How long will I be in therapy?

This is dependent on your unique situation and desires. You may be wanting relief or symptom reduction - this may take 8 weeks to 6 months. If you're going to tackle deeper and long-standing patterns, therapy may take a few years. It took you years to develop your patterns; it will take time to untangle and work through them.

How often should I come to therapy?

For the most benefit, once or twice a week is optimal. I strongly encourage patients come at least once a week. Therapy that happens less than once a week becomes more like putting out fires than actually getting to long-lasting change. 

If you want to build strength, you would not lift weights once a month and expect much progress. Similarly, you must regularly attend to your mental health if you want to heal and grow psychologically.

Are your services confidential and private?

Yes. I am legally obligated to keep all of your information confidential outside of three limitations, noted below, which means I will not disclose any information about you to anyone unless you have a release of information signed for that person and for that particular information. 

The three limits of confidentiality are 1. If you report imminent risk to yourself or another person (i.e., plans and intent to kill yourself or another person). 2. If you disclose to me that a minor or a vulnerable adult is being abused, I am a mandated reporter and will need to report to Child Protective Services or Adult Protective Services. 3. If I receive a valid subpoena or court order, I would need to respond but will contact you. 

What if I have a security clearance at work?

Security clearances are very important for many work roles in the DC/MD/VA region. I have provided security clearance adjudications in my previous roles and am well-versed in the process of obtaining and maintaining a clearance. Participating in therapy does not prevent or impact your security clearance as a sole piece of information. At times, subjects may lie, obfuscate or hide information during their security clearance process—this is far more risky to maintaining your clearance. It is exceptionally rare to lose a security clearance solely based on the diagnosis of a mental health disorder and statistics show it is fewer than 12 in 2 million adjudications. If you are concerned at all, please consider a consultation or discussing this with me during your session. I am happy to answer any questions and relieve any concerns you may have.

Do you offer evening and weekend appointments?

I offer limited evening and weekend appointments based on client needs and my family’s limitations and boundaries. These appointment times are based on first-come, first-served availability. 

How do I get started with therapy?

Please feel free to reach out to Mary@AfterActionWellness.com or click here to schedule a free 10 minute consultation. 

Do you accept insurance?

I accept a very limited number of insurance pay clients. These are clients that would otherwise not be able to afford therapy. For most health care plans, I am considered an out-of-network provider. As a licensed clinical social worker, my therapeutic services qualify for patient reimbursement. They may be partially or fully covered by your health insurance or employee benefit plan.

In fact, here is an article that talks about reasons why you might want to consider an out-of-network therapist:

8 Reasons to See an Out-of-Network Therapist

Why do you not accept all insurances?

With much consideration, I decided not to participate as an in-network provider with most managed care plans. Insurance companies often impose limitations to the duration and type of therapy someone can have, as well as have requirements that may cause a compromise in confidentiality (i.e., insurance companies may require detailed disclosure of specific patient information). Your care should be determined based on what you need and not be decided by insurance companies. They also may end up denying your claim and leave you with the bill anyway. 

For many of the therapies I provide in my clinical specialty, including treating severe post traumatic stress and obsessive compulsive disorder, therapy will require longer, more intensive sessions than supported by insurance billing. Often, clients may be receiving therapy multiple times per week, requiring sessions that range from 60-90 minutes in duration depending on the treatment protocol we are employing in therapy.

I ultimately decided that signing a contract with most insurance companies was not worth the potential consequences and limitations on my patient’s care, as well as based on the insurance companies demands on my time (i.e., doing all their paperwork, chasing after payments, disputing denied claims, etc.), and their undervaluing of my expertise and training (i.e., being reimbursed well below industry standards). 

I believe in helping patients advocate for their needs, set boundaries, and value what they have to offer - this is where I practice what I preach. Setting this boundary helps me give you the utmost care and attention, rather than worrying about financial or administrative stress caused by working directly with insurance companies. 

Is therapy covered under my insurance benefits?

Depending on your out-of-network benefits, you may be eligible to receive reimbursement (typically 60-80% of your session cost). Outside of using the Mentaya tool below, the best way to understand your out-of-network benefits is to call your insurance carrier directly. Here is a step-by-step guide with a list of questions to ask:  

Guide to out-of-network benefits

Some questions to consider asking are: 

Do I have any out-of-network benefits for outpatient psychotherapy visits?  

What is my out-of-network deductible and has it been met?  

How many sessions per calendar year does my plan cover? Are there any limitations? 

Do I need a pre-authorization?  

How much does my insurance pay for an out-of-network provider?  

Is coverage based on a “usual and customary rate” or “allowed amount” for CPT code 90837 (55-60-minute Individual Session) and 90791 (Intake Appointment), or the full rate that the therapist charges? If it’s the usual and customary rate/allowed amount, ask what that amount is.  

You can check to see if your insurance covers out of network benefits using the free Mentaya tool below.