Services

Some of the herd at RDR

Availability

I'm generally available for appointments on Mondays, Thursdays, and at times Friday afternoons.  I also have a limited number of Thursday evening appointment slots—please call me for information about these.  I'm not available on Tuesdays, Wednesday, or Fridays mornings because I work at the Houston VA at those times.  


Adult Services

Individual therapy 

Diagnostic assessments (not for forensic, legal, or employment purposes)


Also offered at the Ranch:  Equine Assisted Psychotherapy (with Drs. Walsh and Baldwin)


Clinical Specialties

Trauma / Post Traumatic Stress Disorder (PTSD)

Veteran issues
Anxiety (for example, panic, worry, phobias…)

Depression

Complicated / traumatic bereavement 

Self-esteem issues

Anger management​

Stress management

Relationship problems

Adjustment issues (e.g., relationship ending, job change, life transition issues)


Issues that I do not specialize in

I do not specialize in/provide services for the following issues:

  • Couples/marital therapy
  • Child/adolescent/family services
  • Eating Disorders
  • Sexual functioning issues
  • Conditions in which the primary (i.e., initial focus of therapy) issue is substance abuse 
  • Severe personality disorders
  • Obsessive Compulsive Disorder
  • Primary psychotic disorders
  • Severe social anxiety


Note:  As a part-time private practice clinician, I am not as available or flexible as some other providers, and I am not often immediately available by telephone. We will both need to take this into account when deciding whether or not I’m the most appropriate provider for you to work with. Persons with more intense issues/needs or those needing frequent between-session contact, may be better served by a different provider with more availability/flexibility in their schedule.    


Fees

Like many other professional services, therapy is not cheap.  I want you to know that I appreciate the large investment of time, money, and energy that a person makes in choosing to work with me.  For this reason, I’m committed to helping my clients reach their goals as quickly as possible.  The good news is that often the primary driving force of how quickly someone reaches their goals is their level of motivation and commitment to the therapeutic process.  Essentially, what this means is that you have a significant degree of control over how quickly things change for you, and you’ll have to work even harder than me both in and out of session to get where you want to be in life.  You’re not alone though.  I’ll be there to guide and support you (and possibly give you a gentle yet swift kick in the bottom—yes, I’m a parent of young children—as needed) throughout the process.

  • $200 for initial consultation (60-70 minutes) which focuses on history taking, diagnosis, treatment planning, and referral (if clinically indicated)
  • $175 per 55 minute follow up session


Reduced fee services may be available in some cases.  Please call me and we can discuss this issue. 


Health insurance Reimbursement

I am not on any insurance panels (although I am a Tricare-approved provider), but my services are eligible for out-of-network insurance reimbursement from health insurance companies and employee benefit plans that offer such mental health coverage. I prefer not to be on any health insurance panels because they limit the privacy and confidentiality of the person I’m working with, they require a psychiatric diagnosis (even in persons who don’t have clearly diagnosable symptoms), their goal is to manage (i.e., "keep their costs down") your access to services, they require extensive paperwork and long phone calls, and they can hinder a mental health provider’s ability to practice effectively by setting limits on number of sessions, type of treatment, etc.  In short, being out-of-network permits me to offer a higher quality service to my clients. 


I can provide the necessary documentation you may need for reimbursement based upon your out-of-network benefits, and, as a courtesy and to make it easier for you, in many cases, I can arrange for an electronic submission for reimbursement to be sent by my office on your behalf to your insurance company.  Your insurance or benefit plan may reimburse you for some or all of the services I provide. Please check your coverage carefully to determine what portion of my services may be reimbursed by your insurance plan.  The best way to do this is to contact your insurance company directly by calling the customer service phone number on the back of your insurance card (there may be a separate number for mental health services information). When speaking with the insurance company representative, you will want to ask the following questions: 

  • Do I have mental health benefits?
  • What are my out-of-network outpatient mental health benefits?
  • How many sessions per calendar year does my plan cover?
  • What is the coverage amount per therapy session?
  • What is the "usual and customary rate" allowable for an initial individual consultation (procedure code 90791) and for a subsequent individual  therapy session (procedure code 90837)?
  • Must I meet a deductible before my benefits will begin paying?  What is it and has it been met? 
  • Is approval required from my primary care physician?


Many individuals who have health insurance decide not to use it for coverage of mental health services, and instead pay for therapy as an "out of pocket" expense, or via a flexible or health savings account. Typically, this is due to privacy concerns and the potential release of personal information to health insurance companies and their affiliated entities.  If you decide not to use your health insurance to cover my services, your personal information and records will not be released to third party payors or their affiliates.