keep me ethically and legally accountable for your safety. Although my training is a high-cost item in my practice, it directly translates to the value for your money.

4. Invisible labor: I spend much more time maintaining my practice than I can charge money for. A lot of personal time is devoted to managing my client schedule between sessions and after hours, responding to inquiries and texts seven days a week. I maintain assessment and progress notes for each client, and have to document all communications between sessions. Clients sometimes require additional administrative help with online billing. I spend time marketing my practice. I offer consultation on my specialty to other therapists for free. I maintain my website with updated information. I speak to parents and spouses for free on the phone. Other things I don't charge for is: preparing before each session, showing up well in advance, and making sure I am appropriately dressed and organized for your time with me. Finally, in our sessions I am 100% absorbed in the details of your life. My fee has to compensate me for recovering afterwards to prevent burnout.

5. Market norms: My fees are not out of proportion to what clinicians in the local market charge. In big cities, therapy easily costs $200-$350 per session, whereas fees in remote areas are closer to $100-$200. Although this still seems expensive, it is ultimately in your interest that my fees do not drastically undercut the fees of other therapists. We will simply stop providing mental health services when we can no longer make a living. If some of us ask too low fees, it pushes others out of the market. Those who ask a very low fee may have a second income through a partner, or little clinical experience. I try to compensate for high market rates by offering a special fee accommodation to 10% of my caseload. For instance, if I have about 25 clients on my case load, I can offer at least two clients the therapy fee that they can afford. Yes, you read that right. If you earn minimum wage, I only charge you what you earn in one hour of work. Unfortunately these spots do not become available very often. If you want to get on my waiting list for this fee accommodation, please send me an email. I would love to keep your name until I can make the same offer to you.

6. Background: I entered this profession as my third career, and bring prior professional skills to my current work. This distinguishes me from someone who has only studied and worked in this field. I studied law for six years in South Africa, I practiced law as a public defender and I completed an additional Master's degree in International Economic Law. I learned to research and litigate in front of appellate division judges. I also taught college-level English in Korea for many years, and studied for five years to obtain my PhD in English Literature. I am capable of academic publications and critical thinking. I am a more mature counselor because of this background. I also have a personal journey in my own mental health that contributes to my genuineness in therapy. Your fee gets you a well-rounded counselor.