Rates, My Approach,
and More.

I currently offer private pay services only at this time. What are some of the benefits of private pay for you?

Out-of-Network Reimbursement:

I use Thrizer to support with potential out-of-network reimbursement. Please note that by using this service, this does not guarantee that your insurance company will pay you. Additionally, if you choose to pursue out-of-network reimbursement, I will be required to make a mental health and/or substance use diagnosis, which will become part of your permanent medical record. 

My Approach

“Feeling like a hero but I can’t fly, No, you’ll never crash if you don’t try, Took it to the edge, now I know why, Never gonna live if you’re too scared to die, Gonna disconnect from the hardwire, Time to raise the flag for the cease fire, Staring down the hole inside me, Looking in the mirror, Making peace with the enemy”

~ Goo Goo Dolls- So Alive

Whether you’ve been to therapy before or whether this is totally weird and wonky territory for you, I believe that it’s important for you to know how I work as a therapist in terms you can actually understand. 

Type of Therapy

“I wish it need not have happened in my time,” said Frodo. “So do I,” said Gandalf, “and so do all who live to see such times. But that is not for them to decide. All we have to decide is what to do with the time that is given us.”

Acceptance and Commitment Therapy

So, this whole Gandalf/Frodo exchange is a perfect example of ACT (pronounced act like “actor”, not A-C-T, like the hideous standardized test). I am trained in two versions of ACT: the original version and TF-ACT, Trauma-Focused Acceptance and Commitment Therapy (pronounced like tee-fact), which is a subset of ACT.

In a nutshell, ACT is all about helping you design a life built for you- a life that has meaning (as defined by YOU) and works for you.

I’ll be totally honest- I was NOT sold on ACT when I first learned about it. I had to do it for my job at the time. When I was asked to read “The Happiness Trap”, I was pretty sure that Russ Harris had no idea what he was talking about and that this whole acceptance thing was some sort of gimmick or sham (sorry, Russ- I promise this was not personal!) I grudgingly started reading the damn thing, and what do you know- it actually started to make sense and spoke to a lot of my own personal challenges with processing emotions and thoughts. Now, I’m pretty sure I won’t use anything else.

You have probably heard of approaches like CBT (cognitive behavioral therapy) or DBT (dialectical behavioral therapy). While I absolutely believe these approaches have value and have seen them both be helpful for folks, I choose to use ACT because of its focus on psychological flexibility- fancy words for “willingly making room for all the uncomfortable shit so you can do what matters and live a meaningful life.”

Sometimes life gives us 3 no-shows and a sick triceratops (cue John Hammond). Or other times, life gives us a bajillion dwarves showing up at our door just as we are getting ready to settle down to a nice supper, and they track dirt everywhere, clean out our pantry, and sing loudly about our house (cue Bilbo Baggins). Or even better, we end up with an alien on our ship and our favorite cat almost gets eaten (cue Ellen Ripley). We can’t control theme park animals, dwarves, or aliens, and we also can’t control our thoughts, emotions, or physical sensations (although I’ll bet most of us have tried- I know I have). These theme park animals, dwarves, and aliens are all the things we don’t want to show up in our lives.

ACT is about building relationship with these things that we don’t want to show up. But whyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy- you may ask (or whine- I know that’s my version of this, personally). Have you ever noticed that a 4-word statement (for example, “I’m not good enough” or “I’m a total idiot” or “No one likes me”) can completely derail your entire day? All of the sudden, your emotions and thoughts are running the show- maybe you make a list of all the reasons you are not good enough or try to eat some Cheetos to get rid of your thoughts (I can vouch for attempting this one) or go on a walk to distract yourself or stay in bed sleeping all day because now the world feels like a shitty and unsafe place.

Most people say, but aren’t the emotions and thoughts the problem? ACT is unique because it is NOT about symptom reduction (e.g. feeling less depressed, anxious). ACT says nope- it is our responses and behaviors to our internal experiences that keep us stuck- not our internal experiences themselves. ACT teaches us skills to help us interact with our painful internal experiences (thoughts, feelings, sensations) so that we can live the kind of life we want to live.

The best metaphor I know for this is Star Wars. In the service of the rebellion, Luke, Leia, Hans Solo, Chewy, Yoda, and Obi-Wan all had to face big challenges – they lost people; they grieved; they got angry; they had to make sacrifices. ACT focuses on making room for the big stuff so you can do the stuff that matters- not stripping away the emotions that make you human.

The main skills you will learn include:

• Defusion skills (to help painful thoughts and emotions so they have less influence).
• Acceptance skills (to make room rather than fight painful emotions and thoughts).
• Self-as-context skills (to learn how to take flexible perspectives on painful emotions or thoughts).
• Present moment skills (to learn how to be present with painful thoughts and emotions).
• Values identification skills (to learn what matters to you and how you want to show up in the midst of painful thoughts and emotions).
• Committed action skills (to learn how to do what matters when painful emotions or thoughts show up)

Trauma-Focused Acceptance and Commitment Therapy

TF-ACT builds upon the above skills and explicitly focuses on changing your relationship with traumatic experiences and the impacts of trauma. Specifically, TF-ACT is designed to address common effects of trauma, including:

• Re-experiencing traumatic events (memories, flashbacks, nightmares, intrusive thoughts/emotions).
• Persistent survival/threat responses in daily life (fight, flight, freeze).
• Psychological rigidity (excessive avoidance, distraction, and disconnection from the body, relationships, meaningful life activities, and painful emotions or thoughts).

If you have experienced trauma, you probably resonate with some of these challenges:

• Struggling to trust others.
• Avoiding activities, people, or places that remind you of what happened to you.
• Believing you are broken or damaged because of what happened to you.
• Distancing or isolating yourself from activities or people you love.
• Feeling lost, confused, or angry and not knowing what to do with all of it.
• Disconnecting from your body, emotions, and thoughts as much as possible.

If no one has told you yet, these responses to trauma are normal. Believe it or not, these challenges are a combination of your brain and your body trying to protect you so that you don’t get hurt again. Most people I work with notice that these responses interfere with their ability to engage in their lives and pull or push them away from the people they want to be. That’s where TF-ACT can come in. Much like ACT, TF-ACT supports you with:
• Making room for painful thoughts and emotions (defusion and acceptance skills)
• Being present with painful thoughts and emotions (present moment and self-as-context skills).
• Acting effectively on your values- what matters to you (values and committed action skills)

If you are interested in building a life that works for you and learning new skills to do so- contact me today to see if we could be a good fit!

EMDR

EMDR stands for “Eye Movement Desensitization Reprocessing.” Try saying that five times fast. But what is it really about and what does it do? EMDR is designed to support your brain with recovering from the impacts of trauma. The way it was described to me in training is that trauma causes blocks in the brain- kind of like these giant icebergs. Our memories/experiences/emotions/responses are frozen and stuck. EMDR supports us with turning the icebergs into water- it doesn’t take away or erase the experiences, emotions, or responses, but it makes them easier to move within in our day-to-day lives.

And yes, as the name suggests, there is eye movement (or tapping, depending on what works for your body and brain) involved (fancy words for this: bi-lateral stimulation, or BLS). And not for no reason, either- science shows that bi-lateral stimulation helps with allowing memories/emotions/experiences/responses to become “unstuck” in your brain and also helps your brain sort out what’s adaptive/helpful vs. no longer necessary. Think of your brain like an LG phone from the 90s- it can still perform the basics, but doesn’t have the newer software upgrades that it needs to function optimally in today’s world. Similarly, EMDR helps “update” your brain.

EMDR gets thrown around a lot as a “magic cure” for trauma. Does it work? Absolutely. Is it for everyone? Absolutely not. If you’ve got your heart set on doing this, let me know- and we can also discuss whether it is really appropriate for you and your needs. EMDR is not a one-stop-shop or quick fix– it involves multiple phases, which include:

• Teaching you stabilization, grounding, and emotional regulation skills.
• Setting up a “stop” signal, for anytime you want to stop what we are doing in sessions.
• Working on an outline of memories you want to target.
• Identifying beliefs and emotions related to the memories you want to target.
• Using BLS to process targeted memories.

Using BLS can feel a little odd at first! As we use it during processing, I’ll ask you stuff like “What do you notice?” or say stuff like “Go with that.” The cool (and unnerving, for a lot of people) thing about EMDR is that your brain does the heavy lifting- it makes connections and builds insights (“free association”), and that also means we don’t always know where it’s going to go or what it’s going to bring up. That’s why we regularly check in during processing sessions by using a SUD (subjective unit of distress) scale AND why you can always stop the session at any time. This is also why it’s REALLY important to make sure your coping skills are solid prior to starting EMDR.

You may be a good fit for EMDR if:

• You’ve experienced one or multiple traumatic events across your lifetime.
• You are willing to develop coping skills to navigate painful internal experiences.
• You are committed to active engagement in the therapy process.
• You have a strong support system to connect with during times of struggle.

You may not be a good fit for EMDR if:.

• You are actively using substances.
• You have ongoing, intense life stressors.
• You frequently dissociate.
• You are unsure about committing to therapy.
• You avoid active engagement in therapy, including building coping skills.

EMDRIA, The EMDR International Association (hyperlink: https://www.emdria.org/), is a great resource if you want to learn more about EMDR.

If you are interested in EMDR, contact me today to see if we could be a good fit!

Other Important Theories and Modalities I Use To Inform My Treatment:

• Attachment Theory
  • How do we give love? How do we receive love? Who are our safe people? Attachment theory is about exploring these questions. There are 4 distinct attachment styles, all of which depend on how our caregivers responded to us as kids. Want to know more about attachment theory and your style? Visit https://www.verywellmind.com/what-is-attachment-theory-2795337.
• Expressive Arts Therapy
  • For those of y’all who are willing to go outside of traditional talk therapy and/or somatic therapy, EXA is for you! Drawing, writing, painting, drumming, dancing, body movement- all of these (and more!) make up the EXA spectrum. To learn more, visit https://www.verywellmind.com/expressive-arts-therapy-definition-types-techniques-and-efficacy-5197564.
• Gottman Approach
  • John Gottman and his partner Julie have a LOT to offer the world. Their research about the effectiveness of relationships (such as the Four Horsemen, relationship bids, conflict management strategies) are pretty fucking amazing, and I use them in a lot of my individual work with folks. They have been in the field for 20-30 years. Check out their website at https://www.gottman.com/.
• Intersectionality Theory
  • Intersectionality speaks specifically to the overlap of identities (such as but not limited to: our gender identity, racial identity, sexual orientation, affectual orientation, neurotype, size, body ability, or spiritual identity) that intersect with oppressive systems, such as capitalism, the patriarchy, racism, sizism, queer or trans phobia, sexism to create experiences of privilege or discrimination. Check out George Washington University’s DEI resource list on intersectionality (hyperlink: https://diversity.gwu.edu/resources-intersectionality).
• Neuroscience
  • Research shows that our experiences re-wire our brains. This is especially true in the case of trauma- the technical sciency word is “neuroplasticity.” Now, that being said, I don’t spend a whole lot of time on this- I want you to learn skills rather than more “stuff.” And for those who want a sneak peak, here is a video on the brain’s role in trauma: https://www.youtube.com/watch?v=a-ddSEHRWVg&t=6s.
• Polyvagal Theory
  • Bring on the science! Polyvagal theory is all about how our nervous systems have evolved and/or been designed (whichever works for you) and how these systems struggle bus quite a bit in our modern society. Check out this video on the nervous system: https://www.youtube.com/watch?v=R2825kDSo4M
• Self-Compassion
  • Not as “hippy dippy” as it sounds, trust me. One of my favorite researchers, Kristin Neff, has spent much of her life defining self-compassion, developing techniques for self-compassion, and researching how self-compassion can change our lives. Visit her website https://self-compassion.org/ for more info.

Good Faith Estimate:

On January 1, 2022, a ruling went into effect called the “No Surprises Act”, which requires practitioners to provide a “Good Faith Estimate” to individuals who are receiving out-of-network services at an otherwise in-network healthcare facility or who are uninsured/self-pay. The Good Faith Estimate provides a list of services and items provided, applicable diagnoses, expected services provided, expected charges associated with expected services, and healthcare facility information. The Good Faith Estimate is meant to allow you to decide if you want to engage in treatment with a specific healthcare facility or provider (in this case, me!) prior to actually engaging in services.
If you are not enrolled in a group health plan, group or individual health insurance coverage covered by a health insurance issuer, a federal healthcare program, or health benefit under the FEHB program OR you are insured and choosing not to use your insurance for coverage, then you are entitled to a Good Faith Estimate, which I provide prior to our intake session. You are not required to sign this estimate or participate in my services; however, in order to participate in counseling with me, this is one of the several documents at intake that must be signed.
If you end up paying more than $400 over the Good Faith Estimate that I provide, you are allowed to dispute. For more information about the Good Faith Estimate, please visit https://www.cms.gov/nosurprises/consumers or call 1-800-985-3059.