I’ve tried couples therapy before and all we did is argue in front of our therapist. Should I try again?
Yes. A well-trained therapist will help you have a new communication experience, one where you feel fully heard by your partner. Your therapist should not allow you to get stuck in the painful patterns of circular arguments. Our couples therapists have the training and skills to accomplish this goal.
If faith is important to us, can that be part of couples therapy?
Whether you have a faith background or not, our goal is to match you with a counselor who can serve you as a trustworthy resource for professional, loving, non-judgmental care. If spirituality is important to you, several of our therapists are well equipped to integrate that into your therapy but would not do so without your explicit request. If this is of interest to you, please discuss this with your therapist before you get started.
What's my first step?
Click on the "contact us" button and we will reach out to you within 24 hours. We would love to hear from you!!
Will talking make things better or worse?
You're probably asking this question because you've struggled to have productive conversations with each other.
Our therapists work really hard to help you constructively handle reactivity, defensiveness and negative emotions. You will learn a highly structured way to talk that will feel completely different and emotionally safe. We will help your conversations shift from a battleground to a comfortable and productive place to connect.
Can we really solve our problems?
Research shows that on average couples endure six years of marital distress before seeking counseling. Nonetheless, therapy is very effective in dealing with long-standing problems by helping you try something different (as opposed to just trying harder). No matter how long you have been struggling, if you are willing to try and receive solid guidance, you can overcome your struggles and feel good about the compromises and trade-offs that you make for your relationship.
What do couples talk about in Couples Therapy?
Communication: The most common place couples start with in therapy is communication. Sometimes the hardest thing about talking is making a safe space for it. If you’re both feeling tense about a subject or it’s sparked painful fights in the past, the couple will avoid tough topics like the plague.
We help couples start from a position of acknowledging each other’s needs. This allows for a calmer and more respectful discussion. You will practice active listening, which many couples are well aware of, but is so often overlooked. Active listening means really taking on board what the other person is saying, without getting distracted or caught up in your own train of thoughts.
Once basic communication skills are being practiced, couples talk about some of the issues that have been bothering them, sometimes for years. Applying the new skills to tough issues will give the couple confidence that they can resolve tough issues and still feel close.
Loss of Intimacy: After years and sometimes decades, many couples drift apart and begin feeling like roommates. The emotional connection fades and the sexual fires go out. Although they still care for each other and have built a history together, they don’t know how to restart the fire. A CRC couples therapist can guide them in rediscovery of the way back to emotional and physical intimacy.
Trust: Trust may be the most important pillar of a healthy relationship. It’s the thing that allows two people to open up to one another, feeling confident that they can share their most authentic selves without fear of judgment or shame. Sometimes it is threatened or destroyed when one person does something that feels to the other like a betrayal—a lie, an affair, or hiding something crucial from the other person.
If you struggle with trust in your relationship, you probably know that it can take a real toll on your happiness. But if you’re willing to enter into a process of understanding, accepting responsibility, forgiveness and reconciliation, you can save a relationship with trust issues and begin to move forward together.
Premarital Counseling: Congratulations! You’ve found someone you want to accompany you through life. You’re on your way to happily-ever-after; however, you are wise enough to take the journey into premarital counseling to ensure your marriage is starting off on a solid foundation. The therapy is customized to each couple but the usual topics include:
Establishing a safe and open space to talk about your expectations for your future together
Learn good communication skills
Explore your relationship patterns and how they can work for or against you
- Understand each other's family and how that influences how they will show up in a marriage
Other Common Issues: No matter who you are with, there will be some areas of life that are difficult for you. If you were with a different partner, you would probably fight about different topics. In couples therapy, you learn how to resolve these differences in ways that feel bonding, not separating. These areas might include:
Discuss the stages of marriage and be prepared to thrive in each one of them
Get alignment around important life values
sexual preferences and connection,
inlaws and extended family,
faith and spirituality,
core values, and
vision for the future
I think we need some outside help, but I fear that my partner will not be open to the idea of therapy.
Often people are reluctant to try couples therapy because of a concern that they will be blamed for all the struggles in the relationship. Our therapists do not allow the blame game happen. Instead, our goal for couples’ work is actually the opposite. In therapy, you’ll learn that there is something that is not functioning within the “system” of your relationship and not exclusively with either of you as individuals. With our help, you and your partner will learn how to identify what’s keeping you from communicating with respect and compassion. You will also learn concrete skills to shift the patterns that are keeping you feeling stuck and isolated.
If your partner still refuses to attend, individual therapy with a focus on the relationship can be effective – though probably not as much. Understanding your own issues and learning some tools to help improve communication can lead to a healthier and more fulfilling relationship. And, your commitment to healing through therapy may inspire your partner to be curious. You may invite him to attend a session to try meet the therapist and give it a try.
What about the DATA SECURITY of your notes and information about us?
SESSION NOTES AND BILLING RECORDS: We take the data security of your personal information extremely seriously. Everyone in our practice uses an established software platform called Simple Practice for session notes, billing, your contact information and scheduling. Simple Practice follows industry best practices (HIPAA compliant) to ensure that your personal health information is kept secure. You can read more about their security process at:
EMAIL / MESSAGING: If you send an email directly to one of our therapists, the data is only as secure as your email provider so please use extra caution. Use of regular email (such as gmail) is usually not HIPAA compliant. Simple Practice has a
secure messaging system which has extra security and is HIPAA Compliant. Feel free to request for your therapist to activate this messaging platform.
VIDEO CONFERENCING: Different therapists use different video conferencing platforms. No system is risk free but our therapists use market leading solutions (Zoom, Doxy.Me...) that have incorporated security procedures.
What about REMOTE / VIDEO therapy?
Since Covid began, the majority of sessions have been on-line. The surprising discovery is that it works GREAT for couples because they are still in the room with each other. Intimacy is possible! And this saves the hassle of fighting traffic and getting a sitter if you have kids.
Here’s what works best for video therapy:
For our video session, if possible, arrange the computer so that you can sit in two separate chairs and both be seen by the camera. During therapy, you will sometimes have the chairs pointed to your therapist and sometimes to each other. Using chairs works better than sitting on a couch.
Please make sure the microphone can pick up your audio clearly when you are talking to each other in the chairs. If that is a problem, you can call into Zoom with your cell phone AND still use Zoom for video.
SECURITY: Please be aware that using video introduces security risk. You should make sure that your computer has the latest security software. By engaging in video therapy, you are agreeing to accept these risks.
How do you handle PHONE CALLS between sessions?
VOICEMAILS: If you need to contact your therapist between sessions, please call her or his phone number and leave a voicemail message. Your therapist is often not immediately available; however, she or he will attempt to return your call within 24 hours.
Please do not include clinical and/or personal content in voicemails. It is preferable for you to journal your thoughts and bring them to your next session. If you need a session sooner than the one scheduled, please let your therapist know.
If an emergency situation arises, please do not leave a voicemail. Please immediately call 911 or any local emergency room. Our therapists do not offer crisis counseling or emergency services.
Can we send EMAILS and TEXTS to you between sessions?
It is tremendously helpful for you to work through your feelings and thoughts between sessions. That is an important part of healing. Often, as clients are processing these thoughts, they send emails or texts with questions that they want to ask or thoughts that they just want to share. Because of this, we have set the following guidelines for emails and texts between sessions.
ADMINISTRATIVE EMAILS: It is fine use email and texts for administrative items such as changing appointments. You can also use the secure messaging in the client portal.
COPY PARTNER: If you do send an email or text and are in couples counseling, please always copy your partner. This helps us maintain trust.
EMERGENCIES: Please do NOT send an email or text for emergency situations. In those cases, you need help that can respond immediately. your therapist is not always available and can NOT be counted on to support you 24 hours a day. The best approach is to call 911.
CLINICAL MATTERS: Even though your therapist deeply cares about you and your situation, please do not send emails with thoughts about what happened in therapy, background on your personal lives, or other matters related to our clinical work together.
This information is better processed by discussing it in session because your therapist can:
fully experience your tone of voice and body language,
ask questions to help clarify what may be unclear,
explore your concern with your partner in real time,
avoid giving you poor counsel based on limited text information, and
BRING THOUGHTS INTO SESSION: We generally recommend that you journal or write an email to yourself and then, when in session, read it out loud in session. This is a great way to prepare your thoughts and then have a robust discussion. If you need to discuss or resolve an issue before our next scheduled session because it is time sensitive, it is best to schedule an extra appointment.
ONE-PARTNER SESSIONS: If you need to communicate something that you do NOT want your partner to hear, please let us know this and we can schedule a special session. See the FAQ about one-partner sessions.
SPECIAL EMAIL COUNSELING: For some couples, the situation is such that the couple needs or benefits from significantly more between-session support. In such cases, we will read and respond to emails between sessions; however, both partners must consent to this and your therapist must approve this "special email counseling" in advance.
With some couples, one partner (who writes a lot) can flood the other partner (who does not feel comfortable with processing through text). In such cases, email counseling is not advised.
When we agree to special email counseling, I bill the time spent separately.
PRIVACY: Lastly, please know that electronic communications, even ones just sent for administrative purposes, can never be guaranteed to be 100% secure. If you send an email, please do so knowing that you are willing to accept the risk of a breach of confidentiality.
FINAL WORDS: It is difficult for me to turn away from your heartfelt communications because we really do care. Please know that our policy is aimed at healthy boundaries and setting up a safe place where you can both feel fully heard. After serving many couples, our experience has taught us that this approach ultimately leads to better healing for you. Please accept our heartfelt apologies if this policy hurts your feelings in any way!
avoid getting caught in the middle.
Will you connect with me on SOCIAL MEDIA?
Our therapists do not accept friend or contact requests from current or former clients on social networking sites (Facebook, LinkedIn, Instigram, etc). Adding clients as friends or contacts on these sites could compromise your confidentiality. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up in session so it can be discussed further.
Will CO-PARENTING counseling be used for the legal system to determine custody?
No. Co-parenting counseling is designed so you do NOT have to rely solely on the legal system. The goal is for both parents to treat each other in a clear kind way so you create the best experience possible for your children. When the legal system is heavily involved, this usually means that one or both parents are struggling emotionally.
Your therapist‘s role in co-parenting counseling does NOT include an evaluation of parenting abilities of either parent. If one of the co-parents determine at any time that we are unable to work together to meet the establish goals of our sessions, please discuss this so we can reset our goals or end therapy.
Your therapist understands that she or he has been given no authority by the court. Therapeutic sessions are not intended to be used for litigation purposes. All parties agree not to call your therapist to serve as a witness in any litigation that currently is in process or in any future litigation unless prior written agreement is made with your therapist.
If you need a custody evaluation, we usually recommend Dr. John Orlando, PSYD, MFT (408-295-5050).
May I bring my BABY into the therapy session and may I leave my CHILD in the waiting room?
Waiting room - 12 and over:
You may bring your child to the waiting room if your child is 12 years old or older and is capable of remaining in the waiting area, without disruption, for the parent's full session time. Please know that responsibility for all aspects of the child's behavior rests solely with the parent, as does responsibility for the safety of the child. There will not be any staff or supervision available to assist your child if he or she is in distress or to prevent him or her from harm.
Waiting room - under 12:
Due to the risk of injury and possibility of disruption to the care of other patients, all children under 12 years old in the waiting room must be under the direct supervision of an accompanying adult at all times.
Infants in therapy room:
Couples therapy is generally not a place for your baby or toddler. Rather, it's a place free of distractions where a couple can focus on each other and learn how to get their needs met. Over the long term, this will better equipped the couple to meet the needs of their child. Your therapist may make exceptions if the couples session is focused on how to interact with the child; however, this should be discussed well in advance.
What about the CONFIDENTIALITY of what is shared in sessions?
Please understand that, in the world of psychology, confidentiality refers to protection of information shared with a therapist from being shared with third parties without the client's express consent.
Privacy, on the other hand, refers to the legal protection of personal medical information from being shared on a public platform.
I will discuss "confidentiality" below.
The session content and all relevant materials to the client’s treatment will be held confidential unless the client requests in writing to have all or portions of such content released to a specifically named person/persons. Limitations of such client-held privilege of confidentiality exist and are itemized below:
1. If a client threatens or attempts to commit suicide or otherwise conducts him/her self in a manner in which there is a substantial risk of incurring serious bodily harm.
2. If a client threatens grave bodily harm or death to another person.
3. If the therapist has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional or sexual abuse of children under the age of 18 years.
4. Suspicions as stated above in the case of an elderly person who may be subjected to these abuses.
5. Suspected neglect of the parties named in items #3 and # 4.
6. If a court of law issues a legitimate subpoena for information stated on the subpoena.
7. If a client is in therapy or being treated by order of a court of law, or if information is obtained for the purpose of rendering an expert’s report to an attorney.
Occasionally, your therapist may need to consult with other professionals in their areas of expertise in order to provide the best treatment for you. Information about you may be shared in this context without using your name.
UNPLANNED MEETING WHILE IN PUBLIC:
If you see your therapist accidentally outside of the therapy office, your therapist will not acknowledge you first as this may inadvertantly inform others of the therapeutic relationship. Your right to privacy and confidentiality is of the utmost importance to us, and we do not wish to jeopardize your privacy. However, if you initiate contact with your therapist first, she or he will be more than happy to speak briefly with you. Nonetheless, your therapist will not engage in lengthy discussions in public or outside of the therapy office as the discussion may be overheard and put your privacy at risk.
COACHING vs PSYCHOTHERAPY:
The above confidentiality and privacy framework addresses psychotherapy. If you are receiving coaching, the rules differ slightly and are explained in the coaching intake form.
When will you share our PERSONAL MEDICAL INFORMATION (PMI)?
Confidentiality refers to protection of information shared with a therapist from being shared with third parties without express consent.
Privacy, on the other hand, refers to the legal protection of personal medical information from being shared on a public platform.
The information below refers to
privacy of "personal medical information."
California law protects the privacy of our relationship such that information cannot be disclosed without your written permission. There are however some exceptions. Below you will see the privacy practices disclosure form which you will be asked to agree to during the intake form process. If you have any questions about any of this, please ask your therapist.
PLEDGE REGARDING HEALTH INFORMATION: Your therapist understands that health information about you and your health care is personal. Your therapist is committed to protecting health information about you. Your therapist creates a record of the care and services you receive from me and needs 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.
Your therapist will:
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.
Your therapist can change the terms of this Notice, and such changes will apply to all information maintained about you. The new Notice will be available upon request.
HOW YOUR THERAPIST MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:
The following categories describe different ways that your therapist may use and disclose health information.
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, your therapist may disclose health information in response to a court or administrative order. Your therapist 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.
CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
Psychotherapy Notes. Your therapist maintains “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: 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.
Marketing Purposes. Your therapist will not use or disclose your PHI for marketing purposes.
Sale of PHI. Your therapist will not sell your PHI in the regular course of my business.
CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION. Subject to certain limitations in the law, your therapist can use and disclose your PHI without your Authorization for the following reasons:
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.
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.
For health oversight activities, including audits and investigations.
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.
For law enforcement purposes, including reporting crimes occurring on my premises.
To coroners or medical examiners, when such individuals are performing duties authorized by law.
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.
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.
For workers' compensation purposes. Although my preference is to obtain an Authorization from you, your therapist may provide your PHI in order to comply with workers' compensation laws.
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.
CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.
Disclosures to family, friends, or others. your therapist 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.
YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:
The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask your therapist not to use or disclose certain PHI for treatment, payment, or health care operations purposes. Your therapist is not required to agree to your request and may say “no” if your therapist believes it would affect your health care.
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.
The Right to Choose How PHI is Sent to You. You have the right to ask your therapist to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and your therapist will agree to all reasonable requests.
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. Your therapist 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 your therapist may charge a reasonable, cost-based fee for doing so.
The Right to Get a List of the Disclosures Made. You have the right to request a list of instances in which your therapist has disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. Your therapist will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list will include disclosures made in the last six years unless you request a shorter time. Your therapist will provide the list to you at no charge, but if you make more than one request in the same year, your therapist will charge you a reasonable cost-based fee for each additional request.
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 your therapist correct the existing information or add the missing information. Your therapist may say “no” to your request, but will tell you why in writing within 60 days of receiving your request.
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.
VENUE AND GOVERNING LAW: This Agreement and all acts and transactions pursuant hereto and the rights and obligations of the parties hereto shall be governed, construed and interpreted in accordance with the laws of the State of California, without giving effect to principles of conflicts of law. In the event a Federal or State action is brought to enforce or interpret this Agreement, the parties submit to the exclusive jurisdiction of the courts of the State of California, and agree that venue for any such action shall be in Santa Clara County, California.
EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on 8/5/2019
Acknowledgement of Receipt of Privacy Notice
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By checking the box below, you are acknowledging that you have received a copy of HIPAA Notice of Privacy Practices.
Insurance / Fees
How does insurance work?
We have tried to cover answers to all the insurance questions that we get from clients. If we missed something, please do not hesitate to ask your therapist.
We have chosen to remain an
“out-of-network” provider for all insurance companies. In our experience, this allows us to provide a higher quality of care, independent from insurance-based rules or decisions.
It is your choice whether you would like to apply for insurance reimbursement or not. If you decide to do so, we provide a “super-bill” to you which includes the standard information (such as diagnosis and treatment codes) that most insurance companies require. You then submit the super-bill to your insurance company for reimbursement.
Please note that we do NOT fill out any forms that are created by your insurance company and do NOT correspond directly with them in any way.
PAYMENT, INVOICES, AND SUPERBILLS
Also, please note that:
Payment for therapy is due when the therapy takes place. Using our online system (called Simple Practice), your credit card will be charged automatically at midnight on the day of your session.
You will automatically receive a
monthly "invoice for services" on the 1st day of the month for appointments during the prior month. This invoice will NOT have a diagnosis and other information necessary for submission to your insurance company.
You can request for a
monthly Superbill as well, which can also be automatically generated on the 1st day of the month for the prior month's appointments. This will have all the appropriate insurance documentation. Some clients prefer to request the Superbill as needed or once per year. Also, some clients chose not to submit to the insurance company in which case a Superbill will NOT be created.
DIAGNOSIS IN COUPLES THERAPY:
For couples therapy, most insurance companies will reimburse for therapy involving two people if one person has been given a diagnosis. We should have a discussion to make sure the appropriate partner is provided with a diagnosis. Your therapist will be able to discuss this with you in advance of making an official diagnosis.
You can log into the online portal and download your invoices and/or Superbills at your convenience.
QUESTIONS TO ASK YOUR INSURANCE PROVIDER:
To find out more about your coverage, call your provider, get the name of the person you are speaking to, and ask the following questions:
HSA AND FSA ACCOUNTS:
Many clients have been successful in utilizing a Health Savings Account (HSA) and/or Flexible Spending Account (FSA) for reimbursement of accrued therapy expenses. Please note that the superbill as discussed above can serve as documentation for your FSA or HSA.
LOWER FEE OPTIONS:
We understand that financial concerns or limitations in your insurance coverage may lead you to use an in-network provider. Also, there are local non-profit agencies that provide low-cost counseling services. Some good sources for finding out about these services are NAMI and Open Counseling.
Does my policy cover out-of-network outpatient psychotherapy?
CPT CODES: If yes, what is the reimbursement for out-of-network psychotherapy services for the following CPT codes: 90834, 90837, 90847.
What is the reimbursement rate for
telehealth CPT codes, 90834-95, 90837-95, and 90847-95?
Your insurance company should understand what a “CPT code” is, and whether they reimburse for these specific codes.
Is there a maximum number of psychotherapy sessions for which they will provide reimbursement?
DIAGNOSIS CODES: Will the insurance company reimburse for the diagnoses which you have discussed with your therapist?
% REIMBURSED: If your insurance company reimburses a percentage of the cost, what is that percentage, and what is the maximum cost per session they are allowing? For instance, they may reimburse 70% of a psychotherapy session (CPT code 90837), but assume that the maximum rate of the psychotherapy session is only $120 (instead of my actual rate). This would mean the client would be reimbursed $84 per session. Another insurance company, however, may only reimburse 50%, but allow a $250 hourly rate, meaning that the client would be reimbursed $125 per session. Thus, it is important to understand both the reimbursement percentage and the maximum per-session rate allowed.
Is a doctor’s referral required and/or is pre-authorization required? What is the name and number of the person to be contacted for pre-authorization?
DEDUCTIBLE: Is there a deductible and how much is it? Is it a yearly deductible? How much of the deductible do I have left over to meet?
ADMINISTRATIVE: What is the address of the office where I should send my claims? To whose attention is the claim to be sent?
We’d like to try therapy, but I am not sure that it’s financially viable right now.
Ask yourself if your marriage is worth fighting for. Also ask yourself what the emotional costs of your ongoing conflicts have been to each of you as well as your family and friends. Your marriage may be the most important relationship of your life. What is the value of feeling and interacting more lovingly, effectively and respectfully now and in the long-term? This is your significant relationship, which radically impacts your life and your wellbeing. Getting help to communicate with your partner in more effective and lasting ways may be one of the best investments you can make.
How much does this cost? Is it worth it?
Depending on your therapist, our fees range from $140/session to $300/session. Sessions last 50 minutes.
The majority of couples are in therapy weekly for a month or two and then attend every other week for two more months. The majority usually end up spending from $1,000 to $5,000 on counseling depending on how much help is needed.
To help put the cost of couples counseling in perspective, it is difficult to buy something for $5,000 that will give you the same quality of life that a healthy relationship provides. If you and your partner feel loved, respected and meet each other's emotional needs, you may be able to do without many other material things and feel much more fulfilled.
What if I am married and my partner REFUSES TO COME?
Even if your partner is not ready for change, you can work on yourself to stop the cycle of pain in your relationship. I often work with one partner in Couples Therapy for One. Our approach in "Couples Therapy for One" is different than in individual counseling where an individual counselor is solely focused on your happiness. Your therapist will be careful not to turn the non-present partner into a villain and will not to undermine a marriage by supporting a one-sided view of the marriage problems. Although your therapist will make her or his best efforts to support the emotional health of an individual client who is in distressed, he or she will hold a high regard for the welfare of the other spouse and the children—and for the lifelong commitment that the client once made to the marriage for "better and worse."
While in couples therapy, may I talk to you WITHOUT MY PARTNER PRESENT?
Our practice is to meet with both members of the couple together for the FIRST session. This has the benefit of establishing the "relationship" as the client and the top priority.
With that said, after the first session, your therapist may:
have a session with one partner alone, but for short periods or for a discreet purpose, and/or
To do so, the partner not attending the session must consent to the individual session in advance. Usually, we accomplish this by giving verbal consent during a couples session or by having the non-attending partner consent by email. This allows us to MAINTAIN TRUST so your therapist can be an effective couples counselor for you.
The typical reasons to meet individually are:
talk on the phone with one partner.
Practical considerations such as travel, childcare or sickness make it difficult or impossible for one partner to attend. In such cases, it may be helpful for the other partner to use the time to work on his or her issues with me. Sometimes progress is made when a partner feels free to talk openly.
Valuable information can be gathered regarding each individual’s history and the individual's commitment to the relationship and to couples therapy.
The individual may be able work on his or her own issues in a less triggering environment so he or she can be more open and less reactive when together. your therapist will only do this for a limited amount of time, usually 2 to 5 sessions.
There are topics which may feel scary to discuss in front of a partner so it may be wise to get your therapist's help on how to express yourself more skillfully or with more tenderness.
Both partners feel stuck in the couples work and decide they need to grow individually so that they can come back together in a healthier way. In such cases, the best course of action is for each partner to find their own individual counselors; however, be careful as some individual counselors, in an attempt to bond with you, may unintentionally demonize the other partner. Alternatively, some couples wish to alternate seeing your couples counselor individually at their regular time of their couples sessions. This will be limited in time (2 to 5 sessions) and should be viewed as an interim step to returning to couples work.
A partner may be considering ending the relationship and need to discuss it without the partner present. Your therapist will help you process your thoughts and carefully weigh your options but will not tell you what to do. Also, your therapist will not share your thoughts on this matter with your partner. If your therapist become aware of domestic abuse or an active affair, he or she would suspend therapy.
To be clear, your therapist can not be one partner’s individual therapist and your couple counselor at the same time.
If you have significant areas of growth that you want to work on in yourself, your therapist would be glad to recommend several excellent individual therapists for you to consider. In this case, if the couple agrees to it, your therapist would consult with that therapist to coordinate individual and couple treatment so they complement each other.
You should be aware that the partner who is not in the individual session may feel left out, anxious, or mad. If that happens, it is a good idea to share those feelings in your next couples session. If, at any time, either partner feels an imbalance in my time and/or support, please tell your therapist. Such feelings could derail therapy, especially if they do not get tended to. It may also be appropriate for your therapist to meet with the other partner so the therapy remains balanced.
What if I tell my therapist a SECRET during a one-on-one session?
After we meet individually, your therapists will NOT share secrets that you tell me in an individual session in a later couple session. It is healthy for you to communicate directly with your partner (not through your therapist).
In very special circumstances, secrets have to get dealt with by the couple and may cause me to stop couple therapy. Your therapist will still NOT tell the partner. Again, that is your responsibility to communicate with your partner. The three criteria that are used to evaluate whether a secret shared individually will cause your therapist to suspend couples therapy are:
1) Is the secret information currently adversely affecting the relationship in a meaningful way? Examples of this would include an ongoing affair, undisclosed boundary violations, current domestic violence or current substance dependence.
2) Would the partner disclosing the information have a therapeutic benefit? For example, disclosing an affair that occurred 10 years ago without recurrence may only hurt the betrayed partner but not furthering the current relationship goals.
3) Does disclosing the information put one of the partners at risk for physical harm?
If the answers to these questions indicate that disclosure would have a net therapeutic benefit, your therapist will urge the partner to disclose the information and support him or her in doing so. If the partner refuses, after a brief period to consider appropriate disclosure (1 week typically), based on clinical judgment, your therapist may suspend treatment until the couple is ready to deal with the critical issue that is being held secret.
After couples therapy ends, can I see you as my INDIVIDUAL therapist?
We do not recommend that your couples therapist become your individual counselor after couples therapy because of the following reasons:
As a deeper therapeutic relationship is built during individual therapy, it would be difficult to return as your couples counselor in a balanced way. You may feel like you have to start over with another counselor. Yes, that is definitely a downside, but this is outweighed by keeping the couples therapy option open in case you and your partner wish someday to return as a couple.
It puts your couples counselor in a difficult position of choosing clients if both partners want to continue individually after couples counseling.
Nonetheless, we will gladly recommend other therapists with whom we work very closely. That way we can, with your written permission, thoroughly brief them so that we minimize the "start-over" experience.
Our focus is on helping couples and other therapists who focus on individuals may serve you better.
I betrayed my partner and need to do a Full Therapeutic Disclosure (FTD). Can I do that with you or do I need to find an individual therapist?
Our general recommendation is for the acting-out partner to select a qualified individual therapist to help you prepare the FTD and then present the FTD to the betrayed partner in the presence of a qualified couples therapist.
The benefits of using a separate individual therapist for FTD preparation are:
The benefits of using your couples therapist to develop the FTD are:
The acting-out partner can be completely honest with the individual therapist about everything, even details the betrayed partner need not know. The actingout party does not have to worry about the information leaking back to the betrayed partner through the couples therapist. The individual therapist can guide the partner on what is truly important to include in the disclosure.
The acting-out partner can feel fully supported by the individual therapist whereas the couples therapist is often splitting support between both partners. For example, when the couples therapist validates the anger of the betrayed partner, the acting-out partner can feel like the betrayed partner and couples therapist are ganging up on him/her.
Extra time must be spent with just the acting-out partner to develop the FTD. If this is done by the couples therapist, it can unbalance the couples work. If done by the individual therapist, the couples work remains balanced.
When the FTD is presented to the betrayed partner, it is easier for the couples therapist to remain neutral as he/she has not been involved in the FTD development.
The couple should weigh the factors above and agree on which course is best for you.
The couples therapist gets a deeper understanding of the background of the betrayed partner. This may help in the couples work.
This approach can save money, at least in the short term, as there is one less person to get up to speed on the background.
What’s The Difference Between Coaching & Counseling?
While coaching and counseling both provide a helpful relationship to support your wellness and growth, coaches and counselors can have significant differences in their training, their methods, and their goals.
Psychotherapy helps a client address and resolve symptoms which, in aggregate, impair her or his ability to function well in daily life. This can include symptoms related to Anxiety, Depression, Mood Disorders, Trauma, ADHD, Addictions and many other problems.
It is understood that unless and until these problems are resolved, it will be difficult for people to make significant improvements in their lives. Once they are feeling stronger and more confident, they can start taking action to change their circumstances.
To practice psychotherapy, the clinician is required to complete:
graduate level education,
licensure by the government (usually the state you reside in), and
thousands of hours of supervised training.
Coaching is focused on helping people "improve" their lives. The basic presumption of coaching is that coaching clients have a solid foundation in their mental and emotional health, and are not currently experiencing a diagnosable disorder.
With coaching, the client must be ready to receive guidance and instruction on how to make changes that will help them achieve their goals. The coaching work focuses on creating and maintaining motivation for change, exploring obstacles, and formulating a clear plan for an improved future.
Coaching is unregulated by governmental authorities; however, many certification programs are available. These programs are run by private companies or not-for-profit organizations. With or without a certificate, anyone can legally call themselves a "coach".
Psychotherapists can provide coaching but coaches can not provide psychotherapy.
Putting the difference into practice:
Sounds pretty straightforward, right? In reality, it is extremely helpful to have the psychological training to assess whether coaching is appropriate or not. It is unethical for a coach to attempt to help anyone who is dealing with depression, anxiety, mood disorders, or other recognized mental health problems. When working with clients, your therapist will make an assessment, usually in the first session, to confirm that you will receive the appropriate level of care.
All of our therapists operate under the laws in the state of California. If you live outside of California, you will be able to receive coaching but not psychotherapy.
Do you provide psychotherapy or coaching outside of California? And is coaching reimbursed by insurance companies?
Our therapists are only licensed to practice psychotherapy in California. Outside of California, they can only provide coaching services. Therefore, our services are available as follows:
As explained in the previous "FAQ", there are several differences between psychotherapy and coaching but one of them is that coaches can NOT provide a medical diagnosis while psychotherapists can do so. Since most insurance companies do NOT reimburse for services unless a medical diagnosis is provided by a psychotherapist, it is unlikely that coaching will be reimbursed.
Thus, coaching services are paid "out-of-pocket" and cost between $140/session to $300/session depending on the coach. Sessions last 50 minutes.
California: Psychotherapy or Coaching (dependent on your needs)
Outside California: Only Coaching
Can you explain your 48-hour CANCELLATION POLICY?
Your appointment time is reserved exclusively for you. When you must cancel, please give your therapist at least 48-hour notice. She or he is rarely able to fill a cancelled session unless notified at least 48-hour in advance. If you are unable to provide at least 48 hour notice, you will be charged the full fee for your session. Our heartfelt goal is to help you and we really dislike charging for late cancellations, so we hope you understand the need to do so.
EMERGENCY EXCEPTION: The only exception to this cancellation policy is a "true emergency". Some examples of true emergencies are car accidents, a death in the family, or both partners are sick. Although frustrating and painful, work issues and cancelled babysitters, do not constitute "true emergencies" in the context of this policy.
OPTIONS TO KEEP THE SESSION: If one person is sick, a child is sick, a babysitter becomes unavailable, or one partner is out-of-town, we can offer:
INSURANCE: Please note that late cancellations fee cannot be included for submission to your insurance provider. An active credit card must be kept on file during the course of therapy to ensure that payment for a missed session can be collected. The credit card on file will be charged following a missed or late-cancelled appointment.
BETTER RESULTS: Over years of practice, we have found that a clear and firm cancellation policy has allowed us to build healthy relationships with our clients and ultimately lead to better results for you in therapy.
to meet individually with one person of the couple to help that person work on his/her issues in a way that may benefit the couple.
What if I am LATE?
We understand that the Bay Area is often a traffic nightmare and that other factors (jobs, childcare...) may make it challenging to get to therapy on time. Since you make the effort to get to the session on time, we want to respect that effort and the value of your time; thus, we work hard to begin each session promptly at the appointed time so you don't have to wait. In order to make this system work, if you arrive late, your session will also end at the scheduled time.
On rare occasions, there are unavoidable emergencies on my end. If your therapist begins a session late for such a situation, your session will be extended to provide the full 50-minute session. Please accept our apologies in advance for such situations.
Neither you or your therapist are expected to wait longer than 15 minutes past the scheduled time for the start of the session unless there has been previous notice. If you know you're going to be late, please send your therapist a text to let her or him know.
How FREQUENT are sessions?
Most of our therapists will schedul an initial double session. Subsequent sessions will be at a regular time, typically weekly or every other week.
Depending on your situation, we recommend starting with weekly to build an understanding of the patterns in your relationship and to get to know you and then, when you are ready, moving to every other week. Having sessions every other week gives you more time between sessions to do the homework and practice what they have learned.
If your relationship is in crisis, we strongly suggest at least weekly. If you wish to supplement your recurring appointments, you can always add a one-time appointment.
We realize that weekly appointments can be a challenge for busy couples, especially if child care is required. This will take real commitment on your part but, hopefully, will help you transform your most important relationship.
When you feel you have made significant progress and are focused on applying the tools that you have learned, sessions typically shift to an "as-needed" basis.
What level of COMMITMENT is required for a RECURRING APPOINTMENT?
Therapy works best when there is commitment and consistency in your work in therapy. Your therapist understands that work, illness, travel and other commitments can be obstacles. If you miss 50% of our scheduled appointments in a 2-month period, your therapist will have a conversation to discuss your care to understand whether the issue is related to your timeslot, high external demands on your lives, an issue with therapy, or due to extremely unusual circumstances. If it is an issue with the progress with therapy, your therapist would love to know so she or he can help address the issue.
If you are unable to keep the regular appointments, it is best to shift to "as needed". For most of our therapists, you simply go to the on-line portal and book any upcoming opening. There usually are a few of these available due to cancellations by other couples.
Once we've made progress, can I see my therapist once in a while? What does WINDING DOWN therapy look like?
When you feel you have made significant progress and are focused on consistently applying the tools that you have learned, talk to your therapist. Usually, you will agree to shift sessions to an "as-needed" basis.
Most of our therapists do not schedule once-a-month sessions because it makes scheduling weekly and every-other-week sessions logistically difficult. If you are ready to see your therapist less frequently, such as on a monthly basis, then:
1) Tell your therapist that you are ready to go to "as needed" schedule. You may feel some anxiety about this but it is usually a time to celebrate your hard earned progress.
2) Your therapist will probably take you off of the recurring schedule.
3) For most therapists, yYou can book a session on the client portal whenever you want to do so. One-time openings are often available when clients on a recurring schedule cancel a session. Please note that you can only book an appointment two weeks beyond the current date.
Thank you in advance for working with your therapist on scheduling matters.