In my many years of working with adolescents (especially those with ADHD or similar traits), I have found that sticking to a rigid 50 minute session can be counterproductive. My experience has led me to understand that counseling with adolescents is only effective as long as they are mentally present, engaged, and actively participating. That does not mean "as long as they are liking it", but rather recognizing and accepting that they have certain thresholds of tolerance. Once we've reached that threshold there may be some benefit to "push just a bit" to help them stretch their ability to stay focused. But beyond that point, it is unlikely that much more of benefit will take place.

Rather than making more progress, forcing them to "endure" another 10 or 15 minutes of discomfort after they are 'done for the day' is more likely to increase their dislike, animosity, and future resistance toward counseling.

In traditional counseling (as when it occurs in the home community)  the parents are quite often at the session. In that case, the extra time 'on the clock' can often be used immediately with the parents. In a residential setting, that option is not available. However, when a child is in a residential setting there are other requirements on a counselor's time that are unique to residential settings and quite important for effective counseling in such settings.  (See the next section for details)
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When I work with a child as a therapist, I am also available to the Talisman staff if they wish to call and consult on concerns that may occur between sessions. In addition, since you (the parents) are not available at the time of the session, I allocate up to one hour monthly for communication with you.  All of these activities are included in the session fee.

There are a few activities that are not covered by the standard fees; but these are not common and would only occur with your prior consent. This could include things like collaboration with other professionals (psychiatrist, previous therapists, educational consultants), participation in educational or treatment planning meetings, or providing written reports at your request. It may also include documentation for insurance purposes, if your insurance company requires specific treatment plans or method of reporting progress. Since these activities often take a significant amount of time, they are considered additional services and do involve additional costs. But again, none of these will be done without your prior knowledge and approval.
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If you select the monthly 'pay as you go' method, I will send you an invoice at the end of each month for the services that occurred during that month. I do appreciate your prompt attention to these invoices, since I am essentially providing 3 -- 5 sessions to your child "on credit" and in good faith that the payment will be made promptly. The downside of this arrangement is that it requires temporarily suspending counseling services, if payment is not received by the due date.

If you use the prepayment discount you will start out the semester with a credit on your account. You will still receive a monthly invoice showing what services were provided in that month. In addition, you will be provided with a monthly statement showing what was deducted from your credit and the balance remaining. (More about the prepayment option is in the next section.)
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If you elect to use the prepayment option, any additional services that you might request during the semester, e.g., educational meetings, consultations, emergency sessions, will also receive a 10% discount.

The prepaid amount for the 2012 spring semester is $1620. This includes the projected 20 counseling sessions and supplemental support listed above.

Prepayment  is offered with a prorated adjustment for any students who begin their counseling on or before the first session in March, which this semester will be March 7, 2012.

Terms for prepayment:
If for some unavoidable reason (inclement weather, illness, etc) the prepaid sessions are not fully used, you will be reimbursed for any unused sessions at the end of the semester. Reimbursement is not made for sessions when I have made myself available on campus at the scheduled time and the session does not occur due to the student's refusal to participate, scheduling changes made by the school or parents, deviations from the initial Talisman Fall 2011 schedule, or errors made by other parties that prevent the session from occurring.

Incomplete Semester refund: If your child does not remain enrolled in Talisman for the full semester you will be refunded the unused balance of your prepayment; however the 10% discount will not apply. Any services provided up to the time of discharge will be adjusted back to the standard Talisman rates.

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 "Yes" refers to the fact that over the past 15 years it has been extremely rare that an insurance company has not paid for my counseling with a child in residential care, provided the parents' policy covers of such services. Only once has an insurance company denied payment due to my credentials or licensure; when the policy specified reimbursement could only be made for doctoral level psychologists.

"No" is because I do not file claim or receive payment directly from the insurance company. Also, I am not currently a 'provider' on any insurance panels. However, that does not mean you cannot get insurance payments for my services. But, you will need to file your own claims. On your monthly invoices I provide you with all of the information that is typically needed to file for insurance payment. Most parents who have used my services in residential settings have received insurance reimbursement... which leads to the "possibly" section.

The "Possibly" part refers to the widely varying terms that different insurance companies and insurance policies have regarding the reimbursement for counseling. If outpatient counseling is covered by your policy, most likely you will be eligible for reimbursement per the terms of your policy. Even policies that 'require' you to use one of their network providers are likely to make an exception due to the unique circumstances related to your child's enrollment at a residential school (being an isolated location and the therapeutic benefits of the counselor coming to the campus.)

IMPORTANT: If insurance reimbursement is a critical concern, I strongly recommend that you contact your insurance provider ahead of time to secure pre-approval before starting services with me. Some companies require this, even when counseling is clearly a covered service. But it 's a good safeguard even if it's not required; because insurance companies don't always play fair, especially when it come to mental health services.

There are times when dealing with insurance companies for payment of counseling services can be quite challenging. Also, there are a number of related issues that I encourage all parents to consider before using insurance for mental health services with their children. If you want more complete information please review the INSURANCE page and the INSURANCE FAQs of my main website or give me a call.

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When counseling takes place with a child living at home, his/her interactions with the family are constant and fluid, requiring a fairly high level of communication with the parents.  However, in a residential setting the focus of counseling is usually less directly about the family interactions; and subsequently the immediacy of feedback with the parents is not as critical.  In addition, counseling in a residential program usually focuses on the students interactions within that program. Just as the Talisman Academy program is designed to provide a slow and steady guidance for a student to make changes, the same occurs in counseling.  Of course, there are occasions when something occurs that is more urgent or requires action on your part. In those instances I will call you.

I do recognize it is difficult to have your child away from home and occasionally you will feel the need to just "check in".  So please don't let the "once a month" arrangement cause you to hesitate about calling any time you want to touch base with me.

I also try to be available on the family visit weekends to meet in person with the parents of the students I am counseling. However, Talisman often has activities for parents around these visits, so meeting with you usually will require a scheduling a separate time to meet at my Asheville office. (see more below)
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Here's what I can do to try and make in person meetings possible.

1) I am usually at Talisman Academy on student arrival day of the semester for the purpose of meeting with parents, especially those who have students newly enrolled. Talisman is very helpful about coordinating my schedule with parents who are interested in meeting with me. The Talisman staff in charge of that changes each semester, but you can simply call their office and let them know you'd like to see me on opening day and it will get scheduled. PLEASE schedule in advance, as my schedule on these days is often full and impromptu meetings may not be possible.

2) Talisman Academy seems to schedule a pretty full day during the family visits to the campus, so it usually doesn't  work for me to meet with you on campus at those times. However, I do try to keep my schedule open before and after your day on campus. So, if your arrival and departure allows for it, quite often we can arrange to meet at my Asheville office. On weekend visits, some parents like to schedule a session with me during the time they have their child with them off campus.

3) I also try to hold my schedule open on the day of departure for the spring break and at the end of the semester. Again, Talisman has a tight schedule for those days, so meeting on campus is not always an option. But, if you are coming to pick up your child at Talisman for the break, we may be able to schedule a time to meet at my Asheville office around the break.

(Please note that meetings at my Asheville office are additional services, unless we are substituting them for our monthly phone call.)

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