At Wind Over Water, one of the goals is to be as transparent about the process of therapy as possible. Things look a little different from the client’s point of view, though, so I asked some of my clients what the most important questions are from their POV, and here are my answers!
Also, here is an article from Psychology Today about what others have asked about their first therapy sessions, and another from the Sunday Edit that also addresses some concerns about virtual therapy.
How do we connect? [for sessions and between sessions]
For your initial paperwork, payment, and each session, you will log into the secure Therapy Portal. This is a HIPAA compliant and secure place to conduct sessions and any other administrative details.
Before your first session, I will email you a set of paperwork to be filled out through the portal. Some of it is demographic and payment information, and the rest is information for you to be aware of and consent forms that you need to sign. Some of them are forms you will be asked to download, fill out, and then sign when you upload them to the portal again. It is easiest to do this on a computer rather than your phone. Please do not hesitate to reach out if you have any difficulties!
For each session, you will log into the portal. If you are not logged in at 5 minutes past the start time for your appointment, I will contact you via email, text, or phone to check and see if there are technical issues or if you forgot your appointment. If I am running late, I will do the same. If we are having technical difficulties, we may conduct sessions over the phone. If you forget an appointment or I am unable to reach you by 15 minutes after the start of your session, you will be charged a cancellation fee that is generated by the system.
To contact me between sessions, your best bet is email. I use a secure email encryption program, but you will not likely see the mechanics of that unless you need records or documents sent to you, in which case they will be sent with encryption and you will have to use a password to decrypt them on your end. Every email I send to you is securely encrypted.
In addition, you can contact me by phone or text using the main number 757-734-1300 – this is also a secure, HIPAA compliant phone line that I access using my cell phone that is password protected with additional encryption.
How do you manage payment?
All payments are managed through the portal. For most, it is easiest to enter their credit card information. If something happens with it, like your card expires or is declined, I will let you know. You can go in any time and add, change, or delete your preferred payment method.
There is more information on my payment page regarding fees, as well as information about Good Faith Estimates.
When you log on, it will ask you to pay for that day’s session and any past due balance that you might have. Though I will go in and make sure that everything was processed correctly, please feel free to go ahead and click “pay” – payment is due at time of service!
I do not accept insurance, but I will provide Superbills for you to submit to your insurance company as requested.
Why is there so much info about Policies, Procedures, and Responsibilities in your paperwork?
I have been the Compliance Officer at my past places of employment, and am very safety and security focused when it comes to protecting my client’s information. I try to cover all the bases with my paperwork, but also try to make it easy to understand and not too redundant. Please let me know if you have any questions about any of the information on these files – I am happy to give you an answer and talk it through!
Information regarding HIPAA, Policies, and all forms can be found at the bottom of each page, and in your portal!
What are sessions supposed to be like?
Your intake session (which can be anywhere from 1-4 sessions at 60-90 minutes each) is a bit different – I will be asking you a lot of questions, and I would like you to be comfortable enough to do the same. This is to establish goals as well as a diagnosis. To do that well, I need to know your history, your current symptoms, and about your personal experiences. I may also have you complete a Release of Information (ROI) so that I can contact and collaborate with any other current or past providers. If you have a medication management provider, primary care doctor, dietician, another therapist, or are coming from a higher level of care, I will need to be in touch with those providers.
Once we establish goals, we will have regular psychotherapy sessions – the frequency of these is determined by the two of us together, though generally I will ask to meet with you more frequently at the beginning and reduce sessions gradually. I almost always want to see clients weekly when we start so that we can get some momentum going and establish trust and rapport.
These sessions are 45-50 minutes long. We will talk about a lot of things, and I will ask you questions at each session about the goals we are working on, homework you might have from a previous session, symptoms, etc. Most of the time, though, you will be determining the content of sessions and what we discuss.
What kind of therapy will we be doing?
I have specialties in working with clients struggling with eating disorders and also in a type of therapy called Dialectical Behavior Therapy (DBT), but that is not all that I do!
What therapists call an “eclectic” approach usually involves several different modalities, and I will use all sorts of resources to help clients reach their goals. I have been using CBT, ACT, DBT, and RO-DBT with clients regularly for years, and have also recently been focusing on CFT and CPT for working with compassion and trauma. Please see my Philosophy page for more information about these.
I have been a clinician for a long time, and have worked with a whole range of clients. Most clients with eating disorders also have some form of anxiety, depression, or trauma, so I work extensively within all of those realms as well. I have many clients who do not have eating disorders at all – and many who once did but are in ‘remission’ with them and are still engaged in therapy for other reasons or for ‘maintenance.’
Maintenance therapy works well for clients who enjoy therapy and want to maintain a connection with a therapist, and I highly recommend it! Not only is it a source of support, but when things happen, you have an already established relationship with someone who knows your history and your coping methods – positive and negative!
How do you work with other providers?
Since I work virtually, most of my communication with other providers is also over the phone or email. Teletherapy also gives the opportunity for joint sessions, when needed, with multiple providers. I enjoy working with other providers, specialists or not, and collaborating about clients.
How is virtual different?
Here is a blog about the pros and cons of virtual therapy. I think it is beneficial for clients who are comfortable in a virtual environment. I think that establishing a trusting relationship is a bit different in teletherapy, but the process is pretty much the same – you need to trust your therapist, and vice versa, for therapy to work.
They say that your brain decides if it trusts someone in milliseconds, but that you need to engage in conversation, problem solving, and conflict resolution in order for your conscious mind to make that determination. Trust and rapport are not always congruent, though, and that’s OK. If you are someone who does not like tele-whatever, it will be more difficult for you to establish rapport with your therapist this way, and that is OK too! Therapy is not one size fits all – nothing really is – so you may have to work a little. I am willing to work through it, also, because my main goal is to help people create a ‘life worth living’ even if they are not yet sure what that means for them.
I hope that answers your questions – if you think of others, please do not hesitate to reach out to me at firstname.lastname@example.org.