I have found that in order to thoughtfully and intelligently answer initial questions, I need to know more about your/your child’s history. This takes more time than 10-15 minutes on the phone. In addition, it’s challenging to get a full sense of my approach to your (or your child’s) specific concern via a 10-15 minute phone conversation. An intake appointment (1 hour) allows for much more discussion and gives both of us a better sense of how we might be able to work together (or not). It is not uncommon for folks seeking therapy services to have intake appointments with several therapists to help decide who is the best fit for them.

It is my belief that we (you and I) should be in charge of treatment decisions, not your insurance company. I do not want to compromise the quality of care you receive by having to work within the confines determined by your insurance company. While I am not an in-network provider with any insurance company (including Medicare and Medicaid), you can submit the receipts from our sessions to your insurance company and seek out-of-network benefits. It will be important for you to check with your particular insurance company to determine your mental health/behavioral health out-of-network benefits and the details of those benefits. We can provide you with CPT codes to help you know what to ask when you call your insurance company. You may have coverage for a good portion of my services. More information about fees and insurance can be found in the business policy.

Yes, I do offer after-school appointment times! That said, these appointment times are in highest demand and are reserved for clients attending therapy sessions consistently on a weekly or biweekly basis. For new clients/inquiries, it is rare for a seasoned child psychologist to have after school appointment times sitting open and available, but we work very hard to get clients into preferred times! [We keep a running list of clients’ preferred times to work toward.] If you are willing to be flexible about the time of day for appointments at first, we will work you/your child into a preferred time as those times open up (as someone finishes therapy or reduces frequency of appointments). Clients who are flexible about time of day for appointments at first are prioritized over clients on the waiting list who are only willing to be seen during after school hours. Please also keep in mind that many schools are very understanding about the importance of mental health treatment, and we are happy to provide a school excuse note. In addition, there are often creative solutions such as scheduling appointments (either telehealth or in-person) during a study hall period or during lunch.

When you set up an initial intake appointment, we will provide you with paperwork to complete electronically. I usually begin intake appointments by answering your questions and then simply asking you to tell me why you are seeking help. I follow your lead and will jump in with my questions. It is very helpful to bring in copies of any previous testing or evaluations that may have been completed. If you sought treatment in the past, it is valuable to know what you found helpful and not helpful about that experience. Some people find it useful to jot down a general timeline to help them organize their thoughts or to make a list of their concerns but this is not necessary.

Testing battery:

Testing batteries (which specific tests are administered) are based upon the presenting concern(s), clinical judgement, and what the data indicates should be further evaluated. The vast majority of testing batteries include: IQ testing, academic achievement testing (including concerns about learning disabilities/disorders), executive function/neuropsychological screening (including concerns about ADHD), and emotional/behavioral functioning screening. If an autism spectrum disorder (ASD) is suspected, then tests and screenings specific to ASDs are also included.

In general, we do not offer testing “packages” that evaluate for only one specific diagnosis. For example, we do not offer “ADHD only testing.” This is because we need to look at the whole student/person to determine all of the factors that may be at play. Administering tests specific to one particular diagnosis only often does not capture the complete clinical picture and may result in “cookbook” recommendations that do not reflect the full functioning (both strengths and weaknesses) of a student or individual. Many symptoms can have varied clinical roots. For example, symptoms of inattention may be related to a sleep disorder, ADHD/executive functioning deficits, anxiety, trauma, a learning disorder, and/or problems with cognition. While some explanations may not be relevant for a particular person, it is essential to both “rule in” and “rule out” various diagnoses and explanations of the symptoms being observed. This is why it is important to look at the whole person and not test exclusively for one specific diagnosis. We have found that this is also a more cost-effective approach to testing—learn about the whole person via one evaluation versus doing several diagnosis-specific evaluations. There are, of course, exceptions to this. For example, someone may have had testing completed within the last year and may need additional testing in particular areas completed (which likely would not require a full battery of tests). Another example is testing for giftedness which does not require a full psychological battery.

Reports:

We believe that psychological evaluations should be written in easily understandable language that clearly outlines the results of the testing data (what it actually means) and provides specific next steps and recommendations for a particular student or individual. While having a diagnosis can certainly be helpful, we aim to individualize our reports to be specific to that student/person and their unique strengths and weaknesses. We also try to anticipate future needs or concerns and address those in the recommendations as well.

Logistics:

With regard to logistics of testing, all testing begins with an intake (one hour). This is an opportunity for us to gather the relevant background information, address your questions about testing, and begin to create the specific testing battery. The intake can be held in-person or via telehealth. The testing itself is typically completed in two 3-4 hour in-person appointments. [If a full battery of tests is not required, then this time will be less.] Once the report is completed (typically within approximately 4 weeks of the last testing session), a feedback session is held (one hour) which reviews the results and recommendations in detail. You will also have the opportunity to ask any questions you have in the feedback session. The feedback session can be held in-person or via telehealth. It is important to highlight that we provide the written report at the feedback session. While other practices may offer feedback sessions more quickly, they may not provide the written report for several months.

I consider you the expert on you and/or your family. I will listen to what you have tried and why it has not succeeded. We will work together to determine what will help your particular situation. I may ask you to try some things you have already tried and will explain why and/or how I want you to do something slightly differently. I aim to truly personalize interventions. We will talk about what challenges exist specific to your situation and how we will work around them. It is common for me to ask questions such as, "When you go home and try this, what challenges might be thrown back at you?". We will then prepare you to address those challenges.

As with many things, it depends upon the circumstances. I strive to provide practical, solution-focused therapy so that you only come to see me as long as necessary - until functioning is restored. The nature of the presenting issue also comes into play, as some issues take longer to resolve than others. For example, I have worked with a child or family for as little as 3-4 sessions to resolve very specific issues. It is more common, however, for treatment to last 3-6 months. Other times, treatment needs to continue longer. The length of treatment also depends upon your goals. Some families want to work on other issues after the initial issue is well-managed. Your attendance to sessions and follow through with recommendations also impacts the length of treatment.

I am happy to consult with other treatment providers, as this can often help treatment move forward more effectively. I will need you to sign a release in order to permit me to talk with these other professionals.

When your child sees me for therapy, you are likely to be involved. For very young children (preschool-1st grade), I may actually work with you more often than with your child. I have found that working with parents/caregivers about how they respond to various behaviors can be highly effective in changing child (and parent/caregiver) behavior to improve interactions. Adolescents, however, generally prefer more privacy and confidentiality and we will come to an agreement about what information is or isn't shared with you. For children between these ages, I generally work with both the child and parents/caregivers, spending time with each separately and combined.

I understand that some children will be anxious about coming to see me (and some parents/caregivers too!). Most children are not likely to sit down in my office and self-reflect about whatever issue has brought them and/or their families in, although some surprise us and do. I aim to provide a comfortable environment and will give your child some time to "warm up." I often play with younger children while we meet to help them feel more comfortable. For example, we may build with Legos, play a board game, or draw while we talk. For older children and adolescents, we may use the computer or other technology to help maintain their interest. I will follow your child's lead. If there are particular things I could do to help your child feel more comfortable, please tell me. During the initial intake (usually done without the child present), we can also discuss how to tell your child about coming in to see me.

With your permission (a signed release), I can talk with your child's school if we feel it would be helpful to the treatment process. For particular presenting issues such as school anxiety or refusal, coordinating treatment with the school is essential.

I use a variety of techniques personalized for each situation. I generally use a cognitive-behavioral framework and "borrow" from other orientations depending on the particular presenting issue. Cognitive-behavioral therapy (CBT) is often very effective in reducing symptoms and improving functioning. This approach usually involves work outside the therapy session which can help treatment move forward more efficiently and effectively. You may be asked to try things between sessions and come back and share the results which will help us determine next steps.

When you make an appointment, that time is reserved exclusively for you/your child. My cancellation policy is at least 48 hours notice (M-F) to cancel an appointment without charges. This is because it typically takes us at least 48 hours to offer the appointment to others and successfully fill it. Clinicians in private practice rely upon booked/full clinical schedules for our livelihood. If someone doesn’t attend their appointment or cancels without much notice, we do not have enough time to fill that appointment with someone from the cancellation list. Charging for the missed/cancelled appointment isn’t meant to be punitive; it’s about not having ample opportunity to fill the appointment and keep my clinical schedule filled/booked. Please be aware that for appointments scheduled on Tuesdays, we need cancellation notice by the Friday before, as emails and voicemails are not monitored over the weekend. Thank you for understanding!