The Therapy Session
What to ExpectTHERAPY STIGMA
Do not let society dictate your mental health. You do what you need to do to move forward in life. Therapy does not need to be a forever thing, just something to help you manage the obstacles in life.
1. Do you accept insurance?
At the moment, I use a third-party billing company called Headway. I Cigna, United Healthcare, Aetna. Premera and Regence. I am also in the process of accepting Apple Health United Healthcare Community Health plan.
2. What specialized services do you offer?
I have experience working as a state worker therefore, I can navigate, develop, advocate and even provide coaching to those with autism, Asperger’s, and other developmental challenges. I am also expanding my services to placement housing for elders.
3. Do you offer sliding scales?
Give us a call and we can figure something out.
The Intake Session
An intake session in mental health counseling is my first opportunity to meet with a client. During this session, I focus on gathering essential information about the client’s background, current challenges, and goals for therapy. This helps me understand the best ways to assist them.
Additionally, the intake session is a crucial time for both the client and me to determine if we’re a good match. This involves evaluating our comfort levels, communication styles, and mutual expectations. It usually takes several sessions to establish this fit, which is vital for effective therapy.
Example of an Intake Session: In our first meeting, I would start by explaining the rules of confidentiality and the general process of therapy. I’d then invite the client to share their present concerns, family history, and any previous experiences with mental health treatment. I would also ask the client what they hope to accomplish through our sessions. Together, we’d discuss our initial impressions and whether we feel comfortable working together to achieve their goals.
The Ongoing Session
In my ongoing therapy sessions, I use a strength-based approach, focusing on my clients’ existing abilities and resources. This approach is combined with a narrative mixed modality, allowing me to adapt the therapy to each client’s unique story and needs.
During these sessions, we explore and reshape the stories that influence my clients’ lives, aiming to empower them and enhance their sense of control. I adjust the methods and techniques based on what the client needs at that moment, ensuring the therapy is effective and responsive to their immediate and evolving needs. This flexible approach helps clients use their strengths to tackle current challenges and prepare for future ones.
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In my ongoing therapy sessions with children, I use a strength-based approach combined with narrative techniques, tailored to each child’s needs. Though some sessions may look like we’re just playing, this play is an essential therapeutic tool. It allows me to engage young clients creatively and non-intrusively, using games and drawing.
For example, while playing a game, a child might be encouraged to describe how they overcome obstacles, reflecting their real-life challenges and coping strategies. Drawing can also help children express emotions they might not yet be able to articulate verbally, serving as a foundation for further discussion.
These activities are not just play; they are structured methods that help children express themselves and understand their experiences in a safe and engaging way.
The Patient and Billing Platforms
In my practice, I use SimplePractice for clinical electronic health records (EHR), which ensures secure and efficient management of client data. For billing, I partner with Headway, a third-party service that specializes in handling the insurance billing process.
Headway streamlines the billing experience by directly interacting with insurance companies. They take on the responsibility of submitting claims, tracking their status, and ensuring timely payment. This service includes verifying client insurance coverage before the start of therapy, which helps in setting clear expectations about costs. Headway’s efficient processing helps my clients avoid the usual hassles of insurance paperwork, allowing them to focus more on their therapeutic journey without the stress of billing concerns.
ADHD Assessments
In Washington State, licensed mental health counselors (LMHCs) follow a protocol that aligns with best practices for ADHD assessment, incorporating state regulations and professional guidelines. Here’s an outline of the protocol:
- Initial Contact and Consent:
- Informed Consent: Obtain informed consent from the client or their guardians if the client is a minor. Explain the purpose, procedures, risks, benefits, and confidentiality aspects of the assessment.
- Preliminary Screening: Conduct a brief initial screening to determine if a full ADHD assessment is warranted.
- Comprehensive Clinical Interview:
- Client History: Gather a detailed developmental, medical, educational, and psychosocial history. For children, include input from parents, teachers, and other relevant adults.
- Symptom Inquiry: Ask about specific ADHD symptoms, including inattention, hyperactivity, and impulsivity, and their impact on daily functioning.
- Behavioral Rating Scales and Questionnaires:
- Standardized Tools: Administer standardized behavioral rating scales such as the Conners’ Rating Scales, ADHD Rating Scale, and the Vanderbilt Assessment Scales. Ensure these are completed by multiple informants, such as parents, teachers, and the individual themselves.
- Medical and Physical Examination:
- Medical Referral: Refer the client to a primary care physician or pediatrician to rule out medical conditions that could mimic ADHD symptoms, such as thyroid disorders, hearing or vision problems, or neurological conditions.
- Review of Records:
- Historical Data: Review past academic records, psychological evaluations, medical records, and any previous assessments to understand the client’s history and symptom trajectory.
- Feedback Session:
- Diagnostic Feedback: Provide a feedback session to explain the results of the assessment, including whether the criteria for an ADHD diagnosis are met based on the DSM-5 criteria.
- Discussion: Discuss the findings, answer questions, and explain the implications of the diagnosis.
- Resources and Referrals: Provide resources and referrals to support services, support groups, and educational programs.
- Documentation:
- Detailed Report: Prepare a detailed assessment report that includes all findings, diagnostic conclusions, and treatment recommendations. Ensure that the report is thorough, clear, and accessible to the client and other relevant professionals.
In Washington State, licensed mental health counselors (LMHCs) are allowed to conduct assessments, diagnose, and treat mental health disorders, including ADHD, as per the Washington Administrative Code (WAC). Here are the relevant points and guidelines regarding ADHD diagnosis:
Scope of Practice:
LMHCs in Washington can perform diagnostic assessments for mental health conditions, including ADHD. They must adhere to evidence-based practices and ensure that their assessments are thorough and accurate.
Educational and Training Requirements:
LMHCs must have a master’s or doctoral degree in mental health counseling or a related field. This includes coursework and supervised postgraduate experience as specified in WAC 246-809-220 and WAC 246-809-230.
Assessment and Diagnosis:
When diagnosing ADHD, LMHCs use standardized assessment tools and clinical interviews. The assessment process must include collecting comprehensive information on the client’s history, symptoms, and functional impairments.
Record Keeping and Confidentiality:
LMHCs must maintain detailed records of assessments, diagnoses, and treatment plans while ensuring client confidentiality as per WAC 246-809-320.
Continuing Education:
To maintain their licensure, LMHCs must complete continuing education, which includes training on current best practices for diagnosing and treating mental health disorders like ADHD (WAC 246-809-600).