Those who are new to counseling, it’s completely normal to feel anxious and maybe even leery about counseling. The idea of talking to a complete stranger about your personal life—how weird is that?! After the first session or two you should feel more relaxed as we get a better understanding of one another in the therapeutic relationship.
Here are a few common questions I am asked to help give you a better idea of what you can expect with counseling:
What are appointments like?
Before your first appointment, necessary forms will be emailed to you for you to read at your leisure and fill out at home to bring in to your appointment. This saves you time in the office and allows me to see more clients. Each type of counseling will include an intake assessment that last approximately 60 minutes. The appointment is largely focused towards asking questions about your history and current situation to get the best picture of what needs to be worked on and what you would like to gain from treatment.
For couple and marriage counseling, I will meet with partners together for their first 55 minute appointment. We will discuss issues and goals for therapy. Then each person will have their own separate 60 minute intake appointments, which allows for them to talk at length about themselves, their past, present, and share who they are as an individual. Having separate intake appointments also allows people to discuss concerns they have that they are not quite ready to share with their partner, but would like assistance with. At times partners will be given paperwork at the initial appointment to take home to fill out and bring back with them at their intake.
Family counseling will require an "identified client." This person will have the intake assessment and insurance will be billed under them. For example, if a teenager on probation is court-ordered for family counseling, the teenager would be the client. Other family members could participate as appropriate to accomplish the family's goals. If you are requesting to have more than one child seen individually in addition to family sessions, each child would require their own intake assessment.
How often and for how long will I be seen?
Counseling is generally scheduled once a week, but can vary based on your needs, availability, and financial situation. After the intake, most appointments are about 55 minutes, or a typical “therapy hour.”
The duration of counseling is never the same. You may feel better after only a few appointments and believe that is enough. Depending on what you wish to work on in therapy, it may take months or even years to feel it is completely resolved. Please know that if I feel you are not making progress in sessions with me, or you think you and your family are not making gains from treatment, I encourage you to express that to me. We can discuss the option of adjusting my therapeutic approach or referring you to another professional. It is an ethical responsibility, and you deserve the best treatment available.
Will my insurance cover appointments?
Almost all insurance will include coverage for mental health services. There are a few that I am unable to bill (Medicare, Tricare, and Straight Medicaid; a.k.a. Fee-for-Service). Medicaid HMO’s, such as McLaren, will only cover 20 sessions in a calendar year. Many private insurances, such as Blue Cross and Priority Health do not have a limit to how many appointments they will cover as long as it is deemed “medically necessary.” Blue Care Network will require prior authorization (I handle on your behalf) and authorize only 20 sessions at a time, but may cover more than that if they deem it is “medically necessary.” Co-pays, deductibles and coinsurance benefits will affect what you may be responsible to pay out of pocket.
When in doubt, simply call the customer service number on your insurance card and they can explain your benefits in more detail. Insurances will not pay for marriage counseling as there is no code for that service to even try to bill them for. Services can be covered with family or individual psychotherapy.
Do I need a referral from my doctor?
No, formal referrals are not required. Typically the only insurance that requires any prior approval is Blue Care Network. Your primary care physician could make a referral that creates a prior authorization or I can obtain one prior to the first appointment.
If I have a co-pay and have a family appointment, do we pay that per person?
You will only pay the co-pay once as the service is only billed once.
How does the payment plan work?
You would be asked to keep a valid credit or debit card on file and we would reach an agreement of how much you would pay each week or every-other week. After signing the agreement, the card would be charged the amount on the designated days until the balance was paid off in full. If the balance gets too high, I may request to adjust the plan. Failure to make payments or keep appointments can void the payment plan. This is not a fee-scale. The full fee does apply, you are simply spreading out the payments.
Do you prescribe medications?
No, I am not a medical professional capable of prescribing. When necessary I have consulted with doctors to inform them of accurate diagnosis so the medical provider could then prescribe for the appropriate symptoms.
What is the difference between counseling, therapy, and psychotherapy?
In short, nothing. They all mean the same thing. With Michigan Law, only Licensed Professional Counselors (LPC’s- the letters after a person’s name) can say that they provide “counseling.” That leaves Social Workers (LMSW), Psychologists (LLP or PhD), and Marriage and Family Therapists (LMFT) to use the phrase “therapy.”
The term “psychotherapy” has more to do with billing insurance. The American Medical Association uses the phrase counseling and therapy in many more situations than those in the mental health field. Someone could receive speech therapy, occupational therapy, nutritional counseling, or physical therapy to name a few. When billing insurance, the wording used is “psychotherapy.”