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"The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only in such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.
– M. Scott Peck

What to Expect During Your First Session

Chrysalis Counseling CenterIf you are visiting this website, you are likely feeling very strongly that there is something that you could use some help with. Whatever the issue is, seeking out support is one of the first steps you can take to help resolve that problem or issue. That is why people seek my services. They have something about their lives that they want to change.

Psychotherapy will provide you with a more balanced view of what is causing you concern or pain, allowing you to be heard and feel supported. It will help you recognize and utilize your strengths, and teach you tools to make changes and achieve your goals.

During the initial phone call, prospective clients provide a brief overview of what is bringing them in for services. This allows me to ensure that my training and experience is well matched to the caller's presenting issues. In the first meeting we begin a comprehensive evaluation so that I can get a clear picture of your unique history, life experiences, and current concerns. This can take from one to three sessions. With this information, we will create a plan together to achieve your goals. During this initial evaluation I will take a lot of notes to help me remember details, but as we continue to meet this will lessen.

I realize that many people have never attended a therapy appointment before. You may be nervous, and have many questions about your treatment. This is a typical reaction, and you are not alone in these feelings. In the first few minutes of the session we will discuss policies so you know what to expect. Once these logistics are out of the way, I want to really learn what you are experiencing, and what may be troubling you. This is your time to voice your concerns, fears, and ask questions.

Please note:
For clients with children, be advised that young babies in arms are welcome in sessions. Please make reliable childcare arrangements for toddlers and older children. This allows clients to make the most out of their time with their therapist, and also prevents children, including little ones, from being exposed to the personal and sensitive information that is often part of the therapeutic dialogue. Your understanding and cooperation is very much appreciated.

Fee Schedule and Session Options

Counseling fees are as follows:

  • $270.00 for initial evaluation appointment
  • $135.00 for 45 minute therapy session
  • $180.00 for 60 minute therapy session
  • $225.00 for 75 minute therapy session

Sessions can be tailored to best meet a client's individual needs and preferences. Rather than the more typical 45 minute weekly session, some clients prefer a 75 minute session weekly or every other week. Others may prefer two 45 minute sessions each week. Feel free to request different scheduling options, and together we can determine what will work best. In the event that you are using insurance to pay for treatment, it should be noted that insurance companies typically only cover standard 45 minute sessions.

Other services may be available for clients, as are professional training opportunities focusing on perinatal mental health. A comprehensive list of fees for all services is included in the new client intake packet provided for your initial evaluation appointment.

Payments

Carefully Consider the Choice to Use Insurance

Payment of all treatment fees and other costs incurred in the therapy setting is the responsibility of the client. I have chosen to contract directly as a Preferred Provider with a very limited number of insurance companies. As a Licensed Mental Health Counselor, oftentimes other insurance companies will reimburse clients for a portion of my services as an out-of-network provider.

However, even if an insurance company agrees to pay for mental health services, I caution clients to think carefully about it. By leaving insurance out of the equation, I am free to provide the services that I clinically determine to be in a client's best interest, and am not constrained by insurance industry rules that limit services or interventions that I might otherwise be able to offer. There are no restrictions when paying privately in regards to the manner in which we hold our sessions–in person, via Telehealth, or by phone–which can greatly increase convenience for some clients, and new parents in particular. When paying for services privately, you also have the right to instruct me, for the sake of safeguarding your privacy, to keep limited records in therapy. If you were to use your insurance, you forfeit that right. My commitment as a therapist is to make every effort to protect the confidentiality of your personal information, and anything that you choose to share with me. For these and other reasons, my preference is always to provide psychotherapy services on a private pay basis, so that I am not bound by contractual obligation to company policies impacting services I might provide or access to my client records.

I encourage you to read the article Why Wouldn't I Use My Insurance Benefits to Pay for My Therapy? by Judy C. Roberts, former Ethics Consultant for the Washington Mental Health Counselors Association. This is a brief overview of things that should be considered when making an informed decision to use insurance benefits to pay for therapy.

Insurance Coverage (in-network and out-of-network)

I am a contracted provider with Premera Blue Cross, LifeWise, and Regence. My counseling fees are also covered by many of the Blue Cross/Blue Shield PPO plans. As exceptions do occasionally occur, typically due to third-party behavioral health benefit subcontracts, please make certain to contact your insurance company directly to verify coverage. A Pre-Visit Insurance Worksheet can be downloaded, if desired, to assist you in this process.

My office will bill the above primary insurance companies as a courtesy to clients. Please note that only primary insurance plans can be billed. Secondary claim submittal is the responsibility of the client and should be handled per the instructions of their individual insurance company. Upon request, a superbill will be provided to the client for use in submitting secondary insurance claims.

Other insurance companies will frequently reimburse clients for my services as an out-of-network provider. This typically ranges somewhere between 50-80% of their determined reimbursable rates for counseling services. If this is the option chosen, I will provide a receipt for the session, which may be submitted by the client to the insurance company for direct reimbursement. In these cases, it is the client's responsibility to pay for the session fees in full at the time of service. Clients will need to contact their insurance company to assess the level and conditions of coverage, if any, as individual plans vary.

Regardless of the ultimate choice to pay privately or to use insurance benefits, the client's portion of payment is always due at the time of service. Cash or check is the preferred method of payment, with debit and credit (MasterCard and Visa) available upon request.

Please note that sliding scale sessions are not available at this time.

Cancellations

Chrysalis Counseling CenterI do my best to run my practice on schedule, so you can therefore expect your appointment to start and end at the prearranged time. In the event that you arrive late for your appointment, that slot will be held for you for up to 20 minutes before the session is considered to have been missed. If you arrive within that 20 minute window, you will be seen for any time that is remaining, but lost time cannot be made up at that visit. If you expect to be late, please let me know as soon as possible by way of voicemail.

Please note that each appointment is reserved exclusively for a specific client. Due to the time commitment made to you in reserving an appointment, I ask that you kindly provide at least a 24 hour advance notice of cancellations, or I must charge you the full amount for the appointment reserved for you ($135.00 for a 45 minute session, or as applicable for any variant of the standard session time that was scheduled). These fees are payable in full at your next appointment. Missed sessions cannot be billed to insurance companies, and are therefore the responsibility of the client. Voice mail is available 24 hours a day in the event that an appointment needs to be rescheduled. This is not intended to be punitive, but is rather a way of protecting my time, keeping my business operating effectively, and allowing those currently waiting for appointments the opportunity to schedule.

How Will You Know When Therapy is Over?

There are several things we will look for to decide when we are ready to conclude our work together in therapy. First, we want to know if the goals you established have been met. Did you accomplish the goals you expected to? Did we accomplish goals that you did not initially expect, but that are now benefiting your life? If so, we will begin to work toward the end of your therapy. I will provide you with many opportunities to practice the "what-ifs," and to demonstrate how much you have learned and gained from treatment. Together we will process the end of therapy, with the awareness that my door is open to you should you find the need arises to return for additional work in the future.

 
by Judy C. Roberts,
MA, LMHC
 
© Chrysalis Counseling Services PLLC. All Rights Reserved.
Information may not be copied and reprinted without permission of the author.
Chrysalis Counseling Services PLLC | Juliana K. Tyler, MA, LMHC, NCC, DAPA, BCPC, CMHS, HBCE, HBFE | Psychotherapist
Certified HypnoBirthing® Practitioner and HypnoBirthing® Fertility Educator, affiliated with the HypnoBirthing Institute
627 5th Street, Suite 201, Mukilteo, WA 98275 | 206.604.0996 | juliana@chrysalis-counseling.com