If you’ve had trouble navigating my site lately, it’s because I’ve been making some changes to both content and layout, and also moved the site to a new server. Things should be smoother going forward, and thanks for your patience.

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I’ve changed the way you can schedule appointments with me on my website. Simply go here to fill out a quick appointment-request form, and I’ll get right back to you with a session confirmation. See you soon!

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Though I have information elsewhere on my site about insurance coverage and payments for sessions, I want to post about it since a number of people have recently been asking about it, and I’ve also tightened up my policy a bit. Here’s how it works:

The fee for each 55-minute session is $100. I offer one 85-minute session (preferably when we first start working together) at the same price, and after that, 85-minute sessions cost $140 ($10 savings, which I offer because 85-minute sessions tend to be a richer experience for both of us).

You can pay by cash or check at the beginning of your session. I can’t accept credit cards in my office, but I welcome your credit card on my site via PayPal.

If you have insurance coverage, here’s how it works: I am a preferred provider with Uniform Medical Plan, and I can receive partial reimbursements from Group Health Options (note: your plan has to be an Options plan). If you are covered by either Uniform or Group Health Options, you would pay me a co-pay of $10, $20, or $30, depending on your plan, and I would then bill your insurer directly for the remainder of the fee.

If you are not insured by Uniform or GHO, then you would pay me the whole fee up front, and file a claim yourself with your insurer. I can provide a detailed receipt for you to file your claim. I need to follow this policy because the insurance-claim system I use does not reimburse me except when I file claims with Uniform and GHO. In my experience with clients, if they have out-of-network-provider coverage, filing claims on their own has been successful.

If you have any questions about these policies, please ask, and I hope this helps you as you discern whether you want to make this investment in your health and relationships. Thanks!

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I found a lot to like in Lee Siegel’s recent thoughts on the trouble and strife of John and Elizabeth Edwards. (I posted about their crisis last year.) As a therapist, I sat up in my chair when I read this:

“A friend of mine once said that the only two people who know what’s going on between a man and a woman are the man and the woman themselves. He was half right. The man and the woman—or man and man, woman and woman; it’s all the same—are the last to know. The idea that we can precisely fathom people’s emotions and motives is absurd. We can barely comprehend our own.”

I’m nodding my head up and down right now. Siegel is right about this. As a therapist, I’m paid to know a lot about relationships, learn a lot about my own clients, and use that knowledge to help them work through their most difficult relationship problems. And I know that to do my job well, I have to have a high degree of self-awareness and self-confrontation. And yet, there’s always something going on that will escape my awareness, and that of my clients. No human being can be fully understood or known by another human being (or themselves, for that matter). I expect that even if I live to be ninety years old, I’ll still not have taken the full measure of my own character, let alone those of others.

But if that’s the case, why do people make judgments about the Edwardses? Or—here’s a more difficult question for me—why do people go to therapy? My answer: as right as Siegel is about the need for humility in these matters, there’s a lot we can know about ourselves and each other. I will die not knowing everything there is to know about myself, but that doesn’t mean I plan to live an incurious life. The fact that we will never know everything about the universe didn’t stop us from launching the Hubble telescope.

So I’ll draw a lesson on humility from Lee Siegel’s reflections, but I won’t be paralyzed by that humility. I’ll keep wrestling with myself and engaging with other people in the adventure of self-discovery because I have faith that our exploration of the human universe will take us far. We’ll never reach the end, but our effort is part of what makes us human in the first place.

Meanwhile, I wish both John and Elizabeth Edwards well. As with all couples who are going through a hellish time, I hope they can find their way to a peaceful resolution of their crisis, and learn a lot about themselves along the way.

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2009 has been a hard year. Many people have struggled with unemployment, the fear of unemployment, and all the other effects of a down economy. (Don’t ask me about my retirement accounts!) But I am confident that 2010 will be better. There are many positive signs: our economy is no longer in freefall, so even if we suffer a double-dip recession, our situation is not as dire as it was a year ago. And though we haven’t yet made health-care reform into a new law, we’re pretty close. There are many challenges ahead, but I truly believe that 2010 will be a better year.

All good wishes to you and yours as we prepare for another year, and I look forward to working with you. Happy New Year!

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They’re not just for couples! If you’re interested, click here for more information.

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As you can see, I’ve embraced Referendum 71 on my website, and I encourage you to join the cause, by voting yes (if you live in Washington), or by contributing to Washington Families Standing Together (wherever you live). I think it helps to point out that the couples and families who benefit from this law (a law that was passed by the duly-elected representatives of the citizens of Washington state) are people you know, ordinary people, and—in my particular case—dog people. (!)

There’s a lot of evidence out there that people who know LGBT persons are much more likely to be liberal about the political issues related to sexual orientation. That’s why I think it’s important for me to let you know that this law currently allows people you know—your neighbors, friends, and family—to choose their kin, fill out their 401(k) beneficiary forms, and visit their loved ones in peace. That’s it. And many of the couples this law protects are elderly heterosexual friends who have found that they can secure their own futures better by pooling their resources and designating their most intimate companions to visit them when they’re sick, and handle their affairs when they die. What’s not to like about this law?

So please vote ‘yes’ on Ref-71. And here’s a photo of two members of one family who thank you for your support!

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I was inspired by my webmaster to add a link on my main page to Washington Families Standing Together, and support them financially myself. If you live in the state of Washington, no doubt you’ve already gotten your ballot for this year’s election. Please vote ‘yes’ on Referendum 71, a measure that affirms current state law that offers the same legal benefits to registered domestic partners that heterosexual married couples enjoy (with one exception: the use of the word ‘marriage’). By voting yes, you are simply affirming what your legislators and governor have already signed into law: equal rights for all families.

Even if you don’t live in Washington, please consider a donation. As my webmaster told me, “this is our Prop-8.” It’s vital that we pass this referendum!

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I got the idea of “Mental health break” posts from Andrew Sullivan. Today I just want to point out–in case you haven’t noticed, though I can’t believe you haven’t–how dazzling the fall weather has been this week. Azure skies, trees bursting with color, a crisp, cool temperature…heaven (by my standards). And I can’t think of a robust reason to post this photo, except that it’s a great shot of a certain dog of my acquaintance, and two pumpkins who surprised us this year. We didn’t plant them. They’re volunteers. But here they are, nice and orange, crying out for carving in a couple of weeks. Don’t miss the delights of this lovely autumn season!

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No fear, this post isn’t about politics! I’m revisiting the question of when and how long to have counseling sessions. The traditional model is one hour, once a week. I’ve learned both in my own work experience and from other therapists that this is not the best model.

It’s not intense enough.

First, let’s look at the first session. When you come in for the first time, you and I need to get to know each other (at least as much as we can in that short hour), work out what your counseling will look like, be sure you’ve filled out the registration forms, and then tackle what you came in to discuss. That’s a tall order. And it’s why I offer a 90-minute first session for the same $100 fee.

But it doesn’t get much easier in later sessions if we limit ourselves to one hour per week. After seven days, you may have forgotten what we discussed, or lost your excitement about it, or let it all blend into itself so that you’re confused, unsure what you were supposed to do to get yourself ready for session 2. Fortunately, I keep good notes and have a good memory, and you are always free to call or email me if you want to check in before the next session, but even so, it isn’t hard for the intensity of our work to lose strength when we stick to the one-hour-per-week model. It’s certainly possible–and it happens often enough in my practice–but it’s not always easy.

So here’s my offer. If you’re a client of mine–brand-new or not, it doesn’t matter–I’m offering you a 2.5-hour session for the price of two sessions ($200), a savings of $50. Ideally we would do the whole thing in one 2.5-hour block (with a short stretch break in the middle). But I will offer you this discount if you schedule two appointments (one for an hour, the other for an hour and a half) in the same week. Either way, we get your intensity up, and we have more time to really dig in and get you moving on your issues.

Please note that this offer is extended alongside my usual practice of offering one free 90-minute session, which means that you could do 2.5 hours on week one, then 2.5 hours on week two, and the whole thing only costs $400 (a savings of $100). It’s like having five sessions in two weeks rather than five. That’s a lot of intensity! I offer this because I do believe that compressing your work with me is helpful for you. You’ll move faster, and you’ll dig deeper.

And if it sounds exhausting, that’s because it can be exhausting! But remember the stretch breaks, and think about it. You could make a lot of progress in a short time, and for less cost. I hope to see you soon!

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