Q. Man, you've got a LOT of kids!
A. Um, thank you? But that's not really a question.
Q. OK, then, what's the deal with counseling?
A. One reason healthy people seek counseling is to get some insights from a well-trained third party who has a full toolbox of ideas for making difficult problems easier. Some people in therapy have major mental illnesses. But most people are just struggling with the normal ups and downs of daily living -- problematic relationships, parenting struggles, money, work, addictive behaviors, grief, depression, broken trust, anxiety, stress, and power struggles.
Q. Do I have to lie on a couch and tell you about my mother?
A. Only if you're Doctor Who and travel back to 1912. Modern therapy is about solving what's wrong right now, not obsessing over your childhood potty training failures.
Q. Speaking of doctors, are you one?
A. Eh-yup. And wrote a whole PhD dissertation on communication scripts -- called Skripts -- for fixing relationship communication. So if you and your hunny struggle with communication problems, man, oh man, do we have some Skripts for you!
Q. What happens in therapy?
Our first session is about getting to know one another, going over some paperwork, explaining our approach, and -- if there's time -- conducting an assessment. If we both (or all, if you're coming as a couple or a family) feel like we're a good match, we set up appointments for the next few sessions. If you're comfortable with getting to work right away, we may also assign some "homework," or send you home with some pamphlets or self-tests to be completed before our next session.
Q. Traffic stinks. Can't I just do this electronically?
A. Absolutely you can. In fact, we're exclusively doing teletherapy, unless you're willing to come visit us in our office in Paris. We do therapy by video, phone, email, and text, and we offer it during extended hours, including the overnight shift. To set up an appointment, just click that blue "Schedule Me" button and choose an "Intake Session" option. Check your confirmation email for a link to the paperwork.
Q. How do you feel about divorce?
A. Divorce hurts. It hurts the couple, their children, and the generations of people who interact with the family. We do everything possible to help you fix your marriage. We BELIEVE in marriage. But sometimes, splitting up is the only way to preserve peace. Those rare times when things really are irretrievably broken, we network with family law attorneys who believe in mediation and amicable resolutions.
Q. How much does counseling cost?
A. If you're struggling with money, you NEED to see us. We'll help you get back on track financially, and if you take the work seriously, every penny you spend on counselling will be more than repaid with long-term financial and career success.
Q. Don't dodge the real question. How much do you charge?
A. We charge $110 a session hour, and treat some clients -- active-duty military and self-paying teens -- on a sliding fee scale, based on family income. That's a bit less than the going rate, which in the Seattle area is $175 an hour and up. The cost for court-ordered Reunification Therapy is $150/session.
(We also do a few hours each week of pro-bono work for various non-profit organizations, as a contribution to our community.)
Q. Why is counseling so expensive?
A. No, no, no! Counseling is cheap. For two reasons.
First: Penny wise; pound foolish. Successful marriage and family therapy will save you a small fortune in attorneys’ fees – not to mention the incalculable value of a happy marriage, a successful career, and thriving children. The costs of addiction can bankrupt you. So can the costs of lawsuits, bail, court fees, custody disputes, depression, domestic violence, suicide. When you find a really good therapist, all of that disappears from your life.
Second: Your counselor is undercharging you. Do you swallow $400 an hour for a lawyer without blinking, but choke at $150 an hour for therapy? Compare the cost of becoming a counselor to the cost of becoming a lawyer. Bet counseling's starting to look like a real bargain!
Q. What about insurance?
A. There are several reasons clients don't use insurance for therapy.
Quality of care. Many of the best therapists don't take insurance. Like hiring a lawyer or an accountant, hiring a therapist is a private undertaking. Many of the best therapists simply won't play the insurance game.
Reimbursement. Insurance reimbursement is a paperwork nightmare -- especially when you're dealing with high deductibles and co-pays. Moreover, your preferred counselor is unlikely to be on your insurance company's panel. Clients often find it easier to just pay out of pocket, when so many good counselors simply aren't part of the system.
Labeling. Insurance covers mental illness. If you don't have a mental illness, your therapist has to find some way to label you in order to get reimbursed -- a very controversial ethical issue, and one that ought to cause clients a great deal of concern. Bottom line: If you don't want to be labeled as mentally ill when you're just trying to keep your marriage together, and if you don't want your permanent electronic healthcare records to document you as mentally ill, you need to hire your therapist privately.
Legal concerns. While patient privacy is an ethical and legal right, if you're fighting for custody, embroiled in a divorce, or fighting a restraining order, the only way to guarantee your treatment records don't get dragged before a judge is to ask your counselor, in writing, not to maintain records. Washington State law (see Section 2) permits this option for private-pay counselors. Insurance companies don't permit it. They need to see your records.
Civil rights concerns. Laws governing background checks and mental health are ambiguous and fluid. But nobody should skip treatment out of fear of losing their civil rights. That's why private-pay therapy is a better alternative.
Privacy. Many large employers self-insure, and some even pay out claims in-house. Are you comfortable with your employer knowing about your mental health treatment? There are some protections in place to prevent abuses, but the law remains somewhat ambiguous.
Q. What's your therapeutic style?
A. We use a systems approach called Reification Therapy, which blends aspects of narrative therapy with a positive form of cognitive-behavioral therapy (CBT). We are happy to explain our approach during our first get-to-know-you session.
Q. How long does therapy take?
A. It's not like the bad old days, where people would see a therapist for years and years, talking endlessly about their mothers or their exes.
For most problems, you'll know, by the third or fourth session, whether we're making good progress. Therapy for a single problem rarely requires more than eight to ten counseling sessions. After tackling one concern, many clients continue therapy to start working on new issues. The key, though, is continuing progress. If you're not moving ahead, you may have the wrong counselor for you.
Q. Hey, I heard you write books.
A. Write 'em, read 'em, and sometimes chew on the covers -- we like to multitask. But if you want a cheap alternative supplement to therapy, we recommend our Skripts series of relationship books, which you'll find under the Publications tab at the Skripts website. Subscribe to our newsletter at no charge to receive book excerpts, discounted event admission to events, and information about online courses.
Q. What part does religion play in counseling?
A. I support you on your spiritual path -- whichever path you choose. Christian clients will find I approach therapy using Biblically sound principles. While I am committed to my own LDS (Mormon) faith, my husband is Catholic and I have healthy spiritually-sensitive relationships with family members and good friends who are every variation of Christian, Jewish, Buddhist, Baha'i, Sikh, Hindu, agnostic, and pagan. Ultimately, I trust that eliminating anger, abuse, and other hurtful thoughts and behaviors from lives helps every person searching for a peaceful, Godly path through life.
Q. Did you really win a Biggest Loser competition?
A. Yep. And we'll tell you everything we learned about weight loss, if you're interested.
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