Questions About Therapy

We know that before beginning counseling, people have many questions, and we've attempted to answer some of them here.  Please contact us by e-mail or phone if you have any other questions. 


What is therapy?

Therapy is a process of change. Clients and therapist work together to examine existing patterns, and set goals for the changes clients desire. Sometimes clients choose to work on one or two very specific behaviors that they would like to change, and after a few sessions feel satisfied with the progress they have made. Other times, clients wish to work on deeper, long-standing issues from their past that are causing current problems. This process will of course take more time.

In either situation, the therapist is there to act as a facilitator of the client's goals. Ideally, therapy proceeds at a pace that feels comfortable, with the client setting that pace, and the therapist offering feedback as to areas that might otherwise be unnoticed. The client should not feel overly pushed, or as though the therapist has their own agenda.

In other words, therapy is a mutual process, but the client is always in charge.

What is the difference between therapy and life coaching?

There are similarities and differences between life coaching and therapy. The emphasis in therapy is on healing the past. Wounds from our past can cause us to repeat old patterns, often unconsciously. Examples would be in how we handle relationships, how we see ourselves and present ourselves to others, and how we handle the emotions caused by stresses in life. Therapy can be immensely powerful in cleaning up "old business" that may be getting in the way of further progress in our lives. Therapy is definitely called for if we have symptoms that are interfering with our lives, such as anxiety, depression, flashbacks from old traumas, or severe problems in our relationships.

Life Coaching places the emphasis on the present and future, rather than on the past. It is possible for Life Coaching to be the best choice even if we have never had therapy. Another scenario would be for a person to have completed therapy and now feel ready to move forward in their goals for the future, unencumbered by old symptoms from the past.

Will my insurance cover therapy?

Insurance coverage for therapy varies widely. A description of your coverage is often found under "Mental Health" in your insurance booklet, or on your insurance benefits website. Basically, there are two major types of coverage, depending on the type of insurance you have purchased. 

  • Traditional "indemnity" insurance, where you pay a deductible and a percentage of the fees after that, will often pay 50% - 80% of fees, up to a yearly maximum of a certain number of visits, or a certain dollar amount per year. Information requested by this type of insurance plan is minimal, consisting mostly of a basic billing form. Frequently, you may use any licensed therapist; some plans require you to choose from their panels.  Many people with this sort of insurance have both "in network" and "out of network" benefits.  If you have this sort of coverage, you will be able to see the therapist of your choice by using your "out of network" benefit.
  • "Managed care" insurance plans differ in that the therapy is overseen by a case manager at the insurance company, and the number of sessions permitted will be fairly limited. More sessions can often be requested if necessary, as documented by detailed reports submitted by the therapist. It is wise to discuss at your first session what type of reporting is required by your insurance, if you have managed care. Confidentiality is very important to us; however, we cannot be responsible for what happens to required reports once they are sent to your insurance company.

Some of our therapists are on HMO and PPO panels.  All of our therapists can accept your insurance if it allows for "out of network" coverage.  Always be sure to check.  Many people are surprised to find out that their out of network coverage covers almost as much as their in network.  By using out of network coverage, you are free to see any therapist you choose or are referred to.

Sometimes, it can be difficult to know what type of insurance you have, especially in the area of mental health coverage.  Your insurance may be a PPO for regular medical claims, but may have "carved out" or contracted their mental health coverage to a managed care organization.  The best way to know for certain is to call your insurance company by using the 800 phone number on the back of your card.  Again, be sure to ask if you have "out of network" benefits.

We've added some information here to more fully answer your questions about insurance.  And if you fill out the form below, you'll be able to get a printed report that will also detail this information. (Our form is coming soon.)

When there is no insurance coverage, or if you choose not to use your insurance coverage, we are sometimes able to negotiate our fees. Please ask your therapist about this.

Should I use insurance to pay for therapy?

There are possible consequences to using your insurance to pay for therapy that should be considered before beginning.  As with any other covered medical service, you authorize your therapist to release your diagnosis and dates of treatment to your insurance.  This information is kept, and may negatively impact you if you need to apply for private life or medical insurance.  

In the case of managed care insurance, your insurance plan authorizes the number of sessions it feels is necessary, based on reports that your therapist is required to fill out regarding your treatment.  Some plans require very detailed reporting, and you should ask your therapist about these before beginning.

In all situations, your therapist is committed to maintaining your privacy and confidentiality at all times.  However, we cannot be responsible for how your insurance company uses this information once it leaves our office.  If complete privacy is a concern, you may wish to talk with your therapist about paying "out of pocket", without involving a third party.

For more information on this topic, please go to our printable page of  information about using insurance.  To view it, you'll need the Adobe Acrobat viewer.  If you don't have it, you can download it for free at the link below.

What are the laws about confidentiality?

By federal law, we are required to inform you of our privacy practices, and that notice is posted in our forms section.  Be sure to read it before beginning therapy.  If you have any questions, please feel free to ask before beginning therapy.

Basically everything between you and your therapist is confidential.  If your therapist believes that your life or that of another person is in danger, then the law requires the therapist to take certain steps.  However, when you authorize your therapist to bill your insurance company, and most especially when your managed care insurance requires treatment reports, then your information is less private.  For more on this, please see the section above

How do I pick a therapist?

Choosing a therapist is a very important and very personal decision. One way to begin is to ask for a referral from others whose opinion you trust -- your pastor or other clergy, your physician, or perhaps a close friend who has been through therapy. At Families Counseling, we are honored that many of the local churches, private schools, and medical professionals feel comfortable referring to us.

Many clients come to us because they have had an opportunity to hear our staff speak at local schools, churches and business gatherings. This is an excellent way to get a sense of what a therapist is like as a person, and to hear some of their views on a certain subject, like parenting or relationships. Our therapists also contribute articles to our blog, and reading these often gives clients a sense of a therapist's basic "style".

No matter how you decide which therapist to call initially, some further information gathering is necessary. When you speak on the phone, feel free to ask about a therapist's background, training, and fee structure. Many clients who come from a specific religious orientation want a therapist who shares their views, and it is very appropriate to ask about that.

If the basic information received over the phone is satisfactory, then scheduling a first appointment is in order. This is a time for both therapist and client to get to know each other, and to determine if they can work well together. Some clients ask about whether the first session is free of charge. Our policy is to charge for the first session, unless you decide at that time that the therapist is not a good match for you. Please discuss this at the time you set your first appointment.

What is marriage counseling?

Marriage and relationship counseling is a very important tool. Counseling can be extremely helpful at any stage of a relationship, from premarital counseling to working with couples experiencing difficulties of many years' duration. Generally the initial session is with both husband and wife, although sometimes one person will start therapy and their spouse will join them later. Therapists work to help couples improve communication skills, learn to handle conflicts constructively, and help to resolve old childhood issues that may be hindering the growth of a healthy relationship. At Families Counseling, we believe that every couple who calls for counseling is demonstrating a readiness to work on their relationship, no matter how severe the difficulties may seem. While of course there can be no guarantees of success, our experience is that the decision to enter therapy is often the first major step on the road to recovery for the relationship.

For some "food for thought" about what couples' counseling entails, please  read our couples' counseling article.

What is premarital counseling?

Premarital counseling begins as a structured set of sessions, usually between six and eight, although some couples choose to continue beyond the initial set of sessions.

Our pre-marital counseling program offers a preparatory inventory instrument or questionnaire to help each individual explore their own core beliefs, values and assumptions about relationships and families. The information gathered from each individual is analyzed with and compared to the other partner's answers. The results are used in the therapy session to help the couple identify and work through potential areas of conflict.

Many important topics are explored in depth: work and careers, child rearing and parenting styles, family of origin and extended family relations, finances, sexuality, holiday traditions, marital roles and responsibilities, and decision making.

Besides exploring potential areas of conflicts, pre-marital counseling also helps build the skills necessary to resolve conflicts. Couples learn to communicate more clearly, "fight fair", and resolve the differences that are inevitable in any relationship.

What is best for my child or teen?

Children of all ages may experience problems from time to time that require the intervention of a therapist. The first step is always consultation with the parents, and many problems are best resolved simply by working with parents to suggest and try out new parenting skills. For young children who need help in dealing with trauma, expressing difficult feelings, or changing certain maladaptive behaviors, individual play therapy is sometimes indicated. Many teenagers feel most comfortable in talking about their concerns with the therapist on their own. In many situations with children of any age, family counseling may be the method of choice. The decision as to how to proceed is made by the parents and the therapist, and may be done at the initial phone contact or after the first session.

To help you decide, we have more information on family counseling and individual counseling for teens and young adults.

What is family counseling?

Family counseling can involve any or all members of a family, for all sessions or just for some. Many times this is a very effective of resolving parenting problems, life stage issues, step-family problems or any other situation that impacts all the family members. Children of all ages have a lot to offer and much to gain from being able to participate in a process that teaches better communication skills, and better ways of expressing difficult feelings.

We have more information about family counseling here..

How are religious or spiritual issues handled?

Several of the therapists at Families Counseling are practicing Christians who are dedicated to helping individuals and families of all faiths integrate their own religious beliefs into their lives. No therapist will ever attempt to impose their own beliefs on any client. Rather, every client can be assured that their beliefs and those of their family members will be respected to the utmost degree. We receive referrals from many sources. Some clients come to us and feel no need to work with spiritual issues, and so the topic may not come up. Other clients, especially those who are referred through their churches, very much appreciate the opportunity to explore ways of better applying their own faith to their lives.  When you call, if you prefer to see one of our Christian counselors please be sure to say so.

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I hope this information is helpful to you.  Please call the office if I can answer any questions.

Deborah Tucker, M.A.
Licensed marriage and family therapist
(LMFT #17142)
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