The Therapy Session

What to Expect

THERAPY STIGMA

Do not let society dictate your mental health. You do what you need to do to move forward in life. Therapy does not need to be a forever thing, just something to help you manage the obstacles in life.

1. Do you accept insurance?

At the moment, I use a third-party billing company called Headway. I Cigna, United Healthcare, Aetna. Premera and Regence. I am also in the process of accepting Apple Health United Healthcare Community Health plan.

2. What other specialized services do you offer?

I have experience working as a state worker therefore, I can navigate, develop, advocate and even provide coaching to those with autism, Asperger’s, and other developmental challenges. I am also expanding my services to placement housing for elders.

3. Do you offer sliding scales?

Give us a call and we can figure something out.

The Intake Session

An intake session in mental health counseling is my first opportunity to meet with a client. During this session, I focus on gathering essential information about the client’s background, current challenges, and goals for therapy. This helps me understand the best ways to assist them.

Additionally, the intake session is a crucial time for both the client and me to determine if we’re a good match. This involves evaluating our comfort levels, communication styles, and mutual expectations. It usually takes several sessions to establish this fit, which is vital for effective therapy.

Example of an Intake Session: In our first meeting, I would start by explaining the rules of confidentiality and the general process of therapy. I’d then invite the client to share their present concerns, family history, and any previous experiences with mental health treatment. I would also ask the client what they hope to accomplish through our sessions. Together, we’d discuss our initial impressions and whether we feel comfortable working together to achieve their goals.

The Ongoing Session

For adults and general clients:

In our sessions, I pay close attention to the strengths you already have, even the ones you might not notice yet. We talk through the moments in your life that matter, and together we make sense of the story you’ve been carrying. I shift how we work based on what you need that day, sometimes we look at patterns, sometimes we unpack a tough moment, and sometimes we build on the progress you’ve already made.

The whole point is to help you feel more grounded and more in charge of your life, using the abilities you already have while discovering new ones along the way.

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For children and their caregivers:

When I’m with kids, sessions often look like play, because play is the easiest way for children to show how they feel. Whether we’re drawing, playing a game, or telling a story, each activity helps them open up in a way that feels safe and natural.

A child might act out how they beat a tricky level in a game, which tells me a lot about how they handle challenges in real life. Or they might draw something that shows what’s been on their mind. None of it is ‘just play.’ It’s how we connect, understand what’s going on inside, and help them find new ways to handle tough moments.

The Patient and Billing Platforms

In my practice, I use SimplePractice for clinical electronic health records (EHR), which ensures secure and efficient management of client data. For billing, I partner with Headway, a third-party service that specializes in handling the insurance billing process.

Headway streamlines the billing experience by directly interacting with insurance companies. They take on the responsibility of submitting claims, tracking their status, and ensuring timely payment. This service includes verifying client insurance coverage before the start of therapy, which helps in setting clear expectations about costs. Headway’s efficient processing helps my clients avoid the usual hassles of insurance paperwork, allowing them to focus more on their therapeutic journey without the stress of billing concerns.

self love, heart, diary

ADHD Assessments

In Washington State, licensed mental health counselors (LMHCs) follow a protocol that aligns with best practices for ADHD assessment, incorporating state regulations and professional guidelines. Here’s an outline of the protocol:

1. Initial Contact and Consent:

  • Informed Consent: Obtain informed consent from the client or their guardians if the client is a minor. Explain the purpose, procedures, risks, benefits, and confidentiality aspects of the assessment.
  • Preliminary Screening: Conduct a brief initial screening to determine if a full ADHD assessment is warranted.

2. Comprehensive Clinical Interview:

  • Client History: Gather a detailed developmental, medical, educational, and psychosocial history. For children, include input from parents, teachers, and other relevant adults.
  • Symptom Inquiry: Ask about specific ADHD symptoms, including inattention, hyperactivity, and impulsivity, and their impact on daily functioning.

3. Behavioral Rating Scales and Questionnaires:

  • Standardized Tools: Administer standardized behavioral rating scales such as the Conners’ Rating Scales, ADHD Rating Scale, and the Vanderbilt Assessment Scales. Ensure these are completed by multiple informants, such as parents, teachers, and the individual themselves.

*ADHD assessments come in several forms, and the type of provider who can administer them depends on the complexity of the tool. Standardized screening and diagnostic measures such as the Vanderbilt Assessment Scales, Conners-3, ASRS (Adult ADHD Self-Report Scale), BAARS-IV, and structured clinical interviews can be conducted and interpreted by LMHCs, LICSWs, LMFTs, psychiatric nurse practitioners, and psychiatrists, as these tools rely on symptom reporting, behavior patterns, and functional history rather than cognitive testing. More advanced psychological tests, such as the WAIS-IV, WISC-V, Woodcock-Johnson, NEPSY, TOVA, or full neuropsychological batteries, require specialized training in psychological measurement and interpretation and therefore can be conducted only by licensed psychologists (PhD/PsyD) or neuropsychologists. Physicians and psychiatrists may diagnose ADHD but typically do not administer comprehensive cognitive or neuropsychological tests. In short, LMHCs can provide ADHD screening and diagnostic evaluations using interview-based and rating-scale tools, while psychologists are the ones qualified to administer the deeper cognitive and neuropsychological assessments when a case requires more specialized testing.

4. Medical and Physical Examination:

  • Medical Referral: Refer the client to a primary care physician or pediatrician to rule out medical conditions that could mimic ADHD symptoms, such as thyroid disorders, hearing or vision problems, or neurological conditions.

5. Review of Records:

  • Historical Data: Review past academic records, psychological evaluations, medical records, and any previous assessments to understand the client’s history and symptom trajectory.

6. Feedback Session:

  • Diagnostic Feedback: Provide a feedback session to explain the results of the assessment, including whether the criteria for an ADHD diagnosis are met based on the DSM-5 criteria.
  • Discussion: Discuss the findings, answer questions, and explain the implications of the diagnosis.

7. Resources and Referrals: Provide resources and referrals to support services, support groups, and educational programs.

8. Documentation:

  • Detailed Report: Prepare a detailed assessment report that includes all findings, diagnostic conclusions, and treatment recommendations. Ensure that the report is thorough, clear, and accessible to the client and other relevant professionals.

My Perspective on Medication

A gentle disclaimer: This is my perspective based on research and years of listening to clients’ stories. It isn’t medical advice. Please talk through medication decisions with a qualified prescribing provider who can give you personalized guidance.

I don’t prescribe medication, but I do walk alongside you as you sort through what might help and what feels right for your life. My job is to stay in my lane, offering clarity, education, and support, while honoring that only you and your prescribing provider can decide what’s best for your body. I care about helping you understand the bigger picture, especially in an area like ADHD where the research is always evolving.

Over time, I’ve noticed something show up again and again in people’s stories: when ADHD goes untreated, anxiety and depression often grow louder and heavier. Many prescribers start with Wellbutrin (bupropion) because it’s widely used, gentle for many people, and can help with mood and energy. But it isn’t a primary ADHD medication, and for many folks, treating ADHD first changes everything.

For example, I often see clients start with Wellbutrin hoping it will lift their mood. Sometimes it helps a little, but the overwhelm, the scattered feeling, the racing thoughts, the guilt, and the constant mental friction stay the same. Then, much later, when they finally try ADHD medication, things click: the fog clears, tasks feel more doable, and their anxiety or depression becomes easier to understand… or sometimes fades more than expected.

On the other hand, when clients start with ADHD medication, their day-to-day life often steadies first. They feel more organized, less overwhelmed, and more capable. After that, whatever mood symptoms remain are easier to see clearly and treat more precisely, because we’re no longer confusing ADHD distress with depression or anxiety.

Because ADHD care changes so quickly, I encourage clients to work with a prescriber who genuinely understands ADHD and keeps up with the latest research, not someone who automatically treats mood first just because “that’s how it’s always been done.” You deserve care that actually fits you.