Frequently Asked Questions
Policies & Confidentiality
Have a question that's not here? Send me your questions through the contact page! I'll be happy to answer them!
It can be confusing at first. After all, we all deal with mental health one way or another! Here is a quick breakdown:
Psychologist: can be a PhD, PsyD, or EdD
Education: 2 year masters degree, 4-6 years for doctoral degree, 1-2 years full time internship.
What they do: A psychologist primarily focuses on assessment and diagnosis. Assessment typically includes Psychological Tests such as (but not limited to), personality tests, ADHD/ADD testing, Educational Testing/Evaluation, testing for intellectual disabilities etc. Many Psychologists focus on various types of research.
A Clinical Psychologist will additionally treat patients in a clinical setting (engage in therapy).
Psychiatrist: can be a M.D. or D.O.
Education: 4 years general medical school, 3-4 years of residency focusing on mental illness and medication.
What they do: Perscribes psychiatric medications. Does not engage in clinical therapy/counseling.
Social Worker: can be a MSW or LCSW-R
Education: 2 years graduate training, 900 internship hours not required to be clinical. The -R designation denotes psychotherapy privilage and this means they have undergone extra training (2-3 years supervised clinical work) to be able to engage in psychotherapy or mental health counseling. MSW's do not engage in therapy.
What they do:
MSW's - provide assistance, advocacy, referrals to individuals and families in a wide range of services. This can include, foster care, adoptions, public health issues, assisted living, medicare, medicaid, and more!
LCSW-R's - typically provide clinical therapy/counseling. They are trained to deal with all DSM V diagnosis, trauma, addictions, emotional problems, abuse, acute, chronic or terminal illness and more. Some LCSW-R's specialize in a specific area. They can also diagnose from the DSM V. They can also provide group counseling.
Mental Health Counselor: can be a MHC, MHC-P or LMHC.
Education: 2-3 years graduate training, 600 hours of internship clinical focus, 3,000 post graduate hours (= at least, 2 years of supervised experience - supervised by and LMHC, licenced psychologist, psychiatrist, psychiatric nurse or MD.) MHC-P's are in the process of completing their post graduate hours and do everything an LMHC does just with extra supervision.
What they do:
An MHC-P or LMHC is trained to help you identify and work on your mental health. They are able to diagnose and treat DSM V diagnosis and may specialize in a specific area. They can also provide group counseling.
Please note: You might notice in the media, online etc, that clinical therapy, counseling, therapy, talk therapy, and psychotherapy are sometimes used interchangeably. Generally this is okay. However professionally, there are differences in some of the terms.
Also note: there is a trend in the Mental Health Counseling world to do more than "talk therapy" and engage in using more hands on approaches using workbooks, art, books, and interventions such as EMDR to assist in the theraputic process. If you have any questions ask your Counselor/Therapist. They can help you find the therapy that is right for you!
No it doesn't! Just like we go to a dentist to take care of our teeth or get a check up from our primary doctor, we go to a counselor/therapist to get a check up or treatment for our mental health. We can all use some help dealing with stress, anxiety, depression, grief and loss etc. Sometimes we need help with more chronic or severe mental health diagnosis such as Bipolar Disorder or Schizophrenia etc. Having a chronic or severe mental health diagnosis might be compared to having a physical ailment such as Diabetes, cardiac issues or high blood pressure. You might need short term treatment or longer term treatment depending on your diagnosis. The point is, there is nothing wrong, weird or crazy about going to see a counselor or therapist! All kinds of people seek counseling for all kinds of reasons! Sometimes, it's because they don't know what's wrong!
PS - some counselors/therapists go see their own counselor! After all, we are human and need check ups too! Besides, if we didn't, it would kinda be like a doctor refusing to go for his own checkup!
I adhere to HIPPA guidelines and laws as well as professional ethics. I do not share your information with anyone! Unless you give me written permission to share information (and you tell me what is okay to share in writing) I can't even admit you're a client!
This means that your partner, kids, pastor, doctor etc...can't call and ask if you are a client or anything else without your permission!
Now, understand that there are exceptions to confidentiality.
If you tell me that you're hurting yourself, are hurting others, or being hurt by someone, then we have to do something about it. If at all possible we will talk about it first and then take action together.
I am bound by Mandated Reporter laws. If it's necessary for me to make a report, if at all possible, we will talk about it first and then take action.
I, and or your records, can be subpoenaed by a court of law. The subpoena must be submitted in writting as an official document and only then can I release the requested information as required by law. I do not and will not include or testify to anything not covered by a subpoena.
Please be assured that I hold myself to the highest standard when it comes to confidentiality. Your privacy is my priority!
Please note: If you are using insurance for any health or mental health related treatment, the insurance companies are allowed to obtain information for purposes of approving and billing/paying for treatment. If you have questions about this, please contact your insurance company and the appropriate medical professional involved.
Nope. Counseling isn't advice giving. Counseling is about helping you help yourself! I do this by teaching you (I.E.- coping skills, what a particular diagnosis means, etc), sometimes reflecting ideas back to you and helping you explore different ideas, and figure out what the problem really is. A big part of what I do is create a safe space for you to explore and work on your problems! Treatment is tailored to you and we collaborate on it! We are a team! Team YOU!
Not necessarily. While medication can be helpful in some cases, not everyone needs it. You should also know, that medication is not considered a cure or to be used all by itself. It is usually recommended that if you are taking medication, that you also engage in counseling/therapy. I usually put it like this - Medication helps you manage some of the symptoms or "takes the edge off" so that you can focus on, and work on, the tools you need to get better!
Some people don't like how their medication makes them feel or just don't want to go on medication. A counselors job is not to perscribe medication. Counselors can however, help you work though any side effects or anxieties you might have. They can also refer you to a psychiatrist (perseciber of medication) if you want.
At your first session, you will come in and I'll say Hi to you! And invite you to sit down. If you haven't already filled out the intake paperwork you will be asked to complete that. I like to get business out of the way, so I will take a few minutes to look over your chart and make sure I have all the information I need including billing information. I'll ask you if you have any questions. Then, I will ask you to tell me about what has brought you in today. I might also ask how you've been eating, sleeping, stress level and feeling about yourself. Or other questions related to the information you give me. You can tell me as much or as little as you are comfortable with. I will start wrapping things up in our last ten minutes. I might ask you how you are feeling about the session and then about scheduling your next session.
In any counseling setting, it is perfectly normal to feel a bit rushed, frustrated or unsure after a first session. You might feel you didn't get enough time or help right away. Please be patient with the process! I promise it will get better and easier if you give it a chance! I recommend that everyone give counseling with any counselor 3 sessions. The first session is paperwork, it can be akward or feel a bit weird but it must be done! The second session is usually a little better, you're getting to know each other, and the third session is usually when you begin to relax and you're getting into things!
Please Note: If things don't feel like they're working or you're not comfortable for any reason, even if it's something you don't think is worth mentioning (or can't be helped, I.E. the counselor is the wrong gender or ethnicity...etc) please tell your counselor! You'd be surprised at what we can do to help remedy the situation. If changing counselors is really what's needed, the counselor might be able to help you find the right one!
I am never offended or upset if you decide we're not the right fit! I just hope that you talk to me about it and don't just disappear! I'm here to help!
That depends.
How long you're in counseling depends on (but is not limited to) your diagnosis, what coping skills you have, how much work you're able and willing to do inside and outside of session.
I try to think of counseling as an investment in oneself. It's about self growth and change. Change isn't always easy and sometimes it can be painful. No one can change you, but you!
The advantange to counseling is, you don't have to do it alone! You've got a partner! Remember, we are a team!
You can be in counseling for weeks, months, years....and even take breaks and come back! Remember, treatment is tailored for you and your needs!
That's okay! Come by yourself! We can still work on things! Many people report improvment for themselves and their relationships from coming to counseling on their own.
Sometimes, once one person comes, the partner or family will follow. Once they see positive change in you, they might want to feel better too! We can also talk about ways to talk to your partner / family about counseling.
Generally, no.
There are many things that are talked about in an individual counseling session that are not appropriate for children to hear. And because minors of any age cannot be left unattended outside of the session room, children cannot come in with you. They may be left with a responsible adult.
In the case of a dependant adult - it would depend on the dependant. If they are safe to be left outside the session room it is permitted.
If you are concerned about this or feel you must bring your children with you please talk to me about it as exceptions may be made. For example: infants in car seats may be fine. Or if the topics of treatment are appropriate for children to hear they may be permitted.
Note to breastfeeding mothers - if you desire to breastfeed during session and are comfortable doing so, I don't mind.
The other exceptions where children or dependent adults may be permitted is in the case of family sessions.
Emotional Support Animal: Even though I love animals...Unfortunately, no. Due to people with allergies, risk of conflict between support animals (if more than one is present - could be a problem), we do not allow them in the office.
Please do bring a picture with you! Talking about your support animal is important!
Service Dogs: If your dog is a service dog required due to a disability, then the dog is permitted by law.
Nope. I don't report substance use. I might ask you some clarifying questions about your substance use and make sure that you're not putting yourself or others in danger.
It's important that we address whatever is going on behind any substance use/abuse and if needed I can refer you to more intensive addictions therapy.
I am a mandated reporter and there are acceptions to confidentiality. If you are concerned, let's talk about it!
Remember, counseling is about helping you!
Not necessarily. When you call Crisis Services they will assess your situation over the phone. The more honest you are with them the better they can help you. Even if they come out to where you are or even if an ambulance/first responders come to you...you don't necessarily have to go to the hospital.
Your situation is assessed and then next steps are decided.
Also - you can't call Crisis Services "too much". They will ALWAYS answer your call and help you. Understand that the help they provide may also be to refer you to the correct group, professional or other support. This referral may then be able to help you further.
It's always a good idea to follow up with your Mental Health professional and or Primary Care Doctor after a crisis call.
Your privacy is very important. What you talk about in a session with me cannot be revealed to another person without your permission. You will hear me say at your first session that "What we say in here stays in here. Unless you are a danger to yourself or others or tell me that someone is hurting you. In that case we might have to do something about it. We would talk about it before we did anything."
There are legal reasons that limit the scope of confidentiality:
1. If you are a threat to yourself or others. This includes acting in a threatening manner towards anyone. risk or attempt of suicide, and reporting the intent to commit a crime (a counselor cannot tacitly aid or abet a crime).
2. The Law requires that I report cases of potential, clear or alleged child abuse. I am also required to report abuse of an at risk adult (elderly or disabled). In these cases, most adults having problems with this are in need of help. It is often a complex and emotional problem that can be helped when a therapist is involved while you meet the requirements of the law. Reports of this nature are not ment to punish you or harm your family, it is ment to help you get the help and support you need.
3. I can be ordered by the court (by subpoena) to provide records and or testify in court. I MUST comply with this request by law. The scope of what I provide or testify to is specified in the subopena and I can only provide what is specified in that order.
4. Parents/Guradians of minors (12 years old and younger;) or Dependant Adults with a guardianship order, are entitled to information communicated by their chidren or Dependant Adults in session. HOWEVER, ethics require that I communicate only in ways that will be helpful. Working with minors and Dependant Adults can be a delicate process. Please know that one of my jobs is to keep my clients safe! Trust that if it is important for you to know I will tell you. Whenever possible I encourage the minor client/ward to reveal the information to the parent/guardian themselves within the session setting. If you have concerns please talk to me!
I do offer collateral sessions on an as needed basis. They will incur the regular session fees.
5. In the event that there are Custodial/Guardian and Non-Custodial parents involved in a case: I will not provide the Non-Custodial parent with any information or documentation that is not approved by court agreement or HIPPA release signed by the custodial parent/guardian.
Note: if there is court paperwork indicating custody or guardianship, you MUST bring a copy to the first session. Without it I will be unable to meet with the child/dependent adult involved or you. The adult who has been awareded legal custody or guardianship must be the one to sign the client agreement etc.
If you have questions about this, please contact me.
6. Information may be disclosed to a third party: doctors office, family member etc only if you sign a "Release of Information" form.
7. You may sign a "Release of Information" form with your doctors office or another therapist and have the requested information sent by me to that third pary. I will only release the information requested and only if the "Release of Information" form is filled out and signed correctly. I have 30 days to respond to such requests.
FOR CLARIFICATION:
Suspected child abuse or dependent adult or elder abuse I am required by law to report this to the appropriate authorities.
If a client is theatening serious bodily harm to another person(s), I must notify the police and inform the intended victim.
If a client intends to harm him/her/their self, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that I am allowed by law in order to ensure their safety.
If you have any questions or concerns about this please contact me so we can talk about it.
Financial misunderstandings can adversely affect the theraputic relationship and your treatment. Therefore every effort is made to make sure policies are clear regarding payment. As evaluation and treatment can be expensive, you are encouraged to discuss any aspects of billing and payment with me. Fee schedules are reviewed periodically and you will be notified in advance if there are any changes being made.
I do not take insurance at this time and only offer fee for service.
Payment is expected in full, at the time of service.
I accept: cash, check and credit/debit cards using Square.
NOTE: If paying with a credit/debit card, there is a $2.35 fee added to your session. This is to compensate for the fees Square charges.
NOTE: Bounced checks will incur a $40 fee which you will be expected to pay along with any outstanding balance on your account before another session can be scheduled. Going forward checks may no longer be accepted and you would then have to pay cash or in the event I can take credit cards, with a credit card.
I do offer a sliding scale. Please don't hesitate to ask for the form.
I can provide receipts by request, so that you can bill for out of network rembursement from your insurance compny. NOTE: I DO NOT FILL OUT INSURANCE PAPERWORK. Out of Network rembursement is between your and your insurance company.
Your balance cannot exceed one visit without prior discussion and approval from me. In the event you owe a balance, you will be notified that another appointment cannot be scheduled until the balance is paid. Late fees may apply if the balance is carried beyond 30 days. Failure to pay your bill within 30 days may cause your case to be closed.
Financial difficulties come to all of us from time to time so please talk to me if you are having financial difficulties as we may be able to work something out!
In the event that I am required to provide expert testimony on behalf of a patient in a legal proceeding, there will be a fee charged for this service. This fee will be based on the actual time spent in court and on the time necessary for preperation of testimony and travel expense. Advance payment is required for this. We will discuss this fee in the event this situation occurs.
If you wish to have me attend a meeting, doctor's appointment or conference on your or your child's behalf (if your child is my client) there will be a fee. This fee will be based on the length of the meeting, time needed to prepare for this meeting and travel expense. We would have to discuss this situation in advance (the sooner the better) to ensure scheduling and understanding of the nature of the meeting and costs.
Accounts having uncollected fees due to non-payment will follow standard collection procedures. This may involve the use of a collection service and or prosecution. In these events the client will be held liable for any and all collection fees and or attorney fees needed to collect the debt.
You must cancel your appointment with 24 hours notice.
For example: If you have an appointment scheduled for 10am Friday you must cancel by 10am Thursday.
Appointments missed or cancelled without 24 hours notice will result in you being billed in full for the service you missed.
In the event you are a no call no show for three appointments your case may be closed.
All missed appointment and late cancellation fees must be paid in full on or before the date of your next scheduled appointment unless otherwise arranged with me. You will not be able to schedule more appointments until your account is paid in full.
You can notify us of a cancellation at any time day or night via email or by leaving a voice mail.
If you are having difficulty attending sessions for ANY reason, please talk to me!
This policy is not ment as a punishment in any way. It is ment to reflect the belief that the time used for treatment is precious and should be compensated for when it cannot be utilized by another client.
Phone Calls:
I am available between 9am - 5pm most weekdays. I will not answer my phone if I am in a session. Please leave me a message with your name and phone number. I will return your call at my earliest convenience. I will make every effort to return your call by the end of the next business day.
If it is an emergency or you feel you cannot wait please call Crisis Services or 911 for help.
Erie County Crisis Services: 716-834-3131
Niagara County Crisis Services: 716-285-3515
E-Mails: I check my e-mail at least once a day and usually several times a day. If your email requires a response I will make every effort to reply by the end of the next business day.
Please note that electronic correspondance may not be secure and you should use caution when sending private information over the internet.
Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn etc.) I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.
I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email for issues regarding scheduling or cancellations. I will do so. If you prefer text messaging for issues regarding scheduling or cancellations, please talk to me first. I may be able to accomodate you.
While I may try to return messages in a timely manner, I cannot guarantee immediate response and request that you do not use these methods of communicaiton to discuss therapeutic content and/or request assistance for emergencies.
Services by electronic means, including but not limited to telephone communicaiton, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of California. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. The 2019 NYS definition of Telehealth is broadly defined as the use of electronic information and communication technologies to deliver health care to patients at a distance.
If we choose to use information technology for some or all of your treatment, you need to understnad that: 1) you retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawl of any program benefits to which you would otherwise be entitled. 2) all existing confidentiality protections are equally applicable. 3) your access to all medical information transmitted during a telemedicine consultation is guaranteed and copies of this information may be available for a reasonable fee. 4) dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent. 5) there are potential risks, consequences and benefits of telemedicine. Potential benefits inclue, but are not limited to, improved communication capabilities, providing convenient access to up to date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy and beeter continuity of care.
Effective therapy is often facilitated when a therapist gathers with a session or a series of sessions, a multitude of observations, information, and experience about the client.
Therapists may make clinical assessments, diagnosis, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations, information and experiences
When using information techology in therapy services, potential risks include, but are not limited to the therapist's inability to make the multitude of observations listed above, and potentially relevant theraputic issues such as: attractiveness relative to social and cultural norms and standards, gait and motor coordination, posture, work speed, any noteworthy mannerisms, gestures, physical or medical conditions including bruises or injuries, basic grooming and hygiene including appropriateness of dress, eye contact, sex, chronological age, ethnicity, facial and body language, and congruence of language and facial or bodily expression. Potential consequences thus include the therapist not being aware of what he or she would consider important information, that you may not recognize as significant to present verbally to the therapist.
Due to the importance of your confidentiality and the importance of minimizing dual realtionships, when in public, should we come across each other, I don't know you, until you know me. Meaning: I will not approach you or acknowledge that I know you, unless you acknowledge me first. If we do interact in an unavoidable situation, I will be polite and respectful as the situation dictates and strive to maintain anonymity and confidentiality. I WILL NOT discuss your therapy with you outside of session. If you do acknowledge that you know me, it is up to you what you tell others about our relationship, if anything. Should you have any concerns about interacting in public, please don't hesitate to talk to me.
I make every effort to ensure your treatment/therapy will be productive. Your honesty is essential for the best possible outcome. Having a good theraputic relationship usually results in more positive theraputic results. I strive to work towards this relationship and understand that trust takes time.
Each client is an individual and because of this and a variety of factors effect the outcome of treatment, I cannot guarantee positive results. Occassionally, treatment may have unexpected results.
If your treatment is not meeting your expectations or you feel we are not a good fit or you are thinking of leaving treatment, please talk to me about it.
I can't fix something I don't know is broken! If there is a way to work out any problems/issues I would like to try. You'd be surprised at how talking about these things can strengthen the theraputic relationship!
If you need to seek treatment elsewhere for any reason, I may be able to help link you with the right professional or treatment. Ultimately, I want you to get the right treatment!
Please don't hesitate to talk to me!
In General:
My expectations of you: To attend your sessions on time and be as honest with me as you can. To treat me with respect. To communicate information as appropriate and problems or questions to me as they arise. Also to render payment at the time of service.
What you can expect of me: To attend your sessions on time and be as honest with you as I can. To provide you with assessment, diagnosis and treatment using the best practices in an ethical and professional manner. To treat you with respect and unconditional positive regard. To communicate information as appropriate and address problems as they arise.
In public, I do not know you until you know me. It is up to you to approach me first and then I will be polite but it is up to you what you tell others about how we know each other etc. I will NOT discuss your therapy in public.
I expect that my clients and myself follow office rules and group rules as the situation dictates.
Please see the Rules section.
Please let me know if you have any questions or concerns regarding the above.
General Rules:
1. No smoking/vaping
2. No electronics use is permitted during session. Please silence your phone/tablet etc or turn it off prior to session.
3. Please silence or keep the volume of electronics as low as possible in the waiting area.
4. If you MUST take a phone call, please step outside or keep your conversation as quiet as
possible and refrain from using the speaker setting in the waiting area. Note that phone
calls taken during a session will result in a loss of session time.
5. Minors of any age and dependent adults may not be left unattended and
Parents/Guardians must remain on site while the child or Dependent Adult is in session. Unless otherwise arranged with the counselor.
6. No verbal or physical threats or violence of any kind will be tolerated.
Group Rules: set at the first meeting of a support group or other group setting and posted for everyone to see.
Class/Lecture/Event Rules: the following of the General Rules and common curtesy is expected. Situation specific rules and guidelines will be made known to participants of these activities.
Please let me know if you have any questions or concerns regarding the above.
Ending relationships can be difficult. Therefore it is imporant to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of treatment. I may terminate treatment after appropriate discussion with you and a termination process if I determine that the psychotherapy is not being effectively used or if you are in default on payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If therapy is terminated for any reason or you request another therapist, I will provide you with a list of qualified psychotherapists to treat you. You may also choose someone on your own or from another referral source. Should you fail to schedule an appointment for three consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons, I must consider the professional relationship discontinued.