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Ask a Therapist

I hear from friends quite a bit about how therapy has helped them and they wish more people knew how beneficial therapy can be for individuals, couples and families who are struggling with every day issues. I asked some friends what questions they have about attending therapy that they would like to have answered. I received so many questions that I decided to make this a two-part blog post. Stay tuned for next week's blog for more questions! If you have your own questions that were not answered here, you can always email me at or call me at (916) 425-7733.

Q: Is there ever a time when you would have to break patient-therapist confidentiality?

A: I take the subject of confidentiality very seriously. I believe the only people that should ever know you are in therapy are you and me. I am also required by federal law to maintain your confidentiality through the Health Insurance Portability and Accountability Act (HIPAA). If I run into you in a store, I will not acknowledge you, unless you acknowledge me first, and under no circumstances will I reveal that I know you through my practice. I don't accept friend requests from patients in order to maintain your privacy as well. There are times when I need to violate confidentiality though. If I suspect child or elder abuse (including physical abuse, sexual abuse, financial abuse (for elders) and/or neglect) I am mandated by the State of California to report that abuse to the authorities. Also, if you let me know that you intend to hurt yourself or someone else, I am also required to seek help either through a psychiatric hospital or law enforcement.

Another exception to confidentiality is with insurance companies. If you choose to utilize your health insurance benefits to see me for therapy you are allowing your insurance company to have access to some of you mental health records. These records can include your diagnosis and progress notes. Some of my patients are not comfortable allowing their insurance company to have access to their records or are not comfortable having a mental health diagnosis on file (as this can affect things such as being able to obtain life insurance or concerns over pre-existing condition exclusions).

Q: What should I expect on my first visit with you?

A: On your first visit, we will begin the session by going over any insurance coverage you have, any co-pays, and how you will choose to pay for my fee. I prefer to store your credit card securely on Simple Practice, the Electronic Health Record software I utilize for my practice. This streamlines the process for me billing you after each session and you will not need to worry about bringing a check or cash to each session. Next, I will begin by asking you what brings you into therapy and ask you questions about your background, including your childhood, family of origin, current relationship situation, past relationship issues, history of mental health issues, current work situation, and any previous experiences in therapy. Last, we will go over treatment goals for your time in therapy. If I suspect you might have a mental health diagnosis, I will ask you questions related to your condition to determine if you meet the diagnostic criteria for a mental health condition.

If you come to see me for couples counseling, we will focus the first session on the state of your relationship and what is bringing you to therapy. For your second session, each partner will see me individually to gather the above information and the third session I will bring you both back in to session to work on relationship goals.

Q: Do I need to bring in anything to our session?

A: Prior to your first session, I will ask you to send me a copy of your insurance card in order to check on your benefits and any co-pays prior to our first visit. I will also send you intake paperwork electronically through Simple Practice, my Electronic Health Record software for you to review and digitally sign. I ask that you complete these tasks prior to our first session in order to maximize our time together. As long as I have received your health insurance information and completed intake paperwork prior to the first session, you will not need to bring anything with you.

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