Psychotherapy
I guide individuals, couples, families, and groups in working through psychological problems in various areas of life.
I employ a range of psychotherapy techniques to support you in the achievement of your desired goals for your well-being. Although I have specialized areas of focus, I also have a general practice and would be happy to assist you in determining if my approach and skills are right for your situation.
There can be any number of experiences that may indicate the necessity or consideration of therapy. Here is a list of symptoms:
Frequent anxiety
Hopelessness
Excessive guilt
Avoiding or numbing feelings or emotions.
Pattern of failure with relationships, jobs, and friends, or self-defeating behaviors.
Any thoughts, feelings, or behaviors that involve the risk of harm to oneself or others.
Worry
Lack of motivation or energy
Shame
Frustration, irritability, or anger outbursts.
Problems after a traumatic event or loss of a significant relationship.
Inability to know what you want, need, or to identify what feelings you are having
Depression
Mood swings
Major life changes.
Difficulty making decisions or being indecisive
Feeling overwhelmed or confused with life events, which may include a crisis.
Desire to change patterns or improve your performance in an area
About Psychotherapy
Psychotherapy, or talk therapy, is most familiar to people when they think about getting professional assistance for psychological issues. It is centered around the idea of a therapeutic interaction that aims to increase the individual’s sense of his or her own well-being in the context of a protected relationship with the therapist. The safe, confidential setting, and the support and direction of a trained psychological expert allow a person to learn skills and gain insights into behaviors, unconscious influences, or negative and unhelpful thought patterns.
Most people do not distinguish between counseling and psychotherapy, but they do have different meanings. Counseling focuses on support and advice. Psychotherapy is centered around the idea that some behavior or thought pattern has become so disruptive that it affects your everyday life, well-being, and relationships.
Psychotherapy focuses on becoming more aware of maladaptive patterns, revealing internal conflicts, and addressing developmental gaps and skill deficits. Once awareness is developed, we work on developing realistic strategies for change, learning, and improvement.
A variety of psychological theories inform my work with clients. I use traditional psychotherapy and counseling models as a foundation for my clinical work. Additionally, I often find it beneficial to incorporate a variety of complementary techniques and methods into the psychotherapy process. In my experience, integrating other methodologies into the therapy process generally facilitates the desired changes more quickly. How much of each is determined by the client’s needs. Please explore the Approaches page for more information on different methodologies.
In general, psychotherapy allows for assistance from a trained professional. Here’s what you can expect:
Learn the causes of your difficulties so you can better understand them and identify what to do about them.
Learn more effective coping and problem-solving skills needed to regain a sense of satisfaction and direction in your life.
Learn how to strengthen relationships and work on problems.
Learn options for negotiating differences, resolving conflicts, and repairing trust.
Learn to identify unhealthy behaviors, maladaptive coping mechanisms, and thought patterns that do not support your well-being.
Learn how to develop effective communication skills, eliminate destructive communication patterns, and how to navigate difficult conversations with confidence.
Learn how to support yourself and others despite difficulties.
Learn self-supportive and family-supportive coping strategies and boundaries.
Learn how to develop helpful, healthy coping mechanisms, behaviors and thought patterns.
Learn about what allows a person to effectively navigate activities of daily living, and strategies that support a person’s well-being.
Learn how to find long-term solutions to problems or problem behaviors.
Learn how to create understanding and identify unmet needs.
Philosophy & Approach
My Philosophy
Psychodynamic therapy is a major influence in my work with clients. The daily challenges we face create physical, intellectual, spiritual, and emotional tensions, which affect the way we feel. Our body sends us signals to alert us to these challenges such as pain, stress, anxiety, worry, or fear.
These signals are often symptoms of larger issues that may need to be professionally addressed. Psychological symptoms have an adaptive purpose and are generally created in our unconscious mind as a solution. Because all sources of our pain are linked, our physical pain affects our emotional state, and our emotional pain affects our physical state. In order to be happy and healthy in mind, body, and spirit we need to tend to the variety of signals our body is sending us.
Many people will address physical pain, yet ignore emotional and spiritual pain. One of the most effective ways to address all of our pain is to heighten our awareness of these signals, understand what is causing them, and identify what is needed to address them.
Therapy is a tool to help aid this process. I believe awareness is an important part of creating change, as is developing self-supportive habits and resolving the need for adaptive problem behaviors and symptoms that all too often become maladaptive.
My Approach
My approach is insight-oriented and trauma-informed. It integrates self-psychology, object relations, developmental, attachment, neurobiology, and family systems theories. I also use cognitive behavioral techniques, guided imagery, and aromatherapy to help manage symptoms. EMDR, a trauma and distress reduction technique, is used when appropriate, along with Hypnosis, Process Healing Method, and other methods that help facilitate desired changes. I draw from these techniques to individualize therapy for each person and situation.
These techniques help foster awareness and guide changes in unwanted personality traits, negative relational patterns, behaviors, and symptoms while increasing positive patterns and desired relational and communication skills.
I encourage you to learn more about the possibilities for creating change so you will be better informed about the options for the work we will do together.
Fees, Facts, Rights & Forms
My therapy rates are as follows:
- No-charge 15-minute initial phone consultation.
- Initial assessment and intake: $160-$190
- 45-50 -minute session: $155
- 60-70-minute session: $160-$185
- 85-90 minute session: $190-$240
For individuals with financial limitations, I offer a limited sliding scale of $110-$165. My sliding fee program is fee-for-service and individuals must pay for services (cash or check) in full for each appointment. To qualify for a reduced fee disclosure of financial need and income is required. Call for details.
Available appointment times vary.
General office hours:
8:00 a.m. — 6:00 p.m.
Monday — Thursday.
Practice and Clinical Consultation hours can be arranged outside of the above hours
Good Faith Estimate Notice
To clients and prospective clients:
Under the law, healthcare providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate (GFE) for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a GFE before you schedule a service, or at any time during treatment.
If you receive a bill that is at least $400 more than your GFE, you can dispute the bill. Make sure to save a copy or picture of your GFE. For questions or more information about your right to a GFE, or how to dispute a bill, see your estimate, or visit www.cms.gov/nosurprises.
Note About Medical Insurance Reimbursement
To use your medical insurance to cover counseling services your plan benefit determines coverage not your insurance company name.
Each insurance company offers many different plans. Please review your plan benefits.
If you want to use your medical insurance for my services I am out of network for all insurances except PacificSource Commercial Network Plans. My services to you are reimbursable under your out-of-network benefit coverage. My services are likely covered by most insurance plans that allow you to choose your provider. I am opted out of all medicare plans and there is no reimbursement for my services with a medicare plan. We can enter into a fee for service agreement.
Please check with your insurance company about your plan coverage for outpatient mental health services to determine your outpatient mental health counseling benefits.
It is helpful to know your:
- plan effective date,
- deductible,
- copay and/or co-insurance,
- and any disallowed amounts,
as that determines your portion of the fees and what will be reimbursed.
Some plan benefits cover in person and telehealth video sessions different so be sure to ask for those details also.
Some insurance plans require prior authorization for services and most deductibles are calendar year but not all.
It is important to know that billing medical insurance for treatment requires a diagnosis of a covered medical condition and the mental health diagnosis will become part of your medical record.
If you have any questions about how to determine your benefit coverage or if you qualify for a medical diagnosis, please call me at 503-944-5032.
Psychotherapy FAQs
Is counseling right for me?
Counseling or psychotherapy can help most anyone who is motivated to work for desired changes and is willing to put the time, energy, and resources into the process. We all have an innate ability to heal ourselves. Learning how to develop that ability is part of the therapy process. If there is no belief in, or commitment to, the process, then it won’t be helpful to you. But if you are willing to be honest with yourself, take ownership of your issues, be open with your therapist, and keep going even when you want to stop, there is great hope for improvement and desired change.
How does counseling work?
The counseling process allows us to examine all aspects of our lives in a safe and confidential setting with a trained professional. The specific approach used by the counseling professional depends on their theoretical approach and educational background.
The training a counselor receives enables them to uncover meaning and understanding from our thoughts, feelings, behaviors and choices that would be difficult to achieve on our own or with someone who knows us. Learning new skills to manage and direct our emotions and behaviors in a way that supports our well-being is part of what helps. Having a neutral person to process with can be invaluable to those seeking to change their lives in a healthy, balanced way. There are also to very helpful mind-body approaches that support insight oriented work.
What are the differences between therapy, counseling and psychotherapy?
Therapy is an effective process that assists in developing skills and healing sources of pain that affect daily life and relationships. It helps in making choices that lead to a more fulfilling lifestyle. Similar to getting in shape physically, successful engagement in therapy requires regular work and a willingness to face our pain and discomfort. There are different kinds of therapies; counseling and psychotherapy are just two of them.
Counseling, when applied exclusively, focuses primarily on defining problems, problem-solving, decision-making, education, guidance and advice.
The exclusive application of psychotherapy involves in-depth analysis of an individual’s psychological makeup through the application of analytic therapies.
Many mental health professionals, however, combine counseling and psychotherapeutic methods of therapy, which explains why it’s often difficult to differentiate between them. I use both in my work, which allows me to tailor my approach to meet the needs of each client. Mind-body modalities such as clinical hypnosis, EMDR, and Brain Spotting are additional tool that can be used in the therapy process to create the desired change.
How do I get started in therapy?
For many people getting started in therapy is the hardest part. Since you are reading this you have taken the first step. It can be helpful to get a referral from a trusted friend. You can simply call or email the therapist. You know what concerns are going on in your life and the therapist can guide you on how to go about the process.
What are the primary characteristics or symptoms of different dissociative experiences?
There are five core dissociative experiences. I will briefly describe each below.
- Amnesia
- Depersonalization
- Derealization
- Identity confusion
- Identity alteration
Amnesia refers to the inability to recall important personal information that is so extensive that it cannot be due to ordinary forgetfulness. Amnesias are often important events that are forgotten, such as abuse or a troubling incident, lasting from minutes to years. Other amnesias, sometimes referred to as micro-amnesias, are more commonly reported to me by clients who have amnesia as a symptom of their dissociative disorder. These micro-amnesias create the experience of engaging in a discussion and the discussion is not remembered, or the content of a conversation is forgotten from one moment to the next. I have had clients who do not remember a phone call with me, or a therapy session, or whether they even came to their appointment.
Depersonalization is the experience of seemingly being detached from, or “not in” one’s body. A profound alienation from the body such as a sense of not recognizing yourself in the mirror or not recognizing a body part are common. In my experience people can find it hard to articulate the experience. I have heard it described as, “I know I am in my body, but I do not feel connected to it.”
Derealization is the sense of the world not being real. I have heard it described as, “It’s like I’m watching my life sort of like a movie.” In other descriptions people say the world seems unreal, foggy, distant, or as if seen through a barrier at a distance. Many people report experiencing these two dissociative phenomena in combination.
Identity confusion is a sense of confusion about self. These individuals have difficulty maintaining consistency in choices because their preferences, values, and opinions are unclear or change drastically at different times. For example, this can result in a person making a decision to use drugs when at other times it would be repugnant to them.
Identity alteration is the sense of being markedly different from another part of oneself. A person may shift into an alternate personality, become confused, and not know who they are talking to or where they are. The person may experience distortions in time, situation, and place such as believing they are years younger than they actually are, believing they live in a different city, or not realizing a family member has died. Other observable changes include using a different voice tone, facial expressions, range of language, or an accent. Though sufferers of this condition may or may not be able to confirm the experience of identity alteration, they usually can confirm becoming confused about their behaviors, speech patterns, demeanor, body language, feelings, or perceptions.
What might I expect in a first therapy session?
Typically we will have talked on the phone and/or communicated by email prior to our first appointment. You will also have reviewed information about my practice and policies which are part of the intake paperwork. In our first meeting, we spend time discussing and creating a mutual understanding of our work together. This generally involves discussion of the following:
First, I want to provide any additional information you need about my training, experience, any of the intake forms and the types of treatment I can provide, as well as clarity on what I am not able to provide. I also answer any remaining questions you have about therapy, review confidentiality and the exceptions to it, and our shared responsibilities and obligations in working together.
Second, I want to get a beginning understanding of the concerns or problems that bring you in and the goals or desired changes you have for our work together. We want to assure compatibility with your treatment goals and my ability to help you achieve them.
Finally, I will provide you with feedback and my initial recommendations based on the information you provided. I will answer any questions you have about my recommendations. Together we will decide if moving forward and entering into a treatment agreement is a good fit.