How do we know if you are the right therapist for us?
Great question! There are so many therapists out there that searching for the right one for you might feel daunting. Some therapists are found online. Other therapists are acquired through word of mouth or by recommendation of family, friends, or colleagues. Most therapists have specific areas of expertise. While ample choice is great, the search can be quite overwhelming. How do you find the right one?
- Call at least three therapists in the specialty you are seeking and interview for fit. As the therapeutic relationship is very important, I recommend basing at least part of your decision upon how comfortable you feel when speaking with each person. It is also important that the therapist you seek has specific training and ample experience in that specialty. Most therapists offer at least a 10 minute no charge phone consultation, and I would encourage you to take advantage of that. I offer a 20-minute no charge no obligation phone consultation. In fact, I require speaking by phone prior to scheduling our first session together to make sure I am the right therapist for your specific needs.
- Choose a therapist who will genuinely meet you where you are at. The strength of the therapeutic relationship is one of the largest predictors of how well counseling works for people. Most people do not respond well to a cookie cutter approach or a one size fits all when it comes to anything, let alone counseling.
My purpose is to listen closely and tune into the unique needs of those with whom I work and to tailor my approach to your unique needs. No cookie cutter. No one size fits all.
- Find a therapist who is genuinely working for you. No one wants a therapist who talks over them or makes little effort to treat him or her as unique. Because I want people to feel they are getting my very best in the counseling office, I regularly solicit feedback from clients with whom I work. Checking in about how I am doing, what is working and what is not helps me to better understand what is best for you. I want you to feel like I am a partner in helping you to attain your specific and unique goals.
Do you accept insurance?
While health insurance is a helpful and necessary benefit for many, marriage and couples counseling is not typically covered under medical plans. For this reason, I do not contract directly with insurance and am considered an out of network provider.
Unfortunately, many insurance companies do not view marriage and couples counseling as medically necessary and will neither cover nor reimburse for expenditures for this type of service. Here is some explanation as to why.
Insurance companies require both procedural and diagnostic codes for anything to be covered or reimbursed. Coding has not been created for couples counseling. While procedural code 90847, “family psychotherapy, conjoint psychotherapy with the patient present,” is the code that comes the closest, it is still far from an exact match. Moreover, it requires that one partner receives a mental health diagnosis.
In addition, insurance companies require a diagnostic code (a mental health diagnosis). Z63.0, “Problems in relationship with spouse or partner,” is the most accurate diagnostic code for couples counseling. However, insurance companies often refuse this diagnosis, as they do not consider it to be “medically necessary”. Consequently, many couples are denied coverage or reimbursement for couple’s counseling services.
A mental health diagnosis for couples does not exist. Mental health diagnoses can only be given to an individual.
What can you do about this?
- Become informed. I strongly encourage you to call your insurance company and inquire about what they will and will not cover around the previously mentioned procedural and diagnostic coding. In addition, I also encourage you to inquire about what (if any) out of network coverage benefit your specific plan provides.
- Know the risks around either of you receiving an individual mental health diagnosis. Please note that like any medical diagnosis, a mental health diagnosis will become a permanent part of your health record. There is often a stigma attached with mental health diagnoses that can prevent you or your partner from being approved for future medical insurance coverage should you want or need to change health plans. A mental health diagnosis can even carry the potential to preclude future career opportunity. Please be aware of the potential risk in this area.
- Upon request, I will do what I can to help. Because I do not contract directly with insurance companies, I am considered an out of network provider, and payment is due at the time of service. However, I am happy to provide you with itemized documentation (called a superbill) containing all the information your insurance company will need to consider possible reimbursement. This includes my tax identification number, Colorado Social Work License number and procedural and diagnostic codes).
- I accept credit cards and health savings account and flexible spending account (HSA and FSA, respectively) credit cards with a major logo on them. Check with your financial advisor or CPA on any possible coverage risk associated with using an HSA account for marriage or couples counseling.
- Obtain a lower fee for service provider. Marriage/couples counseling is not inexpensive. This said, working well with couples warrants specialized training and experience. The best couple’s therapist isn’t necessarily the most expensive one, but someone who charges a fair fee which is also commensurate with their level of training and experience. If you need to seek the support of a resource that will better fit within your budget, I will gladly provide you with information about lower cost options in the community.
What forms of payment do you accept?
I accept cash, check and all major credit cards with a major logo on them. Should you decide to schedule your own appointments on Align Counseling of Colorado’s HIPAA compliant calendar, you can enter your credit card information confidentially for automatic charge. This is a way that prevents anyone from ever seeing your card number.
What is the difference between therapy, counseling, and coaching?
- Therapy (often called psychotherapy), has historically been associated with more in depth practitioner education and specialty. It also has implied more intensive, longer term treatment and problems more severe in nature.
- Counseling has historically been associated with a more generalist but less pathological approach which does not require as intensive of specialized training. Both therapy and counseling require graduate level training and either licensure or registry with Colorado’s Department of Regulatory Agency (DORA).
While there are semantical differences in therapy and counseling, like many other professionals in the helping field, I often use therapy and counseling interchangeably. This is because I want those with whom I work to be able to decide for themselves how they wish to conceptualize it and what they specifically need on this continuum. I have operated in both capacities- working with some for years on deep seated matters (therapy) and others who come in for a brief period, intermittently or on an as needed basis (counseling).
- Coaching is different altogether, and it has a future orientation. It is very goal driven and specific in approach. There are several very good business and personal coaches in Colorado. However, please know that coaching is different from counseling or therapy. It doesn’t require accreditation or standardized training and is governed by differing statutes than therapy or counseling. While there may be some brief discussion of therapeutic matters in coaching, that is not and should not be the focus of coaching. Please know that while coaching can be very beneficial, it in no way should be used as a substitute if therapy or counseling is needed.
Why counseling? Can’t we read a book or resolve this on our own?
I am an advocate for self-help and often recommend books or a CD’s as an adjunct to both individual and couple’s therapy. However, books, CD’s (and even retreats) are not a substitute for counseling.
Many people terminate counseling prematurely or avoid it altogether because they fear that it stir up conflicting, ambivalent, or uncomfortable feelings. While counseling can be emotionally difficult, it also can vastly help people to develop the ability to better navigate and even conquer difficult feelings and situations that previously seemed insurmountable.
Are you going to tell us what to do or tell us we need to end or stay in our relationship?
No. While I may make suggestions for you to try in between sessions, I never tell anyone what to do or whether to stay or go in their relationship. That decision is very personal and not mine to make.
I have worked with many couples where one or both partners feel ambivalent about the relationship. In these cases, I help them to find clarity and better able to decide what is going to be the best.
What if my partner doesn’t want to come or I do not wish for him/her to come to therapy?
No problem. Your relationship can still benefit even if just one of you decides to come!
Family therapists often use the metaphor of a spider web. The idea behind this is that any tweak or change to any part of the spider web (large or small) results in a change in the entire web.
Individual therapy with the goal of improving the relationship can be quite useful for improving it. Some clients even prefer working this way, especially in cases of:
- Personal trauma that adversely affects the relationship
- Ambivalence about the relationship and wanting to clarify
- Seeking self-improvement in the context of the relationship
- Wanting to explore what can be done when the other partner wants things to stay the same
I have worked with many clients who prefer to work in this way, and it can be very helpful and beneficial.
Do you do email, phone or Skype/Facetime sessions?
Email is not a confidential means of communicating. Additionally, much can get lost in translation in an email. I only use email for scheduling appointments and never as a form of therapy. Skype and Facetime are also not confidential or HIPAA compliant and are not utilized in this practice.
As for phone sessions, The State of Colorado requires an initial in person meeting. If you are a Colorado resident but do not live close to the office, phone sessions may provide a convenient alternative to you.
I also provide phone sessions for on-going clients who normally come in person but cannot make it to an appointment. Personal illness, illness of minor children, inclement weather or to obtain support in between in person sessions are some of the reasons why phone sessions can be useful.
Are there any reasons why we shouldn’t do couple therapy?
Yes. There are instances where marriage/couples counseling is contraindicated. The following instances are among a few that might pose risks to one or both partners and need to be carefully considered prior to beginning couples counseling.
- Current or history of physical violence in the relationship
- Untreated major psychiatric illness such as schizophrenia or bipolar
- Untreated Post Traumatic Stress Disorder (PTSD)
- Threat of danger to self or others
- Severe substance abuse
Individual therapy and/or mental health stabilization can help with these problems. Please contact me should you have any questions about whether marriage or couples counseling is right for you.
How do we schedule and reschedule appointments?
You can schedule and reschedule appointments directly through the online scheduler. You can also call or text me at (303) 475-2757 or email me at email@example.com and I can take care of scheduling appointments for you.
Please note that a call or text is required for any sessions that need to be rescheduled or modified within 48 hours of the scheduled appointment time.
Are you ready to take your relationship to the next level? Please don’t wait another minute! Call or text me at 303-475-2757, send me an email firstname.lastname@example.org or click here to schedule your 20 minute no charge initial phone consultation. I look forward to meeting you!
Suzanne M. Smith, Licensed Clinical Social Worker