That is a question that only you can answer. I suggest that before starting therapy, try talking to your trusted friends and family members about your challenges and see if your situation can improve through exercise, healthy diet, more sleep, and social support. If after that, you are still struggling and feeling stuck, then it is probably a good time to seek therapy.

In the first session we will talk about confidentiality and mutual expectations for therapy. I will ask you questions about your history so I can understand the context for your presenting problem and ongoing challenges. We aim to define your goals for therapy by the end of the second session.

No, I do not see children or adolescents in my practice. I do sometimes see children in the context of family therapy, but not for individual therapy. I focus my work on adults and helping them be healthier so that their children can be healthier. There are many great therapists in St. Louis that work exclusively with kids and families. I want your children to see a therapist who specializes in the needs of children. One such therapist is my colleague, Lou Carmichael.

That will depend on your unique situation. Some clients’ issues are more complicated than others (this doesn't mean you're difficult). Some clients progress slower than others. In the beginning most clients come every week or every other week depending on their finances and schedule. Then as they see improvement, we taper off. I have some clients that love having the built-in support of therapy and we meet regularly for years. Other clients come with a specific goal and after 5 sessions feel better and are ready to move on. My average client comes for 6 months. I do my best to adapt the therapy to your individual needs.

A psychiatrist is a medical doctor that is able to prescribe medication. They specialize in the pharmacological treatment of mental health illnesses. Some psychiatrists do practice "talk therapy," but the majority of them focus on monitoring medication responses and suggest brief behavioral interventions to improve the illness.

A therapist is a master’s or doctorate level clinician that focuses on the therapeutic relationship and conversation to help the client improve. Most therapists provide a 50-60 minute session on a weekly or bi-weekly basis. Therapists are not able to prescribe medication, though they may refer a client to a psychiatrist or primary care physician to be evaluated for medication if they believe it can support a client’s overall wellbeing.

I had the same reaction when I first went to therapy years ago. To be able to provide you with the best possible therapy experience, and to help you achieve your goals, I’ve learned that I need to limit the number of clients I see so I can give you my full, undivided attention. My rate reflects my commitment to you, and my goal is to provide a healthy, healing space for every client. I can only do this if I am nurturing my own needs and prioritizing my wellbeing. If my rates were lower, I would need to see more clients and my effectiveness would decline.

If you are physically ill, you go to a doctor, an emergency room, a pharmacy, a chiropractor, or a natural healer. If your car breaks down, you take it to a mechanic. If your heart, mind, soul, or relationships are not well, you need to value yourself enough to heal them. If you do not take care of yourself, you will eventually find that it impairs every facet of your life—your work, your family, your health, and your finances,.

I am not able to accept sliding scale payments. My fee is consistent with that of other therapists with my level of training and experience. If finances are a challenge for you, I can recommend several larger counseling centers that can provide free or reduced services because they receive grants and/or have master-level interns that can provide sessions without charge to meet their degree requirements. Here are some places to check out:

Lutheran Family and Children Services

St Francis Community Services (Bilingual in Spanish)

Covenant Seminary Counseling Center

St. Louis University Counseling Center

Jewish Family & Children’s Service

Creve Coeur Counseling Associates

It depends. I am no longer an in-network provider with insurance companies. If you have a PPO health plan and would like to use your out-of-network benefits, I can provide a super-bill with the documentation needed for your insurance company to reimburse you.

Insurance companies require a diagnosis that justifies the treatment as “medically necessary”. This can be difficult for certain counseling issues where there is real suffering but not a DSM-V diagnosis, such as marital conflict, family discord, existential angst, stress, grief, or loneliness.

Please be aware that once you submit a claim to your insurance with a diagnosis, that will then become part of your permanent medical record. There are certain clients for whom this is problematic: those trying to buy life insurance, those who purchase individual insurance, those who are hoping to work for the government or enroll in the United States military, etc.

I completely understand and support the desire to use your benefits to reduce or cover the cost of the sessions. I will work with you as best I can to make this happen. I will inform you if there is not a diagnosable mental health illness.

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