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Q: How can I select the "right" mental health therapist? A: Deciding you want help is a significant first step requiring time and financial commitments. Once you have made that decision, choosing the "right" therapist becomes the important next step. There are numerous sources to locate suitable mental health professionals. You should be able to get more information and referrals from your company's Human Resource Department for Employee Assistance Programs (EAP); through your health insurance company's customer service telephone or member's website; your physician or other medical health care professional. Another good source is your family, friends, or co-workers who have already taken the important steps to participate in therapy. There also are numerous websites dedicated to mental health care, such as Psychology Today. Whatever method you use to seek out a competent and caring mental health professional, contact them by telephone, tell them about your situation and what you are seeking - and ask questions. Many people are hesitant to ask a professional questions about their background or experience. Any competent professional should be open to questions or concerns regarding their expertise or the therapy process. I welcome the opportunity to provide a free 10 - 15 minute initial telephone consultation to gain a preliminary understanding of your situation, and mutually explore how my background and experience could help you. In your search for the "right" therapist, these are some questions you might want to ask the therapist:
Then, the major questions you have to honestly ask of yourself:
If you can answer yes to all of these questions, and have made a decision about selecting a therapist, then the next step is to make your first appointment. If you decide that you would like to try working with me, we can schedule your first appointment. Before your first counseling session, there are several forms you will need to review and complete. If possible, please review, download, and complete these forms before your first session.
The individual forms in the set are: If you decide to complete the forms at my office, please arrive at least 15 minutes before our scheduled appointment to allow time to do so. You may wait until we meet in person to sign the forms so that we can discuss any questions or concerns you may have first. Q: What are your fees and do you take insurance? A: My counseling fees are $125 for an initial evaluation and assessment session, and $100 for each follow-up counseling and therapy session. If you have managed care insurance or Employee Assistance Program (EAP) benefits, there are several things you might want to consider before deciding to use your benefits for mental health counseling services. If you have physical ailments and need frequent visits to physicians, prescription drugs, or perhaps even surgery, medical insurance coverage can be a financial "lifesaver". However, you should be aware that if mental health treatment appears on your medical records, it may affect how you are viewed by current and prospective employers, and could limit your ability to get future disability, health, or life insurance. Also, involving third parties (insurers) in the process of psychotherapy can be invasive and may compromise treatment. Many insurance plans allow the insurance company to decide whether your situation is even worthy of coverage ("medically necessary" in their language), and if so, control the number of sessions you are "allowed" and "how often" you can attend sessions - thus the well-deserved term "managed care". For example, your insurance plan may require diagnostic and treatment plan information to be provided to them before they will even authorize any mental health treatment or claims payment. The medical industry model in use today is based on treatment for physical health issues - that is identifying an "illness" and classifying it with a diagnosis, followed by treatment. Health insurance companies also follow that same medical model and may require a diagnosis of mental illness (such as depression) before they will authorize mental health services. In other words, I may have to confirm you have a mental "sickness" before they will authorize initial therapy, and will have to continue confirming that "sickness" for on-going counseling. When insurance companies are involved in mental health counseling, it can be almost like having an invisible observer in the room during our discussions and therapy sessions. If you are concerned about this type of third party involvement, you might want to consider paying for mental health counseling and therapy on your own rather than using your insurance or EAP benefits. However, I am a preferred provider ("in-network" or "contracted") with all major managed care insurance companies and Employee Assistance Programs (EAP). As long as you are aware of the risks and limitations of using your insurance or EAP benefits for mental health counseling, and are willing to accept them, if I am "in-network" with your insurance company or EAP, I will be pleased to accept your coverage. Just remember that I am obligated to comply with all their requests for information. I will also file your claims for you, in which case you authorize payment be made directly to me If your insurance company or EAP happens to be one with which I am not contracted, known as "out-of-network", I will provide receipts so you can submit claims to them. Please understand that you may or may not receive any reimbursement. If you do not have insurance or EAP coverage, or if you decide not to use your benefits, my standard counseling fees will apply - $125 for an initial evaluation and assessment session, and $100 for each follow-up counseling and therapy session, payable when services are rendered. If you arrive late for your appointment, your session time cannot be extended. Under limited circumstances, payment arrangements may be available. Payment for services may be made in cash, personal check ($25 service charge for returned checks), or by Visa or MasterCard. Insurance deductibles, co-payments, and co-insurance are your responsibility as is any balance of your account if your insurance company denies payment for any reason -- you are ultimately responsible for payment of your account regardless of your insurance status. I reserve the right to pursue collection of unpaid amounts using the services of a collection agency. Q: What is your policy if I need to cancel or forget an appointment? A: When you schedule an appointment, I consider that a commitment for you and me to work together to pursue your therapy goals. I am unable to help anyone else during that time. Sometimes emergencies arise, but whenever possible, try to put your health ahead of life's daily interruptions and keep your appointment. If I need to cancel or change an appointment, I will give you 24 hours notice, as I know you have reserved time for your appointment. If for any reason I cannot give you 24 hours notice, I will provide our next session at no cost to you. Likewise, I expect you to give me 24 hours notice if you must cancel an appointment for any reason. Your insurance company will not pay for missed appointments. If, for any reason, you cannot let me know 24 hours in advance, or forget your appointment, you will be charged my full fee of $100 as a missed appointment fee for the time you reserved. Q: How do I find out about my EAP or mental health insurance benefits? A: Employee Assistance Programs (EAP) and Mental Health Insurance Coverage are two entirely different benefits Employee Assistance Programs (EAP) Many employers, especially larger ones, offer their employees EAP services as part of their benefits package. EAP typically offers one or more types of assistance to employees, and often to their spouse or family as well. EAP benefits are intended to help employees and their families if they have personal problems, especially if that might affect work performance. EAP usually includes limited benefits for legal, financial, and/or mental health counseling at no cost. EAP availability and benefits are usually not shown on an employee's or dependants' insurance cards. To find out if your company offers EAP benefits, the employee should contact their Human Resource Department to learn about the specific benefits available, if any, and what company (usually a third-party) administers the program. Sometimes, but not always, the same third-party company administers both EAP and mental health insurance programs, and for mental health services these companies may be completely different than the primary insurance company shown on your insurance card. If the employer provides out-patient mental health EAP benefits, I am contracted to provide services for all major EAP administrators. These include Aetna, APS Healthcare, Ceridian LifeWorks, Chestnut EAP, Cigna, EAP International, Horizon Behavioral Services, Interface EAP, Magellan, United Healthcare, and Value Options. To obtain specific information about EAP mental health benefits, the employee or spouse, if applicable, must contact the EAP administrator to request authorization for a limited number of EAP out-patient mental health counseling sessions. The number of EAP sessions allowed (usually 3 to 8 sessions) depends on your needs and the contract between the employer and the EAP administrator. Usually, you will also have to tell the EAP administrator the specific therapist you have chosen to help you. If you feel you might need more counseling sessions than are allowed to resolve your particular problem, it is also very important to ask if you can continue seeing the same therapist under your insurance mental health benefits after the authorized number of EAP sessions is completed. Some contracts do not allow you to continue with the same therapist under your insurance coverage, and you would have to "start all over" with another therapist. The reason for this is, where more than the limited number of EAP sessions are anticipated, some employers would like for you to bypass the EAP benefits and start at the outset using your insurance mental health benefits so that you share in the associated costs through your deductibles, co-payments, and possibly co-insurance. If you decide to go forward using your EAP benefits, the EAP administrator will provide you with an authorization number and the number of sessions authorized. Then you can call me with that information, and we can schedule your first appointment and get started. If you have questions about EAP versus insurance benefits before that, please contact me so I can help you sort it out and determine the better approach for you. Mental Health Insurance Coverage If you choose to use your mental health insurance benefits, I am a preferred provider, which means I have a contract, known as "in-network", with all major managed care health insurance companies. These include Aetna, APS Healthcare, Beech Street, Behavioral Health Systems, Blue Cross/Blue Shield, Cigna, ComPsych, CorpHealth, Great West, HAS Premier Providers, Horizon Behavioral Services, Humana, Integrated Behavioral Health, Magellan, Managed Health Network, MultiPlan, Private Healthcare Systems (PHCS), Texas True Choice, UniCare, United Healthcare, Value Options, and several other smaller insurers. I am also a preferred provider for TriCare (military) mental health services, but you must obtain a referral from your primary care physician (PCP) before I can see you. Unfortunately, I am unable to accept Medicare coverage. Because every contract and plan are different, I cannot tell you exactly what will be covered until we verify your specific insurance benefits. As a courtesy to you, I will verify and file your insurance for you if you desire. However, please remember that my professional relationship is with you and not your insurance company. Fees vary, depending on your insurance carrier, contract, and services to be provided. If you would like to verify your insurance benefits to learn the exact cost prior to making an appointment, call the toll-free number for Mental Health or Substance Abuse listed on the back of your insurance card. If a separate toll-free number is not listed, call the main customer service number shown on your card. Tell them you want to find out about mental health and/or substance abuse benefits, and they can refer or connect you to the correct telephone number, which is often a third-party administrator, totally separate from the company that provides your medical coverage. Be sure they understand you are verifying mental health and/or substance abuse benefits and not medical benefits. For mental health insurance coverage, here are the things you will need to ask or find out about:
Sometimes verifying benefits can be difficult, time-consuming, and frustrating. If you cannot obtain a clear answer, please give me a call and let me assist you. Q: How long does therapy last? A: The length and frequency of therapy varies from person to person. Sometimes people achieve their goals in a few sessions, while others may take several months or even longer. Factors that influence the duration of therapy include the nature and complexity of your issues, your life circumstances, and your motivation. You will probably know whether our association feels "right" within our first several sessions, and can decide whether to continue with me or request a referral to see another practitioner. A: Usually sessions are once a week, although more frequently may be helpful in certain situations. When too much time elapses between appointments, progress can be noticeably slower and momentum lost. Q: What if I can't afford your fee? Do you offer a sliding scale? A: I recognize that some people do not have insurance coverage or may be unable to pay my full fee. In order to be accessible and helpful to as many people as possible, I'm sometimes willing to consider alternative arrangements, but only on a limited case-by-case basis. My consideration of such cases is based on confirmed family income, what day and time of day you would be willing to meet, and my current client caseload. Q: Can you assure me that my privacy will be protected? A: I am very careful and respectful about client privacy and confidentiality. For example, if we should run into each other at a local event, a retail store, or some other place outside the office, I will not even greet you or act as if I know you, unless you initiate that greeting. In that way, you will never be forced into a compromising situation of explaining to someone accompanying you "how you know me", thus maintaining your privacy unless you wish to divulge it. Q: What about confidentiality? A: You have a legal and professional right to the confidentiality of what we discuss in our sessions, and even to the fact that you are in therapy with me. I am required by law to safeguard that confidentiality. You should know, however, that there are some legal exceptions:
My practice complies with federal laws governed by the Health Insurance Portability and Accountability Act of 1986 (HIPAA). Before treatment begins, I will ask you to read my Notice of Privacy Practices (NPP) and sign a Consent to Use and Disclose Your Health Information. Often there are times when it would benefit you for me to contact others who are providing medical or psychological services to you, such as other therapists, psychiatrists who prescribe medication, and primary care physicians. I will do so only after discussing it with you, and with your explicit written permission for me to share information with others by signing an Authorization to Use and Disclose Protected Health Information (PHI). Q: What if I have an emergency and need urgent help? A: My main business telephone number is (281) 538-8008. I am usually in my office weekdays during scheduled appointments. If I am in session with a client, I can not be interrupted and will not be available to take your phone calls. However, I do check my voice mail frequently, and am notified automatically when I have messages. On other days, including week-ends or if I am out of town, I check for messages daily. If you cannot reach me by phone but need to talk to someone urgently, you may wish to call Crisis Intervention of Houston, Inc. If you are in crisis or have a life-threatening emergency, call 911 or go to your nearest emergency room immediately. Q: Does being in therapy mean I am mentally ill? A: "Health" can be viewed from several perspectives - physical, mental, emotional, and spiritual. The generally held viewpoint of "health" defers to physical well-being alone. Yet, the mind is complex, and controls nearly everything we do. While studies have demonstrated the effect of the brain's chemical and genetic composition, what we think and perceive, and what we do, are also influenced by our environment, upbringing, and social interactions. Pervasive drug advertising also leads too many people to believe that medication will "solve" or "treat" nearly any medical or mental health problem. How we think and feel emotionally can frequently be out-of-sync with sound physical health. Mental health therapy can help us reshape our perceptions and behaviors. The medical industry model for physical health is based on identifying an "illness" and classifying it with a diagnosis, followed by treatment. Using that model, health insurance companies also require a diagnosis for mental illness (such as depression) before they will approve mental health services. It has become commonplace to want to classify or label nearly everything in society - to put it in a neatly defined slot. Unfortunately, for these and other reasons, there remains an unwarranted stigma associated with seeking help for mental and emotional problems. My belief is that people who seek out and participate in therapy are motivated to work on meaningful changes that will improve their overall well-being. In fact, I think people who participate in therapy are better off than those who do not even realize they need therapy. If you come to me for help, I will do my best while Helping You Discover the Power of Change. Q: What are Cognitive Behavioral Therapy (CBT) and Solution-focused Therapy? A: The three main tenets of Cognitive Behavioral Therapy (CBT) are that it is collaborative, helps you identify your automatic thoughts, and helps you try out alternative thoughts and behaviors in order to develop more flexible, optimistic, and effective coping strategies. As humans, we think, then feel, then act-in that order. But we may only be aware of one of these states. Cognitive Behavioral Therapy (CBT) teaches you to become aware of how you think-what you say to yourself. Normally, we are not aware of our thoughts (cognitions) because they are automatic. Our breathing is also automatic and part of our autonomic nervous system which operates without our awareness or intervention (thank goodness!) Since our thinking is so rapid fire and unconscious, we have to train ourselves to become aware of our thoughts. Most of the time we don't have a clue about what we were thinking when we experience an emotion or behave a certain way. We can start with our emotions or our behaviors, and backtrack to discover our thinking. Recording our thoughts as soon as we can when we are in a negative emotional state can be very helpful. Beliefs, assumptions, and patterns of negative thinking soon emerge to reveal what your perceptions are of the events in your life, and that determines your feelings and behaviors that follow. We "learn" most of our views of the world and behaviors that make sense to us. When we notice that the consequences or outcomes occurring in our life are painful to us and others, it's time for a change. The good news is that what has been "learned" can be "unlearned"! CBT teaches you how to do this, and gain control over your responses to the relationship you have with yourself, others, and the world. You can choose better responses, as alternative ways of thinking about things, and create better outcomes to help you reach your goals, be at peace, and find joy and happiness. Often, we see what we want to see, and hear what we expect, and that can be a distortion of reality. There is a good chance that if your life isn't working, you are dealing with some errors or distortions in your thinking. You and I will collaborate to identify irrational thinking assumptions, beliefs, and explanations that shape your understanding of the world, other people, and yourself. Once these habitual thoughts are held up to the light of reality, we'll examine whether they are working for you. You'll learn to ask yourself different questions that will lead you to alternative ways of thinking and a more objective view of your situation. Solution-focused Therapy focuses on present and future solutions to the nature of your presenting problem(s). We notice "exceptions" to the problem-times when the problem doesn't exist, and past successful coping behaviors are utilized and applied to current problems. Change begins with us doing something different to get a different result. Solution-focused Therapy helps you create change with the "viewing" and "doing" of the problem. We start with the present-what's working, what's not working, and what we do not want to change. The past is examined to search out relevant strengths and abilities used to resolve past problems; and this is brought into the present to help with current problem coping or resolution. It is not used to discuss deficits, trauma, or pathology. Solution-focused Therapy doesn't ask "why", but "what" keeps you stuck. What correlates to the problem versus causes the problem. Therapy focuses on helping clients notice what happens just before the problem occurs, while the problem occurs, and just after the problem occurs. Changes in those areas can create a positive ripple-effect towards the client's ultimate goal. In Solution-focused Therapy, noticing the very first signs of positive change help you develop the hopefulness that is so necessary for successful therapy. And this focus also leads you to be able to decide when you no longer need therapy.
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Copyright 2007 Janis B. Rice ~ Licensed Professional Counselor