Questions to Ask Your Insurance Company Before Starting Counseling

I understand that counseling is an investment and if you're already paying an insurance premium, you want to use the services that might be available. Even though I don't accept insurance (except EAP direct referrals), there may be options for you to use insurance to cover a portion of your counseling services.

First of all, you can use an HSA card (Health Savings Account) to pay for counseling/therapy services. It's actually super easy... just use the card like any other credit card and we're good to go!

This is also something to consider if you're planning to pay for counseling ongoing and need to decide how much you'd like to contribute to your HSA each year when your company has open enrollment.

Secondly, consider other ways insurance might contribute. I recommend everyone call their insurance company to ask the following questions before beginning counseling with any practitioner:

>> How much is your deductible?

It is important to understand how much you need to contribute out of pocket each year before your insurance "kicks in." This varies greatly depending on your insurance plan so you must talk with your HR department and/or insurance company to know this number.

>> How much have you contributed to your deductible as of this point in time and when does that reset?

Perhaps you've had some other large medical expenses and have already met your deductible, so most medical expenses are now covered by the insurance. Or perhaps you're still $9,538 away from meeting it... who knows! 

Although many deductibles reset at the beginning of the year, some reset based on the employer's enrollment schedule, which can be at any point in time. Make sure you know this date so you can anticipate when you'll need to cover expenses again.

>> Are out of network providers covered under your plan?

Some plans, typically plans that are PPO, allow you to choose any provider for any health service. This is a genuine open market so that you can choose whomever is the best fit for your needs. However, you will initially need to pay for this service out of pocket and then seek reimbursement from your insurance company, so plan for a time gap. 

>> If yes, at what rate will they reimburse you for the following CPT codes billed by a licensed psychologist: 90791, 90834?

These are the two codes I typically use for billing your initial session and ongoing sessions. There are different rates for different kinds of therapists, so make sure to note that I'm a psychologist (this is typically reimbursed at a slightly higher rate than Master's level therapists). 

You can click here to learn more about my fees, but I generally charge $200 per session. Subtract whatever amount you will be reimbursed to identify how much you'll need to contribute out of pocket.

>> If no, does the insurance company offer single case agreements so that you can see an ADHD specialist?

This only applies if you're seeking services specifically for ADHD, but may be an option. There are times when insurance companies do not have someone in network to meet your specific need. In those cases, they may allow me to contract with them for a single case agreement. This means that I'm still not on their panel, but they will pay me directly to see you.

However, if they have someone in the area who specializes in ADHD and has openings, this likely is not an option. Additionally, if you're looking for help with general work stress or career issues, insurance companies will view any licensed mental health clinician as capable of providing that service and are not likely to make an exception. 

Taking it from here...

I know dealing with insurance is complicated. Ahem, that's a big part of why I choose not to do it! However, I do have some experience in this area so feel free to contact me if you get confused or have any other questions after talking with your insurance company. 

And remember that if you do choose to use your insurance, they will have access to my notes about our work together. They will also require that you meet criteria for a mental health diagnosis in order for us to work together. While I would love to #endstigma around mental health disorders, I also understand there are many reasons you may not want that kind of information easily available to others. 

There are also many cases where people do not meet criteria for a mental health disorder but would still find counseling helpful. In fact, this is a large portion of the clients I see regularly. They are "typical" people dealing with a stressor, looking for insight and wanting some support. And, like it or not, insurance doesn't pay for that. 

Hopefully, this helps you make more informed decisions about how you choose to pay for counseling, both now and in the future! Please feel free to share this post with others to help #endstigma around mental health and make sure your friends and family have the information they need about using insurance. 

How Counseling is Like Steering a Ship

While creating an analogy for something completely different, I realized how much counseling is like steering a ship (side note: this is how ADHD works... this odd connection is an example of how it can be a strength!).

For this example, the ship is the journey of counseling. There are two people steering this ship, the therapist and the client. They determine together what the destination will be, the route to get there, and who may come along for the ride as a passenger. 

In counseling, the therapist and client are like co-captains.

Neither one is really the only captain, it's more like they share the responsibility at different times. When you come in for counseling, for example, the therapist takes over as captain and guides the session, checks in on how the direction is going, talks strategy, etc.

However, the therapist can't be the captain when you leave the office. That's up to you. So, you take over responsibility and make sure you're steering the ship where you've decided to go, use the strategies discussed, and decide if you need to call for back up at any time.

In the beginning, you might need to call for help more often.

Perhaps you don't feel quite ready to tackle navigating around that iceberg or that reef. Perhaps pirates are headed your way and you're not sure what to do. You call up your co-captain and they help you out.

Over time, you become more familiar with how to address these challenges and call on the co-captain less and less. Pretty soon, you're sticking to your schedules and feel comfortable handling your shift all on your own, no problem!

As with any journey, it's hard to predict what might happen in counseling.

In the first session, you decide with your therapist what your destination is; however, you both may be unaware of the hurdles along the way that will require you to change course for a bit.

You might have an unexpected problem arise that requires your immediate attention. It may only require a quick phone call or adopting a new coping skill. It doesn't impact your overall path, simply redirects your attention briefly.

Or you might have a more significant problem, like a huge reef you weren't anticipating. This requires you to take a detour and navigate through some different waters, but all still on the path to your goal.

You may even discover an undocumented island and stop there for a bit to rest or reflect. This gives you an opportunity to really focus on one aspect of your work together, without the typical distractions that other issues may bring.

In the counseling world, this might look like an extended session that allows you to focus on a topic for 2-4 hours instead of the typical 45-60 minutes. Or it may be that you decide some evaluation tools are needed to determine the best course of action moving forward. So you take time to complete those and reflect on how they relate to the longer work.

As co-captains you also get to decide who else is on the ship and what role they play.

Perhaps you have a loved one visit for a bit (like 1-2 sessions) because of their impact or expertise in one area. Or maybe you decide it's best to include a partner in the work for most of the journey. You can also decide that this journey is best with the two of you alone. It all works.

The best part about being co-captains is deciding when, and how, to end the journey.

Sometimes the journey is short, like with brief counseling, or sometimes it is longer and may last a few months. Your counselor will make recommendations and guide you, often encouraging you when they feel you're ready to move on. But however long it is, you get to decide if you're ready to move on.

If you're interested in counseling for help with ADHD or help with work stress or career choices, schedule a free phone call to see how we can work together. You can also shoot me an email by clicking here

Accommodations: Why you probably don’t need extra time

Many college students with ADHD or learning disabilities receive accommodations in order to complete their work at a more even level with their peers. However, accommodations are often chosen based on a standard template, rather than based on what would actually be most useful for the individual student.

Many college students receiving accommodations may be familiar with the most commonly recommended resources but not aware of how they are meant to help and what alternatives are also available.

Using accommodations can sometimes take time away from students by setting up services with the school’s disabled students or psychological services center, attending extra college counseling meetings, coordinating services with professors, etc. 

If the accommodations are appropriate and helpful, this time is well worth it. However, this is often not the case.

Understanding each type of accommodation offered and when it benefits you will enable you to maximize the services available while not wasting time for services you don’t need. 

Remember that accommodations, as much as possible, are meant to provide an equal platform for students with a disability so they can be evaluated fairly. This way the student is being tested on their knowledge of the content area, rather than how well they can track words on a page or write quickly.

Below is a list of some accommodations for students with ADHD or learning disabilities, how they can be helpful and when to maximize them:

Extra time

Extra time is one of the most commonly recommended and most commonly requested accommodations. However, in my work as a Learning Disabilities Specialist, I found that extra time was only useful in certain circumstances. 

For example, many students would set up taking a test outside the classroom in order to use their extra time. However, they would often finish the test well before the regular test time was over, anyway. This is especially true for most students with ADHD. They may need a quiet room or breaks (see below) but the time itself is rarely an issue.

When to use it

If you genuinely use the extra time for exams on a regular basis, keep doing it!

Look at when you need extra time. For example, some students only find extra time useful for math exams or for writing exams. Consider things like how quickly and easily you write, how quickly and easily you read, whether or not you have difficulty tracking items and how long it takes you to edit or check your work after it’s complete. 

If you notice that you only use extra time for certain exams, then use your accommodations then but don’t worry about wasting time with others. 

Priority registration

Priority registration can be extremely beneficial for some students, but again, is not always needed. This gives identified students first priority in choosing classes and is usually more helpful at large universities where classes may fill up quickly.

When to use it

Priority registration is especially helpful for students with physical disabilities so they can plan out their schedule to allow for time to get from one class to another and maximize proximity of classes. It may also be necessary for students with a medical condition that have to attend regular medical appointments (e.g. dialysis) and need to ensure they can work classes around that schedule. 

Another helpful way to use priority registration is for class size.

If you have ADHD and your school has two large classes but two other classes that have fewer students, you would likely benefit from attending the smaller sized class that will have fewer distractions and more attention from the professor. Also, if you have more severe ADHD and find that afternoon classes work significantly better for you, priority registration will ensure you don’t end up with an 8am class.  

Breaks

I find that breaks during tests are one of the best, yet least used and recommended accommodations. Breaks can mean anything from allowing a student with a medical condition to get up and stand during the test, to giving a student with ADHD a 15 minute break in between a math exam.

When to use it

I recommend examining your successful study habits to see if breaks would be a useful accommodation. Do you typically have difficulty focusing after a certain period of time? Do you find yourself needing to move around or stand after sitting for a specific timeframe?

If you can identify how breaks help you stay on track or minimize a disability, then you can present this as an option to your school counselor.

Quiet room

This is another accommodation that is often misused but when used in the appropriate circumstances, can make a world of difference.

It’s fairly self-explanatory, but this means the student takes their exam in a room separate from the rest of the class. This may be in a room alone or even with 2-4 other students (especially during busy times like finals when schools may not have dozens of rooms available). 

When to use it

If you find yourself distracted by outside noises at all, a quiet room is beneficial. While things like windows and being around others is beneficial for creativity, it is rarely helpful for detail-oriented tasks that must be done in a certain timeframe. Removing as many distractions as possible can be a game changer for things like math or science exams.

Note taker

Note takers are different in that they are used for regular classroom days, rather than for tests. Students who have difficulty writing due to a medical condition or dysgraphia may find it helpful to have a note taker. This is often another student in the class who is designated to provide a copy of their notes.

When to use it

If you have dysgraphia, meaning that you need to focus so much on the act of writing that you are unable to focus on the content being written, a note taker can make a huge difference.

Likewise, if you have a medical condition (recent surgery and your dominant arm is in a sling) that prevents easy writing, this can be absolutely necessary for collecting information you need to use later in the class.

Scribe

The use of a scribe may be related to having a note taker or may be for another reason. Rather than writing down what a professor is saying, a scribe writes down what you are saying so that you do not need to write it yourself. This most commonly relates to essay or short answer exams. 

When to use it

Similar to a note taker, if you have dysgraphia and the act of writing itself takes up take and energy unrelated to the actual content on which you’re being tested, a scribe can help. This may also relate to severe dyslexia or even ADHD, where editing and reviewing answers becomes confusing. This way you can have someone else write and then read back to you what they have written. 

Reader

A reader is someone who can read content and test questions to you during an exam. They don’t interpret things or help with answering questions, they simply read whatever content is on the exam.

When to use it

If you have to spend time focusing on the act of reading, as is often the case with dyslexia, a reader can take that pressure off so you’re able to focus on the content of the exam instead.

For students with ADHD, a reader can also be useful so you don’t spend time reading the same sentence over and over. However, it’s not useful for all students with ADHD because some students are better able to focus when reading on their own.

Other technology

There are lots of technology tools that are helpful for people with ADHD or learning disabilities. These tools can be used for exams or for study.

These include things like the Kurzweil, which is a computer program that will read textbooks or anything else you scan and upload to a computer. Most computers are also able to read documents aloud.

Sometimes a computer itself is also considered an accommodation.

For example, some people may not need a scribe if they can simply type their in class essay on a computer. Or the may not need a reader if a computer can read their exam to them. 

Due to concerns about accessing information not available to other students, computers are often only used in an office with a test monitor, or a scribe or reader may be required instead. 

Some professors are hesitant to give students access to their computers or audio recorders during class but these can also be great alternatives for students who have trouble taking notes.

Sometimes typing the information is easier than writing. And recording lectures can be helpful for students with ADHD in case they have trouble focusing during an entire lecture or miss an important detail about an assignment.

Ultimately, accommodations are hugely beneficial for students with ADHD and learning disabilities, but the accommodations must have a reasoning behind them.

Make sure your accommodations make sense for your weaknesses, and also for the specific classes to which they apply.

Once you’re able to identify the accommodations that are most useful to you, you can create habits that will help throughout your lifetime. This skill of adapting to work differently is priceless and the key to creating a successful career.

If you're still looking for help with figuring out the best strategies to manage school or work, schedule a free 20 minute consultation to see if counseling may be a good fit for you. 

5 Ways to Infuse Happiness into Your Work Day

We all have those bad days at work… days when we wake up late only to discover there is a major accident causing traffic on our way to work, the boss was there waiting to discuss something important right away and then we find out someone else called in sick and we need to cover their workload.

Not. Fun.

Sometimes it feels like these days happen multiple times in a row and you’re stuck in a perpetual negative work rut. 

However, there are some quick ways you can infuse a little happiness into your work day.

These are nice and easy things that multiple studies have shown to improve your mood. And you can do them discreetly on your lunch break, before walking in to work, or any time during the day.

1. Try a journaling exercise.

Don’t worry, this doesn’t have to be long! However, identifying things about which you are thankful is proven to increase happiness.

A short investment in time and money is The Five Minute Journal, which encourages you to write out three things you are thankful for each day. It also encourages you to identify daily goals and an affirmation, then check in for five minutes at the end of your day. Five minutes at the beginning and five minutes at the end of your day. Now that’s doable.

2. Download an app to help you appreciate the positive things.

Not into writing? No problem!

You can download an app like Happify which asks you a series of questions to learn about what may be causing you stress and then assigns you daily activities based on the recommended “track” to address your answers.

Or you can purchase the Five Minute Journal app and add pictures about the things you’re thankful for, or take notes directly on your phone. You could even do your own challenge by setting a reminder on your phone to draw or take a picture of something you’re thankful for each day.

3. Write a thank you letter to a mentor, friend, family member, etc.

This video below shows just how impactful this task can be… and the more unhappy you’re feeling, the more likely it is this will boost your mood!

4. Set reminders with affirmations.

Do a google search of things like “positive affirmations for managers” or “positive affirmations for work” and then write down those quotes in your phone as a reminder to go off every 1-2 weeks.

If you keep about 10 of these in your phone, set at different times, you’ll get a nice little reminder to stay positive or appreciate something throughout your work week.

5. Phone a friend.

As the Soul Pancake video shows, people’s moods were obviously lifted when talking to the people for whom they were thankful. Think of a friend or family member who is usually positive or provides an empathic ear and give them a call to say hello. It’s likely they’ll appreciate hearing from you and both of your moods will get a little lift!

If morale at work is poor, you can even share some of these tips and try to get your colleagues working on their happiness. It’s likely that you’re all influencing one another, so do your best to make a positive contribution. 

And if you’re still feeling stressed out after trying one or two of these strategies, feel free to sign up for a free 20 minute consultation to see if counseling may help. Make sure you’re in control of your actions and emotions and creating positive things for your life. 

Why I Decided To Quit My Job… All Five of Them

In eight years I’ve had five very different jobs. Some of them overlapped and some lasted longer than others. The consistent thread among the five of them is that I’ve left them all on my own terms and felt very good about that decision each time. 

However, deciding whether or not to leave a job is not something to take lightly.

I carefully thought it through each time and there were different reasons based on each job and that time of my life. 

The job I left because I hated it

My first full-time job was a poor fit from early on. Unfortunately, the manager who hired me left very soon after I started and the position morphed into something different from that for which I was originally hired.

However, I was committed to staying there for at least one year because I was gaining necessary training related to my career and trying to provide some consistency for clients under my care. 

There were good and bad moments with that job.

  • I formed some wonderful friendships and felt very supported by my colleagues.

  • I learned priceless strategies for managing my time in a busy environment.

  • I was exposed to clinical experiences I would not have chosen to put myself in, but those experiences have proven valuable throughout many points in my career to date. 

However, I knew the job was not what I wanted and I was not paid well for the stressful work.

I began to resent the company and dreaded going in to work each day. I came home feeling exhausted because it was emotionally taxing to be there knowing it was not a good fit. I stopped working out, didn’t eat as well and gained weight. I wasn’t always fun to be around. 

Basically, the negativity surrounding my work was permeating every other area of my life.

I pulled through for exactly one year and left on good terms. Thankfully, I was also working just two days a week as a contractor for another company and when I left this job I was able to obtain more hours there. Which brings me to that position…

The job I left because I wasn’t growing

I originally started this job to make some extra money while working in my previous position, and because it was work I truly loved. As I started to work more hours I was able to learn some new skills and take on additional responsibilities. My coworkers were fun (for the most part) and the schedule was flexible.

This was the good life!

However, three years later, I was still doing exactly the same work. The job was very specific and the company was a small business so there was no room for advancement or expanding my position.

It was difficult to leave this position because of the many perks, but I realized that I wanted to grow in my clinical skills and it wasn’t going to happen staying there. 

I looked around for other jobs and had the good fortune of finding something that would be a good transition fairly quickly. It seemed like something that would provide me a lot of opportunities in a new area of my industry so I took it. 

The job I left because I had a new opportunity

This next job was also a really great fit for me and I learned soooo many things. I found out that training was a skill of mine and was given opportunities to pursue this more. I worked with a supportive, hardworking and intelligent team of people. My boss was the best I’d ever had (and still have ever had). 

Every job has its ups and downs so things weren’t perfect but as far as jobs go, it was a pretty great deal.

I knew going in that this wouldn’t be a long-term position and my boss knew this, as well. She offered me opportunities to grow as much as possible but some point it became clear it was time for me to look into entry-level management (since my ultimate goal was to manage my own business). 

I used the fact that I had a good job to take my time and select what would be a good stepping stone for me.

I talked to my boss about it. I spent time asking lots of questions during interviews, and then identified what was a good chance for me to gain some management experience and new responsibilities. 

The job I left because I needed flexibility

This new management position was for a much smaller company so I ended up doing some things that were well beyond what I had done before, but also things that our program assistant in our previous company had done. I learned about management, represented the company at district meetings and was given the opportunity to pursue a lot of my training interests.

However, at this time I had also started my own business on the side and it was begging for more of my free time.

My commute was one hour each way to and from work. I struggled to manage things at home while also starting a business. I needed some flexibility.

Again, I took the opportunity to look for other positions while I still had a good job. I looked for jobs that would be closer to home or provide telecommuting options.

I also approached my boss about flexible work options, something that was really hard for me to do. He was very understanding and didn’t say “no” but he said “not yet.” 

That kept me looking until I found the perfect solution… a job that would allow me to telecommute two days a week and also gave me a large pay increase.

My future boss seemed great and it was something totally new where I could learn more skills. I dove in head first. 

The job I left because the company was poorly managed

My next (and last) job was honestly a train wreck from week one.

Some things were amazing:

  • My boss was really great and she was teaching me so much.
  • I was now managing a larger team and had the opportunity to impact program policies because we were starting this from the ground up.
  • I was learning new clinical skills.

However, the upper management of the company was working from a traditional management mindset that suits factory employees rather than a motivated team of highly educated people.

There was inconsistency and the company espoused values that were no where near the actions or policies enacted. 

Due to poor communication, lack of planning, and short-sighted and abrupt decisions, the program began to struggle very early on. That put pressure on everyone involved. I was required to relay bad news to my employees on a regular basis.

Morale was low and things continued to go from bad to worse. 

Thankfully, I was able to turn lemons into lemonade and use one of these unfortunate circumstances in my favor. I finally decided it was time to focus on my business full-time. The timing was perfect because moral dilemmas in management were becoming more common and I could no longer support what was happening in the company or the program. 

My personal values were out of alignment with the values expressed by the company.

I was no longer growing as a professional and I had the opportunity to pursue my own business. It was time to call it quits for the last time. 

Life Lessons

So what have I learned from all these career moves?

Your work impacts your life in a multitude of ways that include so much more than just money. Finding a good fit is priceless, but the job that is a good fit for you now may not be a great fit two years from now.

If you’re trying to decide whether or not it’s time to leave your job, ask yourself the following questions:

  • Does my boss provide me the support I need?
  • Am I growing professionally (learning new skills, exposed to opportunities, etc.)?
  • How do I feel when I arrive home from work each day?
  • How does this job fit in to my long-term career goals?
  • Are there things I can adjust now to make my job better?

It’s important to identify how much of a conflict it is for you to work in your position at your company.

If the company’s values aren’t in alignment with your values, that is when conflict and discomfort is likely to arise. Or perhaps your skills and goals are not a good fit for the needs of the position (e.g. being over or under-qualified). 

Evaluating the situation as objectively as possible and identifying the potential mismatch can help you decide what action to take next.

That may be looking for other jobs, asking your boss for training, or deciding on a timeline for advancement so that you feel motivated to stay where you are and gain all the experience you can. 

If you’re still not sure where you fit in to the working world, a personalized career assessment can provide you guidance that is based on your interests, skills and potential for growth.

Sign up for your free 20 minute consultation today and find out more about how a career assessment can help you achieve a more fulfilling life.