Practice Policies

Below are my general policies for my counseling practice. If you have any questions or concerns about any of these policies, please discuss them with me. Because each person's situation is unique, I may at times adapt one or more of these policies to the needs of a specific client. If you feel your needs would be better met by an adjustment to one of these policies, please ask me about it.

THE PURPOSE OF THERAPY

The purpose of our work together is to support you in living with greater awareness, choice, and aliveness. People often come to therapy hoping to get rid of a part of themselves, such as a feeling, a habit, or a way of relating that causes pain. My aim is not to fix you or to make you into someone different. I aim to help you come to know yourself more fully: what you feel, what you need, how you respond to the people and situations around you, and how you sometimes interrupt or protect yourself from your own experience. From this fuller awareness, new and more satisfying ways of living tend to become possible.

HOW THERAPY WORKS

My approach is grounded in relational Gestalt therapy. A central idea in this approach is called the paradoxical theory of change: change happens not when we try hard to become who we think we should be, but when we fully recognize and accept who we already are. When we fight against parts of ourselves, those parts tend to dig in. When we turn toward our experience with curiosity and compassion, it is free to shift and move on its own.

For this reason, much of our work will focus on awareness of what is happening right now, in the present moment. This includes your inner experience (sensations in your body, emotions, thoughts, impulses) and your relational experience (what happens between you and me, and between you and the important people in your life). We may notice together how you make contact with others, how you hold back, and what you long for. At times I may suggest experiments, which are small, voluntary ways of trying something new in session so that we can learn from what you notice. You are always free to decline or change an experiment.

I also believe that the relationship between us is itself an important part of healing. Therapy offers a place where honest, respectful contact can happen, where difficult feelings can be met rather than avoided, and where old patterns can show up and be understood in a new way. Many of the patterns that bring people to therapy were formed in relationship, and they are often best understood and reshaped in relationship as well.

OUR SHARED COMMITMENTS

Because therapy is a relationship, each of us carries responsibility for how it unfolds. I think of responsibility here as our ability to respond to what is actually happening, rather than as blame or obligation. We both commit to being honest with each other, including when honesty is uncomfortable. We both commit to treating each other with kindness and respect. We both commit to making a sincere effort to bring awareness to our experience, both what is happening inside each of us and what is happening between us. And we both commit to saying when something does not feel right in our work together, so that we can explore it rather than let it go unspoken.

MY RESPONSIBILITIES AS YOUR THERAPIST

I am responsible for providing a safe, confidential, and respectful space for our work, within the limits described in my Informed Consent. I am responsible for being present with you, listening carefully, and responding honestly, including sharing my own observations and reactions when I believe they will serve your growth. I am responsible for paying attention to my own experience in our sessions, taking ownership of my mistakes and blind spots, and staying open to your feedback about how our work is going.

I am responsible for pacing our work with care, respecting your boundaries and your right to say no, and explaining my reasons for any approach or experiment I suggest. I am responsible for maintaining my professional training, seeking consultation when appropriate, and referring you elsewhere if I believe another provider would serve you better. Finally, I am responsible for holding the professional boundaries of our relationship so that the focus remains on your well-being.

YOUR RESPONSIBILITIES AS MY CLIENT

You are responsible for bringing yourself as honestly as you are able, including the parts of your experience that feel uncomfortable, embarrassing, or uncertain. You are responsible for making a genuine effort to notice your experience, including your feelings, your body, your thoughts, and your reactions to me and to our work, and to share what you notice when you are willing. You are responsible for letting me know if something I say or do doesn't sit right with you, if you feel stuck, or if you want something different from our sessions.

You are also responsible for respecting your own limits: you never have to share more than you are ready to share, and saying "I don't want to go there right now" is itself valuable information. Outside of sessions, you are responsible for caring for your safety, using crisis resources when needed, and following the practical agreements in these policies regarding appointments, payment, and communication.

Neither of us will do this perfectly, and that is okay. Ruptures, misunderstandings, and moments of disconnection are a normal part of any real relationship. When they happen in therapy, they can become some of the most meaningful parts of our work, as long as we are both willing to turn toward them together.

APPOINTMENTS

You are responsible for coming to your session on time and at the time we have scheduled. Unless otherwise specified, individual sessions are between 50 and 60 minutes. If you arrive late, we will still end on time. If you cancel a session with less than 24 hours' notice, or do not show up for a session without prior cancellation, I request that you pay the full session fee. I offer phone and video telehealth sessions, and we can typically switch to meeting virtually if roads are unsafe or if you would prefer not to meet in person on a particular day.

If you miss a session and do not attempt to reschedule, I will assume you have chosen to end therapy, and I may make your appointment time available to someone else. If you repeatedly reschedule appointments, I may suggest that we revisit these policies to meet both of our needs. If you would like to receive appointment reminders by email or text, please let me know.

PAYMENT

You are responsible for paying at the time of your session unless we have made other firm arrangements in advance. My current fee for an individual session of 50 to 60 minutes is $160. Longer sessions are prorated at this hourly rate. Occasional between-session phone calls of less than 10 minutes are normally free. However, if we spend more than 10 minutes in a week on the phone, if you leave more than 10 minutes of phone messages in a week, or if I spend more than 10 minutes in a week reading and responding to your emails, I may bill you for that time on a prorated basis.

In some cases of financial need, my normal fee may be reduced on a sliding scale. Please ask if this is a possibility you would like to explore. I typically adjust my fees annually to account for inflation and cost-of-living increases, and I will give you advance notice of any change.

I accept payment by cash, check, credit card, and HSA card. I can keep a card on file electronically, and my scheduling software will offer you this option.

Insurance. I do not bill insurance and I do not accept MaineCare. I choose not to take insurance because this allows me to focus my time and energy on our work together, minimize paperwork, and keep my rates lower. Some insurance plans offer out-of-network benefits that may reimburse you for part of my fee if you have a qualifying mental health diagnosis. To request reimbursement, you submit a form called a superbill, which I am happy to provide. If you plan to seek reimbursement, please tell me at the start of treatment so that we can discuss a possible diagnosis and the other implications of submitting to insurance. Fees for missed or late-canceled sessions are generally not reimbursable by insurance.

Good Faith Estimate. Under the federal No Surprises Act, as of January 2022 you have the right to receive a Good Faith Estimate explaining how much your medical and mental health care will cost. Because you are not using insurance to pay for my services, I am required to give you a Good Faith Estimate of expected charges, in writing, before your first session or upon request. You can also ask me for one at any time. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Keep a copy of your Good Faith Estimate. For questions or more information, visit www.cms.gov/nosurprises or call 1-800-985-3059.

COURT TESTIMONY and LEGAL INVOLVEMENT

My services are limited to supporting the health and well-being of my clients. I do not provide court testimony, forensic assessments, custody evaluations, letters to attorneys, or any other services for court or legal purposes. By beginning treatment with me, you agree not to involve me in legal proceedings, including divorce or custody cases, and not to ask me to testify or provide records for legal purposes.

Under Maine law (32 M.R.S. §13862), what you share with me in therapy is privileged, and I cannot be required to testify about it without your consent. There are limited exceptions. A court may order disclosure when your mental or physical condition is at issue in a case, or when a judge decides that disclosure is necessary for the proper administration of justice. If I receive a subpoena or court order for your records or testimony, I will notify you, assert privilege on your behalf where it applies, and release only what I am legally required to release.

If I become involved in legal proceedings related to your care, whether at your request or because of a subpoena or court order, you agree to pay for my time and any expenses involved. This includes preparation, travel, waiting time, and testimony, billed at my current hourly rate, as well as any attorney fees I incur in responding.

ELECTRONIC COMMUNICATION

I cannot ensure the confidentiality of any form of electronic communication, including email and text messages. If you prefer to use email or text for scheduling or cancellations, I am happy to do so. While I try to return messages in a timely manner, I cannot guarantee an immediate response. Please do not use email or text to discuss therapeutic content or to request help in an emergency.

SOCIAL MEDIA

To protect your confidentiality and avoid dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc.). Connecting on these sites could compromise your confidentiality and our respective privacy, and it could blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet.

TERMINATION

Ending relationships can be difficult, so it is important to have a termination process that allows for closure. The appropriate length of this process depends on the length and intensity of our work. I may end treatment, after discussing it with you and engaging in a termination process, if I determine that therapy is no longer serving you or if you are in default on payment. I will not end our therapeutic relationship without first discussing and exploring the reasons for doing so. If therapy ends for any reason, or if you request another therapist, I will provide you with a list of qualified providers. You may also choose someone on your own or through another referral source.

If we have had no contact for 60 days and you have not scheduled a session, I will consider your file inactive and our therapy relationship ended. You are always welcome to contact me about resuming our work.

VACATION, RETREATS and CONTINUITY OF CARE

I am away from the office several times a year for vacations, professional meetings, silent meditation retreats, and other personal reasons. I will tell you well in advance of any anticipated lengthy absence.

In the event that I become unexpectedly unable to practice due to illness, injury, or death, I have designated a licensed colleague who will have access to my client contact information. This colleague will contact you to let you know what has happened and to help you find continued care. By signing these policies, you consent to this limited access to your information for this purpose.

CRISIS
I am usually available for brief between-session phone calls. However, it can typically take me 24 to 48 hours to return a phone message or email, and often longer over the weekend. If you are in crisis, please call the Maine Crisis Line at 1-888-568-1112, call 911, or go to the nearest hospital emergency room.