What happens in our first session?

The first session is sometimes a time of anxiety for someone who has never talked with a therapist.  Also, many things are going on at once.  You will be telling your therapist about the issues and concerns that have led you to your appointment and your therapist will be asking questions to more fully understand the context, history and intensity of your concerns.  While it may take additional sessions to feel like you have adequately recounted all the relevant issues, most people feel some relief just for having started the process.  At the conclusion of the first session, you and I will make a decision together as to the “fit” of our working together and how that might proceed.

How long are sessions and how long will I have to come?

Sessions are usually 50 minutes long.  On one occasion, I worked with someone who at the beginning of our work together only wanted to talk 20-25 minutes a session.  In time, however, this person found it helpful to stay for the full 50 minutes.  On other occasions, there may be good reasons to plan for longer sessions.  If that is the case, we will talk about it.

The duration of our work together is ultimately up to you.  I may offer my opinion as to your progress and readiness to conclude your work.  I believe that the way someone ends psychotherapy is very important.   Sometimes, a pause is important and helpful.  Sometimes, conclusion of our work is right.  It is important to pause or conclude psychotherapeutic work consciously and collaboratively.  

Will Insurance cover my sessions?

I am an “out of networks” provider relative to insurance companies and I am happy to assist you in obtaining reimbursement that you are due.    Some plans include reduced reimbursement percentages for out of network providers.  Other plans (HMOs and some POS plans) do not have out of network benefits.  Contact your insurance provider to learn the specifics of your plan.  For Medicare subscribers, I will submit claims to Medicare for you.  You are responsible for your copay and in accordance with Medicare guidelines.

What should I ask my insurance company?

When you call your insurance company, you want to learn about several important issues.  First, ask if you have “Out of Network” coverage.  If you do not have out of network coverage, you would have to see someone in your network to use insurance.  If you do have “Out of Network” coverage, you will want to learn what your deductible is (and whether mental health is a separate deductible than general medical) and when your deductible ‘resets.”  Most deductibles reset January 1st but some plans have different times of the year when a deductible must again be met.  Also ask for the specifics of the reimbursement plan.  Plans range from 80/20 to 50/50 or less.  Additionally, ask the representative how many covered visits you have per year and ask if referrals or authorizations are necessary.  Some insurance companies change their coverage over time unless the therapist completes forms for continued authorization—even for out of network therapists.  Make sure you know all these issues so you are not surprised. 

Is what I tell my therapist private?

What you talk about to a psychologist is “privileged.”  This means that information from your sessions belongs to you and can only be revealed to someone else with your written consent.    There are only a few exceptions to this protection of confidentiality.

If you are using insurance, a diagnosis code must be shared with your insurance company to obtain reimbursement.  If authorizations are necessary, further information will be sent to them (usually a standardized form) containing information about the specific nature and severity of the issues you are working on, your progress to date, and the plan of treatment for the future.  This is one of the reasons it is best not to use insurance if possible.

Other limits of confidentiality involve genuine and serious threats of danger to self or others or suspicion of current child or elder abuse or neglect.  Feel free to discuss this with me if you have any questions.

What if I’m taking (or thinking about taking) medication?

Only physicians can prescribe medications in Georgia.  However, I have a general knowledge of many common medications and how they have been helpful to others I have worked with.  If you wish (and with your permission), I will discuss medication issues with your physician if we think that beginning medication is necessary, if you are not obtaining the desired result, or if side-effects are too great with the medication you are already taking.  Also, if you need a referral to be evaluated for medication, I can help you in that regard as well.

There are many whose reliance on medication is appropriate and beneficial.    There are also many people I have talked with who aspire to decrease or end their use of medication.  If this is your goal, I will work with you to gain the emotional tools and the altered perspectives you need to successfully move forward  and live your life without medication.  Sometimes this takes time and concerted effort in psychotherapy.  But rest assured, it is possible.