North Pole by Michael Fatali

Q: How can I select the "right" mental health therapist?

A: There are numerous sources to locate suitable mental health professionals. You should be able to get more information and referrals from your company's Human Resource Department for Employee Assistance Programs (EAP); through your health insurance company's customer service telephone or member's website; your physician or other medical health care professional. Another good source is your family, friends, or co-workers who have already taken the important steps to participate in therapy. There also are numerous websites dedicated to mental health care, such as Psychology Today.

Whatever method you use to seek out a competent and caring mental health professional, contact them by telephone, tell them about your situation and what you are seeking - and ask questions. Many people are hesitant to ask a professional questions about their background or experience. Any competent professional should be open to questions or concerns regarding their expertise or the therapy process.

In your search for the "right" therapist, these are some questions you might want to ask the therapist:

  • What are their education and training credentials, background, and experience?
  • How long have they been in practice?
  • Are they licensed to practice by a governing board?
  • What is their approach to therapy?
  • Do they specialize in areas of concern to you?
  • How long are appointments, how often should you see them, and how long does therapy last?
  • Are they available for emergency consultation if you experience a crisis?
  • What are their policies regarding privacy and confidentiality?
  • What are potential risks to therapy?
  • What advice do they give clients about getting the most from their therapy experience?
  • What are their fees and financial policies?
  • Are they a preferred provider with my insurance company?

Then, the major questions you have to honestly ask of yourself:

  • Am I "open" to change and committed to actively participate in the therapy process?
  • Will my schedule and lifestyle enable me to attend therapy appointments as scheduled?
  • Am I comfortable with being able to meet the financial investment?

If you can answer yes to all of these questions, and have decided that you would like to try working with me, we can schedule your first appointment.

If possible, before your first session, please review:

Then download, print, and complete the following set of:

If you decide to wait to review and complete the forms at my office, please arrive 15 minutes before our scheduled appointment to allow time to do so. You may wait until we meet in person to sign the forms so that we can discuss any questions or concerns you may have first.

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Q: What are your fees and do you take insurance?

A: I am a preferred provider with all major insurance carriers (managed care), and Employee Assistance Programs (EAP), and also accept self-payment.

If you choose to use your insurance or EAP benefits, you should be aware that if mental/behavioral health treatment appears on your medical record, and your medical record ever becomes compromised, it may affect how you are viewed by current and prospective employers, and could limit your ability to get future disability, health, or life insurance. Also, you should know that involving third parties (insurers) in the process of psychotherapy can be invasive and may compromise treatment, since many insurance contracts allow the insurer to decide whether your situation is worthy of coverage (“medically necessary” in their language), and if so, the number of sessions which you are “allowed” and even “how often” you can attend sessions – thus the term “managed care”. Finally, I believe my efforts would be better spent actually working with patients to achieve solutions, rather than filling out paperwork, requesting sessions, sending reports, filing claims, and doing battle with insurance companies.

As long as you are aware of the above risks and limitations, are willing to accept those terms, and I am a provider for your insurance company or Employee Assistance Program (EAP), known as “in-network”, I will be pleased to accept your insurance and file your claims for you, in which case you authorize payment be made directly to me. Your plan may require diagnostic and treatment plan information to be released to them before they will authorize payment. If you request that I accept your insurance or EAP benefits, I am obligated to comply with their requests for information.

If your insurance company or EAP happens to be one with which I am not contracted, known as “out-of-network”, I will provide receipts so you can submit claims to them. Please understand that you may or may not receive reimbursement.

If you do not have insurance or EAP coverage, or decide not to use your benefits, self-pay sessions are available as follows:

Initial evaluation and assessment session $125
Follow-up session (45 minutes) $100
Follow-up session (60 minutes) $120

All payments are due when services are rendered.  Payments may be made by cash, personal check, Visa, or MasterCard.  There is a $25 charge for returned checks and $5 for declined credit cards.

Insurance deductibles, co-payments, and co-insurance are your responsibility as are any balances on your account.

If your insurance company denies payment for any reason -- you are ultimately responsible for payment of your account regardless of your insurance status.

I reserve the right to pursue collection of unpaid amounts using a collection agency, small claims court, or attorney.

 

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Q: What is your policy if I need to cancel or forget an appointment?

A:When you schedule an appointment, I consider that a commitment for you and me to work together to pursue your therapy goals.  I am unable to schedule anyone else during your reserved time.  Sometimes emergencies arise, but whenever possible, strive to put your health ahead of life’s daily interruptions.

I am usually unable to schedule others who desire help on short notice so, except in emergencies, I expect you to give me at least 24 hours advance notice if you must cancel an appointment.  Insurance companies and Employee Assistance Programs (EAP) will not pay for missed appointments.

If you cannot let me know at least 24 hours in advance that you must cancel or change your appointment, you may be charged a missed appointment fee of $60 for the time you reserved.  Forgetting your appointment, unanticipated work commitments, or schedule conflicts, are not valid excuses for missing an appointment.  Other reasons, such as car trouble, traffic, illness, or other emergencies, will be considered on an individual basis.

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Q: How do I find out about my EAP or mental health insurance benefits?

A: Employee Assistance Programs (EAP) and Mental Health Insurance Coverage are two entirely different benefits

Employee Assistance Programs (EAP)

Many employers, especially larger ones, offer their employees EAP services as part of their benefits package.  EAP typically offers one or more types of assistance to employees, and often to their spouse or family as well.  EAP benefits are intended to help employees and their families if they have personal problems, especially if that might affect work performance.  EAP usually includes limited benefits for legal, financial, and/or mental health counseling at no cost.

EAP availability and benefits are usually not shown on an employee’s or dependants’ insurance cards.  To find out if your company offers EAP benefits, the employee should contact their Human Resource Department to learn about the specific benefits available, if any, and what company (usually a third-party) administers the program.

Sometimes, but not always, the same third-party company administers both EAP and mental health insurance programs, and for mental health services these companies may be completely different than the primary insurance company shown on your insurance card.

If the employer provides out-patient mental health EAP benefits, I am contracted to provide services for most major EAP administrators.

To obtain specific information about EAP mental health benefits, the employee or spouse, if applicable, must contact the EAP administrator to request authorization for a limited number of EAP out-patient mental health counseling sessions.  The number of EAP sessions allowed (usually 3 to 8 sessions) depends on your needs and the contract between the employer and the EAP administrator.  Usually, you will also have to tell the EAP administrator the specific therapist you have chosen to help you. 

If you feel you might need more counseling sessions than are allowed to resolve your particular problem, it is also very important to ask if you can continue seeing the same therapist under your insurance mental health benefits after the authorized number of EAP sessions is completed.  Some contracts do not allow you to continue with the same therapist under your insurance coverage, and you would have to “start all over” with another therapist.  The reason for this is, where more than the limited number of EAP sessions are anticipated, some employers would like for you to bypass the EAP benefits and start at the outset using your insurance mental health benefits so that you share in the associated costs through your deductibles, co-payments, and possibly co-insurance.

If you decide to go forward using your EAP benefits, the EAP administrator will provide you with an authorization number and the number of sessions authorized.  Then you can call me with that information, and we can schedule your first appointment and get started.  If you have questions about EAP versus insurance benefits before that, please contact me so I can help you sort it out and determine the better approach for you.

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Mental Health Insurance Coverage

If you choose to use your mental health insurance benefits, I am a preferred provider, which means I have a contract, known as “in-network”, with most major managed care health insurance companies. Unfortunately, I am unable to accept Medicare or Medicaid coverage.

Because every contract and plan are different, I cannot tell you exactly what will be covered until we verify your specific insurance benefits.  As a courtesy to you, I will verify and file your insurance for you if you desire.  However, please remember that my professional relationship is with you and not your insurance company.  Fees vary, depending on your insurance carrier, contract, and services to be provided. 

If you would like to verify your insurance benefits to learn the exact cost prior to making an appointment, call the toll-free number for Mental/Behavioral Health or Substance Abuse listed on the back of your insurance card.

If a separate toll-free number is not listed, call the main customer service number shown on your card.  Tell them you want to find out about mental/behavioral health and/or substance abuse benefits, so they can refer or connect you to the correct telephone number, which is often a third-party administrator, totally separate from the company that provides your medical coverage.  Be sure they understand you are verifying mental/behavioral health and/or substance abuse benefits and not medical benefits.

For mental health insurance coverage, there are benefit provisions you need to research:

  • Am I covered for individual, marital, and family counseling (as applicable)?
  • Am I subject to any pre-existing condition clauses? If so, what do I need to do?
  • How many sessions are allowed per year, and is that a calendar year or other "plan year"?
  • What is the deductible and has it been met? If not, how much is left?
  • What is the co-payment?
  • Is there any co-insurance?
  • Is the therapist "in-network" and how much do they pay?
  • Are there "out-of-network" benefits and how much do they pay?
  • Do I need to pre-certify or pre-authorize sessions? If so, what has to be done?

Sometimes verifying benefits can be difficult, time-consuming, and frustrating. If you cannot obtain a clear answer, please give me a call and let me assist you.

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Q: How long does therapy last?

A: The length and frequency of therapy varies from person to person. Sometimes people achieve their goals in a few sessions, while others may take several months or even longer. Factors that influence the duration of therapy include the nature and complexity of your issues, your life circumstances, and your motivation.

You will probably know whether our association feels "right" within our first several sessions, and can decide whether to continue with me or request a referral to see another practitioner.

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Q: How often would we meet?

A:Usually sessions are once a week, or every two weeks, although more frequently may be helpful in certain situations.  When too much time elapses between appointments, progress can be noticeably slower and momentum lost.

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Q: Can you assure me that my privacy will be protected?

A: I am very careful and respectful about client privacy and confidentiality.

For example, if we should run into each other at a local event, a retail store, or some other place outside the office, I will not even greet you or act as if I know you, unless you initiate that greeting. In that way, you will never be forced into a compromising situation of explaining to someone accompanying you "how you know me", thus maintaining your privacy unless you wish to divulge it.

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Q: What about confidentiality?

A: You have a legal and professional right to the confidentiality of what we discuss in our sessions, and even to the fact that you are in therapy with me. I am required by law to safeguard that confidentiality.

My practice complies with federal law governed by the Health Insurance Portability and Accountability Act (HIPAA).  Before treatment begins, I will ask you to confirm that you have read and understand my Notice of Privacy Practices (NPP) and you will also have to agree to and sign a Consent to Use and Disclose Your Health Information.

Except in certain situations, such as those mandated by law, information will not be released to anyone without your prior written authorization. Legal exceptions include:

  • I am required to notify authorities or affected persons if I have good reason to believe that you are threatening serious bodily harm to yourself or others.
  • I also must notify authorities if I have cause to suspect, or evidence of, abuse or neglect of a juvenile (under age 18) or elderly or disabled person.
  • If you are involved in a legal proceeding, a judge may order me to disclose otherwise confidential information about your treatment.
  • Requests by parent(s) of minor client(s)
  • Third party insurance or EAP information requirements

This information is explained in detail in my Notice of Privacy Practices (NPP) which you will be provided.

You can ask me to communicate with you about your health and related issues in a particular way or at a certain place which is more private for you.  For example, my Client Information Form requires you to specify your preference(s) as to whether or not I can call your home, work, or cell phones, leave voice messages, or communicate via email or texting.  Any such communications will usually be about scheduling or appointments, or a message to return my call, but may be about your health information only if initiated by youBe aware that none of these means of communication are 100% secure or private, but by indicating your preference(s) on the Client Information Form you will be specifying that you accept those risks.

Often there are times when it would benefit you for me to contact others who are providing medical or psychological services to you, such as other therapists, psychiatrists who prescribe medication, and primary care physicians.  I will do so only after discussing it with you, and with your explicit written permission for me to share information with others by signing an Authorization to Use and Disclose Protected Health Information (PHI).

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Q: What if I have an emergency and need urgent help?

A: My main business telephone number is (281) 538-8008. I am usually in my office weekdays during scheduled appointments. If I am in session with a client, I can not be interrupted and will not be available to take your phone calls. However, I do check my voice mail frequently, and am notified automatically when I have messages. On other days, including week-ends or if I am out of town, I check for messages daily.

If you cannot reach me by phone but need to talk to someone urgently, you may wish to call Crisis Intervention of Houston, Inc.
at (713) HOTLINE OR (713) 468-5463.

If you are in crisis or have a life-threatening emergency, call 911 or go to your nearest emergency room immediately.

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Q: Does being in therapy mean I am mentally ill?

A: "Health" can be viewed from several perspectives - physical, mental, emotional, and spiritual.

The generally held viewpoint of "health" defers to physical well-being alone. Yet, the mind is complex, and controls nearly everything we do. While studies have demonstrated the effect of the brain's chemical and genetic composition, what we think and perceive, and what we do, are also influenced by our environment, upbringing, and social interactions. Pervasive drug advertising also leads too many people to believe that medication will "solve" or "treat" nearly any medical or mental health problem.

How we think and feel emotionally can frequently be out-of-sync with sound physical health. Mental health therapy can help us reshape our perceptions and behaviors.

The medical industry model for physical health is based on identifying an "illness" and classifying it with a diagnosis, followed by treatment. Using that model, health insurance companies also require a diagnosis for mental illness (such as depression) before they will approve mental health services. It has become commonplace to want to classify or label nearly everything in society - to put it in a neatly defined slot.

Unfortunately, for these and other reasons, there remains an unwarranted stigma associated with seeking help for mental and emotional problems.

Seeking help or consultation with a professional can be a wise decision and sometimes takes courage.  Others who choose not to risk change get to keep their problems!

If you choose to work with me, I will do my best Helping You Discover the Power of Change.

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Q: What are Cognitive Behavioral Therapy (CBT) and Solution-focused Therapy?

A: The three main tenets of Cognitive Behavioral Therapy (CBT) are that it is collaborative, helps you identify your automatic thoughts, and helps you try out alternative thoughts and behaviors in order to develop more flexible, optimistic, and effective coping strategies.

As humans, we think, then feel, then act-in that order. But we may only be aware of one of these states. Cognitive Behavioral Therapy (CBT) teaches you to become aware of how you think-what you say to yourself. Normally, we are not aware of our thoughts (cognitions) because they are automatic. Our breathing is also automatic and part of our autonomic nervous system which operates without our awareness or intervention (thank goodness!)

Since our thinking is so rapid fire and unconscious, we have to train ourselves to become aware of our thoughts. Most of the time we don't have a clue about what we were thinking when we experience an emotion or behave a certain way. We can start with our emotions or our behaviors, and backtrack to discover our thinking.

Recording our thoughts as soon as we can when we are in a negative emotional state can be very helpful. Beliefs, assumptions, and patterns of negative thinking soon emerge to reveal what your perceptions are of the events in your life, and that determines your feelings and behaviors that follow.

We "learn" most of our views of the world and behaviors that make sense to us. When we notice that the consequences or outcomes occurring in our life are painful to us and others, it's time for a change.

The good news is that what has been "learned" can be "unlearned"! CBT teaches you how to do this, and gain control over your reactions to the relationship you have with yourself, others, and the world. You can choose better responses, as alternative ways of thinking about things, and create better outcomes to help you reach your goals, be at peace, and find joy and happiness.

Often, we see what we want to see, and hear what we expect, and that can be a distortion of reality. There is a good chance that if your life isn't working, you are dealing with some errors or distortions in your thinking. You and I will collaborate to identify irrational thinking assumptions, beliefs, and explanations that shape your understanding of the world, other people, and yourself.

Once these habitual thoughts are held up to the light of reality, we'll examine whether they are working for you. You'll learn to ask yourself different questions that will lead you to alternative ways of thinking and a more objective view of your situation.

Solution-focused Therapy focuses on present and future solutions to the nature of your presenting problem(s). We notice “exceptions” to the problem—times when the problem doesn’t exist, and past successful coping behaviors are utilized and applied to current problems. Rather than focusing on problems, this approach seeks to empower you towards solutions.

Change begins with us doing something different to get a different result. Solution-focused Therapy helps you create change with the "viewing" and "doing" of the problem. We start with the present-what's working, what's not working, and what we do not want to change. The past is examined to search out relevant strengths and abilities used to resolve past problems; and this is brought into the present to help with current problem coping or resolution. It is not used to discuss deficits, trauma, or pathology.

Solution-focused Therapy doesn’t ask “why”, but “what”, “when”, or “how” a problem occurs. What is the cause of a problem, and what perpetuates the problem? When does a problem not occur? What do you want? More of? Less of?

Therapy focuses on helping clients notice what happens just before a problem occurs, while the problem is occurring, and just after the problem occurs.  Even small changes in those areas can create a positive ripple-effect towards the client’s ultimate goal.

In Solution-focused Therapy, noticing the very first signs of positive change help you develop the hopefulness that is so necessary for successful therapy. And this focus also leads you to be able to decide when you no longer need therapy.

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Janis B. Rice ~ Licensed Professional Counselor
16821 Buccaneer Lane ~ Suite 119 ~ Houston, Texas 77058
Phone: 281.538.8008 ~ Email: info@janisrice.com

Website © 2017 by Janis B. Rice
With special thanks to Mr. Michael Fatali for permission to use his
unique and inspirational photographic images © www.Fatali.com

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