Scope of Practice
My areas of expertise include: Anxiety and stress related problems, trauma/ptsd issues, depression and mood/emotion dysregulation, relationship problems and life transitions.
There are times that incorporating psychotherapy, bodywork, and creative modalities might be helpful. You have the choice of working exclusively in one modality or integrating these. Which intervention used will depend on your situation. All therapeutic work, including verbal, movement, body awareness and hands-on therapy, is strictly professional, not personal, and conducted with the intent to educate you on how these modalities might facilitate your process in therapy.
I will inform you at the end of our initial assessment where I might be able to help you with your healing and integration and/or refer you for other or additional services for issues outside of my scope of practice. I might suggest ideas for continued integration of your work between sessions.
The Process
Before your first session, there are a few forms and a brief history to fill out which will help us get started. The first 2-4 sessions will involve an evaluation/assessment of your needs and focus in therapy. I will offer you some potential ways we can work together to make progress on your defined goals; and, importantly, we need to see if my therapeutic approach works for you.
Chances are you initiated psychotherapy because you were experiencing blocks, challenges and distress associated with one or more areas of your life.
Psychotherapy has the potential to help you shift positively, but not without significant effort and engagement in the process. There are times that you will experience discomfort in sessions such as difficult feelings and discussion of uncomfortable aspects of your life. However, it has been shown that pursuing therapy can lead to significant reduction in feelings of distress, increased satisfaction in interpersonal relationships, greater personal awareness and insights, increased skills for managing stress and resolutions to problems. Sometimes change is smooth and easy but more often it is slow and can be frustrating as it brings up stuff that might have been buried or defended against.
One thing is for certain change is inevitable. Your engaging in therapy will get you a little further down the road if you are curious and open to become increasingly self-aware.
It has been determined that online therapy will likely be effective for treatment, not to mention convenient and gets you out of the Austin traffic gridlock. But, if it is determined that another form of intervention is more appropriate, referrals to other professionals will be offered
Ending therapy/termination of sessions. It can be very empowering to engage in a pre-planned final session. This allows us both to honor the work you have accomplished and indicate opportunities for continued growth in the future. Also, you have the right to terminate therapy and communication at any point. Maybe we weren’t the right fit or treatment just wasn’t working right now given life circumstances or with me as your therapist. If so, I hope we can talk about your concerns as I take any issues very seriously and respect your decision. With the intention of handling your therapeutic journey with the utmost respect and care, I can provide you with names of other therapists who might be a better fit if you’d like and even help you transition to the next phase.
Appointments
Generally, we should plan on meeting at least one time weekly, so we can get a clear assessment of what’s bringing you into therapy and hone in on whatever various themes are presented. These appointments are 50-minutes including scheduling your next appointment. I generally adhere to a Monday-Wednesday, 9am-8pm CST scheduling calendar. Occasionally, I am engaged in continuing education trainings and workshops or a vacation, but you’ll get plenty of notice from me.
I notice that the content in sessions weaves in and around various areas and that these themes ultimately are presenting in a concerted effort towards change. You and I may decide after a particular wave of relief, insight or integration occurs, that spacing out appointments is necessary to adjust and track your progress while staying connected to sessions as a resource while this transition and transformation happens.
Cancelling [insert sad face]. We are not open for business hours Friday thru Sunday. So if you must cancel, please do so 24-hours on the business day before your appointment [For example, if your appointment is Monday at 10am, you must cancel by Thursday at 9am; or, Tuesday at 1pm, you must cancel by Monday at 12 pm]. Not cancelling in time, I will be charging you $125. Also, cancelling is not covered by any insurance, so this is on you. Please try to schedule at a time that works for you to keep your appointment and keep the rhythm of your therapy in process so we don’t skip a beat.
Fees
The standard fee for the initial intake session is $230. You are responsible for payment processing at the time of your session. For your convenience, I have a secured credit card entry program integrated into my practice software that can be used to collect your payment. Hopefully this credit card that you have on file will stay current and there will be no reason to contact you about failure to pay which incidentally is truly bad form that I will have to recover via collection agency (so let’s practice good juju with paying for services rendered shall we). My services, moving forward (as of January 2022), are rendered and charged to you, not the insurance company.
There are times that other professional services might incur that will be charged to you. For example, you might need me to fill out extended, lengthy forms or we might have to have an intermittent session regarding an adjacent issue or theme. It is always best to schedule a separate session for these types of professional services outside of our therapeutic container.
Good Faith Estimate
The Good Faith Estimate (GFE) shows the costs of services that are reasonably expected based on information known at the time the estimate was created and does not include any unknown that may arise due to extenuating circumstances. Although I set the intention to let you know in advance of any additional charges for other services, federal law allows you to appeal outstanding charges to you. Currently, the full rate for services is $230/50-minute session. Generally, individual counseling sessions are typically held weekly for a period of 2-3 months then sessions move to a bi-weekly, then monthly/bi-monthly format towards a successful treatment termination of services. There are simply too many variables to offer you a specific cost of treatment; however, every effort will be made to present you with the necessary information to base your decision to initiate, continue and have a successful treatment experience. The GFE once issued is good for 12 months at which point another GFE will be created and reviewed; however, this GFE [separate form included in your file and copy made available to you] is not a contract.
Disclaimers: There may be additional services recommended as part of treatment that are not reflected in the GFE initiated at the onset of services. Any billing substantially in excess of the annual estimated amount in the GFE may be resolved in the dispute process; however, this is not applicable as fee for service due at time of service. Any changes in scope pertaining to the GFE must result in a new GFE.
Insurance
I get it. You want to be able to use your health insurance for mental health services. I would too! So working with me, you want to make sure that your insurance policy has an out-of-network clause that allows you to participate with the therapist and services of your choosing.
Be stealthy with your understanding of the insurance plan you’ve signed up with. I am fortunate to have a billing assistant that can help you understand filing claims and getting some information about your coverage, but note that we cannot guarantee that your insurance will cover sessions. I will offer you what is called a “superbill” that you can submit to your insurance company.
Records
I am required to keep all appropriate records of the services that I provide for seven (7) years. Your paper records are maintained to a secured triple-locked location in my office. Since that method of recordkeeping is bust’n at th’seams, I am transitioning to an electronic record; so, eventually your entire record will be scanned (paper copies shredded) and maintained through my secured online mental health databank.
Confidentiality
So this is a VERY big deal. I would not be a therapist if I violated your confidentiality. So, we will need to really take a look at this because it is just SO incredibly important for you to understand it and its limitations moving forward in therapy.
All client records are to remain confidential and not to be used for purposes other than health care (treatment coordination with other professionals/entities) and its administration. You have the right to share your information in writing (signed release of information which can be cancelled at any time).
There are a few emergency provisions or exceptions in which information can be disclosed to others without written consent: Duty to warn and protect, threats to public safety, reporting abuse of a child or vulnerable adult, prenatal exposure to controlled substances, death of a child, professional misconduct, judicial or administrative proceedings, and minors/guardianship access as required.
To expand on the Duty to Protect, this means that if you are a danger to yourself, I will get as much support around you as possible including but not limited to your emergency contact, legal authorities conducting a health and safety welfare check on you, and effort to call other family members to get you safe and get you to the care your need.
Other provisions to the confidentiality include: Lack of client payment and collection agency utilization to collect debt, insurance companies/third-party payers regarding client services, non-identifying case consultation with other professionals in order to provide the best treatment, contacting the client and using discretionary caution of exchange of information to another in order to preserve the confidentiality of the therapeutic relationship between client and professional.
I understand that violating confidentiality of client records may result in a civil legal action to the fullest extent of the law, reporting to the licensing board and a complete lost of my ability to practice professionally. So yes, I take this extremely seriously.
I am dedicated to serving you and every client seeking my help and support. I adhere to the Code of Ethics of the American Counseling Association and the Rules and Regulations for the Licensed Professional Counselors in the State of Texas. I do not discriminate between my clients or professionals based on age, race, creed, disabilities, handicaps, sexual orientation, preferences, or other personal concerns. I aspire to maintain an objective, professional relationship with you and every client and will continually evaluate my personal limitations, strengths, biases, and effectiveness in an ongoing pursuit of self-improvement. I am an eternal student and very engaged in my field of study, psychology.
Contact
There are multiple websites, professional organizations, social networks and professional colleagues that I have listed my contact information that you may have inquired about services with me. Through this entire growing “web” of networking and search engine optimization, I’m so thrilled you found me!
To make or reschedule appointments, questions about billing or paperwork, I ask that you contact Kathy Kurowski, Billing Specialist at (512) 934-8971. She’s awesome and she can help you with getting on the client portal, arranging payments, scheduling and more.
I do not answer my phone during sessions. Please leave a message on my confidential voice mail and I’ll get back with you as soon as I am able (usually within 24-48 hours)—Otherwise, if you are a current client, you’ll probably know well in advance that I’m off the grid, hiking Kilimanjaro, vacationing in an earthship in the high desert.
If you have been taking a break from therapy and are now returning, please contact Kathy and she’ll get you scheduled or refer you to my on-call colleague covering for me. Although I hope this doesn’t happen, if you are in an emergency, please call 911 or go to the nearest emergency room. I’ll want to know what’s going on with you as soon as you are able and if you need to engage in this higher level of care.
Text and Email will not be used in lieu of therapy. If you choose to text or email me, please note that it is not a secure medium. IF you choose to communicate confidential or privately via encrypted email, texts or telephone, I will assume you have made an informed decision and view it as your agreement to take this risk that such communication may be intercepted.
My take on social networking is this. Y’see, I just can’t accept a friend request or follow you on social media because it is more likely to compromise your privacy, confidentiality and the container of our therapeutic alliance. I have a couple of professional media platforms like FaceBook: MOJObyDrJohn, Instagram: mojowrkn and LinkedIn: Michelle John Phd which you may follow. I am developing a YouTube Channel that you may view. But, your participation on these public pages is not private and I cannot control who likes or responds to my posts. It is my hope that maintaining a presence online offers tools, research, insights and motivation in therapy only. In other words, this is a professional platform not a personal one. I hope you understand, I still think you are cool.
Is therapy right for me?
There are many reasons why people come to therapy. Sometimes it is to deal with long-standing psychological issues, or problems with anxiety or depression. Other times it is in response to unexpected changes in life such as a relationship issues or work transition. Many seek therapy to assist with their own personal exploration and growth. Working with a therapist can help provide insight, support, and new strategies for all types of life challenges. Therapy can help address many types of issues including depression, anxiety, conflict, grief, stress management, body-image issues, and general life transitions. Therapy is right for anyone who is interested in getting the most out of their life by taking responsibility, creating greater self-awareness, and working towards change in their lives.
Do I really need therapy? I can usually handle my problems.
Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you’ve faced, there’s nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you’re at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.
How can therapy help me?
A number of benefits are available from participating in psychotherapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that counselors can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:
Attaining a better understanding of yourself, your goals and values
Developing skills for improving your relationships
Finding resolution to the issues or concerns that led you to seek therapy
Learning new ways to cope with stress and anxiety
Managing anger, grief, depression, and other emotional pressures
Improving communications and listening skills
Changing old behavior patterns and developing new ones
Discovering new ways to solve problems in your family or marriage
Improving your self-esteem and boosting self-confidence
What is therapy like?
Every therapy session is unique and caters to each individual and their specific goals. It is common to schedule a series of weekly sessions—typically 50 minutes. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues or ongoing for personal growth. There may be times when you are asked to take certain actions outside of the therapy sessions, such as reading a relevant book, journal, or keeping records to track certain behaviors. It is important to process what has been discussed and to integrate it into your life between sessions. For therapy to be most effective, you must be an active participant, both during and between the sessions. People seeking psychotherapy are willing to take responsibility for their actions, work towards self-change and create greater awareness in their lives. Here are some things you can expect out of therapy:
Compassion, respect and understanding
Perspectives to illuminate persistent patterns and negative feelings
Real strategies for enacting positive change
Effective and proven techniques along with practical guidance
Is medication a substitute for therapy?
In some cases a combination of medication and therapy is the right course of action. Working with your medical doctor you can determine what’s best for you. It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of distress and the behavior patterns that curb progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness.