Frequently Asked Questions

What is it - Psychotherapy, Counseling, Consulting, or Coaching?

In today's world, many new terms are being used to describe mental health counseling services based on clients' needs. Although many consider these terms to be more or less interchangeable, some prefer to differentiate between them. Traditional psychotherapy usually refers to a formal relationship between therapist and client where the client desires in-depth exploration of self to help uncover subconscious (hidden) feelings and triggers for undesirable behaviors. Today, some therapists offer more informal services such as "consulting" or "coaching". These services generally do not involve long-term or in-depth therapy, but may be useful for those seeking basic information or education, brief assessments and recommendations, helpful tips or motivational enhancement. They are suitable for either office or online services, and may offered at a lower cost than traditional psychotherapy. As the client, you always have the choice of what kind of service you want. However, if your issues and needs are complex, your therapist/counselor may recommend other types of services if he/she considers them more appropriate for you.

What should i consider when choosing a therapist?

First, ask yourself what type of therapy do you want ― for example, in-depth psychotherapy, brief or solution-focused therapy, information or education on a specific topic, or motivational enhancement (coaching)? Most generalist therapists (including myself) can do any of these according to your needs.

Second, do you need a therapist with specific expertise in an area of interest? Again, most generalist therapists treat common mental health problems such as anxiety, depression, stress reactions, relationship conflicts, adolescent behavior problems and parenting issues. Some therapists may have more expertise in certain areas and may advertise as such. Usually therapists who have certain specialties have additional training and experience in those areas; for example, treating substance abuse/dependence, early childhood disorders, schizophrenia, obsessive-compulsive disorder, sexual identity or behavior issues, etc. They may have additional credentials indicating they have passed exams measuring competence in the specialty; for example, a Certified Advanced Addictions Counselor (CAAC) or similar credential indicates expertise in treating addictive disorders. At a private agency, usually the intake person in the office maintains a list of specialty areas for each therapist, or you may speak with a therapist directly.

Third, does the therapist accept my insurance or can I afford to pay the therapist's rates? In general, if your insurance is commonly used in the area you reside in, it should be useable at most clinics. However, the clinic will need to verify your coverage before you can be scheduled for services. In today's world, insurance benefits are changing rapidly, and more and more people have to share the costs of health care services with employers. To keep premiums down, you may have high deductibles and/or copays, or may be limited in the number of sessions you can use. Remember that mental health benefits are often separate from medical benefits, so it is important you check with your insurance company for your benefits before enrolling in outpatient counseling. If you do not have insurance, or your insurance costs are too high, you may be able to obtain lower cost services as a "private pay" (no insurance used) client. Often, therapists in private practice offer a "sliding scale" fee based on income, although rarely will an individual session be less than $50-$60, depending on the therapist's experience and competitive rates in the locality of practice. Another option for those with few resources to pay for services is to call their county community mental health agency or family services agency (found in the phone book). These agencies accept public funding which will pay for all or part of a person's treatment.

The bottom line is this: The more you know about what your needs and resources are, the more you know what to find out before choosing a therapist. Even after you've seen a therapist, if you feel that he/she is not a good match for your needs, you can request a transfer to a different therapist as long as there is someone available who has the experience or approach you prefer.

What are your areas of expertise and what methods do you use?

As a generalist practitioner, I treat most common mental health disorders. I also specialize in certain areas of practice. My practice includes treating anxiety and panic disorders, mood disorders such as bipolar and major depression, stress reactions, relationship conflicts, family problems, abuse/trauma survivor issues, codependency, anger management and domestic abuse, ADD/ADHD, substance abuse/dependence, sexual behavior problems and addiction, and compulsive money-related behaviors (e.g., gambling, shopping, hoarding), among other things. I use a combination of approaches (eclectic) that I believe suits the client. These approaches may include helping someone to change negative thought patterns or cease destructive behaviors, develop insight into the origins and depth of their psychological problems, or explore spiritual beliefs or the meaning of a person's life in the world. At times I may utilize constructive challenges to try and move someone to action. I believe not only in meeting someone where he/she is at, but also in helping that person grow emotionally and evolve beyond limits that may be due to biological or developmental circumstances. I believe that much of therapy is directed toward helping someone to mature emotionally and evolve beyond childhood beliefs and behaviors. Many people did not have emotionally mature and stable enough role models (e.g., parents) in childhood to guide them through necessary developmental stages that each of us must go through to "grow up" emotionally. Of course, clients may choose how much depth they wish to go into; some may simply desire brief, solution-focused therapy or motivational counseling.

What about confidentiality, privacy and security using internet-based services?

Confidentiality of client information is governed by federal and state laws. In general, a provider of counseling services may not disclose to any third party personal information shared by a client except in extreme circumstances such as threats to personal safety or security. Sharing information electronically is governed by the HIPAA (Health Insurance Portability and Accountability Act) of 2004. This act provides safeguards against transmission of personal information by electronic means (faxes, internet, telephone, etc.). Online text-based communications should be sent via secure servers (i.e., the company transmitting the information protects against outsiders accessing information being exchanged between computers). Most web hosting companies use "SSL" (Secure Sockets Layers) technology which indicates a transaction is secured. Information transmitted via dwcounseling goes through secure servers used by the web hosting service. Transactions processed through PayPal are also secure.

Encryption technology allows for text-based messages to be "scrambled" in a way that if they are intercepted by someone they were not intended for, they are unreadable. However, using encryption may add to the cost of online services or slow down message retrieval. Currently, encryption is NOT standard on my e-mail services, but may be requested by clients if desired (instructions will be given at time of request).

What about anonymity?

With online counseling, it is theoretically possible to be completely anonymous; that is, to not reveal your real name or other personal information. This is different than confidentiality, which is the protection of information shared by someone known to the provider through a professional contact. Keep in mind, however, that most online services use verified e-commerce transaction systems (such as PayPal) to transact business. Thus, your personal information may be available to the transacting company, even though the provider may not know who you are. In general, don't expect that complete anonymity can be guaranteed (at least not by me), although I don't have a problem with someone using a pseudonym ("fake name") as long as basic contact information (name, e-mail address, emergency contact phone) is provided.

What do i do if i am feeling suicidal or otherwise am considering harming myself or others (or believe i am in danger of being harmed by someone else)?

Either dial 911, call a local crisis hotline or the police, or proceed directly to an emergency room. If I am aware or suspicious of significant risk of harm to yourself or others, I may breach confidentiality as permitted by state and federal laws to protect you or the public. For online counseling, I can attempt to contact appropriate authorities only if you provide a valid emergency contact person and locality you reside in. I will discontinue to treat anyone who I believe (based on evidence provided) is likely to engage in violent behavior leading to significant harm to self or others.

What if i have a complaint or am dissatisfied with your services?

Naturally, I hope to be able to help you gain insight and skills to manage your problems. However, I understand that not all therapist-client relationships work out for a number of reasons. If you (or I) feel that I am unable to provide the services you need or in a way that is acceptable to you, you are welcome to request a transfer or find another therapist. If you believe that I have violated any of your legal rights, or have engaged in unethical practice (based on standards established by the National Association of Social Workers and other accrediting bodies) you may consult with me, clinical supervisors (at office locations), the appropriate accrediting bodies or the state's Department of Community Health or other appropriate government agencies. Hopefully, if you are not satisfied with my services, either we can resolve it through communication or through a referral to another provider. Note that fees for services that were already paid for (whether used or not) are not refundable except under certain conditions as specified in Terms of Service.

What if there is a technical problem that prevents communication?

As reliable as internet connections are today (at least through major providers), there are a number of reasons why an internet connection might not work or be available immediately. Remember that for online services you must allow enough time to complete payment transactions. If a technical problem occurs in the transmission network or local computer which prevents online communication, you will be notified as soon as possible and allowed to obtain a credit or refund for any unused, prepaid services.

What if i have questions about your services not answered here?

Send me an e-mail with your question to: dwines@dwcounseling.com.

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