Hi, I'm Aimee! :) 
You can text or
e-mail me to schedule or ask any questions!

Frequently Asked Questions (FAQs)

Q: What happens during the initial phone/email/text consult?

A: I will call you at a time that is convenient for you, or we can do a consult via e-mail or text if that's more comfortable and convenient! Then you can tell me a bit about what made you decide to seek counseling or what specific issue(s) you need help with. Feel free to ask how I can help you with your specific issue(s) or needs. If you feel comfortable talking with me and think I’ll be able to help you, we can go ahead and schedule your first counseling session!

If you want to skip the consult and schedule an appointment right away, we can do that too. I know you especially might want to go this route if you are seeking a gender confirming hormone therapy &/or surgery assessment and referral letter. Or maybe you just get a good vibe from reading about me after having likely done much research to find a therapist, and you are ready to get started ASAP. Call, text, or e-mail to schedule!

Q: What are your fees?

A: My rates per session (which are a full hour in length- longer than the typical 45 to 50 minute session) are as follows:

Individual counseling online: $125 per session

Individual counseling in office: $150 per session

Couples counseling online: $150 per session

Couples counseling in office: $175 per session

Q: Do you accept health insurance?

A: I only accept clients who self-pay, and you can see my fee schedule above. But this does NOT mean I cannot accept clients who do have insurance. If you choose to use your health insurance, you can ask your insurance company if they reimburse for “out of network” therapists. If so, I am happy to provide you with a bill to submit to your insurance company so you can seek reimbursement and/or apply your fees toward your deductible.

I totally understand if you have insurance and want to use it because it's less expensive. I get it, and I've done the same before (with mixed results)! However, there are several reasons I do not personally work with insurance companies in my private practice, and the short version is this: I believe it is the most ethical, the most clinically appropriate, and-of utmost importance-the most therapeutically beneficial to you as my client if you are in charge of your own treatment, rather than a third party (an insurance company).

To learn more about why I do not accept insurance, please continue reading below the dotted line. To skip this detailed answer, please scroll down to the next Q.
  
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I believe the type of treatment you need should be decided by you and me together, and whether it continues should be dictated by how YOU feel you are progressing in therapy. In fact, research shows that a strong therapeutic relationship is the best indicator of whether a client will make progress in treatment. When clients give feedback that they feel heard, understood, and respected by their therapist, positive change occurs sooner than later. 

However, when a health insurance company pays for your treatment, an insurance company employee performs what is called "utilization review", so that person is the one giving your therapist “feedback” regarding whether your treatment is “working” (without ever even speaking to you-the client!), and sadly, the bottom line is for them to make the insurance company the most money, often by limiting coverage for services.

Insurance companies require the following:

1. That you be given a diagnosis in order for services to be “approved”. Although diagnoses have a place in treatment and can be helpful sometimes, they can also be problematic for many reasons:

  • An appropriate diagnosis can rarely be made in one session, but this is typically required in order for services to be approved.

  • Some clients’ situations do not warrant the diagnosis of a mental disorder, but because one is required for therapy to be approved, some therapists will provide a diagnosis anyway to be able to help their clients. If a therapist decides against providing a diagnosis, then clients won’t get the help they need. As you can see, this creates an ethical bind for therapists who simply want to help clients with their very legitimate, but not diagnosable, issues.

For example: you may be having difficulty managing the stress of “coming out” to certain individuals, dealing with grief resulting from a breakup, or facing struggles in a relationship. These are not diagnosable conditions in and of themselves, although sometimes enough symptoms develop to meet criteria for a mental disorder as classified in the DSM-5.

Did you know that couples’ therapy is not typically a covered benefit, simply because it is not considered “medically necessary”?

  • A diagnosis will become a part of your permanent medical record, which may affect your future insurance coverage.

  • Unfortunately, there continues to be a negative stigma attached to many mental disorders. As much as there is no shame in being appropriately diagnosed with one of these disorders, their symptoms can usually be resolved with therapy (and sometimes the addition of medication). However, a diagnosis often becomes a “label”, which can negatively impact how clients perceive themselves in the long-term or how others view them, even health care providers.

2. Notes from our sessions would have to be submitted to your insurance company, and a third party (who does not know you personally) would be “reviewing” your diagnosis and treatment.

I feel this is an invasion of your privacy, as a stranger will be reading about your personal issues to deem whether they should cover therapy. There is also a chance that your treatment would still be denied, or limited to a certain amount of sessions, after this “review”. While my hope is for you to feel better sooner than later, every client is unique and progresses at a different pace in therapy. Also, everyone has different needs and issues, and they may not be “resolved” in 6, 8, or 12 “pre-authorized” sessions. If I am helping someone process sexual trauma or grief over the loss of a loved one, I feel it is unethical for me to cut off services if my client still feels they need to continue therapy.

3. On a personal note, I would have to spend a good portion of my working time calling insurance companies and doing unnecessary paperwork to have your treatment approved, and this is time I would rather spend either working with my clients or researching the best treatment options for my clients. I spend the time I am not with my clients researching evidenced based treatments and locating resources that will be beneficial given my particular client’s needs or situation.

4. Along with the above, reimbursement rates for therapists who accept insurance are much lower than standard rates for therapy, which forces therapists to overbook clients and spend less quality time with each client. I choose to see fewer clients so that I can give them the attention they deserve. The last thing you need to deal with when talking about your personal issues is to be sitting across from a burned out therapist who is waiting to go home!

5. Unless an insurance company provides “out of network” coverage, you would have to select from a list of providers your insurance company has approved. As I mentioned before, having a strong therapeutic relationship is the most important factor when it comes to seeing positive results in therapy. Finding a therapist you feel comfortable with and who works specifically with LGBTQ+ issues (especially transgender issues or open/poly/CNM relationship issues) may not be easy to find on these pre-approved lists. You should be able to choose your own therapist-someone you really trust and know has the ability to help and understand you.

​​Q: Are you LGBTQ+?

A: Yup! I'm a pansexual/bisexual cisgender woman, and I use the pronouns she/her/hers. I share my LGBTQ+ identity simply because clients often ask about it anyway, and I'm totally okay sharing this part of myself with you! My (usually) femme appearance can sometimes be read as straight, and even LGBTQ+ people make assumptions based on stereotypes. We all do to some degree! 

Having said that, I won't share much else about my personal life, simply because it is very important that we keep therapy about you. I don't want you spending your money and time in therapy hearing about my life! Also, I would never use my personal life experiences, background, or identity to inform your treatment or assume that what makes me happy would make you happy! That's silly. 

Instead, I use my graduate level counseling education and post-graduate therapy training and experience to help provide you with the specific interventions and tools that will work best for you in your particular relationship or life circumstance to address your particular problems, no matter what kind of relationship or circumstance you are in. Most of all, I want to really learn about you (and your partner(s) if doing couples/relationship therapy) so we can figure out what internal strengths and external tools we can draw upon to help you heal and grow. 


Q: Can I talk about ______________ in therapy?

A: Whatever you just filled in that blank with, the answer is a resounding YES! Often people are hesitant to discuss issues related to sex, sexuality, and gender because there are a lot of judgments, assumptions, stereotypes, and taboos surrounding these topics in our society. But those are the very topics I'm trained to discuss and am knowledgeable about, and I feel super comfortable hearing about all of them! I also work with individuals who are in open/poly/CNM (consensually non-monogamous) relationships, and I am kink/BDSM friendly as well.

Below are more issues/topics (in addition to sex, sexuality, and gender) that I welcome you to talk about in therapy. Some of these may be a significant part of your identity or impact your everyday life, and I want to provide you with a supportive, confidential space to talk about how they affect you, how you feel about them, and (if relevant) how to cope/deal with them:

Race/Racism

Ethnicity

Cultural Background

Religious Background

Current Religious and/or Spiritual/Mystical Beliefs


Atheism, Agnosticism, Questioning Religion/Beliefs

Political Views

Finances/Money

Intersectionalism (e.g., navigating two or more possibly conflicting cultures/parts of your identity)

Disability/Ableism

Aging/Ageism

Privilege/Lack of Privilege

Abortion/Reproductive Health

Medical Issues/Chronic Health Problems

Serious Mental Illness (I have extensive experience working with this issue)

Self-Harm or Suicide*


Drinking/Smoking Pot/Taking Drugs

Sexual Concerns

Masturbation

Kink/Fetish/BDSM

Polyamory/Consensual Non-monogamy/Open relationships

Dreams/Nightmares

Dissociation/Flashbacks

Seeing or Hearing Things that may not be there

Body Image/Fat Shaming

Animal Rights/Welfare

Veganism/Vegetarianism

Tattoos/Body Modifications

No matter your reason for seeking therapy, with me you will find a safe, private space where you can talk about literally anything!

* NOTE about self-harm and suicide: I want you to know that bringing up self-harm or suicide in therapy does NOT automatically mean you'll be sent to a psychiatric hospital! People (understandably) fear this might happen if they just say the word "self-harm" or "suicide", so they sometimes don't want to bring it up. First, self harm is not the same as a suicide attempt (though in some cases it is possible a self-injurious behavior can rise to the level of being lethal).

If you have done either (self-harmed or thought about/attempted suicide), please don't be ashamed to bring it up with me. It is incredibly common to have or have had suicidal thoughts/attempts or self-harming behavior, especially in the LGBTQ+ community, where these rates are even higher.

Keep in mind:

1. Suicidal thoughts and attempts are more common than we talk about in our society, and having suicidal thoughts is not the same as carrying them out. It can help to talk about these thoughts to help you from carrying them out.

2. Self-harming is a way of coping with intense emotional pain and distress. It is rarely used with the intention of ending one's life, but instead as an attempt to alleviate emotional or psychological suffering.

If you bring these issues up in session, we will explore healthier ways to cope and assess together your level of current risk to yourself. More often than not this conversation allows us to talk through these thoughts and urges and create a coping/safety plan so you know how to handle these thoughts or urges when they arise! A big part of therapy for many people is to learn how to manage/cope with distressing/uncomfortable thoughts and feelings. I'll help you learn how to do that!

If we decide you are still seriously at risk, we will then consider hospitalization, and I'll be very upfront with you if that seems like a necessary next step to ensure your safety. 

If you are currently experiencing intense suicidal thoughts and are seriously considering harming or killing yourself, please call 1-800-273-8255 now, or if you are in imminent danger call 911 immediately. Click here for more resources.

Q: Why do you specialize in working with LGBTQ+ clients?

A: I genuinely love helping people grow in therapy (and of course welcome all clients!), but I went into private practice in order to specifically focus on helping to meet the needs of the beautifully diverse LGBTQ+ community. I am passionate about increasing support for sexual and gender minorities, including individuals who are:

Lesbian

Gay

Bisexual

Bigender

Transgender

Queer

Questioning

Intersex

Asexual

Agender

Aromantic

Pansexual

Two-Spirit

Genderfluid

Genderqueer

Gender Non-Conforming

Nonbinary

Demisexual

Demiromantic

(If I left out your LGBTQ+ identity, please e-mail me and I'll add it to this list!)

During the last several years of working in the field of mental health counseling, I realized that (unfortunately) many therapists are not entirely competent to work with LGBTQ+ clients, or to treat certain LGBTQ+ related issues. Because therapists are people too, they are at risk of holding the same prejudices against sexual and gender minorities that are still prevalent (but changing!) in society.  Sometimes they are simply uneducated about or have no experience working with such issues or clients, and as therapists, we are ethically obligated to only provide treatment in areas for which we have gained competency and training.

This is why I also spend part of my time working toward educating those in my profession (and the public) about LGBTQ+ identities and related issues-so there can be more LGBTQ+ affirmative therapists! I have given presentations and lectures on LGBTQ+ issues in both agency and college/university settings and continually educate about LGBTQ+ issues, as I think it is important to advocate for my clients in the public sphere as much as I help them in personal counseling.

I also ensure *I* stay educated and up to date on the most evidence-based and competent care. In October of 2017 I attended Harvard Medical School's "Advancing Excellence in Transgender Health" conference, which was a live, 2 day training course in Boston, MA offered by the Fenway Institute . I learned so much great information and was thrilled to be in such an affirming environment. I look forward to attending even more trainings in 2018 related to LGBTQ+, open/poly/CNM relationships, and kink/BDSM issues!

Q: How does online counseling work?

A: I use doxy.me , which is a secure, HIPAA compliant video counseling platform. All you need is your personal computer with a microphone and webcam (either internal or external). I will send you a link to log in to your session, and you will not need to register or provide any private information to the website. So easy!

Q: What if I need psychiatric medication? Can you help with that?

A: I am very fortunate to work in conjunction with an LGBTQ+ friendly psychiatrist, Dr. Jacqueline Hubbard , and if medication is needed as an adjunct to therapy, I am happy to refer my clients to her for an evaluation and medication management. 

Q: What kind of counseling approach/interventions/techniques do you use?​

A: I am a client-centered therapist, which means that I value my clients’ needs and feedback above all else. As I mentioned earlier, a strong therapeutic rapport is the most important factor in therapy-regardless of theoretical orientation or approach. I am supportive, caring, and compassionate, and I am down to earth with my clients. I like to be able to use humor with my clients so we can laugh together and feel connected on a human level!
 
Along with my client-centered approach, I utilize evidence-based practices and techniques, including cognitive behavioral therapy (CBT), solution-focused therapy, and mindfulness-based interventions. Cognitive behavioral therapy (CBT) is incredibly beneficial for most clients, especially for those dealing with anxiety, depression, or identity/self-esteem issues.  Mindfulness based interventions are also a significant part of my practice, as  they have been shown to reduce anxiety, depression, and stress and to increase relationship satisfaction, the ability to focus, and overall well-being. I also utilize techniques from the  Gottman Method , which has been shown to help decrease conflict and increase positive feelings in relationships. The Gottman Method is also one of the few evidence-based couples therapy approaches that has studied same sex couples .
 
I always empower my clients by providing education on the mental health or relationship issues they are facing, helping them locate sources of community support, and assisting them in finding relevant self-help tools and resources. It is important for us to increase your access to the knowledge and resources that will continue to help you after therapy ends with me. Therapy is an investment in yourself, and months and years from now I want you to feel that your time and money in therapy was definitely well spent.