FAQs

Appointments (4)

No, not at all!  I often tell my clients that only the brave enter counseling and analysis. Choosing to address life issues or events in order to heal them is a significant decision. Therapy calls on one’s inner resources and invites exploration.  I try to make therapy as unintimidating as possible. Often I call it working on matters of the heart. In fact, studies show that people who seek out counseling or therapy are actually MORE psychologically healthy than the general population! This may be because it takes great strength to make the decision to get help. Psychotherapy and counseling are becoming more and more well received in our culture, in part because mental health is finally being respected.  Following the Affordable Care Act, mental health is now covered by insurance plans. Many have sought psychotherapy or counseling at one time or another. Writers, doctors, nurses, teachers, business people, artists, athletes, academics, and admired public figures have benefited from therapy support at different times in their lives, so you are definitely not alone! In addition, many counselors, therapists, and psychologists have gone through their own psychotherapy in the course of their training. Note: Typically, I do not see clients who have not achieved a consistent and abiding year of sobriety from addiction to alcohol or drugs. Your clear and defined year of sobriety is my best working environment.

This varies for each person.  Frequently it depends upon the commitment a person is willing to make to their therapy process and the severity of the problems and issues we are addressing.  We will discuss this.

Yes.  I help individuals with depression, anxiety, relationship, and career changes, and other emotional issues and difficulties.  Often problems don’t seem to have a name, so I encourage individuals who are feeling stuck, isolated, worried, or having distress to call. If I cannot be of help, I usually know licensed professionals in the therapy community who can be of help.

See Services for a list of services provided by my practice.  You are invited to call to ask questions.

Yes.  I have appointment times during mid-morning, afternoon, and early evening.  Evening hours are ordinarily in highest demand.  Please call my office, 503-287-1526, to ask about openings.

Confidentiality (1)

Via its laws, Oregon protects the client-psychotherapist relationship, and the Oregon Board of Licensed Professional Counselors and Therapists specifies how confidentiality is treated in our relationship.  I will not release clinical information about you, including whether or not you are in therapy, to anyone unless given express written permission to do so by you (called Informed Consent), or if one of the conditions applies in the next paragraph.  In any of the situations below, I will make every effort to discuss these things with you below.

There are a few situations that allow or require the release of confidential information:

1) The therapist or counselor must act appropriately when there is danger to the patient or to another person at the patient’s hands.  This may involve others when necessary to protect the patient if the patient is suicidal, intends to harm another person, or is unable to provide self-care at a level necessary for basic survival. State law also requires the report of abuse or neglect of a child, elder, or vulnerable adult when there is reasonable belief that it has occurred or is likely to occur in the future.

2) In response to a court order, a counselor must testify or release records.  A counselor does not release records or testify in response to a subpoena unless the patient or patient’s guardian has given written authorization to do so.

3) As professionals, we do consult with one another from time to time to improve our quality of service to you.  Case material is sometimes used in training, consultation, and writing.  This is always without identifying information and with great care and respect for your privacy.

Emergencies and Contacting Me (2)

I will let you know ahead of time when my office is closed for major holidays, my own vacation times or for continuing education courses or conferences that I attend.

I do not provide emergency services. If you find yourself in an emergency, do not wait for me to return your call. Call 911, or call any of these Oregon County Mental Health Emergency Lines. Trained, empathetic professionals staff these lines and are available to speak with you.

Multnomah County: (503) 988-4888

Washington County: (503) 291-9111

Clackamas County: (503) 655-8401

You may leave a message on my telephone service at night, but typically, I will return it the next day. I ask people to think through their situation and whether in an emergency they want to wait for contact from me or if it is wiser for them to speak to someone right away.

Fee (2)

For people who do not use insurance or wish to pay out of pocket, the fee is $150/session for individual adult psychotherapy, payable by check or cash at the time of service. The practice does not take debit or charge cards.

For individuals using BCBS, PacificSource, and Lifewise insurance in Washington State, a co-pay is paid in each session in keeping with your insurance contract with your carrier.  My practice sends a claim the insurance company for you.

If I am not on your insurance panel but you wish to use insurance, the customary out of pocket fee is charged. My practices completes out of network billing for individuals who wish to have their insurance billed.  You are reimbursed by your insurer per your insurance contract.  Billing is done via a HIPAA complaint, encrypted software system.

A Senior fee is offered for individuals 65 and over.  Please call to discuss.  The practice cannot bill Medicare or Advantage plans.

$20.00 per session for group therapy, in accordance with the average fee for counseling services. Payable in one-time payment for group sessions offered in any six to eight week group period.

Telephone contact under 10 minutes will not be billed.  Longer telephone sessions billed on a pro-rated fee based on he in-person rate, and fifty-minute telephone or electronic sessions are billed at the same rate as in-person sessions.  Electronic/telephonic sessions should be cleared with your insurance company beforehand.

Document preparation billed at $175 per hour.

Court appearances billed at my per diem rate.

Missed appointments or cancellations are billed at full fee unless cancelled at least 24 hours in advance of the appointment time.  Insurance does not pay for missed sessions. This policy allows use of my time by another client.

I have a limited number of appointments available on a sliding fee scale. We can discuss your particular needs, and I will ask for proof of income.

Fees are raised or reviewed annually.

BlueCross/Regence and PacificSource insurance are accepted.  I am BCBS Preferred Provider.  For these carriers, I typically collect your co-pay and bill the insurance company.

It is important that you contact your insurance company to thoroughly understand:

  • What amount of mental health coverage you have annually.
  • What is your mental healthcare deductible, that portion of the ongoing billing you will pay out-of-pocket before your benefits cover a portion of your mental health services?
  • What your co-pay is.

Out-of-network means I cannot accept a co-pay from you or bill your insurance company as a provider on your insurance company’s provider network. It does mean that payment of my customary fee of $150.00 is requested from you at the time of service and that I will bill your insurance for out of network reimbursement for you within 48-72 hours.  Statements for HSA’s or other savings plans can be documented for you.

For clients who wish privacy concerning their therapy, cash payment offers that option.

Psychotherapy, counseling, and analysis are investments in yourself, your healing, and your growth toward wholeness.  You are working on your own goals and interests, work that is vital.When you call me to discuss what life issues you are facing, I will also be glad to discuss my fee with you.

Office Policies (3)

The Affordable Health Care Act mandates that mental health therapy be offered via your health insurance policy. Before you purchase your or your family’s policy, ask about out of network benefits and deductible amounts (the amount you have to pay before benefits cover costs).

  • Insurance: Blue Cross Blue Shield of Oregon, Pacificsource, and Lifewise of Oregon list Carol on their Preferred Provider Panel.
  • Carol is “out of network” for other insurance panels, but she quickly electronically bills out of network providers after each session.  She accepts payment in session and bills the company for you.  Therefore, before entering therapy with Carol or anyone, call your insurance company to be clear about the nature and extent of their mental health therapy benefits.  Ask about out of network reimbursement. Ask about any deductible for mental health benefits.
  • Working with Carol Out of Your Insurance Network:  I accept my regular fee from you at the end of each session.  Within 48 hours, I electronically bill your insurance for the session via a HIPPA level encrypted software, directing them to send any reimbursement owed within your policy to you. Again, please check your deductible for out of network providers.
  • Declining to Use Insurance:  Should a person be covered by mental health insurance benefits but decline to use them with my practice, the person must sign a “Private Pay Agreement” which waives any future right to bill the insurance company.  Should an insurance plan decline treatment provided by my practice and should the person wish to continue in therapy, details of this agreement also apply.
  • For Seniors:  Licensed Professional Counselors like myself are not permitted to accept Medicare insurance.  This is due to Federal omission of that license from the Affordable Care Act.  To compensate for this omission for the many seniors who wish to see me, I offer a senior rate.  Please call my office to discuss this option.

Counseling and therapy are investments in yourself, your healing, and your growth toward wholeness. You are working on yourself, work that is vital.

Each person is unique, so reasons for seeking therapy vary with the person. Each reason is valid.

Engaging in therapy is a purposive step into a confidential process of personal work.

During our first sessions, we will talk about how long therapy tends to last for people experiencing your particular difficulty and level of severity.

Sometimes, more frequent meeting are needed for a short time at the beginning of therapy or during crisis periods until you feeling better. I see people in Jungian Analysis for longer periods of time often twice a week.  People in Jungian or psychodynamic therapy come to session once a week for a period of time.

I see graduate and doctoral students in psychology, depth psychology, and counseling psychology who are working toward program requirements.

Sessions are 50 minutes in length.

Our First Appointment (2)

People differ of course and therapists do too. In searching for a therapist, you are seeking the absolute best match between you and the licensed therapist. To help you find a therapist, ask friends who have had a successful therapy for a referral. Your doctor can give you referrals. Sometimes other allied healthcare workers can also refer.  Trust your first reactions.  You can ask therapists questions: how do they approach psychotherapy, what are their areas of expertise, training, or experience before you make your appointment. Make sure they are licensed.

Another option is to think about is individual, or couples, or family therapy. Sometimes a group is more helpful, or it can be less expensive. Sometimes a free group such as AA, NA, Overeaters Anonymous, or another such group can help you move toward individual therapy if you are not ready now. Check your church, temple, medical clinic, or community center for further offerings.

Jungian Analysis is a long-established form of psychotherapy. One of its goals is to help us better understand how the unconscious works in our lives so that we can gain insight into ourselves and create a more satisfying and whole life. Analysis helps us recognize elements in our unconscious that can lead to healing.  Regular meetings, dreams and dream analysis, expressive arts, sand play, or journal writing help this process.

Please note:  When a psychotherapist uses the words Jungian Analyst or Certified Jungian Analyst to describe their professional expertise, they attest they have completed many years of particular and difficult post masters or doctoral training. Their training institute officially certifies them. Also, Jungian Analysts are required “to do their own work,” that is to purposely engage in many, many hours and sometimes years of their own psychotherapy during their training as Jung insisted.  Jungian Analysts continue to take specific, ongoing training in their field, for example, at an institute like this one, www.junginstitut.ch/english/.

The word Jungian is easily borrowed, such as when people presume the title “Jungian Psychotherapist” or “Jungian-Oriented Counselor.” Potential clients need to know ahead of time that these practitioners have not completed the training that Jungian Analysts have undergone. These therapists cannot do analytical work.  A therapist with one of these titles may have interest in Jung, but that does not indicate expertise nor fully understanding how Jungian Analysis or therapy works.

The training that I and other Jungian Analysts have taken allows us to offer a unique analytical encounter, to meet the Analyst’s ethical requirements, and to use this professional designation in our title. Other practitioners who borrow these kinds of titles or w

If you are early for your appointment, please take a seat on the porch or there are coffee shops nearby where you can wait comfortably:

Hollywood Library Café NE 43rd and NE Tillamook

Fleur de Lis, NE Hancock and NE 42nd

Whole Foods Market NE 43rd and NE Sandy (closest)

At your appointment time, knock on my door.  I will greet you.  We will immediately go into my office.  During the first few minutes of our first session, I will give you my policy, consent, and personal disclosure statement as required by the Oregon Board of Licensed Professional Counselors and Therapists. I am ready to respond to questions you have.

We’ll begin the conversation where you wish to begin.   I will listen and learn more about what brings you to therapy.  I’ll be determining whether or not my training and experience are a likely match your needs, and whether or not I feel I can be of help to you, or if I need to refer you to a licensed professional who is more appropriate for you. You will also be deciding whether or not you feel you want to work with me.  If you feel it is not a match, I will refer you to another licensed professional.  Within the first few sessions, we will discuss how long your therapy is likely to last, its risks and benefits, and what we will be doing during the sessions.  I will encourage you to ask questions about any concerns you have at any time during our work together.

What is a Jungian Analyst? (1)

What Is Jungian Analysis?

Jungian Analysis is a well-known, serious, longer-term form of mental health therapy offered by a certified Jungian Analyst.  It is a process of focusing on matters of the mind, body, heart, and one’s soul which are encountered in the turbulent journey of life.  As a process, it is based on theory and deep training, which take time for the practitioner to learn and to apply.

The ability to practice as a certified Jungian Analyst reflects an institutionally validated capability from specific training in Analytical Psychology by specific Institutes.  Analytical Psychology is the psychology theory developed by the Swiss psychiatrist Carl G. Jung.  It takes a long time to become a Jungian Analyst and to handle its theory and application in a clinical setting.

The approach values people’s ability to progress in their healing in spite of all their difficulties. It seeks to expand consciousness and to expand the personality.  Jungian psychology values the human unconscious.  We see the unconscious in dreams, daydreams, slips of the lip, repeated relationship patterns, what we “put” or project on other people, and in the repeating patterns or unconscious decisions made in our life.  The unconscious also holds trauma and repressed material.  I am extensively trained and experienced in helping people with the courageous work of looking deeply into one’s inner self. Together, our goal is to help you find and absorb present, but unexpressed parts of your personality, and through this exploration to become a more aware and distinct individual. Each person’s journey with his or her unconscious is an individual endeavor. I join others who call this process doing our own, ongoing work of healing and differentiation. Through this process of honoring the unconscious, the unique individual is awakened.

Jungian therapy is a shorter-term therapy, focusing on getting below the surface of the presenting symptoms, for example, an anxiety.  In working to get “below” the symptom, we can work to improve a person’s mental health surrounding the issue or issues.

Qualifications to be able to call oneself a Jungian practitioner:

This is consumer advisement.  A Certified Diplomate in Jungian Analysis, such as myself or other Jungian Analysts in Portland, have engaged in post-graduate study for many years beyond their master’s or doctoral degrees.  We have taken hundreds of hours of personal analysis, and in the case of the C.G. Jung Institute Zurich, engaged in long-term, demanding seminars as well as intensive group and individual clinical supervision in an international context.  I was also required to research, write, and defend a thesis on an original topic.  A Jungian Psychotherapist or a Jungian-Oriented Counselor is not a Jungian Analyst.

If you specifically want a trained Jungian Analyst or to know that the person working with you understands the complexities and challenges of Analytical Psychology (the basis of Jungian work) and its applications, look at my qualifications and background or go to pnsja.com/our analysts.htm for more choices.

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