Before meeting for our first session, you can reach out to request an initial consultation call for us to get a preliminary sense of each other. This a free 20-minute call that allows us to lay some foundation and get early questions answered. If we decide to move forward, our first session gives us a better opportunity to explore our fit. In that session, I'll review some foundational details about therapy, including administrative information, and my approach to the work. I'll ask a bit about your background as well as what's bringing you to therapy now and what hopes you have for this work. Of course, I will be happy to answer any questions you have for me. No need to plan ahead for the session. Just bring what you're already carrying and a sense of curiosity, which is always a helpful adventure tool. We'll take it from there.

Once scheduled, we'll meet at the same time each week for 50 minutes. The weekly frequency of therapy is found to be optimal, and I typically do not begin work with a new client at a lesser frequency. However, once we've already established a therapeutic foundation, more or less frequent sessions can become available.

It's no problem. I ask that you cancel your session or inquire about rescheduling at least 24 hours prior to your scheduled start time so that I may open it up for other clients who may need it. Cancelations or reschedules communicated within that 24-hour window will be charged the full session fee. You can cancel your appointment by simply emailing me at THFtherapy@gmail.com.

My current fee is $200 per weekly individual session. As an out-of-network provider, I'm happy to supply you with a superbill each month which you can submit to your insurance company for possible reimbursement. Eligibility for these out-of-network benefits is determined by your specific coverage, and I cannot guarantee reimbursement at any time. Please contact your insurance provider for more information. At this time, I do not have any available sliding scale spots. I understand therapy can be costly, but money shouldn't be a barrier to getting the support you deserve. Private practice is only one way of getting therapy. Other options, including reduced-fee and sliding scale providers, are available depending on what you've budgeted for therapy. Don't stop here, explore your options!

Currently, I'm exclusively offering video telehealth sessions for residents of California. For video sessions, we'll use a HIPAA-compliant web-based video program and you'll be emailed the link for our session prior to our meeting time. You won't need to download anything unless you're using a phone or tablet, but the app for those devices is simple. It's easy to log in and more convenient than commuting to an office. With virtual sessions, it seems like where you are shouldn't matter. But due to state licensure limitations, I'm unable to serve anyone who lives outside of California and any California residents who are out of state for an extended period of time. Some states may allow temporary or long-term exemptions to this, so when you reach out to connect about therapy, let me know which state you're currently located in and if you're a resident there. Apologies for any inconvenience this may cause.

At this time, I do not have any open couples spots.

Affordable access to therapy is important. To support this, I often rotate sliding scale spots and pro-bono opportunities so that I'm able to provide services to a wide range of people. Understandably, some of the most common questions I get about affordability are centered around insurance. There are a number of reasons many therapists, including myself, remain out-of-network with insurance companies. Those reasons include: Diagnosis requirements: Not everyone who comes to therapy meets the criteria for a diagnosis in the DSM. Insurance companies determine reimbursement eligibility on preliminary diagnoses, putting the emphasis -- and the limitations -- of your care on a set of criteria that may not apply to you. This means therapists either need to turn away clients who don't fit those criteria or apply a diagnosis that may not serve the client in a clinically meaningful way. Determination of treatment: When working with insurance companies, they determine the framework and course of treatment based on diagnosis. This means that you and your therapist are not the ones collaborating on your treatment plan. If your insurance company decides you're only eligible for 10 sessions, your therapist won't be able to see you beyond that. This means that the context of any diagnosis (e.g. the impacts of undiagnosable trauma, how unexpected events may re-prioritize your therapy needs week-to-week, or what diagnoses you may actually have but won't be determined in our first few sessions) become irrelevant and unsupported. This makes it difficult for therapy to be a process of healing, taking a natural course rather than an arbitrarily rushed one. Access to records: When in-network with insurance companies, your confidential records go from being my-eyes-only to being accessible to many. While still kept confidential within the agency, insurance company providers, administrators, customer service representatives, and others within the organization will gain access to all or some portion of your records. Resource limitations: Remaining out-of-network, I'm able to give my full attention and energy to my individual clients. When working in-network, time slots that would otherwise be open for client meetings instead become allocated to long phone calls, paperwork, and client advocacy with no guarantee of success. As you might imagine, the clinical standards of a financial institution and the clinical standards of a clinician are not informed by the same values and priorities. I understand this complex process can be frustrating, but my hope is that transparency around this issue illuminates why I choose not to include these barriers to treatment in my work with clients. Private practice therapy isn't the only option for care. There are quality clinics in California that provide mental health care on a sliding-scale basis, so if you find yourself saying "Vanessa, this all makes sense, but that still doesn't mean I can afford your fee," I hear you! Reach out and I'll be happy to help you with referrals to trusted low-fee therapists.

While telehealth is convenient, there are details that can help make the experience as seamless as possible for you. Ensure you have a private and safe space to talk on a personal and secured network; somewhere you feel comfortable and cannot be overheard or interrupted by others. Avoid engaging in dangerous activities while signing on for our call. I won't meet with anyone driving a car during therapy. Do engage in grounding activities, such as coloring, doodling, stretching, walking, or using a fidget toy during session, if you find them helpful, but avoid multitasking with distracting tasks, such as shopping, working, and texting. As stated above, this also includes driving and other risky activities that require your full attention. At the time of our session, ensure the device you're using (laptop, tablet, phone) is as close to your WiFi router as possible. A site like speedtest.net will help you determine if your WiFi is strong enough to carry our video session. Upload speeds are recommended to be 10 Mbps or higher. The fewer devices using WiFi at the same time will improve your experience as well, so if you're sharing your connection with someone using a lot of bandwidth in the next room (video games, streaming, etc.), your speed may become slow. This also means turning off the WiFi on your nearby phone if you’re meeting with me on your laptop or tablet. If you're using a phone or tablet, you will need to download the Telehealth by SimplePractice app for iOS or Android. Information about this will be emailed to you prior to our first session. If you're using your laptop or computer for sessions, you can use the web-based link sent via email and avoid downloading any programs. But please ensure you're opening the video link in your Chrome browser. In lieu of a commute back home or change in environment, do something to ritualize the end of your session before integrating back into your space. This can include taking a walk, therapy journaling, drawing, dancing, meditating, etc.

You can reach out to me via my contact form and I'll reply via email. Once we're in communication, email is typically the best way for us to stay in touch about appointments, cancellations, and any needed communication in between sessions. You can also text for appointment changes or confirmation and by doing so, you consent to me returning your text. Please keep texts brief and related to administrative issues, which include setting up, confirming, or changing appointments, or contacting me in the event we experience technical issues during our virtual session. While I use a HIPAA-compliant texting app, in order to further protect your confidentiality, please avoid sharing any personal or clinical information via text as we will save longer, in-depth conversations for our session time.

I'm not available for crisis services. If you're experiencing an emergency, call 911, visit your local emergency room, or utilize these crisis resources.

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.