Frequently Asked Questions
What to know before starting therapy
Answers to common questions about fit, fees, telehealth, privacy, diagnosis, and what to expect.
Getting Started
What is actual therapy like?
ExpandSessions are conversational but structured. We focus less on retelling events and more on understanding how your mind is organizing those experiences in real time, so we can identify and shift patterns.
The goal is not just insight, but change that shows up in your day-to-day life.
How do I know if you’re the right therapist for me?
ExpandMy work tends to resonate with people who are analytical, self-aware, and used to thinking their way through problems, yet still find themselves stuck in the same patterns.
If you’re looking for a structured, thoughtful approach that focuses on understanding and shifting those patterns, rather than just managing symptoms, we’re likely a good fit.
How do I book an appointment?
ExpandClick any “Book Free Consultation” button on this site to access my secure online scheduler. Choose a 15-minute time that works for you. If you don’t see availability that fits, feel free to email me, I can sometimes adjust my schedule for the right fit.
What happens in the free consultation?
ExpandWe’ll have a relaxed 15-minute video call. You’ll share what’s bringing you in, I’ll explain how I work, and we’ll both get a sense of whether it feels like a good fit.
No pressure, no judgment, and no unnecessary jargon. If we decide to move forward, we’ll schedule your first full session.
How will I know if we're a good fit?
ExpandGreat therapy requires a genuine working connection. During the consultation, notice whether you feel heard, understood, and reasonably comfortable. Some nervousness is normal.
I’ll also be direct about whether I can help with your specific concerns. If I’m not the right fit, I’ll help you find someone who is.
Fees and Insurance Questions
What is your fee?
ExpandMy fee is $175 per 50-55 minute session. Payment is due at the time of service.
Do you take insurance?
ExpandI don’t bill insurance directly. This allows for greater privacy, flexibility, and a more individualized approach to your care.
Using insurance typically requires assigning a diagnosis and sharing certain information with a third-party payer. For some clients, that’s acceptable. For others, especially those who value discretion, it’s not.
I’ve chosen a private-pay model so we can focus fully on your goals without external constraints.
Why does using insurance or not matter?
ExpandFor some people, it doesn’t. But I’ve worked with many clients whose privacy needs go beyond the norm, including professionals in sensitive roles or individuals who prefer to keep personal matters fully separate from medical systems.
What are the risks of using insurance for therapy?
ExpandWhen you use insurance, several things can happen:
- You must receive a formal mental health diagnosis, even if your main goal is personal growth or stress management.
- That diagnosis becomes part of your permanent health record and may be visible to future insurers or employers conducting background or medical reviews.
- Insurance companies can review your clinical records, including treatment goals and progress notes, to determine whether your care should continue.
- Coverage is often limited to “approved” diagnoses and specific treatment models.
These practices can lead to privacy concerns, treatment restrictions, and, at times, the need for therapists to justify your continued care to people who have never met you.
So what are the benefits of paying privately?
ExpandWhen you pay privately, therapy remains entirely between us. We decide what to work on, how often to meet, and when you’ve met your goals — without outside interference.
This allows me to:
- Work with you as a whole person rather than a diagnosis code
- Keep my caseload smaller so I can dedicate full focus, creativity, and attention to each client.
- Tailor sessions to your unique needs and pace.
- Invest in continuing education and professional growth to keep my work thoughtful and evidence-based.
Private-pay therapy also allows me to model the same values I teach: autonomy, authenticity, and intentional choice.
What about privacy and record-keeping?
ExpandCounselors are required to maintain basic progress notes that briefly summarize sessions and treatment goals. Mine are intentionally concise — enough to meet ethical and legal requirements, but nothing more.
These notes are stored securely and will only be released if you request them in writing or if a court order legally compels disclosure. I do not share client information with third parties or insurance companies.
Can I still use my insurance somehow?
ExpandIf you have out-of-network benefits, I can provide a superbill for potential reimbursement.
Keep in mind that submitting claims allows the insurance company to request documentation to determine eligibility for reimbursement.
Why should I pay for therapy when I can just use AI?
ExpandAI chatbots may offer some psychological explanations, ideas, or help organizing your thoughts. But good therapy involves more than just receiving helpful information. A human therapist develops an understanding of your particular difficulties over time, continually adapts treatment to your changing needs, and helps you make real changes in your life. Human therapy also comes with professional responsibilities and safeguards that ordinary chatbots don't provide.
For a more detailed discussion, read Why Should I Pay for Therapy When I Can Use AI?.
What’s the bottom line for private pay counseling?
ExpandChoosing private-pay therapy means choosing autonomy, privacy, and the freedom to do meaningful work without bureaucracy in the room. It allows us to focus on what matters most — your growth, your healing, and your ability to live with intention and clarity.
Virtual Therapy Logistics
How does online therapy work?
ExpandWe meet through a HIPAA-secure video platform. You’ll receive a link before each session. Click it, and we’re connected.
You can attend from anywhere private in Texas, Oregon, Washington, Nevada, or Florida: your home, your car (as long as you're parked!), wherever feels comfortable and confidential.
Is virtual therapy as effective as in-person?
ExpandResearch shows that for most concerns, online therapy is just as effective as in-person. Many clients find it more comfortable since they’re in their own space without the added stress of commuting.
What technology do I need?
ExpandA device with a camera and microphone (phone, tablet, or computer) and internet stable enough for video calls. If your connection is shaky, we can switch to phone.
What if I'm not in Texas, Oregon, Washington, Nevada, or Florida at the time of the session?
ExpandI can only see clients located in states where I'm licensed or registered to provide telehealth. If you're temporarily traveling within these states, that works! If you're elsewhere, I'll help you find a therapist licensed in your location.
The Therapy Process
How long does therapy take?
ExpandThe honest answer: it depends. Some people need a few sessions to get unstuck, while others benefit from longer-term work. Many clients notice meaningful improvement within 6–12 sessions.
We’ll regularly check in on progress and adjust as needed.
What therapy approaches do you use?
ExpandI’ve received formal training in multiple evidence-based therapy approaches, but I tailor how I use them to the individual rather than relying on a single method. I work at the level of patterns, cognition, and nervous system responses, which tends to resonate with analytically minded clients who understand their struggles but still feel stuck.
We focus on identifying and shifting patterns so they better fit your goals and lived experience, using a mix of structured strategies and experiential approaches such as Brainspotting. I’ll always explain what we’re doing in clear, practical terms.
Can I text or email between sessions?
ExpandFor quick logistical questions, absolutely. For therapeutic topics, it’s best to save those for sessions where I can give you my full attention - and where your privacy is protected.
If you’re in crisis, I’ll provide appropriate resources that are available 24/7.
What if I need to cancel?
ExpandLife happens. Please provide at least 24 hours’ notice when possible. Late cancellations or missed sessions may incur a fee, as that time was reserved specifically for you.
Privacy and Safety
Is online therapy confidential?
ExpandAbsolutely. I use HIPAA-compliant platforms with end-to-end encryption. Your privacy is protected by law and by my professional ethics. What we discuss stays between us, with very few exceptions (see below).
What are the limits of confidentiality?
ExpandI’m required to break confidentiality in specific situations, including:
• If you are at immediate risk of harming yourself or others
• If there is suspected abuse or neglect of a child or vulnerable adult
• If records are required by court order
Whenever possible, I will discuss this with you first.
Is my information secure?
ExpandAll platforms I use meet HIPAA security requirements. Your notes are kept in encrypted, password-protected systems. I take your privacy seriously—both legally and personally.
Specific Populations and Concerns
I think I might be neurodivergent. Can you help?
ExpandAbsolutely. Whether you're self-diagnosed, professionally diagnosed, or just starting to wonder, we can explore what neurodivergence means for you. I can refer you for formal psychological testing if you need it, and I support you through the discovery process and help you develop strategies that work with your brain.
Is this a safe space for LGBTQ+ people?
ExpandYes. This is an LGBTQ+ affirming practice. Your identity is respected as an integral part of who you are, not something to pathologize or change.
My role is to support you in living authentically while navigating the realities of your environment.
Do you offer couples or family counseling?
ExpandPattern Shift Counseling currently provides individual therapy for adults located in Texas, Oregon, Washington, and Nevada, and is registered to provide telehealth to clients located in Florida. I do not provide couples counseling, family counseling, or counseling for children or adolescents. If you are looking for these options, I may be able to offer you some referrals.
Do things need to be ‘bad enough’ for therapy?
ExpandTherapy doesn’t require that things be “bad enough.” It’s a space for examining patterns, values, and the way you’re moving through your life—whether something feels off or you want to be more intentional about what’s already working. You don’t need to be in crisis to seek this kind of support. Therapy isn’t just for emergencies; it’s for growth, understanding, and creating a life that feels more livable.
Still Have Questions?
I get it, starting therapy is a big step. If your question wasn't answered here, please reach out. No question is too small, too weird, or too specific.
OR