Frequently Asked Questions

Addiction Recovery

I work primarily with adults who are newly sober and want to work on mental health and personal growth challenges.

Anxiety Therapy

I work with adults 18+ who are tired of living in a constant state of stress, dread, overthinking, or waiting for the next thing to go wrong.

Personal Growth

I work with adults who want to understand their patterns, build self-esteem, clarify their values, and make more intentional choices. This work is for people who are not necessarily in crisis, but know they want more from themselves, their relationships, their work, or their daily life.

Location

Clients must be located in the state of Florida at the time of service. If you’d like to know more about how I work, please see my Meet Michelle page.

Generally speaking, I do not. Here’s my reasoning.

An exploratory consultation phone call is similar to speed dating - there's no commitment and no obligation. When you schedule a psychotherapy session, that’s a different vibe. You expect me to show up, give you my best, and invest in your success, as you should. 

Research shows that the therapeutic relationship is the most important determinant of success in therapy. We will work together to establish that relationship. It will develop over time - not over a 15 minute phone call. 

There are two excellent ways for you to get a sense of how I work. One is to browse through my website. The other is to share what matters to you here. I’ll reply to you by email within 24 hours.

The short answer: I serve all of Florida. At this time, I’m accepting new clients for telehealth appointments only.

The longer answer:

I am licensed to provide psychotherapy in Florida. By law, you must be located in Florida at the time of service even though we are meeting online. If you are an out-of-state resident but are physically located in Florida, I can offer counseling services for you only while you are in Florida.

I am required to verify your location at the start of each session. If you are not located in Florida, the session will be terminated immediately with no refund.

Please let me know as soon as possible if you’ll be traveling outside the state so we can make arrangements for you to see someone where you’re going or take some assignments with you to work on until you return.

At this time, I do not have any open slots for in-person sessions. If meeting in person is a dealbreaker for you, you’ll want a different therapist.

I offer therapy via secure video conferencing, phone, and text-messaging for adults throughout Florida.

Your initial session will be a video session. After that, it’s up to you whether you prefer video or phone sessions. I recommend video sessions for the first month.

Phone therapy is an excellent choice for clients who

• are constantly on the go.

• have trouble finding a private space in which to set up a video conference.

• find it challenging to process all their senses at once and prefer to focus their energy.

• have difficulty sitting for long periods due to chronic pain or other disabilities.

• spend a lot of time onscreen and would prefer to limit screen fatigue.

• want to eliminate grooming time.

In our first session, we will discuss how often we should meet. That frequency may change over time. In the beginning, I recommend weekly one-hour weekly video or phone counseling sessions.

Studies show that long term treatment has the highest success rate. To get the most out of your therapy and make lasting changes, I strongly recommend we meet weekly for a minimum of 6 months. For the first month, I recommend weekly one-hour video sessions. If you prefer phone sessions, we can switch to audio-only sessions after the initial video session. I also offer therapy services via HIPAA-secure text messaging.

If you'd like to meet more often than once a week, let me know. We will review your treatment plan and progress periodically. If it is warranted, we may decide to meet less frequently. Frequency will be decided collaboratively based on your progress, your outstanding goals, and your state of mind.

A treatment plan is like a school syllabus. Can you imagine taking a college course without receiving a syllabus? You wouldn’t know what to do - what to expect of the instructor or what they expect from you. In therapy with me, you'll know what to expect, and you are always welcome to ask questions.

When I worked in treatment facilities and took over cases from other clinicians, I always asked the clients what they’d been working on in their treatment plans. Believe it or not, the most common response was, “I don’t have one.” This is not likely at treatment facilities. Treatment centers are required to generate treatment plans for all clients in order to get paid.

So why would a client say they did not have one? It is possible that the clinician did not review the treatment plan with the client, did not provide the client with a copy of it, or wrote it in such clinical language that the client had no idea what was expected of them.

That's not going to happen with us. I will personalize your program based on the things you tell me you want to work on. I will make sure you understand every aspect of your treatment plan, and I will give you a copy of it so you can refer to it any time you like.

When someone other than the client participates in the client’s therapy, we call that person a collateral. This could be your friends, family, other healthcare professionals, or legal team - anyone who can provide insight or assistance with the therapeutic process. Collaterals are not clients and do not have a right to your records or to records regarding collateral sessions and interviews.

They get involved one of two ways: collateral sessions or collateral interviews. Collateral sessions take place during a client session. Collateral interviews take place outside a session when you, the client, are not present. I will not hold secrets for a collateral regarding information they offer about you, nor will I keep it from you that someone contacted me about you.

My role in collateral communications is to gather information and provide educational resources or clinical referrals when beneficial.

The purpose of interviewing a collateral session without your presence is so people in your life can

• provide background information or another perspective on your history and current struggles

• receive education and resources regarding your diagnosis and symptoms

• improve communications and boundaries between you and the collateral

• support your progress

Not exactly. I do not work with couples or offer family therapy where the family is the client. I do, however, strongly encourage family members to get involved in supporting their loved one’s treatment, and I will invite a family member to join you for your session if you and I agree that it would be helpful. In this context, family sessions should be considered collateral sessions, where you are the individual in therapy and the collateral is there as a supportive presence. The family member is a guest, not a client.

Such sessions are billed at my base hourly rates. Your family and friends should not expect phone, text, or email contact with me outside of sessions or scheduled interviews. If I am contacted by your family and friends outside of a collateral session or interview, I will

• not respond at all unless I have a written release of information from you to speak with them.

• respond in a limited manner according to the written release of information you provided specifically for that contact.

• respond with “Per HIPAA law, I can neither confirm nor deny whether someone is or has been a client, or even if they have contacted me”.

• not respond to voice mail messages from collaterals because it is my policy to limit calls to appointments only.

Sometimes. Each family situation is unique. Timing matters because sometimes family members are ready to hear from each other, and sometimes they are not. I do not offer family therapy where the family is the client. However, I believe it is invaluable for family members to participate in the client’s treatment, and research shows better long term outcomes for clients whose families get involved in supporting their work in therapy.

I will invite a family member to join you for your session if you and I agree that it would be helpful. There are two ways I involve family members or other support persons:

1. Collateral sessions

2. Collateral interviews

“Collateral” is the term we therapists use to refer to anyone in the client’s sphere, such as family, friends, other emotional or recovery supports, other healthcare workers, and legal professionals.

Collateral Sessions

The purpose of a collateral session is to provide insight or assistance with the therapeutic process for the support of the client. As the clinician, my role in a collateral session is to gather information, facilitate communication, and provide educational resources or clinical referrals when beneficial.

It is also my role to discourage triangulation in therapy. Triangulation is when you have three people and one of them pits the other two against each other, one of them tries to control or repair conflicts between the other two, or two of them gang up on the third. Triangulation can increase stress and conflict and stall or prevent conflict resolution. In these cases triangulation is counterproductive to the healing process and can twist therapy sessions from empowering experiences into wearisome and soul-crushing experiences. When triangulation is present, I may advise against collateral sessions at that time.

Collateral Interviews

A collateral interview may be a phone conversation, email, or video session that takes place without the presence of the client. The purpose of a collateral interview is for the collateral to:

• provide background information or another perspective on the client’s history and current struggles.

• receive education and resources regarding the client’s diagnosis and symptoms.

• improve communications with the client.

• set goals for healthy boundaries between the collateral and the client to support the client’s progress.

• discuss the discontinuation of enabling behaviors.

• point out and discourage triangulation.

• refer collaterals to a therapist when appropriate.

Policies for family members and other collaterals:

• I will always consult with a client before agreeing to involve a collateral. A signed release of information from the client is required before a collateral session will be considered.

• Collateral sessions are not therapy sessions for the family member(s). The collateral is a guest, and is there to support the client. Collaterals should not substitute these sessions for their own therapy and recovery. It is important for family members of addicts and alcoholics to have a recovery of their own so they can process how their loved one’s addiction has affected them.

• The family member is there to provide background, insight, or feedback about the issues the client is working on in therapy, or to request resources for their own education and recovery regarding the client’s case.

• Collaterals are not clients and are not protected under HIPAA law. The right to confidentiality is held by the client, not the collateral.

• Collaterals are not entitled to any records resulting from the session or interview.

• Collaterals should be aware that records of a client’s collateral sessions and interviews follow the client’s chart wherever the client authorizes the materials in it to go.

• I will not hold secrets from a client on behalf of a collateral. If someone contacts me about a client, I will notify the client and may discuss the content of that contact.

• Collateral sessions and interviews are billed at my base hourly rates.

• Family and friends of clients should not expect phone, text, or email contact with me outside of sessions or interviews.

Note to family members and other support persons:

If you contact me about a client, and I do not have the client’s consent to speak with you, I will:

• not respond at all unless I have a written release of information from the client.

• respond in a limited manner according to the written release of information the client provided specifically for that contact.

• respond with “Per HIPAA law, I can neither confirm nor deny whether someone is or has been a client, or even if they have contacted me”.

• not respond to voice mail messages from collaterals because it is my policy to limit calls to appointments only.

I applaud you for caring enough to come here seeking help for someone you love. That takes enormous love and commitment, and I recognize your pain and concern. The professional ethics codes that guide my conduct expressly discourage us from soliciting clients. Calling someone who has not contacted me about therapy for the purpose of talking them into it would be considered solicitation.

One way I can support your efforts is to encourage you to pass along my website link, my email, and my phone number so your loved one can reach out and ask any questions they might have. Another way I can support you is to suggest you consider therapy for yourself to help you navigate the frustrations you experience if your loved one chooses not to pursue therapy at this time.

Please be aware that if your loved one does contact me as a result of your legwork, I will not be able to tell you so unless they have signed a release for me to speak with you. That is the law regarding confidentiality.

Then speak up and we’ll find one that will. It’s natural to experience some discomfort when trying new things. That’s an expected element of therapy. But I don’t ever want you to feel locked into something you aren’t on board with. If the approach we’re working on doesn’t sit well with you, please tell me so I can offer you a different strategy.

Diagnosis based on DSM criteria is accepted practice right now here in the United States. As a licensed clinician in the state of Florida, state law requires me to document a diagnosis “if applicable” (Florida Administrative Code). Applicable means clinically applicable, based on symptoms, assessments, and evidence-based research. I will carefully assess and evaluate your symptoms over time, so we can get a clear and accurate picture of where you are, compare where you are to where you want to be, and provide you with the tools to move forward.

A clear diagnosis gives us language for describing what’s going on with you, and that can make it easier for you to communicate your struggles to me and your loved ones. Having a diagnosis offers a sense of legitimacy to what you’ve experienced. Plus, if you and I agree that you meet the criteria for a particular diagnosis, that knowledge directs us to a large body of reliable, evidenced-based treatments that we know we can count on to help you with your symptoms. That said, I believe strongly in confirming the presence of a diagnosis before saddling you with a label that will follow your medical records for the rest of your life.

You can read more about my clinical approach by selecting the Approaches tab in the website navigation menu.

I do not post client reviews or testimonials on my website, as it is discouraged by the ethics codes of my professional licensing organizations out of concern that it could result in a breach of clients’ privacy. However, there are external websites and services that ask for reviews. I do not control these external sites. Please keep in mind that any time you post a review, you are breaking your confidentiality. It is your right to do so, but it’s important to be aware that anything you put on the internet is out there forever.