On this website, I do use the terms interchangeably. In reality, though, counseling more generally pertains to the typical difficulties of living, usually to a specific issue and for a limited period of time. Therapy focuses more on the individual, going deeper into who you are, how you see the world, and the patterns in your life that may relate to your current situation. I am trained as both a counselor and a depth psychotherapist, so the course we take together will depend on the situation. That said, my approach to counseling issues will always involve gaining a clear and shared perspective on the lens through which you see the world and how that impacts the possibilities you imagine.

In your first session, you can expect to have the time and space to tell your story - especially about what’s happening in your life and your ideas about the improvements you’re hoping for. I will help with some questions if it seems hard to know where to begin. I’ll also offer some preliminary feedback and explain more about how we might work together. There will be no pressure to commit to further sessions - in fact I’ll encourage you to take some time to think about whether or not you and I are the right team for you.

Professional therapists have a duty to keep in-private the information shared between the therapist and patient during the course of their therapeutic relationship. This includes individual conversations conducted with spouses in couple’s therapy – they are not shared with the other spouse unless permission is granted. All records of this information are kept securely.

There are, however, by law three instances where confidentiality must be broken for the general welfare:

• Serious threats of self-harm or suicide;

• Serious threats of homicide or harming another individual;

• Sharing information about dependent person being at risk of abuse - whether a minor or an elderly person.

Professional Supervision: In keeping with standards of professional ethics, brief notes of counseling sessions are kept and periodic consultation with other helping professionals occurs in their capacity as clinical or peer supervisors. Any identifying information is carefully guarded or omitted altogether. With the patient’s permission, information pertinent to the therapist/patient relationship may be sought. This includes consultation with current or past medical and psychotherapeutic professionals.

Yes, I do offer the possibility of online sessions. In fact, I maintain both an international and US virtual practice which I manage with careful navigation of time zone differences and legal considerations. For Denver and Foothills clients, I do like to ask that we meet face to face at least a few times to take advantage of the benefits of sharing space. Though technology has granted us an invaluable gift in expanding the accessibility of mental health care, I do believe there is also an important psychological advantage to setting time apart, in a space apart, to freely explore sensitive topics in the physical presence of a trusted and committed professional.

We ALL need therapy at some point! It’s an outdated notion that counseling or therapy is reserved for the ‘broken’ or ‘weak’. To the contrary, psychotherapy is the course of the courageous - for those who seek to see more clearly and pursue their best selves and lives.

Success in therapy is largely related to your good hard work - in session and out. Good hard work can be thought of as active engagement, openness, and a willingness to be a true partner in bringing about the changes you seek. . Other important factors? The fit between you and your therapist is critical.

Though many of my clients are successfully reimbursed for their sessions through HSA, FSAs or through out-of-network benefit schemes, I do not directly accept insurance. In addition to their notoriously burdensome administrative requirements and low reimbursement rates, insurance companies impose upon the therapeutic relationship and process in ways that I do not believe are in my clients’ best interests.

• Therapists are required to provide a diagnosis and treatment notes in order to gain claim approval. This means a lot of people you don’t know have access to your personal health information.

• Insurance companies require a mental health diagnosis in order to deem a claim reimbursable. In my experience, however, people seek counseling or therapy for many reasons, and many of those reasons don’t constitute a diagnosis per se. It would be a violation of professional codes of conduct to assign a diagnosis that is invalid, solely for the purpose of being paid.

• When therapists take insurance, they are often required to use treatment methods that are covered by the client’s plan. This means that the therapist, who knows you and has made a personal assessment, has less to say about how you are treated than the insurance company does.

For clients claiming out of network or HSA/FSA benefits, I am happy to prepare a Superbill according to their insurance company’s documentation standards.

This is a great question. Here are a few things to keep in mind as you think about making the most of your time in session:

• All topics are acceptable. Whatever is going on, whatever thoughts or feelings you are having are welcome. We can only really make progress if we are straight with one another. Instead of judgment, expect appreciation for your openness.

• The more consistent you can be in your attendance, the more likely we can move forward in a meaningful way.

• Try to come prepared, having thought about what you’d like to share.

• Don’t hesitate to share how you are feeling about the sessions and how we’re relating. Therapy is a relationship, and it’s important that we learn to work honestly and collaboratively.

• Ask questions! Do speak up if something isn’t making sense or you need more clarification. “Thinking about thinking” is new for many people, and like many new things, may take a while to do with ease. You can expect equality in this relationship - two imperfect beings working hard to understand and be understood.

You are in control of any information shared about your decision to begin counseling: the fact that you go, who you see and certainly what you discuss. As explained in the question regarding the Guarantee of Confidentiality, there are limited but important circumstances under which confidentiality must be waived:

• Threat to self

• Threat to others

• Information regarding child or elder abuse