FREQUENTLY ASKED QUESTIONS

The counseling process is intended to help guide you in gaining self-awareness, and making changes to your life. Your loved ones mean well, but they have a stake in your life, and what you do will impact them too. They may also not see the same need for change that you do or understand the way that things impact you.

Your counselor’s role is to be more objective and to be on your side. A good therapist does not only tell you what you want to hear; they call you out when needed in order to support your growth. Their goal is to help you live your best life and sometimes that may be uncomfortable.

Counselors are sometimes described as a mirror that can be held up for clients to see themselves more clearly or from a fresh perspective.

Counseling is a conversation between the counselor and client. Clients are the experts in their own lives but counselors are able to offer different perspectives, to help clients develop new skills and to challenge existing patterns that aren’t serving the client.

In order for counseling to be effective clients need to engage in the process and utilize what they are working on in session. You can absolutely vent in your session but if that is all you do nothing changes. Someone who comes in, vents a little and then works on challenging their thoughts and behaviors in session and applying that to daily life will get more out of counseling.

You are always welcome to bring topics to sessions that you want to focus on and to provide input about what you want from treatment. Your counselor will also suggest topics that might need some attention.

When you arrive for your in-person intake session, you will grab a seat in the lobby and your counselor will call you back to their office when they are ready. If your appointment is virtual, you will log on using the client portal and your counselor will meet you there. It is important that virtual clients have a quiet, private space for sessions. You are welcome to have beverages, fidget toys, and tissues at hand. Make sure that you are comfortable in your seat, you are going to be there for almost an hour.

After introductions, your counselor will provide an opportunity to ask questions about any paperwork you have completed. Next, they will review confidentiality with you and tell you a little about how they work as a counselor. You are welcome, and in fact encouraged, to ask questions or to seek further clarification during this process. You can also ask any questions you have that will help you determine if this counselor is the right fit for you.

Once all the questions are out of the way, for the rest of the session, you will work with your counselor to establish preliminary goals for treatment and share background information about yourself. It is helpful for us to understand your past in order to address present concerns.

If you are interested in scheduling future appointments you will have time to do that before the end of the session.

Now pat yourself on the back, you made it through a big step!

There is no absolute right answer to this question but there are some important things to consider:

First, will you feel comfortable talking with them? Counseling only works if you are willing to be vulnerable with your counselor. It is normal for it to take some time to get to know each other and get really comfortable but if you don’t feel willing to share with them at all, it’s probably not the right fit.

Second, does this counselor have knowledge and experience with the things that you want to work on? We have different specializations, if you are coming to counseling to work on an eating disorder, you want a provider that knows how to treat eating disorders. If you have several concerns to work on, it may be important to know which ones are your primary focus and choose someone that will be a good fit for those. Some examples of specialization: trauma, eating disorders, personality disorders, substance use, relationships, domestic violence, faith-based counseling, LGBTQIA+ affirming, OCD, women’s issues, men’s issues, play therapy, adolescent therapy, relationship counseling, kink affirming, consensual non-monogamy affirming. If you are not sure if something is a specialization ask about the counselor’s experience and knowledge with that subject. 

Third, do they work in a way that is a good fit for you? Are you looking for specific types of therapy and can they provide it, or are there therapy types you aren’t interested in?  Examples here might include EMDR, DBT, play therapy, couples therapy, or faith-based counseling. Do you prefer a more directive or more collaborative style? If you want to walk out of every session with a homework assignment, make sure that is something they can provide. 

Fourth, are there things that are deal breakers for you? It is not necessary to have the exact same beliefs as your counselor but there may be things that you feel more strongly about. For instance, if you are a member of the LGBTQIA+ community, you might not want to work with someone who has a “love the sinner, hate the sin” attitude. It is okay to ask screening questions to determine if you are going to be comfortable with them. Sometimes counselors might be unwilling to answer certain questions, if you are not comfortable with that that’s okay, or maybe they will give you a reason for not answering which might be okay with you.

Finally, if you feel like someone isn’t a good fit for you, you are allowed to break up with a therapist. A good therapist will understand this and be open to helping you find the right fit. If you don’t feel comfortable telling a therapist that you don’t want to work with them, that’s okay too, you are not obligated to keep seeing them or to tell them why you are going a different way. 

Many counselors are willing to do a free 15-30 minute consultation prior to scheduling to see if it’s the right fit. This can be a great way to do some initial screening before scheduling a full appointment and without having to share as many details or invest too much time or money.

Clients can decide what they want to work on, and are allowed to set boundaries if there are areas of their lives that they do not feel comfortable talking about. These things may change over the course of therapy and that is okay too. If your therapist thinks that talking about those things is needed they can offer you a clinical explanation for why and you can decide if you would be okay with that, they should never force you to talk about something. 

I have worked with clients talking about their feelings, blocks around events or impacts of those events without ever knowing exactly what happened and that can be an option in some cases as well.

Is there such a thing as TMI in therapy? Not really, you can talk about anything you need to talk about. We have probably heard it before. That said, we don’t necessarily need to know every detail of every situation to be effective. 

Am I allowed to swear? For damn sure! If that is how you authentically communicate, bring it on!

What if I cry too much? Never happened, seriously, never. Crying is welcome and encouraged when that is what you are feeling. That’s why we have tissues in the room. If it helps in grad school, we used to get really excited when we got a client to cry, because it showed us we were on the right track. After practicing for a while it becomes a normal part of our day and we are comfortable with other people responding to their feelings with tears. 

What if I can’t cry? That’s okay too, there is room in therapy for every type of person. 

I have a dark sense of humor; do I need to filter? You are welcome to make the joke, it will probably get a laugh. It might also lead to a conversation about why you made the joke. Dark humor is a thing because it helps a lot of people but sometimes it’s important to look at what it is covering up.

Absolutely! Talk to them about it. We want feedback from our clients to make sure they are benefiting from our time together and constructive criticism is a part of that.

I would invite you to identify why you didn’t like what was said so that you can clearly express your concerns.  You may be able to do this on your own or you may find working with your counselor helps you sort it out. Hopefully, you can talk it out and move forward.

Counselors saying something off, does sometimes happen for a few different reasons:

It might be a misunderstanding, in which case you both need to get on the same page. They might need to clarify what they said or provide additional insight/information. Easy enough to fix. 

It might be something that you weren’t ready to hear, then they can help you deal with the emotions or concerns it brought up.

They might be wrong and need to own up to that. Counselors are human too and sometimes we make mistakes. When this happens, the counselor should be willing to own up to their mistake and work to fix it when possible.

If this was something that can be worked through great!-sometimes the process of doing so can strengthen the therapeutic relationship. If not, you may need to find a different counselor, and keep in mind that one wrong fit doesn’t mean counseling is not for you.

In the event that what was said or done was so wrong that you feel it cannot be addressed with your counselor, you can report ethical violations to the state board.

Sorry, no clear answer to this question. It depends on what brings you to therapy and what your goals are. Some things may be short term and be addressed reasonably quickly. Some things may take much longer to address. I have worked with clients that met their goals in 2 months and clients that attended therapy for several years, as they added new goals or addressed years of trauma.

You will work with your counselor to determine what is right for you. This can be impacted by finances, schedules and what feels right to you. In general, when you start you will come weekly, or every other week. Any further apart and it feels like you are starting over every session. Occasionally people come in twice a week, but that is usually for a shorter period of time while working on a specific goal.

Therapy doesn’t have to be forever. In general, the goal is to get you to a point that you are able to handle things on your own. You and your therapist will work together to determine when the right time to stop therapy is, and often you will taper off sessions for a while instead of stopping abruptly.  

Being able to consistently use the tools and skills you have learned in counseling or not having much to talk about in sessions anymore can be signs that you are ready to take a break. It can feel scary to stop counseling but it is a good thing!-even if it is a little bittersweet. 

If you find yourself in a place where you need support again, we will be there, until then, you got this!

Counselors are not prescribers; they cannot determine if you need medication or not. They can help you consider the pros and cons of medication and explore your feelings about if it is right for you. Not everyone who attends counseling needs or wants to be on medications.

Yes, except for the following exceptions:

• Abuse, or neglect of a minor, a person with a disability or an adult over 65. Your counselor is a mandated reporter and is required to report abuse to the state.
• Suicidal or Homicidal ideation. If you have an active plan to harm yourself or someone else that is reportable. Your counselor should work with you to help make sure you are safe, but this may mean accessing a higher level of care. It is okay and important to talk about suicidal ideation in therapy when it happens. Talking about suicidal thoughts does not mean you will automatically end up hospitalized.
• You request that your counselor speak to someone and sign a release. This is frequently a psychiatrist or prescriber to discuss symptoms.
• Insurance. Your insurance company may request access to treatment records in order to keep paying for sessions.

All of the same confidentiality applies for minors, with the caveat that parents are allowed access to some information.

The process works best when minors have as much privacy as possible, they need to be able to speak freely to their counselor without worrying that everything they say is being repeated to their parents. Counselors may share some basic information with parents but not all of the specifics. For example, I may say to a parent that we are working on coping skills for anxiety. I wouldn’t provide specific information about what the client is anxious about unless the client wanted that, or there was a specific way the parent could be providing support to their child.  

If there are concerns about safety this information will be immediately shared with parents. In general, we try to get the minor to talk to their parents themselves first. If they are not willing to talk to their parents themselves the counselor may help them have the conversation or may just talk to the parents directly.

I accept Aetna, Cigna, Optum (United Healthcare, Oxford, and Oscar), and Blue Cross Blue Shield of Texas.

A fee of $75 dollars will be charged for sessions canceled less than 24 hours in advance. This time period is so that your counselor can have a chance to fill the time slot.  Clients may request exceptions for emergencies. These will be approved or not based on the situation and how frequently the client has had emergencies.

Clients can set up payment with a credit, debit or HSA/FSA card through the online portal.