Ask Anna (FAQs)
Q: Do you have a Mission Statement?
A: To help individuals, couples and families live more self-esteeming and self-healing lives by improving wellness of the mind, body and spirit.
My Values Statement is that I believe every person has a right to opportunities for health, to heal past trauma, define realistic goals, and change hurtful patterns of behavior. My goal is to remain encouraging and realistically flexible, while utilizing an eclectic range of treatment methodologies such as psychoeducation and “carefrontational” support of experiential learning. Success is created from a collaborative exploration of goals, setting priorities, diligent effort and continued patience.
Q: Who are your typical clients?
A: Each person, couple or family who comes to see me is different! Of course there are some similar issues that bring clients to my door specifically. Although I do treat individuals for general depression, anxiety, grief and addictions, the majority of my practice is devoted to sexual and relationship concerns, intimacy disorders and healthy dating and sexuality. My adult clients come individually, as half of a partnership, or part of a family.
- Group may meet weekly, subject to weather, scheduling commitments, minimum client enrollment (nonrefundable advance payment to reserve one’s seat). Call for current availability.
- Please email or call to ask about current availability and pricing for Individual, Coupleship, Group Intensives, Workshops, Presentations, or In-Services.
Q: What kind of therapy do you do?
A: Licensed as a Clinical Social Worker, Licensed Independent Addictions Counselor, and having earned specialized certification as a Sex Addiction Therapist and Multiple Addictions Therapist, including Love Addiction and Love Avoidance, and money disorders, I am professionally considered a “psychotherapist” and use different eclectic and EMDR therapy methods, aimed at the whole person. For instance, psychiatrists might use medication as their principal method of treatment, while I tend to look at all aspects of a person’s unique experiences and how everything fits together. For example, if you go to a physician’s office for the flu, you might receive “the prescribed” medication or shot, and general advice, and your doctor will also take into consideration your own individual medical history, allergies and unique needs. When you come in to my office we’ll explore what fits for you and take into consideration your own unique psychological, biomedical, social and emotional history and individual needs, wants and abilities.
Q: Do you take Medicare?
A: Anna has ‘opted out’ from accepting Medicare, so clients are not eligible, ever, to submit for services under Medicare.
Q: What if I am very concerned about my privacy when discussing highly sensitive issues?
A: What you share in your sessions is private, with certain limits that we will discuss. One of the primary reasons I don’t take insurance, and my clients do not submit to their insurance, is because of the possibility that the client-therapist relationship could be compromised when there is uncertainty about what information will find its way in to some sort of Medical Information Database (such as your mental health diagnosis, assessments and evaluations on your progress and overall functioning, history of substance use, sexual behaviors, or medication use, and communication about the number of sessions you attend with insurance case managers who authorize benefits). If you do decide to submit your sessions for reimbursement then it is your responsibility to check with your insurance provider about what rights to confidentiality you may have given away.
Q: Do you take walk-ins?
A: No, I do not because informed consent is still required prior to our initial introductory meeting.
Q: Do you make house calls?
A: It depends on location and circumstance and is a case-by-case basis. For instance, if you are in a domestic violence situation then meeting you in the privacy of my office, comfort of your home or office, or other agreed upon location can be a way to support your safety. If you’re homebound, have difficulty getting out of your home, or have acute anxiety, then you may still be able to have access to psychotherapy without having to rely on others for transportation.
Q: Do you take crisis calls?
A: No, and I am not ‘on call.’ In case of an emotional crisis or life-threatening emergency, always call 911. Some established clients have set up, and are charged for, check-ins via phone in-between scheduled sessions. Clients usually appreciate a bit of additional support outside of regular sessions since my practice is out-patient. Individuals needing a higher level of care may be referred to in-patient, residential, or Intensive Outpatient (IOP) before returning to regularly scheduled outpatient therapy.
Q: Do you offer telehealth services?
A: Yes, for clients in Arizona, Utah and Michigan. Detailed information is provided in the Informed Consent document. Basically, Telehealth sessions are conducted by video or phone instead of in person, and as with any electronic communication, it carries some inherent limits to privacy and security, technical issues can occasionally disrupt a session, and Telehealth is not appropriate for emergencies.
Q: What if I just want to be happy!
A: That’s a reasonable goal, although it’s not possible to be happy or content all the time. Happiness is more an “extra” result rather than a concrete destination. Life and therapy are journeys, and require a commitment to stay the course, because both are rocky and you will likely fall down at times. What is enough for you may differ from what is enough for someone else because each person has their own level of “comfort” and “satisfaction.” Expecting to never experience times of pain, loneliness or sadness is not generally realistic. If you think and do things that bring you joy and satisfaction then you’re likely to feel happier with yourself and life in general. If you think and do things that keep you stuck in helplessness (for instance, self-sabotaging patterns of negative or cognitive distortions, or unhelpful behaviors, including staying in a victim role), then you’ll probably end up feeling less happy. A positive attitude helps, as well as a support system and doing something to promote healthy change. Progress, not perfection!
Q: Why do I keep making the same mistakes?
A: Sometimes we get stuck repeating harmful patterns (habits) when we haven’t explored past losses and figured out the connections of our past to the present. The unresolved grief (anger, pain, etc.) then keeps us in negative beliefs about ourselves and the world (“I’m not enough” and “The world’s not safe”). Healing involves challenging your beliefs (and expectations) and then learning new skills (including positive self-affirmations and relational communication) to move you toward creating the life you want (instead of repeating the life you’ve had).
Q: How did I get to be addicted or mentally ill?
A: Most clinicians believe that becoming dependent on a chemical or behavior, or even sometimes experiencing mood swings (depression, anxiety), is a result of a combination of social, psychological or mental, and physical or genetic factors that interact with the personality of an individual. Think about growing up as a mix of nature, nurture and habit. Trauma or less-than nurturing experiences also impact how we learn to cope with uncomfortable feelings. If you continue to “use” a pattern of behavior in spite of direct or indirect adverse consequences, then I’d urge you to seek help.
Mental illness is described by NAMI (the National Alliance on Mental Illness) as “medical conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others, and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.” Although there is misinformation and stigma about mental illness, we all probably know someone who has suffered or experienced bouts with major depression, anxiety, trauma and obsessions. These all might be part of the spectrum of mental illness or a psychiatric disorder. Humans are perfectly imperfect and will naturally be challenged by uncomfortable emotions and feelings sometimes!
Q: Is my problem that I just don’t have enough will power?
A: According to the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), addiction is a brain disease that responds well to treatment. Research continues to provide new and better understanding of how alcohol, tobacco, other chemical substances (drugs), and behaviors such as gambling, sex or romance, affect the brain. Some people need help to “get started” toward defining dreams, write out an action plan and encouragement to stay on track. For others, the chronic disease of addiction is much more difficult to treat and frequent slips and relapses occur. Nobody can make another person choose health. Even the best therapists cannot “force” you to change your thoughts and behaviors. Change is a complex process that progresses in stages. That first step to ask for help can be really hard.
Q: Do I have to spend the rest of my life in therapy?
A: Sometimes longer-term support is useful for more serious or chronic issues. The October 1, 2008 issue of the Journal of the American Medical Association published a study that revealed individuals receiving psychodynamic psychotherapy lasting a minimum of a year, or 50 sessions, experienced 96% better overall outcomes than shorter-term psychotherapy. Typically, individuals that benefit from longer therapy are interested in more insight-oriented exploration of connections between the past and present. Also, if there is a characterological disorder, Dual Diagnoses, need to change long-term habits, addressing addictions and life changes, longer-term therapy is more effective than short-term or “brief therapy.” Some people come to therapy for specific reasons and for a limited amount of time. Some people come several times a year whenever they want a “boost” or to check-in after their initial improvement. I see clients weekly, every other week, once a month, every few months, or what works best for the client; from regular sessions of 55 minutes to several hours, or weekend Intensives.
Q: Why does it take so long to see results!?
A: Actually, some concerns can be managed quickly within a few sessions if there aren’t other issues involved (goal-setting for example). EMDR used in conjunction with psychotherapy can sometimes be useful in 6 to 12 sessions depending on the nature of the concern. As a culture, though, we have come to expect time to compress into unrealistic “right now” immediacy. We want the Quick Fix, the Cure Pill and the Therapy Miracle Hour. Recovery, healing and treatment just don’t usually work that way. One tool to overcoming negativity is to write a Gratitude and Win list in order to focus on total progress made over time.
Q: What if I fail? What if I need something more?
A: Most people “fail” when challenging themselves to do something in their lives. A person cannot really fail “at” therapy because it is a constant learning and growing process. Sometimes more intensive work might be necessary to prepare for, or help with, out-patient therapy. Workshops, Weekend or Week Intensives, Sober Living Houses or Intensive Out-Patient work are all additional and commonly used resources. Sometimes in-patient or residential living is necessary. If any of these might be useful we can discuss and explore these options together.
Q: What if I’m not ready for therapy?
A: Everyone processes at their own pace. Sometimes slowly and sometimes quickly. Although there’s no judgment about the speed at which a client is expected to go, if unhelpful behaviors stay unchanged then negative consequences likely will remain. In therapy you’ll receive some suggestions about how to replace old methods of coping and support as you practice new tools. I will encourage and carefront. We will work collaboratively. Your part is to follow through with treatment recommendations and Never Give Up.
Q: I’m afraid that I’ll die if I don’t …
A: That’s a normal reaction when you’re dependent on anything to take away uncomfortable feelings. Most people really need to learn how to be okay with themselves, intimate with another person, and have healthy touch experiences. For sex addicts, whether alone or in a partnership, I suggest a temporary period of celibacy, which always brings up anxiety. To which I say, “Well, if you can’t say no, then you can’t choose yes!”
Q: I’m afraid I’ll die if I’m alone.
A: When losing a relationship with someone (through separation, divorce, medical health issues, or death), it’s normal to experience a combination of feelings of sadness, pain, loneliness, fear and anger. These feelings are normal grief reactions to loss or expected loss. It’s important to process grieving instead of stuffing or avoiding, or jumping into harmful behaviors to numb the discomfort.
Q: What does recovery mean?
A: The PROCESS of healing and recovery can be thought of as learning, and PRACTICING, to live without resorting to escape from discomfort through harmful or less-than nurturing behaviors. Healing, recovery and repairing the damage to oneself and others requires looking at relational-emotional issues, effort, hard work, and time. It’s completely normal to experience varying degrees of ‘Frequency, Intensity and Duration of Triggers’ while remaining abstinent from using familiar escape hatches.
Q: What is EMDR?
A: EMDR is an acronym for Eye Movement Desensitization and Reprocessing. It is a tool that sometimes is used in conjunction with traditional psychotherapy. EMDR is an integrative approach that has been used to address symptoms of post-traumatic stress, anxiety, depression, and has also been used with individuals suffering from phobias, panic disorders, pain control and addictions. We can discuss using it if appropriate on a case-by-case basis.
Q: What is Somatic Consciousness?
A: Somatization generally refers to when a person’s psychological discomfort is expressed in the body as a physical complaint. “Somatic” is a Greek word that means relating to the body and consciousness is really about being aware. Thus, “Somatic Consciousness” is a term to describe how you can become more mindful and present in your body, to your visceral sensations and feelings. When we focus on how to help you stay in your authentic self, really in the moment, you can observe and participate in your process without becoming emotionally overwhelmed. Although I am not a Somatic Experiencing Practitioner (SEP), I can refer you to someone with that certification.
Q: Therapy versus Coaching?
A: Coaching and consultation are not psychotherapy. Psychotherapy uses methods to address mental health issues, where you’ll explore and process how your thoughts, emotions and behaviors impact you. Coaching and consulting focuses primarily on more specific envisioning what you — or an organization — want in the present and future (perhaps basic problem-solving of simply one specific situation). Visit MyCoachAnna for coaching or consulting.
Note on Fees:
Q: Fees? Cancellations?
A: Under the federal No Surprises Act, you are entitled to a Good Faith Estimate (GFE)* of expected charges before services begin and you become an official client, which we can discuss at our first phone call. I can also provide you with a receipt, upon request, that you may submit to your own insurance company for out-of-network provider reimbursement; however, you may not receive a diagnosis or CPT code as I do not take or file insurance, nor accept copays or assignment.
*Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide individuals who are not enrolled in an insurance plan or a Federal health care program, and not seeking to file a claim with their insurance via superbill or via an in-network provider, with a “Good Faith Estimate” of expected charges at the time of scheduling health care items and services. A Good Faith Estimate explains how much your medical and mental health care will cost over the period of time you are in treatment. Under this law, health care providers need to give patients who don’t have insurance or who are choosing not to use their insurance an estimate of the expected charges for medical services, including psychotherapy services.
Fee-for-service basis means I do not accept or file any insurance, although I do accept third-payers (spouse, parent, trust fund). Payment or ‘a card swipe’ for a session can occur before or after each session. With a signed ‘Card Consent,’ information to charge your credit or HSA cards via Square or PayPal can be retained for monthly or bi-monthly charges. Please let me know if you need to discuss other payment plans.
Cancellations. ONLY an unforeseen, urgent, crisis matter will not be charged. We greatly appreciate scheduling changes made via telephone voicemail, text or email within 48 hours; you must verify your appointment was cancelled otherwise you will be charged at least $100 and up to your full session fee. Your first “No Show,” “I forgot,” or “I wrote down the wrong date,” is a ‘first and only freebie.’ Cancellations may be made by leaving a voicemail, or text with the words clearly spoken or texted: “—URGENT SCHEDULING MATTER—”. If you do not hear back from us we probably did not receive your message. Please send another voicemail, text or email.
New Clients
- Your first step is reaching out and leaving a voicemail with your name and best phone number (or email if you prefer). I will reach back out to you. After a brief phone call we can decide if an Initial Introductory Meet-and-Greet is appropriate. This meeting is to see if we’re a good fit to work together.
- Once you decide to move forward to work with me, we will schedule your first full session (usually 90 minutes) and I will email you the New Client Intake Forms (PDF) to complete beforehand.
- Complete the fill-in forms online (Adobe Acrobat), or download and print them to complete at your leisure and bring them to your first session.
- I recommend clients arrive 30 minutes prior to our Initial Introductory Meet-and-Greet so you can complete paperwork if needed, use the restroom, grab a drink of water, and relax a bit before I come out and escort you to my office.