In the process of growing up, all of us have absorbed ideas about who we are and what we can expect. Some of these things we were specifically taught; others we figured out by watching and making assumptions. Most of these constructs we internalized long before we had the ability to be objective and discern how valid they were. When our lives are going well, we rely on these understandings and can be flexible in altering or adding to them as we see fit. When we are in distress, however, we often fall back into rigid patterns of thinking and behavior and may lose some of our ability to be objective and self-supportive. It is harder at these times to see options and our struggles may lead us to feeling hopeless and self-blaming.
Therapy provides a relationship in which clients can self-explore, discover the root of some of their feelings and thoughts, and experiment with new ways to approach their circumstances. The kind of relationship that provides this context depends on (1) client honesty, (2) mutual trust between therapist and client, and (3) therapist professionalism and support. Sometimes change can occur quickly with just some fine-tuning of one's assumptions and specific behaviors. For deeper issues having to do with self-image, trauma, grief and loss, and relationship patterns, it takes longer to understand feelings and assumptions that may have begun in childhood. I will be interested in the precursors of your present experiences, but the kind of therapy I practice will always be focused on what is relevant for your life now.
I grew up in Texas and graduated Phi Beta Kappa with majors in English and Spanish. I have a Ph. D. in Counseling Psychology earned in 1978 at the University of Texas at Austin. I am a licensed psychologist in Virginia and certified in Thanatology by the Association for Death Education and Counseling. In addition to maintaining a private practice since 1981, I taught graduate counseling and psychology courses at both Shippensburg University of PA and Texas A&M University for about 28 years. While at Texas A&M, I served as director of the APA-accredited Counseling Psychology program and individually developed and taught doctoral courses in Gender Issues in Psychotherapy, Advanced Psychotherapeutic Skills, and Dying and Bereavement Issues in Psychotherapy--in addition to teaching the traditional courses of Group Psychotherapy, Theories of Psychotherapy, and Clinical Supervision, and supervising practicum students. I also taught in the Texas A&M medical school. If you are interested in reviewing my curriculum vitae, please go to the link at the top of the page. Areas of special training and expertise include women's and gender issues in general and specifically working with survivors of trauma, abuse, and victimization, LGBT issues, loss, and relationships.
My approach to therapy is relational and integrative. Nothing much can happen in psychotherapy without trust, so as I listen and develop ideas about what you are experiencing, I will share those impressions with you so that you can correct them if necessary. I tend to use a variety of techniques in therapy, trying to find the ones that work the best for you. I have a thorough knowledge of the major theories and have both taught and supervised doctoral students using these theories. Major influences on my thinking have been cognitive-behavioral approaches, feminist therapy, the Stone Center work, and quasi-hypnotic approaches such as Ego State Therapy and imagery. Some of the techniques I use are likely to include dialogue, mindfulness, sentence completion, cognitive reframing, self-monitoring experiments, visualization, journal-keeping, drawing, and reading books.
Couples therapy can in some ways be more difficult than individual therapy because the person you have issues with is right there, listening and reacting to what you are saying. When working with couples, I often help the individuals express in different ways what they have been trying to communicate for some time. The goal here is not uninhibited unloading, but rather getting clear what it is that one wants the other to understand and then finding a way to communicate that such that one's partner can truly hear and possibly empathize. In couples' therapy, I facilitate rather than referee. I use techniques such as sentence completion, imagery, behavioral suggestions, reverse role-play, and paraphrasing.
My Responsibilities to You as Your Therapist
With the exception of certain specific exceptions described below, you have the
absolute right to the confidentiality of your therapy. I cannot and will not tell anyone else what you have told me, or even that you are in therapy with me, without your prior
written permission. If you elect to communicate with me by email at some point in our work together, please be aware that email is not completely confidential.
The following are legal exceptions to your right to confidentiality. I would inform
you of any time when I think I will have to put these into effect.
1. If I have good reason to believe that you will harm another person, I must
attempt to inform that person and warn them of your intentions. I must also contact the
police and ask them to protect your intended victim.
2. If I have good reason to believe that you are abusing or neglecting a child or
vulnerable adult, or if you give me information about someone else who is doing this, I
must inform Child Protective Services and Adult Protective Services.
3. If I believe that you are in imminent danger of harming yourself, I may legally
break confidentiality and call the police or take other measures to get you hospitalized, but will explore all other options with you first.
4. If you tell me of the behavior of another named health or mental health care
provider that informs me that this person has either engaged in sexual contact with a
patient, including yourself, or is impaired from practice in some manner by cognitive,
emotional, behavioral, or health problems, then the law requires me to report this to their licensing board. I will do this without mentioning your name.
I keep very brief records, noting only that we have met, what interventions were used
in session, and the topics we discussed. If you prefer that I keep no records,
you must give me a written request to this effect for your file and I will note only that you attended therapy in the record.
If a third party such as an insurance company is paying for part of your bill, I am
normally required to give a diagnosis to that third party in order to be paid. Diagnoses are technical terms that describe the nature of your problems and something about whether
they are short-term or long-term problems. If I do use a diagnosis, I will discuss it with
you. All of the diagnoses come from a book titled the DSM-V; I have a copy in my
office and will be glad to let you borrow it and learn more about what it says about your
IV. Other Rights
You have the right to ask questions about anything that happens in therapy. I'm
always willing to discuss how and why I've decided to do what I'm doing, and to look at
alternatives that might work better. You can feel free to ask me to try something that you
think will be helpful. You can ask me about my training for working with your concerns,
and can request that I refer you to someone else if you decide I'm not the right therapist
for you. You are free to leave therapy at any time. You have the right to refuse anything that I suggest. I do not have social or sexual relationships with clients or former clients because that would not only be unethical and illegal, it would be an abuse of the power I have as a therapist.
Therapy also has potential emotional risks. Approaching feelings or thoughts that
you have tried not to think about for a long time may be painful. Making changes in your
beliefs or behaviors can be scary, and sometimes disruptive to the relationships you
already have. We will talk about your ongoing reactions during almost every session.
You normally will be the one who decides therapy will end, with three
exceptions. If we have contracted for a specific short-term piece of work, we will finish
therapy at the end of that contract. If I am not in my judgment able to help you, because
of the kind of problem you have or because my training and skills are in my judgment
not appropriate, I will inform you of this fact and refer you to another therapist who may
meet your needs. If you do violence to, threaten, verbally or physically, or harass myself or my family, I reserve the right to terminate you unilaterally and immediately from treatment. If I terminate you from therapy, I will offer you referrals to other sources of care, but cannot guarantee that they will accept you for therapy.
I am available for brief between-session phone calls during normal business hours. I will let you know if I am going to be out of town for more than a week and will provide you with the name of another psychologist whom you can reach if you need to speak with someone. .If you are experiencing an emergency when I am out of town and believe that you cannot keep yourself safe, please call 911, or go to the nearest hospital emergency room for assistance.
V. Managed Mental Health Care
If your therapy is being paid for in full or in part by a managed care firm, there
are usually further limitations to your rights as a client imposed by the contract of the
managed care firm. These may include their decision to limit the number of sessions
available to you and to decide the time period within which you must complete your therapy with me. Such firms also usually require some sort of detailed reports of your progress in therapy, and on occasion, copies of your case file, on a regular basis. I do not have control over any aspect of their rules. However, I will do all that I can to maximize the benefits you receive by filing necessary forms and gaining required authorizations for treatment, and assist you in advocating with the MC company as needed.
Your Responsibilities as a Therapy Client
You are responsible for coming to your session on time and at the time we have
scheduled. Sessions typically last for 50 minutes. If you are late, we will end on time and not run over into the next person's session. If you miss a session without canceling, or cancel with less than twenty-four hours notice, I cannot bill these sessions to
your insurance, so you will need to pay for them at your next appointment unless your missing was because of an emergency. If you no-show for two sessions in a row and do not respond to my attempts to reschedule, I will assume that you have dropped out of therapy and will make the space available to another individual or couple.
You are responsible for paying for your session weekly unless we have made
other firm arrangements in advance. My fee for a session is $100.00 for individual therapy and $120 for couple therapy. If we decide to meet for a longer session, I will bill you prorated on the hourly fee. Emergency phone calls of less than ten minutes are normally free. However, if we spend more than 10 minutes in a week on the phone, if you leave more than ten minutes worth of phone messages in a week, or if I spend more than 10 minutes reading and responding to emails from you during a given week, I will bill you on a prorated basis for that time.
If you have insurance, you are responsible for providing me with the information I need to send in your bill. You must pay any co-payment at each session, and pay for any deductibles that your insurance company requires. I will bill directly to your insurance company via electronic means for you once a week. Please be aware that it is usually 3 or 4 weeks from the time I bill until the insurance company notifies me of coverage.
If you're unhappy with what's happening in therapy, I hope you'll talk about it with me so that I can respond to your concerns. I will take such criticism seriously, and with care and respect. If you believe that I have behaved unethically, you can complain about my behavior to the Virginia Psychology Licensing Board. You do not have any responsibility to maintain confidentiality about what happens in a session, since you are the person who has the right to decide what you want kept confidential.
Please feel free to contact me at 757-903-4665 or firstname.lastname@example.org for more information about my practice or to schedule a session.