Frequently Asked Questions

What is Mental Health and Mental Illness?
Mental health is a state of being that helps us deal with the ups and downs of life, it helps us cope in times of stress, it encourages us to do better and become all that we can be, it increases our potential for positive growth, and it aids us when we need to face our fears. It enables us to become useful contributors in our relationships with others, in our neighborhoods, communities, and world in which we live.
Mental Illness is the opposite. It refers to the feelings we might have such as when we are unable to cope with the challenges of daily life or have faced some significant trauma, grief or distress. It causes problems in our relationships with others such as with a partner, spouse, friend, or family member. Mental Illness can make us feel burned out or anxious when we go to work or school, perhaps we don’t want to get out of bed in the morning, or it makes us feel very tired throughout the day. We may want to isolate from others, or we get so distracted we can’t complete a project and even the simplest of tasks seems overwhelming. We may be fearful of even stepping a foot outside our front door, we may get irritable, easily frustrated, angry or maybe we might turn to illicit substances to numb these feelings.
Many people with mental illness do not want to talk about it. It may be a cultural factor or a feeling of shame. Mental illness is not something you should ignore and it is not anything you should be ashamed of. It can affect anyone; in fact, the World Health Organization says that everyone knows someone that has been affected by mental illness. You are not alone. Treatment and help are available and we are constantly learning more about how the human brain works and how it processes our feelings. Mental illness can take many forms from mild to severe. One thing we do know is that the earlier you seek treatment the less you will suffer and you will get back to feeling better and understanding how to live, get better and/or cope with the mental illness that you might have.

Can counseling cure my mental illness?
Okay, cure is maybe the wrong term. You can recover from mental illness and many people with mental illness go on to lead happy and productive lives. Cure refers to never feeling sad, lonely, anxious or angry again and that is just not the way the human brain works. With treatment, we can teach you effective ways to cope with your feelings and manage them in a way that you feel better, respond to difficult times in healthier ways, and have more significant and loving relationships with those around you. Counseling does work if you are willing to be open, try new things, and be patient. It is not an overnight success but feeling better is achievable and we will support and give you guidance along this journey.

Why should I seek professional help instead of talking with a friend?
Friends are a wonderful part of life and we always encourage good friendships and support. They are the shoulder you cry on when things get tough or the person that brings over the meal when you need it. But friends, although essential, may not have the ability to teach the skills you might need to lead a more fulfilling life. Counselors can help you explore things like your background as a child or adult and point out ways in a non-judgmental manner how that has affected your ability to cope today. Counselors give you a fresh and different view point from which your friends don’t have. Counselors are bound by strict confidentiality whereas friends are not. Many times, things you would not want to share with your friend can be shared with a counselor. This leads us to the idea of having boundaries. Boundaries with your friends is very different than having boundaries with your counselor. You are completely free to disagree with your counselor whereas with your friend you may have some hesitancy to do so for fear of hurting their feelings. Counselors have a duty to uphold Professional Boundaries so it’s about you and your growth, not about their feelings. Counselors have dedicated time to devote to you so you don’t have to feel guilty that you are taking up their time. With a friend, they might want to talk about themselves or they may not have the time to talk with you because they have kids at home and they need to go. Counselors have devoted, scheduled time to speak just about you. Feeling listened to without judgment or worry is a very powerful feeling indeed. These are just some of the reasons that having professional counseling can be very rewarding.

I’m on Medication, do I really need therapy too?
“The other thing is that if you rely solely on medication to manage depression or anxiety, for example, you have done nothing to train the mind, so that when you come off the medication, you are just as vulnerable to a relapse as though you had never taken the medication.” ~Daniel Goleman,Ph.D Author, psychologist, science journalist and TED Talk speaker. Medication for mental illness has been around for a long time and mental illness is considered a “medical condition”. However, most professionals, doctors, psychiatrists, and therapists alike agree that the best way to treat mental illness is a combination of medication and mental health therapy.
Some people maybe able to work through their mental illness using therapy alone and have been able to utilize techniques offered in therapy as effective coping and grounding skills to reduce and control their symptoms. Some other people have solely used medication to control their mental illness such as depression. Using medication alone does combat the symptoms but often times people aren’t able to get to the core beliefs of what is causing their depression or mental illness and symptoms return forcing them to either up their dose, change medication or seek out therapy to help change those core beliefs.
Our value is that we encourage the use of medication when it is indicated by the severity of symptoms, by the diagnosis, and/or requested by the client. We will make referrals to psychiatrists through the insurance company and if you don’t have an insurance company, we will work with you to find psychiatrists that are able to help prescribe medication to alleviate your suffering. We will also provide you with techniques and skills that will help ground you and alleviate your symptoms without the use of medication. This way, you get the best of both worlds. Techniques and skills of therapy and medication when you need it.

My child is going into therapy, should parents be present? What do you do with children online? My child cannot sit still, what should I do?
We believe that a child is part of a larger family system and that having parents present at least during a portion of the session is of utmost importance. With that said, children in California, ages 12 and over have to consent to treatment and to parents participating in the therapy process. We encourage children of all ages to take an active part in the treatment process and we talk with kids about what we will share with their parents. We work with children using a variety of tools such as video games, memory games, building emotional vocabulary, utilizing child friendly yoga, various tools, designing routines, discussing feelings and emotions and building social skills. We help children learn to utilizing grounding skills such as four-square breathing, sensory grounding, and using exercise when they feel angry or upset. At times, on-line therapy is not appropriate for children that have difficulty sitting still and maintaining focus for long periods of time. We do everything we can to encourage participation but if a child is not able to maintain focus, we would encourage and likely refer to an in-person therapist.

Does my insurance cover mental health therapy and/or self-improvement?
The general answer is usually, yes, insurance covers mental health illness but does not cover self-improvement. Mental health is making great strides in the insurance market and more and more providers, the medical community, and society as a whole are understanding the connection between mental health and physical health along with work productivity, medical necessity, and positive self-worth. With that said, mental health insurance authorizations and coverages are vast indeed. Some plans have co-pays, some have deductibles, others have carve-outs and have assigned mental health care to third party payors. We will work with you and your insurance company for authorization for mental health therapy.
A point to note is that if we are planning to utilize mental health services under insurance, a person must meet, “medical necessity”. Imagine it like this, if a person were to go to the doctor’s and have a disease, the doctor would diagnose the disease and treat it. The insurance company would pay and everything works out well. Now imagine, a person goes to the doctor and says, I want to be the healthiest person ever and I want to check in every week to make sure I am on track. The doctor does not have a diagnosis and does not have anything to treat. The doctor is able to give pointers, education, mark progress on things like weight and BMI and diet on how to stay healthy. However, the insurance company will not cover this because they only insure if the person feels sick or has a “diagnosis”. They may cover one physical a year but they surely won’t cover weekly physicals. It’s often true with therapy, a person may come in and think they want to utilize self-improvement services but they don’t have a diagnosable mental health illness and so the therapist is unable to bill insurance. We can still offer education, pointers, tools and techniques, but we won’t be able to bill insurance. In these cases, we will bill privately as a cash pay client. This often is mental wellness or self-improvement rather than mental health illness and should not be confused with the other.

How do I know if I meet “medical necessity”?
In general, there are three things that determine if a person meets “medical necessity”. One is a verifiable diagnosis. At Attend Therapy, we utilize tests and the DSMV to determine a diagnosis. These tests and guidebook are things that rate the level of anxiety, depression, mood disorders or level of stress such as in Post Traumatic Stress Disorder. We administer these tests and review symptoms at the first session so that we can determine a diagnosis at the start of therapy. Second, we discuss “impairments”. We talk about how this diagnosis is affecting your life. It might be that depression is causing you to not be able to get up and go to work, or someone that is anxious might have a hard time driving a car or someone with trauma might be having flashbacks and anger issues that are causing harm in relationships. These are called impairments in life functioning. Lastly, we have to come up with a treatment plan together with you to treat the mental illness. We utilize treatments and goals such as psychoeducation, a decrease in symptom reduction, reviewing progress in therapy, and various evidenced-based psychotherapy treatments. If all of these three things are met, then we have met “medical necessity” and the therapist is able to bill your insurance. If these things are not met, then we would need to bill privately for your care. Have more questions, talk to a counselor at your first session and they will be able to tell you whether you meet medical necessity or whether we need to utilize self-improvement services.

What happens in a therapy session? What should I expect?
For those that remember the 1950s and 1960s, laying on a couch is no longer required. Most therapy sessions including the first one begins with a friendly greeting and finding out what has happened since the last session or what is bringing you into therapy. This is your time to drive the conversation and discuss whatever it is you would like to process during that session. Sometimes, you may not really know what you want to talk about but you do know that you want to feel better and so the counselor may talk to you about your treatment plan, homework that might have been assigned or some other technique that may help in your circumstance to feel better. We may utilize a mindfulness technique or go through an EMDR sequence target plan. In all cases, you don’t have to worry that we will ever force you to talk about something that you don’t want to talk about. We believe that through support and encouragement you will bring up things when you are ready to talk about them. We might bring up issues with you that you may not see in a way that is gentle, kind, and compassionate. We want to be your partner along this journey and help you learn how to manage your feelings and emotions in a way that is healthy and positive so that you can be the best “you” ever.

How long does therapy treatment last?
There are so many different ideas about how long therapy treatment lasts. Some people come into therapy saying that they believe every person should have weekly therapy, other people want to come in and get care and leave as quickly as they came in. In all cases, therapy is an art form with guidance from various types of therapy models such as Cognitive Behavioral Therapy, Family Systems Therapy, Acceptance and Commitment Therapy, Eye Movement Desensitization Reprocessing Therapy, and Psychotherapy practices. Further, every client is different in how they respond to each type of therapy and what they find useful and not useful. In general, we do not believe that therapy should go on forever but that we are a tool in the tool box and a person can utilize our services when they need or want them. In the beginning, when symptoms are high and feel more intense, we may recommend weekly therapy, as a person begins to stabilize, we encourage titration off of therapy services. This would look like having sessions once every two weeks or once a month or every three months as a check in. Eventually we would expect someone to be able to graduate and go back to leading their lives in a fulfilling and positive way and if symptoms should return, we will be available for continuing and reinitiating care.

Can I pick my therapist?
We encourage all of our clients to be as active in the treatment process as possible and this includes picking your therapist from the profiles we have on our website. Of course, each therapist has set hours that they see clients so you may have to alter your idea of seeing your therapist at the therapist’s availability. If the therapist is not available at the time you need, we can send a request to see if that therapist is able to see you at a different time. If not, we would give you times that other therapists may be available to help you. In all cases, the choice is yours on who you see as your therapist. Perhaps, you don’t mind seeing one or another therapist, in this case, we would match you according to availability and scheduling.

Will my therapist write an animal support or service letter for me?
With the rise of support animals in our communities, we are often asked if we can write an animal support letter. Unfortunately, there are many requirements in writing these letters, one of which is that we observe the animal and client together, usually in an in-person setting. As all of our therapy appointments are held on-line, we are unable to meet this requirement and thus do not write any animal support letters of any kind.

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