Therapy:

How long does therapy usually take? This is a tough question to answer, and the reason for that is that therapy is an individual process, and different people progress at different paces. That said, many will feel some relief even in the first few sessions. This is because taking this often difficult step to work towards positive change is a powerful one, and it often in and of itself creates a shift in our attitudes and gives us some hope.  

How does therapy work — how will you help me?  My first goal will be to help you reduce your uncomfortable symptoms — things like overwhelming sadness or anxiety, racing thoughts, or panic attacks. Then we’ll partner to work toward your goals, and we’ll do this by exploring your emotions, looking at patterns in your relationships and your typical ways of coping with stress, and thinking about how past experiences might be impacting your world today. We’ll check in often to make sure you’re making the progress you want.

What about child therapy? How is that different from adult therapy? Much like adult therapy, child therapy is about creating a safe space, where all feelings and thoughts are accepted and can be explored. Unlike adults, though, children tend to communicate best through play, so that’s how we’ll spend our time — on the floor playing (and sometimes drawing or using clay or reading a book together). One of the most important things about this play, though, is that it’s completely child-led. The therapy room will be a space where your child will get to make choices and lead the way, which is often in and of itself helpful to children in working toward better emotional awareness and regulation. I will also dedicate some of each session spent with your child to working with you; we’ll talk about your goals and concerns for your child, and I’ll empower you to help your child continue her therapy gains at home.

What if I find out there is something really wrong with my child? It can feel scary to begin therapy for your child. You might be worried that we’ll uncover some awful truth or diagnosis, and that’s enough to keep some parents from ever calling a therapist. In reality, most of the time, we find that simply providing children a safe space to explore emotions and develop positive coping strategies — and empowering parents to help with big feelings at home — is enough to effect some positive change. Sometimes a diagnosis is appropriate and helpful; in those cases, we’ll discuss the diagnosis in the context of your child as a whole person, focusing on how we can use this additional information to help your child succeed and feel good.

Who will see my child’s diagnosis? Any diagnoses will be completely confidential unless you choose to share. The only exception to this is if you want to use your insurance to get reimbursed for our work together. Even though I am an out-of-network provider, many insurance companies will still require a diagnosis in order for you to get reimbursed. Please note, however, that even if you do choose to share your (or your child’s) diagnosis with your insurance company for reimbursement purposes, that diagnosis is protected health information and covered by HIPAA, so it is confidential and cannot be shared without your permission. Click here for more information about using your insurance.    

Is therapy confidential? Yes. I am ethically and legally bound to keep what you share during our work together between you and me unless:

  • You give me your written permission (i.e., sign a release of information) to share specific information

  • You choose to use your insurance’s out-of-network benefits to get reimbursed for services (in which case, I will be required to share a diagnosis, dates of sessions you attended, a CPT code for services, and very occasionally, other information, such as a treatment summary)

  • You tell me that you want to hurt yourself

  • You tell me that someone is hurting a child or dependent adult

  • You tell me that you plan to hurt someone else

What about confidentiality in child therapy? Child therapy is a little different. You will be included in the process by checking in with me and your child at the end of each session, and as your child’s legal guardian, you have a right to his Protected Health Information (which includes what goes on in therapy). That said, I won’t tell you every detail of what happens in each session; there may be times when it’s important for me not to share something in order to maintain your child’s sense of trust and safety, both of which are integral to the therapy process. Rest assured, though, that I will always share important information with you, with your child’s permission whenever possible, and you will be kept in the loop about overall progress and themes in the therapy.

What if you can’t help me (or my child)? It is my intention to be genuinely helpful to all with whom I work. That said, while my experience, education, training, and way of working will be helpful to many, it won’t be the right fit for all. If you or I realize that I am not the best person to help you or your child, I am happy to provide referrals to someone who may be a better fit. Ultimately, whether it’s with me or another provider, I want you to feel better and reach your goals.

I don’t have childcare — can I bring my baby with me to therapy? Yes, absolutely! I would never want a lack of childcare to keep you from getting the help you need. I keep a pack-and-play in my office, and I have plenty of toys, so we’ll make it work. That said, if you want therapy to be a time just for you, that is perfectly okay, too! And if it’s overwhelming to even think about getting baby ready and out the door, I offer in-home services and teletherapy for new parents to make the process of getting help a little easier.

What about older children? Can they come to therapy? We’ll approach this on a case-by-case basis. Generally speaking, bringing children over age two to therapy can present challenges. The therapy process will sometimes bring up sensitive or painful topics, and it’s often not ideal for children. That said, as I noted above, I never want a lack of childcare to keep you from getting the help you need, so we’ll discuss your situation and figure out the best way forward. And do keep teletherapy in mind as an option!

I’ve heard of "walk & talk” therapy. Do you offer that service? Yes! I offer this service to interested clients (ages 8 and up). I’m a firm believer in the benefits of moving our bodies and of making movement a habit, and sometimes really great therapy happens while we’re moving. If you’re interested in doing walk & talk therapy, we’ll discuss the walk & talk process during your initial intake session to see if it feels like a good fit. If it does, we can start meeting outside and walking while we do our sessions.

Do you take my insurance? I am an out-of-network provider for insurance companies. This means that I don’t bill your insurance directly. I will, however, provide you with a superbill (which is an insurance-specific receipt) for any services rendered. You can then submit this superbill to your insurance company — insurance companies will typically reimburse you for a portion of your expenses from therapy or testing. That said, different insurance companies reimburse at different rates, so you’ll need to contact your insurance company directly to better understand your out-of-network benefits for mental health services. For more information about insurance and a list of questions to ask your insurance company, click here.

What are your fees? Fees for all services are listed here.

Parent Support:

How are parent consultations different from therapy? The guidance and support offered through parent consultations is different from therapy, which is applicable when a child is struggling more than would be expected given his age and development. Parent consultations are offered because, well, the parenting struggle is real. It can be so hard to know the best way to respond in the face of our children’s big feelings and challenging behaviors. The vast majority of the time, these challenging behaviors and big feelings are completely normal, expected, and healthy parts of childhood — but that doesn’t make them any easier to navigate, and parents often need guidance and support.

How do I know whether my child is struggling more than she should given her age and development? Great question. Parents will often call with concerns about their child, and through our discussion, we’ll figure out that the child’s challenging behaviors — although difficult to navigate — are an expected part of healthy development. If you’re unsure about how to best support your child, schedule your free 15-minute phone consultation, and I’ll help you discern which service will be most beneficial for your family.

What sorts of behaviors and challenges do you help with through parent consultations? Parent consultations are a wonderful place to address almost any parenting issue, including but not limited to: how to respond to crying and other big feelings, understanding and navigating tantrums, difficulties with transitions, struggles at mealtime or bedtime, managing difficult behaviors (e.g., hitting, biting, pushing, yelling, etc.), helping an older child adjust to having a new sibling, finding a routine that works for your family, and school-related issues. If you’re struggling with any of these — or with something not mentioned here — schedule your free 15-minute phone consultation, and let’s talk about how I can help.

How old are the children of parents you help through parent consultations? I offer support to parents of children of ALL ages, beginning in infancy. In fact, the younger the child, the more helpful these consultations often are. I will provide information and perspective around what you should expect to see given your child’s current age and circumstances, tools to help you navigate the difficult moments with confidence, and strategies to reconnect when you’ve handled things differently than you hoped you would (which is a normal part of parenting for all of us!).

Medication:

Will you put my child on medication? Medication is a scary topic for most parents. I look at medication like this: It’s useful *only* in situations where a child is struggling so much that other interventions (like therapy or home and school-based strategies) aren’t effective. For example, imagine a child who’s so anxious that she’s refusing to attend school. Or a child whose hyperactivity keeps him from being able to absorb information. Or a child who is so sad she can’t get out of bed. These children might benefit from a trial of a medication that’s been shown to be safe and effective in children; we might see that with even a small dose of the right medication, the child is now able to be helped by other interventions.

Will you prescribe the medication? No. As a licensed clinical psychologist in NC and VA, prescribing medications is not in my sphere of training or competence. If we think that medication may be beneficial for you or your child, I will refer you to a psychiatrist — a medical doctor with special training in mental health and psychotropic medications. If the referral is for your child, I will refer you to a psychiatrist with expertise in working with children. The psychiatrist will offer a medication consultation, where s/he will work with you to determine 1) whether a medication trial makes sense and 2) which medication to try. I will communicate closely with the psychiatrist throughout this process; research shows that the best treatment happens when professionals communicate and collaborate.

Will my child be on medication forever? This is another common worry parents have when we discuss medication. The short answer is not necessarily. Many children only need a short trial of medication to move through a specific crisis. However, others require longer-term medication use, and in that case, we will work closely with a psychiatrist to make sure your child is on the right medication and the lowest effective dose to help him or her feel good and be successful.

If I take medication to help with a Perinatal Mood or Anxiety Disorder, will I need to take it forever? In many cases, no. Many women will only need to be on medication for 6-9 months while their hormones stabilize and they work towards healing through therapy, social support, and lifestyle changes. That said, sometimes the perinatal period will bring out an underlying mental health vulnerability, and in those cases, medication might be necessary for a longer period of time.

I am pregnant and on medication for my mental health — should I continue my medication? This will, of course, always be a decision that you will make with your psychiatrist, who should be meeting with you throughout your pregnancy and after delivery to make sure your medication needs are met. That said, in most cases, the answer is YES. Current research overwhelmingly shows that many psychotropic medications are safe — or pose very minimal and manageable risks — during pregnancy and while breastfeeding. Older studies showed some concerns with medication during the perinatal period, but those studies have since been refuted. The much larger risk in most cases — to both mother and baby — is to stop the medication and risk the return of symptoms.

Will medication make me (or my child) feel “numb”? No, the right medication for you at the right dose for you should not numb your feelings, and that definitely isn’t the goal! While on medication, you should still feel like you. You’ll still experience life’s typical highs and lows. You’ll still be able to experience joy in happy moments, and on the contrary, if you experience a major life stressor, such as a move or job loss, you’ll still feel the many emotions that come with that experience. The difference is that your lows won’t be quite so low, nor will they last for so long; your anxiety won’t overwhelm your ability to think through situations; your mood won’t fluctuate quite so easily.

What does “perinatal” mean? “Perinatal” refers to the roughly 22-month time period from when a woman becomes pregnant through her baby’s first birthday. This is a time when a woman, due to hormonal and lifestyle shifts, is particularly vulnerable to mental health struggles and specifically to Perinatal Mood and Anxiety Disorders (PMAD’s).

Testing:

What information will testing give us? It depends on the reason for the evaluation, or the question we’re asking.

  • Cognitive measures give us information about how your child thinks, processes, accesses, and stores information. These measures will also give us a sense of your child’s cognitive strengths and areas that might require additional support.

  • We can also learn about your child’s attention and Executive Functioning (i.e., things like impulse control, regulating emotions, shifting focus from one activity to another, organizing time and materials, getting started on tasks, and monitoring one’s progress during a task).

  • Achievement testing tells us how much your child has accomplished academically and where they might need extra support.

  • Social-emotional measures will give us a sense of which painful symptoms your child might be experiencing (e.g., sadness, anxiety, low self-esteem, or social stress). These measures can also help us understand how your child approaches the world, experiences and processes emotional stimuli, copes with stress, and interacts in relationships.

From this data, I will write a detailed report, with background information, findings, an assessment of strengths and challenges, and recommendations for both home and school (if applicable).    

What if we find out something is wrong? It can feel scary to request a psychological evaluation for your child. You might be worried that we’ll uncover some awful truth or diagnosis, and that’s enough to keep some parents from ever requesting an evaluation. In reality, parents tend to find the information from their child’s evaluation extremely helpful. Often, it helps them “connect the dots” of their child’s struggles. In addition, I use data from an evaluation to create recommendations for home and/or school that are tailored to your child’s strengths, challenges, and needs, and parents find this to be a wonderful resource. Sometimes a diagnosis is appropriate and helpful; in those cases, we’ll discuss the diagnosis in the context of your child as a whole person, focusing on how we can use this additional information to help your child succeed and feel good.

How long will testing take? A psychological evaluation will typically require three or four meetings in total. The first meeting will be about an hour with parents to discuss concerns and questions and create a plan for testing. Then I will meet with your child to conduct the evaluation, which usually takes one or two sessions of about four hours (this varies depending on how long it takes your child to complete the testing and also on the sort of evaluation we’re doing). Finally, I’ll meet again with parents to discuss findings and recommendations for moving forward.  

Who will see my child’s testing report? All written reports will be completely confidential unless you choose to share. If your child’s school requests an evaluation, and you choose to seek that evaluation privately, you will have to give your written permission for the school to see the report. In the event that there is sensitive social or emotional information in the report that you do not wish to share with your child’s school, I am happy to put together a separate report for the school upon your request. This separate report will contain only information that is relevant to your child’s education.

The pediatrician is concerned that my child may have ADHD. Is there a chance this isn’t actually the case? Yes. When there are concerns about ADHD, it’s important to have a licensed psychologist conduct an evaluation to confirm or rule out the diagnosis. Social-emotional difficulties, for example, can look a whole lot like ADHD, often manifesting as inattention, irritability, homework struggles, and problems with organization — and yet we’ll help a child in this situation differently than a child with an ADHD diagnosis. The good news is that an evaluation will give us insight as to what’s causing your child’s struggles — be it ADHD or something else — and provide guidance toward helping him feel good and be successful.

If you evaluate my child, can she then see you for therapy if needed? Yes, definitely — and this is often a great situation as children are already comfortable, and I already have a lot of helpful information to guide our work.

What about the other way around — can you do an evaluation for my child if he’s already your therapy client? Unfortunately, no. It wouldn’t be ethical for me to conduct an evaluation with a child I’m seeing for therapy; the testing itself and my conclusions are likely to be biased because we are already working together. If I’m seeing your child for therapy, and we determine that an evaluation would be helpful, I will make a referral to another psychologist — and with your permission, that psychologist and I will collaborate to ensure the most comprehensive and effective treatment possible.

How much will an evaluation cost? Please check out the Getting Started page for information about fees.

Don’t see your question? I’d love to hear from you! Click here to send your question via the online contact form, or ask it during your free 15-minute phone consultation — click the button below or call 919-344-1296 to schedule.