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Common Questions
Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychologist and client, and the particular problems you bring forward. There are many different methods I may use to help you deal with the problems you wish to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and in your daily life. Psychotherapy can have both benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness and helplessness. On the other hand, psychotherapy has been shown to have benefits for people who go through the process. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you specifically will experience. Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, I will be able to offer you some first impressions of what our work will include and a treatment plan to follow, if you decide to continue with therapy. You should evaluate this information along with your opinions of whether or not you feel comfortable working with me. Therapy involves a large commitment of time, money and energy, so you should be very careful about the psychologist you select. If you have questions about my procedures, we should discuss those concerns as they arise. If your doubts persist, I will be happy to help you set up a meeting with another mental health professional for a second opinion. Meetings I normally conduct an evaluation that will last from 2 to 4 sessions. During this time, we can both decide if I am the best person to provide the services you need in order to meet your treatment goals. If psychotherapy is begun, I will usually schedule one 50-minute session (one appointment hour of 50 minutes duration) per week at a time we agree on, although some sessions may be longer or more frequent. Once an appointment hour is scheduled, you will be expected to pay for it unless you provide 24 hours notice of cancellation. Under some circumstances, I will try to find another time during the same week to reschedule the appointment, and waive the fee. This concession is made in the case that the cancellation was genuinely unavoidable, could not reasonably be anticipated in advance, and you do not have a record of repeated late cancellations. HOW MUCH WILL THIS COST? The first appointment, which usually involves extra time and paperwork, is $150. After that, the hourly fee is $120. In addition to weekly appointments, I charge this amount for other professional services you may need, though I will break down the hourly cost if I work for periods of less than an hour. Other services include report writing, telephone consultations lasting longer than 10 minutes (or repeated telephone contacts within a particular period of time), attendance at meetings with other professionals at your request, preparation of records or treatment summaries, and the time spent performing any other service you may request of me. The hourly rate for psychological testing is $150, due to the higher costs of psychological testing materials. When I perform a battery of tests requiring a written report, I will charge one hour's fee to write the report, although that process typically takes considerably longer. If you should become involved in legal proceedings that require my participation, you should be expected to pay for my professional time even if I am called to testify by another party. Because of the difficulty and challenges of legal involvement, the fee for such services is considerably higher. A separate sheet of information regarding legally related services is available upon request. Billing and Payments You will be expected to pay for each session at the time it is held, unless we agree otherwise or you have insurance coverage which requires another arrangement. Payment schedules for other professional services will be agreed to when they are held. While I routinely accept a number of clients for a reduced fee plan, you should not assume that this applies to you unless we have agreed to this in advance. If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, I have the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court. If such legal action is necessary, its costs will be included in the claim. In most collection situations, the only information I release regarding a patient's treatment is his/her name, the nature of services provided, and the amount due. WILL MY INSURANCE COMPANY PAY FOR THIS? In order for us to set realistic treatment goals and priorities, it is important to evaluate what resources you have to pay for your treatment. If you have a health insurance policy, it will usually provide some coverage for mental health treatment. I will fill out forms and provide you with whatever assistance I can in helping you receive the benefits to which you are entitled; however, you - and not your insurance company - are responsible for full payment of my fees. It is very important that you find out exactly what mental health services your insurance policy covers. You should carefully read the section in your insurance coverage booklet that describes mental health services. If you have question about the coverage, call your plan administrator. Of course, I will provide you with whatever information I can based on my experience and will be happy to help you in understanding the information you receive from your insurance company. If it is necessary to clear the confusion, I will call the insurance company on your behalf, at your request. Due to the rising costs of health care, insurance benefits have become more complex. It is sometimes difficult to determine exactly how much mental health coverage is available. "Managed Health Care" plans such as HMOs and PPOs often require authorization before they provide reimbursement for mental health services. These plans are often limited to short-term treatment approaches designed to work out a specific problem that interferes with a person's usual level of functioning. It may be necessary to seek approval for more therapy after a certain number of sessions. While a lot can be accomplished in short term therapy, some clients feel that they need more services after insurance benefits end. (Some managed-care plans will not allow me to provide services to you once your benefits end. If this is the case, I will do my best to find you another provider who will help you continue your psychotherapy.) You should also be aware that most insurance companies require you to authorize me to provide them with a clinical diagnosis. Sometimes I may also have to provide additional clinical information such as treatment plans or summaries, or - in rare cases - copies of the entire record. Information submitted to the insurance company will become part of the insurance company's files and will probably be stored in a computer. Though all insurance companies claim to keep such information confidential, I have no control over what they do with it once it is in their hands. In some cases, they may share such information with a national medical information database. I will provide you with a copy of any report I submit, if you request that I do so. Once we have all of the information about your insurance coverage, we will discuss what we can expect to accomplish with the benefits that are available and what will happen if they run out before you feel ready to end our sessions. It is important to remember that you always have the right to pay for my services yourself to avoid the problems described above, unless specifically prohibited by a managed care contract. WHAT INSURANCE COMPANIES CAN YOU WORK WITH? I have existing relationships with the following insurance companies. These companies will reimburse for services under some plans.
WHY AM I ALWAYS TALKING TO YOUR VOICE-MAIL? I don't have a secretary, because I like to keep my office simple to run. I don't answer the phone when I am meeting with a client in my office out of respect for that person. I do, however, check my confidential voicemail many times a day. I try to return urgent calls as soon as I possibly can. Routine calls I try to return the same day. It is helpful if you will leave me several different phone numbers and times when you will be available at those numbers, so I have the best chance of finding you when I get a chance to use the phone. HOW DO I MAKE AN APPOINTMENT WITH YOU? Often, I cannot be reached immediately by telephone. While I am usually in my office between 8:30am and 4:30pm Monday through Friday, I probably will not answer the phone when I am with a client. When I am unavailable, my telephone is answered by confidential voicemail that I monitor at least several times a day during the week. I will make every effort to return your call on the same day you make it, with the exception of weekends and holidays. If you are difficult to reach, please inform me of multiple times and telephone numbers to assist me in returning your call. In the case of a genuine emergency, you can reach me through my cell phone. That number, as of January 2004, is (205) 612-2336. In the event the emergency contact information changes, new information will be available on my office voicemail message. If you are unable to reach me and feel that the situation is urgent, contact your family physician or go to the nearest emergency room. If I anticipate that I will be unavailable for an extended period of time, I will provide you with the name of a colleague to contact, should it be necessary. WILL YOU KEEP RECORDS ON ME? The laws and standards of my profession require that I keep treatment records. You are entitled to a range of rights determined by Alabama state law and the regulations of the Health Insurance Portability and Accountability Act (HIPAA). Specific considerations regarding your records, my handling of those records, and your access to them are dictated in the HIPAA and State of Alabama Policies and Procedures. Please review these Policies and Procedures carefully, and ask me any questions you have concerning matters in the document. Generally, however, you are entitled to inspect or copy certain records in my possession, unless I believe that seeing them would be emotionally damaging to you, in which case I will be happy to send them to a mental health professional of your choice. In general, I recommend that you review them in my presence so that we can discuss the contents. Clients making this request will be charged an appropriate fee for any time spent in preparing information requests. Minors If you are under eighteen years of age, please be aware that the law may provide your parents the right to examine your treatment records. It is my policy to request an agreement from parents that they agree to give up access to your records. While not legally binding, this commitment is important in my view to the development of a trusting therapy relationship with a young client. If your parents make this agreement, I will provide them only with general information about our work together, unless I feel there is a high risk that you will seriously harm yourself or someone else. In this case, I will notify them of my concern. I will also provide them with a summary of your treatment at various points in the process, along with suggestions for how they can support and promote your progress. Before giving them any information, I will discuss the matter with you, if possible, and do my best to handle any concerns you may have with what I would like to discuss. IS IT TRUE THAT ANYTHING YOU AND I DISCUSS IN PRIVATE WILL REMAIN A SECRET FOREVER? In general, the privacy of all communications between a client and a psychologist is protected by law, and I can only release information about our work to others with your written permission. But, there are a few exceptions. In most legal proceedings, you have the right to prevent me from providing any information about your treatment. In some proceedings involving child custody and those in which your emotional condition is an important issue, a judge may nonetheless order my testimony if s/he determines that the issue demands it - even if you wish for such information to remain confidential. There are some situations in which I am legally obligated to take action to protect others from harm, even if I have to reveal some information about a client's treatment. For example, if I believe that a child, elderly person or disabled person is being abused or neglected, I am legally required to file a report with the Department of Human Resources. If I believe that a client is threatening seriously bodily harm to another, I am required to take protective action. These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the client. If a client threatens to harm him/herself, I am legally and ethically obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection. These situations occur rarely in my practice. If a similar situation occurs in my handling of your issues, I will make every effort to fully discuss it with you before taking action, unless doing so places someone in danger. I may occasionally find it helpful to consult other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The consultant is also legally bound to keep the information confidential. If you don't object, I will not tell you about these consultations unless I feel it is important to our work together. While this written summary of exceptions of confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have at our next meeting. I will be happy to discuss these issues with you if you need specific advice, but formal legal advice may be needed because the laws governing confidentiality are quite complex, and I am not an attorney. More information concerning specifics of confidentiality, particularly regarding my records of your treatment, is available in the HIPAA and State of Alabama Policies and Procedures. WHAT ARE THE DIFFERENCES BETWEEN PSYCHOLOGISTS, PSYCHIATRISTS, and COUNSELORS? A Psychologist is an individual with a multiple degrees culminating in a Ph.D. in Clinical Psychology from a specially accredited program in psychology, and at least two years of supervised work experience. Psychologists are trained to perform psychological testing procedures, including personality evaluations and academic testing, make formal diagnoses and provide many kinds of therapy. The only responsibility psychologists in Alabama may not assume is that of prescribing medications. Psychologists typically work with a family doctor, internist or psychiatrist to coordinate behavioral and medication interventions, when medication is needed for a particular individual. Psychologists are licensed to practice by the state. A Psychiatrist is a medical doctor with special training in the diagnosis and treatment of mental and emotional illnesses. In Alabama, psychiatrists are the only group of mental health professionals qualified to prescribe medications used to treat psychological disorders. They do not ordinarily provide psychotherapy and very few are trained to perform psychological testing procedures. Psychiatrists are licensed by the state. Licensed Professional Counselors and Clinical Social Workers typically have at least a master's degree in counseling, psychology or social work. They are trained to provide individual and group counseling, but are not typically allowed to make formal diagnoses of psychological conditions in Alabama. Both Professional Counselors and Clinical Social Workers are licensed to practice by the state. HOW DO I KNOW IF I NEED TO BE SEEN FOR TREATMENT? Is there a behavior, feeling, or situation that is causing you significant distress, or is interfering with your ability to perform your usual activities and really enjoy your life? Many people seek therapy because of a specific, definable psychological disorder, such as a major depressive disorder or post-traumatic stress disorder. Others may seek therapy because of a situation, such as dealing with a substance-abusing family member, a tense work environment with ongoing downsizing, or a normal change of life issue. These individuals often desire to improve the quality of life and respond more effectively to circumstances that are partly or entirely beyond their control. Has the troubling behavior, feeling or situation not improved over time, or even gotten worse? We all have difficult periods in our lives, most of which do not require therapy. We turn to family members, friends, clergy and others for support and guidance. We read books that give us a fresh perspective, rely on our faith or philosophy for strength or wisdom, or try yet different ways to deal with the challenge. Typically, such normal "self-help" approaches are all that are needed to get us back to enjoying life fully. However, when a problem persists despite our best efforts, or if it worsens, it is likely time to seek professional help. Is the troubling behavior, feeling or situation bad enough that serious consequences are possible? It is one thing to have a few sad days, in which we don't feel like ourselves and don't enjoy our usual activities because we are preoccupied with a concern. It is another thing to be unable to function - perform normal job activities, tend our children, manage our finances, or take care of ourselves bodily. When the problem is serious enough that consequences include self-harm, loss of employment, failure in school, inability to take care of persons dependent on us, or failure to adequately care for ourselves on a regular basis, it is definitely time to seek professional help. In the case of children, a problem can be serious enough to justify professional help if the child or adolescent is simply failing to achieve normally expected developmental milestones or independent living tasks within a reasonable time frame. CAN YOU PRESCRIBE MEDICATIONS FOR ME? No, only physicians can prescribe medications in Alabama. However, I routinely work closely with family doctors, psychiatrists, internists and pediatricians to ensure that those individuals who need medication receive good continuity of care between the different care providers. If I feel that medication may be important for your care, I will ask that you give me written permission to speak with the appropriate physician so that there is good ongoing professional communication.  |
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