Q. Will you accept my insurance?

A. For many reasons, my practice does not accept insurance. I believe that involving corporate third parties in the highly personal, private content and process of therapy is invasive and may compromise treatment. To me, no insurance company should decide whether your situation is worthy of coverage ("medically necessary," in their language), and if so, how many sessions you are "entitled" to.

I also am aware that if mental health treatment appears on your medical record, it may affect how you are viewed by current and prospective employers, and could limit your ability to get disability, health, or life insurance in the future.

Finally, I believe that my time and energy are much better spent actually working with patients, rather than filling out paperwork, sending reports, and doing battle with insurance companies.

If you choose to submit claims to your insurance company, you can use the receipts that I provide when you pay for each session. Please know that you may or may not receive reimbursement. If using your insurance is essential to you, you may wish to seek another therapist.

Q. Are you licensed psychologist to practice in California to provide health services?

A. I am a Licensed Psychologist in California. My license number is PSY20609.

Q. How long does therapy last?

A. The course of therapy varies from person to person. Sometimes people achieve their goals in just a few months, while in other cases it may take a year or longer to complete our work. Factors influencing the duration include the nature and complexity of the issues we're addressing, your life circumstances, your motivation, and many other variables.

You probably will know whether our partnership feels "right" within our first several meetings and can decide whether to continue with me or to seek a referral to another practitioner.

Q. How often would we meet?

A. Usually sessions are once a week, although it may be beneficial to meet more frequently in certain situations. Unless we are nearing the completion of our work together and are "tapering off" our meetings, I will not do therapy on a less than weekly basis. When too much time elapses between appointments, I find that progress is noticeably slower and momentum is lost.

Q. What if I can't afford your fee? Do you offer a sliding scale?

A. I recognize that some people may be unable or unwilling to pay my full fee. In order to be as accessible as possible, therefore, I'm willing to consider alternative arrangements on a case-by-case basis.

For those who do not pay the full fee, I require that you "pay" by doing hands-on volunteer work for a local nonprofit organization, such as, Habitat for Humanity, Meals on Wheels, the library, schools, churches, or any other nonprofit or charitable organization. I urge you to select a group or cause that you genuinely care about so that your service has personal meaning.

Here's how the plan works. For each therapy session you:pay 75% of my regular fee ($135) plus one hour of volunteering; or pay 50% of my regular fee ($90) plus two hours of volunteering; or pay 25% of my regular fee ($45) plus three hours of volunteering.

At each of our sessions, you will provide written documentation of your volunteer service. This does NOT mean that you need to tell the organization you're helping that you are in therapy. You need only ask them to give you a brief statement on their letterhead that indicates how many hours you worked that week.

This plan has worked very successfully in other communities, and I believe it benefits everyone. It allows me to offer my services to people who otherwise might not be able to afford the cost of therapy. It gives patients a chance to "give back" without feeling as if they're receiving something for nothing. And it brings an infusion of hands-on assistance to our community as a whole.

Q. Can you assure me that my privacy will be protected?

A. I am very sensitive to people's concerns about privacy and confidentiality.

I am aware that we are likely to run into each other at local events, at the grocery store, or other places outside the therapy office. To respect your privacy, I may not greet you or act as if I know you, unless you indicate that it's okay.

Q. What about confidentiality?

A. You have a legal right to the confidentiality of what we discuss in our sessions, and even to the fact that you are in therapy with me, unless you give me written permission to disclose that information (for example, to your medical doctor). I am required to safeguard that confidentiality.

There are, however, some legal exceptions:

• I am required to notify the authorities if I have cause to suspect that a juvenile (under age 18) has been abused or neglected.
• I also must contact the authorities if I have reasonable cause to believe that abuse or neglect of an elderly or disabled person has occurred.
• If you are involved in a legal proceeding, a judge may order me to disclose information related to your treatment.

Q. Does being in therapy mean there's something wrong with me or that I have a mental illness?

A. It is very unfortunate that in American society, there is still a stigma associated with seeking help for emotional and mental problems. My view is just the opposite: I see people who come to therapy as strong, courageous, and motivated to work on what's distressing them.

The dominant perspective in the mental health field relies on a medical model of illness and treatment. Insurance companies, for example, require a diagnosis of a mental illness (such as depression or obsessive-compulsive disorder) in order to approve psychotherapeutic and other services. And drug company advertising has influenced many people to believe that medication that acts on brain chemistry will "solve" most mental health problems.

I am not comfortable with that mindset. Although I am trained in making diagnoses, I don't think that using formal diagnostic labels with patients is always necessary - unless it may be helpful in explaining what I think is going on. I do often apply techniques and treatment approaches that have been shown in research to be effective for a particular condition. At the same time, however, I recognize that people and their problems usually are complex and demand a thoughtfully tailored approach to treatment.

In summary, I generally don't look at people as "ill" or "weak," and I don't rob them of their humanity and individuality by thinking of or referring to them as "cases" or by diagnostic labels.

If you come to me for help, I will not treat you as if you are sick and helpless. Instead, I will do my utmost to impart my firm conviction that you have the potential to change your life for the better.