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Frequently Asked Questions

Is therapy right for me? Do I really need therapy?

Deciding to see a therapist is an individual choice. It is admirable that you have the ability and self awareness to realize that you would likely benefit from therapy. There are many reasons why clients come to see me. Sometimes it is due to long term challenges with depression or anxiety. They are exhausted and want help to manage it better, improve functioning and participate fully in life.

For some clients, it is because of unexpected challenges and losses, events like divorce, death, an illness, or work/life transition. They want help with situational stressors that are causing them difficulty sleeping, eating, parenting, or concentrating. Maybe you have always had the ability and the support to cope with challenging situations and you have never even considered therapy before. This time around it may be more difficult due the extent of the stressors or feeling more vulnerable.

Other times clients describe being “haunted” by past traumatic incidents in their life and they want to deal with theses ghosts and more on to a more joyous life. They talk of being tired of relying on unhealthy ways of coping like over-eating, overusing alcohol, or abusing drugs as a way to numb them-selves.

Many clients are seeking advice and guidance while they pursue personal exploration and growth. Working together, I help provide support, insight and new strategies to deal with life’s challenges. I can help you address many different issues including: depression, anxiety, grief, stress, medical, life transitions, sexuality, and trauma. If you are interested in improving your coping skills, increasing self awareness, and leading a more fulfilling life, I can help you.

How can therapy help me?

There a many benefits that may come from participating in psychotherapy. Here is a list of some of these benefits:

  • Learning improved ways to cope with stress and anxiety while practicing good self care skills.
  • Support and encouragement in the midst of a challenging life transition.
  • Resolving the issues and concerns that prompted you to seek therapy.
  • Improving your own self acceptance, self- esteem, body image, self awareness and self confidence.
  • Identifying, managing and expressing emotions including anger, grief, and sadness.
  • Resolving past trauma and childhood issues that are impeding your life satisfaction.
  • Learning creative problem solving skills and applying these skills to enrich your personal life and relationships.
  •  Defining your personal values, life goals and living a life of meaning and purpose.

Life is too short not to live it to the fullest.  If you are looking for a safe place to talk, to gain insight, to improve ways of coping, to build on your strengths, and to move forward, I hope you will please contact me.

What is therapy like? How long does a session last?

During therapy sessions we will discuss your primary issues and concerns that brought you in for therapy. Most commonly we will have weekly sessions that last 50 minutes. This is the time length of a normal session that is paid by insurance. If you are in need of a longer therapy session, this would need to be arranged prior to your session as I may have another appointment scheduled immediately after your appointment. Therapy can be short term focusing on a specific issue or longer term addressing issues with greater complexity or ongoing personal growth. Sometimes I will request you to take actions outside of our therapy sessions, such as keeping a journal, reading a book, keeping track of specific behaviors. To get the most from therapy, it is important for you to actively participate during and between sessions. What I believe in and I will provide within the realm of our therapeutic relationship is:

  • A safe, understanding, compassionate, respectful environment where we can work together.
  • A pace that is comfortable and safe for you.
  • An individualized and holistic approach.
  • Perspectives to illuminate persistent patterns and negative feelings.
  • Understanding of what may be hindering you and help for you to gain insight.
  • Support in whatever sensitive issue you are seeking therapy for.
  • New strategies for making positive changes and improving your coping skills.
  • Assistance in helping you to build on your strengths.
  • Guidance along your new path of life.
  • Achieving all that you want your life to be.

What is the difference between EAP sessions and psychotherapy sessions?

The EAP is not meant to replace mental health or chemical dependency coverage through a health plan. EAP is not for chronic and serious problems.
EAP uses a short term brief problem solving model of counseling. It also assists clients in finding longer term counseling services, community resources, specialty-focused programs such as chemical dependency treatment, domestic violence or anger management programs. Since I am also an independent licensed clinical social worker, I would be able to provide ongoing psychotherapy if it is deemed to be clinical appropriate. If that should occur, we could discuss what would be in your best interest.

I want to learn more about how I might use an EAP benefit.

Employee assistance counseling is brief and solution-focused. If you are covered by an EAP through your employer or your partner/spouse, you may have from 1-8 sessions that would not cost you anything. I recommend that you call the employer to explore whether you have an EAP benefit that includes counseling sessions, and if so, who the EAP provider is. The EAP that your company contracts with can assist you with referrals to in-network counselors. I may or may not be in-network with your specific company’s EAP. If you are interested in working with me as your counselor, you could ask them if I am a contracted provider with your EAP. Prior to making an appointment with any EAP counselor, it is important that you contact your company to obtain an authorization number for EAP sessions.
Some of the problems that EAP counseling often addresses include:
•           Life adjustments and transitions
•           Relocation and moving stress
•           Job loss
•           Parenting challenges- including single, blended and military families
•           Emancipation of adult children living at home
•           Marital/couples/partner relationships
•           Unplanned pregnancies
•           Grief and loss
•           Financial stress
•           Family members with serious mental or physical illnesses
•           Crisis situations that do not involve risk of harm to yourself or others
•           Work-live challenges
•           Elder care issues
•           Substance abuse or dependence
•           Critical incidents related to the work place- deaths, bank robberies, accidents, etc.

I have specialized training in employee assistance and am credentialed as a Certified Employee Assistance Professional (CEAP) by the Employee Assistance Certification Commission.

EAP is a resource for brief counseling. It is not for medical services. If employees or their family members are in need of seeing a psychiatrist for medication evaluation and management, they need to contact their medical health plan.  An EAP counselor does not provide clinical diagnoses, psychiatric testing, psychological assessment or school related assessments. These services are beyond the scope of services provided by the employee assistance program and would be needed to be prior authorized by your insurance company.

I have often thought of seeing a therapist, but am concerned that I will be labeled with a diagnosis that will follow me for the rest of my life. Is that true?

If you come to see me for therapy using your employee assistance benefit, you will not receive any diagnosis. Instead, you will have an identified problem area. This might be: employment, relationship issue, economic, parenting, etc.

If you are using your insurance coverage for therapy, I will be required to provide a diagnosis within the first couple of sessions. The purpose of a diagnosis is to treat the specific symptoms attached to a diagnosis. Symptoms are treatable and the distressful symptoms are what we would focus on in therapy. You have a right to know your diagnosis and we would discuss this fully to ensure that we are in agreement. A person’s diagnosis is not a part of their personal identity.  Most times when clients seek outpatient psychotherapy services it is due to situational stressors and would most likely have an Adjustment Disorder diagnosis.  If someone is given a diagnosis like Major Depressive Disorder, this diagnosis and the accompanying symptoms will not necessarily remain forever.  Symptoms usually go into remission and then a Major Depressive Disorder diagnosis would no longer fit the symptom criteria.

What is the purpose of having a diagnosis?

Clinicians use a diagnosis is to identify symptoms that are causing psychological distress and/or maladaptive ways of coping. The symptoms are what psychotherapists use to develop treatment plans.  In addition, a diagnosis is used to provide a third party payer (insurance) a category of symptoms that for treatment. If using insurance, a diagnosis and treatment plan is required in order for services to be paid. A mental health diagnosis is comparable to a medical diagnosis that a physician would need to share with your insurance company for reimbursement.

Sometimes, clients opt to pay for services out of pocket to avoid a diagnosis being disclosed. This is an individual choice. If this is something you are interested in, we can discuss possible direct fees for psychotherapy.

Will I need to take medication? And is medication a substitute for therapy

In some cases a combination of medication and therapy is the best course of action. Please be aware that I am not trained to prescribe medications. Working with your medical doctor, you can determine what is best for you. We can also talk together about whether a referral for a medication evaluation would be helpful. These are typically done by a psychiatrist, a nurse practitioner or sometimes by your primary care physician.  A medication evaluation is a comprehensive medical assessment to determine if medication would be useful in symptom relief during therapy. Medications are not always necessary and if they are, they may be time limited while we work together on improving coping skills. It has been well established that the long-term solution to mental and emotional problems and the pain that comes with them cannot be solved only by medication. Instead of simply treating the symptom, therapy addresses the cause of distress and identifies the behavior problems that impede progress. However, research has shown that the best treatment outcome for depression is a combination of therapy and medication management. Taking medications is an individual choice. We can discuss your past experience with medication, medication compliance and possible chronic medical conditions at your first or second session. My belief is that sustainable effects of therapy are best obtained through an integrative approach of body, mind, emotions and spirit. If you are taking prescribed medical or psychotropic medications prior to starting therapy, please bring a list of your medications with you to your first appointment with me.

How long does therapy last?

There are so many variables that determine how long someone participates in therapy. Sometimes people use therapy for situational stressors as a way to maintain good mental health. This is a way to have an objective source of support outside of family and friends. Sometimes people come in to therapy when there is a life crisis- such as a death of a loved one or a divorce. They may need several sessions of therapy to sort things out. It really depends on what your needs are. Although you are always free to discontinue therapy at any time, I encourage you to choose a planned termination date. This allows us time to wrap up your therapy and solidify the gains you have made to ensure continued success. My goal is to always to “work myself out of a job;” I you to lead the best life possible as soon as possible,

Will my therapy be confidential?

Whatever you share with me in the context of a therapy session is both personal and confidential. Ethics of privacy are held in high regard in terms of protecting each client’s confidentiality. No information is disclosed without prior written permission from the client.

There are certain situations where information may be disclosed such as consent that you sign releasing information for coordination of treatment with other providers and/or with third party payers (insurance companies) for continuation and payment of therapy.

The only other instances when I, as your psychotherapist would be required to breech confidentiality would include:

  • Suspected child abuse or dependent adult or elder abuse. In such instances, therapists are required to report this immediately to the appropriate authorities.
  • If a client is threatening serious bodily harm to another person, the therapist is required to call 911.
  • If a client intends to harm him/herself or others, the therapist will make every effort to work with the client to ensure their safety. If an individual is not cooperative, safety measures may need to be made for the client’s safety, such as psychiatric hospitalization. 

Will you be available 24/7 if I should have a crisis?

I am not always available 24/7. In the event of a psychological or emotional Emergency, please contact the Twin Cities Crisis Connection at (612) 379-6363 or call 9-1-1 if you are experiencing thoughts of to harm yourself or others. If you are not experiencing a life threatening emergency, you may leave me a voice mail at 763-443-3348 and I will call you back between 8am and 10 pm Central Time. When I am out of town, I will have therapist colleagues who will be available to provide back-up for you in event of a non-threatening crisis.

How can I pay for this? Do you take insurance? How does insurance work?

If you are using health insurance to pay for services, check with me regarding whether I am in network or out of network with your carrier. If in network, I will submit for reimbursement on your behalf. If out of network, I will provide you a receipt that you can use to submit to insurance. You will want to contact your insurance company to check on the following:

  • What are my outpatient mental health benefits? Do I have coverage (for individual or couple) counseling?
  • What is the coverage amount per therapy session with an out of network LICSW?
  • How many therapy sessions does my plan cover each year?
  • How much does my insurance pay for an out of network provider?
  • Is approval or referral required from my primary care physician?
  • How do I submit a claim for reimbursement for an out of network provider?
  • Can I use my HRA or flexible spending account to pay for services?
  • Do I have a deductible? If so, is my deductible combined with medical and behavioral benefits or is it a separate deductible? Has my deductible been met?
  • Is there anything else I need to know?

You may also qualify for reimbursement under another employee benefit plan, such as a HSA (Healthcare Savings Account), or a FSA (Flexible Spending Account). Reimbursement from a HSA often has fewer restrictions.  If you have a credit card connected to an HSA, I am able to accept payment through my Square iPad application.

What are your fees and how can I pay them?

If you have an authorization for EAP sessions, there is no charge whatsoever to you or your dependents who receive EAP counseling with me.

My fee is $120 for a 50 minute therapy session. My fee for an extended session of 80 minutes in length is $180. At times I am able to provide therapy on a sliding fee scale. Please inquire about this if you are not able to afford the full fee for service charge. Fees or copayments are due at time of each session. Payment is accepted by cash, check or by any major credit card.

I am happy to provide you with a receipt that you can submit for your flexible spending account if you have one.

At this time, I do not accept insurance. We could discussion possible options: 1) if you have an HSA account, to pay for sessions directly from your HSA; 2) to pay me directly by check or credit card and submit to your insurance provider. This can be applied to your out of network insurance deductible. For additional information, go to my rates and insurance page.

What forms do I need to fill out?
Here is a downloadable link to my intake forms. The same forms are also available in my Helpful Forms section. 

Contact Information

Nancy Duffey Black, MS, LICSW
Duffey Black Consulting, LLC
Specializing in Critical Incident Response Services
Madison Lake, MN 56063
(763) 443-3348 (P)
Nan@DuffeyBlack.com

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Copyright 2020 Nancy D. Black, LICSW, CEAP, SAP, LLC
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Last updated: Sunday February 09, 2014