Questions and Answers

What is the difference between psychotherapy and counseling?  While some use these terms interchangeably, they are different in scope. A psychotherapist is qualified to provide counseling, but a counselor may or may not possess the necessary training and skills to provide psychotherapy.  As a Licensed Marriage & Family Therapist (LMFT), I am qualified to provide both.  

The term “counseling” in mental health is usually  used to denote a brief treatment that is focused mostly on a single problem or behavior.  It often targets a particular symptom or situation and offers suggestions and advice for dealing with it.  “Psychotherapy” is generally a longer term deeper treatment that focuses more on gaining insight into long standing or more global issues.  The focus is on the client’s thought processes and way of being in the world, as well as specific  (often multiple) problems.  In actual practice there is some overlap.  Generally speaking, psychotherapy requires more skill and training than simple counseling.  It is conducted by professionals trained to practice psychotherapy such as licensed marriage and family therapists, licensed psychologists, licensed clinical social workers, or psychiatrists. 

How frequent are the sessions?  I typically meet with people once a week for 50 minutes.  I find that couple sessions often work better in 75-80 minute sessions if at all possible.  This will incur a higher fee.  Sometimes clients will choose to come more frequently, twice a week or more during times of crisis or to deepen or enhance the work.  Occasionally people ask me about meeting every other week.  In my experience, this doesn’t work as well as meeting weekly.  People have noticed that they spend more time reporting events of the past two weeks leaving less time to address deeper issues.  In other words, you get less return on your investment of time and money.  Of course, there are exceptions, particularly in the current economy, so I invite you to discuss any concerns you have about session frequency or length.  

How long will therapy take?  The length of therapy varies and is impossible to know from the beginning. The length of treatment depends on a number of factors such as the nature and severity of the presenting concerns, personal motivation, and any unanticipated events that occur during the course of therapy.  It can be daunting to begin without knowing what will happen or how long it will last.  If you are using insurance to pay for therapy, the insurance company determines the length of therapy and we will need to structure goals accordingly. Some insured clients work on specific issues in blocks of time returning when the next year’s sessions begin.  Others switch to private pay when insurance has reached its limit.   

What does it cost?  My fee is mid range for Humboldt County.  I am a contracted provider with many insurance companies (more on insurance below). Please call me to discuss my current fee and what insurance I accept. If you don't have mental health benefits on your insurance plan, or if you choose to private pay, note that I do have several sliding scale fee slots so check with me to see if these are currently filled or wait listed.   Note that there are reasons that you might find therapy less of a financial strain than you fear:  People in therapy feel supported emotionally and therefore less deprived than they did before. For example, if you’re someone who tends to overspend in an attempt to comfort yourself, you’re less likely to do this after developing healthier coping strategies with your therapist.  Therapy is not only a place to discuss emotional issues, it’s also a place to discuss practical issues like budgeting.  

Can I use my insurance?  I am an in-network provider for many insurance companies so please discuss whether or not you want to use your insurance when we first speak. For information about which insurance companies I am paneled with, see my posting at www.ncamhp.org.  (I am unable to accept MediCal or MediCare). 

Many insurance companies require a psychiatric diagnosis and other confidential information on billing forms and treatment plans. This information is then stored in a database somewhere outside of your or my control. This is usually sent to a national medical information data bank, the Medical Information Bureau (MIB).  [You can check accuracy of their file by checking www.mib.com/html/request_your_record.html  (MIB website) or calling MIB at 866.692.6901].  For some people, this confidentiality risk is a reason to consider bypassing insurance and privately paying for sessions instead. With this said, please know that I have worked with many clients that do choose to use their insurance to fund therapy.  

What is the difference between in-network and out-of-network providers?  An in-network provider is one contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates. An out-of-network provider is one not contracted with the health insurance plan. Typically, if you visit a provider within the network, the amount you will be responsible for paying will be less than if you go to an out-of-network provider. Though there are some exceptions, in many cases, the insurance company will either pay less or not pay anything for services you receive from out-of-network providers.

As a general rule, PPO, POS, and HMO plans make use of provider networks. Indemnity plans typically do not. If you are interested in psychotherapy or counseling, it is important to check your insurance plan to see if they cover “mental health” (or “behavioral health”) benefits. Be aware that you may be required to meet a deductible each year before your insurance company will pay the provider’s fees.  After the deductible is met, most insurance companies require you to pay a copayment fee to your clinician at time of service.

What works in therapy?  Research shows that the biggest factor (about 50%) is the client’s motivation. The next biggest success factor (about 30%) is the relationship between therapist and client, sometimes called the “therapeutic alliance.”  Another factor (about 8%) is related to the kind of therapy. For example, Cognitive Processing Therapies and Prolonged Exposure Therapies are good treatment modalities for certain trauma experiences. People are sometimes surprised that there are so many ways of doing therapy (traditional talk therapy, sandplay therapy, art therapy, cognitive behavioral therapy, EMDR, dance therapy, and more).  The remaining factors are not yet known - the research is still ongoing about the last bit of what makes therapy work.  

To summarize, wanting to do the work and finding the best matched therapist are the two strongest factors for successful therapy.  I suggest that we try two sessions and then discuss goodness of fit. If not (this is rare), I will help you find a therapist that better matches your needs. 

What can I expect at the first session?  The first session is a very crucial session.  It is important to come to that session as ready as possible to openly discuss what brings you to therapy.  With that said, concerns and goals sometimes shift a bit and deepen over time as you feel safer and more comfortable with me.  Much of the focus of the first session will be getting to know each other, sharing your presenting problem, and mutually exploring therapy goals.  Many clients choose to bring paper or a notebook to sessions.  This is optional but useful.  It is common to be apprehensive about the first session.  I have been told by clients and colleagues that I have a calming and nurturing presence that helps calm those fears quickly.  

I will give you my undivided attention during each of your sessions. You can expect confidentiality (see intake forms for more information).  You will have access to a phone number that links you to after hours assistance if needed. If appropriate, you may be given something to think about or practice in between sessions.

How can I make an appointment?  Call my office phone at 707.445.4183.  If I am in session or out of my office, you will automatically get my confidential voice mail.  I check this throughout the day and will call you back as soon as possible. Please leave your name, your phone number, several best times to reach you, and whether it is okay for me to leave you a message if you don't answer.  

You can also email me at patt@patriciajonesmft.com   I check emails once or twice per day, not as often as I check voice mail.  Note that any email (the technology itself) is not as confidential as voice mail.  

How do I reach you before or between sessions? When you call me, you may occasionally reach my confidential voice mail if I am in session or away from my desk.  I generally return calls within 24 hours during the business week. I also have an answering service that can reach me at other numbers for urgent calls or late cancellations. If you leave me a voice mail or message, please let me know if it is all right to leave you a phone message or voice mail if I don't reach you.  I do arrange for a licensed colleague to cover during my vacations.

If you have a life threatening emergency, I may not be able to call back soon enough - call the Humboldt Ccounty Mental Health 24 hour Crisis Line at 707.445.7715 or go to your nearest hospital emergency room.   

I would be happy to answer any further questions during a free 10 - 15 minute preliminary phone call.