Frequently Asked Questions
How do I know if I am ready for counseling?
That is a question that only you can answer. I suggest that before signing up for therapy, try talking to your trusted friends and family members about your problems and do some research on your situation to see if you 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.
What is the difference between a psychiatrist and a therapist?
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 is indicated.
Do you treat kids?
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.
Do you see LGBTQ couples or individuals struggling with sexual identity issues?
No, and it's the same reason I don't work with children: because I do not have specialized training and experience in this area. I want you to go to a therapist who really gets your experience and can support and guide you accordingly. I recommend my colleagues, Rebecca Mercurio and Tamara Blum. I am happy to see LGBTQ individuals who are struggling with other issues, such as depression, anxiety, loneliness, chronic health issues, etc. which are within my scope of practice.
How many sessions will I need?
That will depend on your unique situation. Some clients’ issues are more complicated than others (this doesn't mean you're crazier or 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 they come every other week or month for years. Other clients come with a specific goal and after 5 sessions feel better and are ready to terminate. My average client comes for 6 months. I do my best to adapt the therapy to your individual needs.
What can I expect in the first session?
In the first session we will talk about confidentiality, expectations for therapy, and I will ask you a lot of questions about your history so I can get a context for your presenting problem. We will also define your goals for therapy.
Why is therapy so expensive?
I had the same reaction when I first went to therapy years ago. To be able to provide you with the best possible service, however, I need to limit the number of clients I see so I can be healthy and give you my full, undivided attention. In the past, I tried to lower my fee, requiring me to see more clients to be able to meet my financial needs, but my therapeutic effectiveness declined. My goal is to provide a healthy, healing space for you and I can only do that if I am healthy myself.
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, your finances, and your faith.
Do you have a sliding scale fee option?
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
Agape Christian Counseling Center
Washington University Psychological Service Center
Jewish Family & Children’s Service
Creve Coeur Counseling Associates
Can I use my insurance to cover the sessions?
It depends. I am an in-network provider with Aetna, Anthem Blue Cross and Blue Shield, and Tricare. I am also an EAP provider with H&H Health Associates and St. Luke’s EAP. However, 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.
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.
If you have a PPO health plan with another insurance carrier 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.
Also, please be aware that once I 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.
Are you going to make me talk about my feelings?
No. I’m not going to make you do anything. Some people really struggle with identifying their feelings. Some people don’t believe they even have emotions. That’s okay. We can start right there. The Latin root of the word emotion is “to move”. Essentially, our feelings (joy, sorrow, anger, love, hate, jealousy, fear, shame, etc.) are what move—or drive—our behavior and choices. Thus, it behooves us to understand them better.
Are you going to psychoanalyze my relationship with my parents and tell me what a bad upbringing I had?
No. I am a parent and I understand just how hard it is to be a parent. I believe your parents did the best they could with the resources and capacities they had available at the time. If your parents are like me and my husband, they made some bad decisions along the way. Research has shown that the environment we grew up in does significantly impact who we are today. The hard reality: we cannot change the past. The good news: we can change how the past affects us in the present!
I see in your bio that you went to a seminary for your master's degree. Is this religious counseling?
No. This is professional counseling. If faith, religion, or spirituality are a part of your worldview, we will integrate it into the counseling to the extent that you desire so long as it enriches your growth process. If spirituality is not a part of your life, it will in no way be pushed upon you.