Frequently Asked Questions

What should someone expect when starting therapy?

The initial meeting with any therapist should include a thorough discussion of the problems and issues that are of concern.  One aspect of this includes the presence, degree, and persistence of any symptoms, such as problems with mood, sleep, appetite, energy level, weight, concentration, memory, interest in activities, feelings of anxiety or panic, change in behavior, interpersonal difficulties, work or home life, substance use, or sense of self.  Another area typically addressed is past experiences of difficulty, including functioning at work or school, relationships, and family of origin.  In addition, questions about safety are raised, including the presence or history of intentions to harm oneself or others.  A discussion of your rights as a client, including the limits of confidentiality, and what to do in case of emergency will also be included. 

While I treat a wide range of problems and work with a great variety of clients, the best outcomes occur when there is a good fit between therapist and client.  If you find yourself questioning whether we can work well together to meet your goals for therapy, it is perfectly acceptable to raise this concern.  

What does the therapist expect of a client?

Optimally, I expect openness and a willingness to work together to change whatever it is that has caused the client to seek my help.  While it may be comforting to expect that I have all the answers, in reality success is most likely when I can help each client or family to find her/his/their own answers.  Sometimes I may assign homework, such as practicing a relaxation exercise that I have taught the client during a session.  Clearly, those clients that are able to do the homework will benefit most markedly.  However, if someone has not done it, I hope that we can discuss this, because often great improvements can come from identifying the obstacles to following through.

What should I do if there is an emergency?

Go to your nearest emergency room.  I do not have privileges at any of the area hospitals, but your insurance company can direct you, if needed.  If you need to contact me between sessions, one of the practitioners at PAFC carries the pager 24/7, and usually can reach me, otherwise he or she will answer your questions; the pager is reached through our office number:  (920) 738-9999. 

What are the limits of confidentiality?

Overall, everything you say in therapy is held in confidence by your therapist, which means that I do not talk about you with others.  However, there are some exceptions, and you have the right not only to know these exceptions but to discuss them at any time. 

  • If you are paying for therapy with insurance, your insurance company will require knowledge of your diagnosis and when you attend therapy or psychological testing.  Some insurance companies may require more details, such as treatment plans and progress, especially if I am requesting additional therapy sessions.
  • I am a mandated reporter.  This means that if information is given that reveals past or present danger to a child or an elderly person, I am required by law to report this to the state (ie., to Child Services).  While this has occasionally occurred in my professional experience, I do not go behind a client’s back to make such a report; instead, I let a client know when I must report something.  If there are unwanted or unpleasant consequences, I do my best to maintain my relationship with the client and help the client manage such consequences.
  • If a client reveals intent to harm him or herself or others, I may need to breach the client’s confidentiality in order to protect the safety of that client or others.  Again, I do my best to work with the client and gain the client’s cooperation in such circumstances.
  • Any time records must be sent, such as to a physician, the client’s written authorization is required, and this may be revoked by the client at any time.  A court order is the only exception to this.

What are some common reasons for psychological testing?

Referrals for psychological testing come from various professionals for various reasons.  For children, the most common is a referral for testing from pediatricians or schools to clarify academic and/or behavioral problems that children are exhibiting.  Infrequently, I may recommend testing, typically when the initial assessment suggests that further information is needed. 

  • What might I expect if I’ve been referred for psychological testing?

    Every testing referral begins with a clinical interview, in which I ask a number of questions regarding the concerns that have brought you in for testing.  Based on the reasons for the testing, I will administer the tests that are appropriate.  Some of them might involve answering questions about information like that learned in school; others might involve responding to questionnaires about which statements or behaviors are descriptive of you.  Some of the tests may be done on a computer, and others might involve manipulating objects.  Some questionnaires can be sent home with you or are for a teacher or parent to complete.   Some of the tests get harder the further along you go; others do not.  Because of this, it can be difficult to determine exactly how long the testing will take.  I am always willing to answer any questions you might have. However, I usually cannot tell you whether or not you have answered a question correctly.

  • How long does it take?

    Psychological testing can take anywhere from an hour or two to several hours that may be spread over two or more days.  This will be discussed when you schedule your appointment.

  • Is this neuropsychological testing?

    No.  I am a clinical psychologist, not a neuropsychologist, who has a specialty in advanced study of brain anatomy and functioning.  Some of the psychological testing that I administer may involve some of the same tests that a neuropsychologist administers, but typically the neuropsychologist uses a wider array of tests that highlight and pinpoint specific brain functioning in a more detailed manner.

Are psychological services covered by insurance?

Insurance coverage varies widely, depending upon your plan.  Most insurance plans will cover some psychological testing and various lengths of psychotherapy.  Just like with medical care, many plans have different in-network and outside-network coverage.  While my services are in-network for many plans, for some I am outside their network.  The best way to find out about your coverage is to call your insurance company directly.  The office staff where I work can help you with this.

If I don’t have insurance coverage for your services, what are the typical costs?

I bill per therapy hour, with a standard therapy hour lasting 45 – 60 minutes.  For EMDR sessions, I prefer 90 minute sessions, if allowed by insurance or the client can afford the additional time out-of-pocket.  For testing, some tests are billed by a flat rate, others by the hour.  Currently, my hourly rate is $200.00/hour; I try to keep this rate commensurate with average psychologist fees in Appleton.  I also do my best to meet the needs of the community at large by offering a few sliding scale appointments for those without insurance coverage, but these typically are booked up.

What do the letters "Psy.D." stand for?

My degree is a Psy.D. rather than a Ph.D.; both are doctoral degrees, but the type of school determines which degree is awarded.  Psy.D. stands for Doctor of Psychology, indicating a professionally-based curriculum, taught by practitioners of clinical psychology.  Ph.D., on the other hand, stands for Doctor of Philosophy, indicating a broad-based university degree that is typically more research-oriented and is taught by college professors, some of whom may practice clinical psychology.

Both degrees require completing four to five years of challenging, graduate-level courses after completing a Bachelor's Degree, and both require the completion of an extensive thesis paper as well as a year of internship to earn a degree as a clinical psychologist.  Some schools may require a Master’s Degree before acceptance into the doctoral program.  Although a Master’s Degree was not required for my course of study at of the Illinois School of Professional Psychology (now called Argosy University), some of the coursework for my Master’s Degree from the University of Western Ontario allowed me to waive some of the classes required for my doctorate.

For the Psy.D., the extensive thesis is called a Clinical Research Project (CRP); for the Ph.D., it is called a dissertation. Both require a thorough study of published materials on a specific topic and may involve independent research, as well.  Both also require that this work is done under the direct supervision and guidance of a thesis advisor, with approval by a committee of two or three other professors or doctoral-level teachers in the department.  The main difference is that a dissertation must be orally defended in a closed meeting with the thesis committee, all of whom have read the paper and will challenge and critique the work, sometimes very aggressively, to determine whether or not the student's work is of sufficient quality to earn the doctoral degree.  The CRP, however, does not require this oral defense; instead, the committee’s challenge and critique of the thesis is done individually throughout the process of completion, determining what changes must be made for the project to be deemed acceptable for earning the degree. In my own case, I successfully completed an oral defense of my Master's Thesis, and my CRP was approved by my faculty committee.

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