Common Questions about therapy

---

There’s no one-size-fits-all answer. How long therapy takes depends on many things: your goals, the type of issues you're working on, how long they've been present, your personality, and your motivation for change. Therapy is often a gradual process, and while there’s no quick fix, many people do start to notice shifts with regular sessions and a strong connection with their therapist. Sometimes, it might feel a little worse before it feels better and that’s a normal part of the healing process.

In most cases, I recommend starting with weekly sessions for about the first eight or so weeks. This helps build momentum and gives us time to dig in. I totally understand that counseling is a big investment of both time and money, and I've found that starting consistently tends to lead to better outcomes and fewer drop offs. Over time, we can space sessions out if that fits your goals. If you're feeling like you need more support upfront, we can do more than once a week too.

Standard sessions are 50 minutes, but I do recommend an initial 80 minute session to give us more room to explore. For couples, 80 minute sessions are usually best since there are two people in the room and time flies. I'm flexible with session length and happy to adjust as your needs evolve.

Yes, absolutely. I've worked with many couples successfully through telehealth. Depending on what you're navigating, some couples choose to join from different rooms, especially if emotions are running high, while others sit together on a couch with a laptop in front of them. Both setups can work well. Please don’t let the virtual format hold you back. I've been supporting couples remotely since 2018, and it can be just as effective as in person work.

If you're running late, just shoot me a quick text to let me know. If it’s a rare occurrence and I have some wiggle room in my schedule, I’ll do my best to make up the time but that’s not always possible. If I’m ever the one running late (which is rare), you’ll always get your full session time. I do my best to stay on schedule and respect your time.

If you miss a session without notice, you'll be charged the full session fee unless there's an emergency or a weather related issue. In that case, we’ll simply reschedule. I do my best to be respectful of your time, and I ask the same in return.

I require a full 24-hour notice to cancel or reschedule a session, or the full session fee will be charged. While I do my best to be flexible and understanding, I hold firm to this policy because this is both my livelihood and a commitment to the therapeutic work we’re doing together. Missed or late cancellations not only impact my schedule, but they also interrupt the consistency that’s often key to progress.

Valid last minute cancellations are generally limited to major medical emergencies or severe weather. For instance, if you or your child have been unwell all day and cancel just a few hours before your session, the full fee still applies. The same goes for forgetting your appointment or oversleeping.

If something comes up and we’re both available to shift your session to another time that same week, I’m happy to do so without a fee. However, if you reschedule and then cancel the new appointment, even with proper notice, you’ll still be charged the full session fee.

That’s totally okay, there would be zero hard feelings. The most important part of therapy is feeling safe, heard, and understood by your therapist. If that’s not happening with me, I fully support you in finding someone who’s a better fit. I’m always happy to offer referrals or just wish you well on your way. Therapists truly want you to find the right person, because progress is so much harder when you don’t feel a connection.

I choose not to accept insurance because it often limits the type and length of therapy I can offer. The work I do, especially around narcissistic abuse, difficult relationships, and family estrangement, is often complex, long-term, and requires flexibility, creativity, and deep trust. Insurance companies tend to focus on short-term, diagnosis driven care, which doesn’t always align with the real life needs of my clients.

In many cases, there isn't even an appropriate diagnostic code for what someone is going through, especially when it comes to emotional abuse or relational trauma, making reimbursement unlikely. I also work with many people who, for personal or even safety reasons, prefer not to have their mental health care documented through insurance.

By staying out-of-network, I can tailor our work entirely to your needs, not to what an insurance company will approve.

If something comes up between sessions that you’d like to share, and it’s not urgent and not a regular thing, you’re welcome to email me. I care deeply about my clients, but to protect the quality of care I provide, I ask that most communication stay within your scheduled session time.

If it’s something truly urgent that I need to know about, please reach out, but keep in mind that therapy works best when we process things together in session. If I responded to every message from every client between sessions, I wouldn’t have the time or presence to give anyone, including you, the attention they deserve.

If you're experiencing a medical or mental health emergency, please do not contact me first. You must get yourself safe first by calling 911 or going to your local emergency department. 

My practice is not equipped to manage crisis counseling.

You may also text the Suicide and Crisis Lifeline at 988 or call 1-800-273-8255 for immediate assistance. 

For domestic violence support, you can contact the National Domestic Violence Hotline at 1-800-799-7233 (SAFE).

The Global Association for Suicide Prevention website is www.iasp.info.

Please note I am not responsible for any charges you incur by seeking emergency services. For more information on different hotlines and emergency contacts, please visit the "Contact" page and scroll to the bottom.

Yes. Like all therapists, I have specific areas of expertise where I feel confident and competent. You can learn more about these on my "Client Issues" page. It’s important ethically that I only work with clients whose concerns I’m equipped to support, and I will gladly refer you to someone better suited if needed.

With experience, I’ve become more discerning about cases I won’t take on, even within my areas of competency, including:

• Anyone currently in a physically abusive situation
• Anyone who has perpetrated physical abuse as an adult
• Couples experiencing active affairs
• Couples with physical abuse in the current relationship
• Couples showing clear patterns of contempt, coercive control, gaslighting, or severe power imbalances
• Couples where there is extreme discord, with a risk of escalation to physical violence, especially if firearms are located in the home or there is quick access to them.
• Clients involved in child custody disputes where I might be subpoenaed
• Anyone abusing or neglecting children or animals (which I am required to report)
• Anyone in active addiction or severe disordered eating
• Anyone with persistent and severe suicidal ideation

Additionally, I will end therapy if a client is abusive toward me or if I feel unsafe for any reason, and I will provide appropriate referrals.

I don’t identify as religious, but I am quite spiritual. Many of my clients have a strong faith, and I welcome exploring religion or spirituality as part of our work if that’s important to you. If you’d like to incorporate your beliefs into sessions, please feel free to bring it up. I'm here to support you however feels most meaningful.

Absolutely. I’m open about this because therapy truly changed my life. I know firsthand how powerful it can be with the right therapist. I’ve experienced intense anxiety and have navigated difficult, toxic, and narcissistic relationships that took a real toll on my mental health. I’ve been there, and that’s why I’m here for you.