It’s normal to have questions about therapy.  If you don’t see your question answered here, please reach out to us via email or give us a call.  It is important to us that you feel comfortable and informed as you contemplate starting counseling.


What forms of payment do you accept?

Cash, check, or credit card payment.

Please note that registration with the client portal includes supplying a current credit card that can be securely kept on file. This credit card may be used for automatic billing if that is your preferred method of payment or in the event that you have a late cancellation, it may be used for a missed session.

Do you take insurance?

Not directly, no. We are not considered in-network with any insurance companies and do not directly bill them. We do, however, provide you with a “superbill,” which is a receipt for clinical services that includes all of the information the insurance company would need to process an out of network claim. Many of our clients find that their policies offer some out of network benefits that can defray a substantial portion of the session fees. Healthcare flexible spending is another option for reimbursement.

Determining out of network benefits is the responsibility of the client. Please call your insurance company in advance of your first appointment to help avoid unpleasant surprises.

Some questions that may be helpful to ask your insurance company representative:

  • Do I have mental health insurance benefits?
  • What is my deductible and has it been met?
  • How many sessions per year does my health insurance cover?
  • Are distance counseling sessions (video, phone, email) covered under my plan?  (The location of services — if your insurer asks — is 02 for distance services.)
  • What are my mental health benefits for out-of-network providers?
  • What is the coverage amount per therapy session?
  • Is approval required from my primary care physician?

Your insurance provider may ask you some questions in return about what service you are receiving.  You will want to provide them with some specific CPT codes (these are the codes that identify to the insurance company that you are receiving some kind of mental health treatment and how long the session last) to ensure they are covered.

*Please note that these codes typically refer to in-person and video sessions, not email or phone sessions, which are much less likely to be covered.

  • 90791   Psychological Diagnostic Interview (typically just the first session)
  • 90834   Individual Psychotherapy, 45 Minutes
  • 90837   Individual Psychotherapy, 55-60 Minutes
Why should I work with you?

The truth is that not every therapist is going to be a good fit for you.  For all of the advanced degrees, training, and experience that therapists have, we all know one humbling thing to be true: the most important element for therapy to be successful is the quality of the relationship between you and your therapist.

While we can’t guarantee that you and your therapist will click, what we can commit to you is that we regard good fit as an “of course” that you deserve to have.  If it’s not there with one of us, you won’t get pressure tactics or lengthy, uncomfortable questioning; in fact, we will offer you
referrals or suggestions for finding a new therapist, even outside of our practice.  We believe in the power of good therapy to change lives and genuinely want the best for anyone who crosses our paths.

If this approach appeals to you and you would like to make an appointment, please request a convenient time in the client portal and we will be in touch soon.  Thank you for the chance to work with you.

Should I submit to insurance? Yes or No?

The decision to submit your receipts to your insurance company is one you should weigh carefully.

The Pros

  • Cost. If your insurance provider will pay for part or all of your therapy fees, it can help keep costs down.
  • Monitoring. Your insurance company requires that your therapist stay current with paperwork and document progress and have the ability to audit records to ensure compliance.
  • Easy Referrals. Your insurance company  maintains a list of area providers that are within theirnetwork.

The Cons

  • Diagnosis. To access your insurance benefit, your assigned therapist is required to assign you a mental health diagnosis, which will become part of your MIB profile. MIB is the Medical Information Bureau and is the centralized clearing house for health insurance usage – performing essentially the same task as the credit bureaus do for your financial information.
  • Loss of confidentiality. The insurance company may require ongoing information from your therapist regarding why you are going to therapy and what progress you are making. They can audit your therapist’s files and request clarification from your therapist regarding your issues.

* Please note, however, that your therapist will only offer them the basic information to which they are entitled.  If you have any questions about that, please ask.

  • Limited choice. Seasoned clinicians often choose to stay out-of-network rather than joining insurance panels due to the cons listed above. Your choice of therapists within-network may be limited.
  • Potential issues with seeking life insurance coverage. Depending on the diagnosis that your therapist assigns to you, some life insurance companies may see you as a heightened risk, choosing to raise your rates or deny you coverage altogether. It is a good idea to secure life insurance in advance of beginning therapy for this reason.

* Please note that this information is not intended to scare you from using your insurance coverage or to scare you from seeking help when you need it.

While the “cons” are important considerations, we have many clients who do opt to seek reimbursement from their insurance companies and have not reported negative consequences.

Is it normal to be nervous about counseling?

It can feel anxiety-producing to talk with someone you have never met about highly personal issues.

New clients often have questions:

What should I talk about?

Where should I start?

There’s no right or wrong way to begin talking about the issues that are important to you. Your therapist will help to get you started by providing you with information about how we work, asking you questions, and beginning to collaborate with you on getting what you need out of the counseling session.

Will it get easier to reach out?

It may feel daunting to you to reach out and make an appointment. We understand and work hard to make accessing help as easy for you as possible. With an online appointment scheduler so you can make or cancel appointments on your own, email communication so you can communicate
in your own time without pressure, and a warm, supportive attitude so you know we’re here to help, we can work through your initial discomfort and establish a positive, supportive, collaborative relationship.

I’ve always felt this way so maybe I always will. How can counseling help?

It’s common to feel doubt or despair about the possibility of getting help, especially if you feel like you have tried everything already.  It can be helpful to think of therapeutic change as happening in a spiral, rather than a straight line. When we have emotional issues or situations, rather than getting past them and never having them happen again, we re-visit them, but hopefully each time we circle around a little faster and at a higher plane. The therapists at Nova Terra have worked with many people who have started out feeling hopeless but are later thankful that they gave therapy another try.

Will my therapist judge me?

We’re all human and have parts of our lives that are going less well than others. We also make mistakes. Your counselor’s role is not to be your judge and jury but to help you understand the context in which you made some choices you may regret, to gain insight into what thoughts and feelings made those choices seem “right” at that time, to help you cope with feelings of sadness, shame, and regret, and to figure out how to have a happier present and future.

Our job is to hold out hope and optimism for clients’ futures, even when they can’t see or feel it yet for themselves. We work on helping these clients make sense of the past, accept responsibility where necessary, and let go of corrosive shame. One client, said to Elizabeth as she finished treatment, “You are the first person who didn’t treat me like one big sickness. You believed in me.”

What can I do to improve faster?
Effective therapy is the result of the quality of our collaboration, but also of the individual work we each put in behind the scenes. Clients can help their symptom alleviation significantly by doing a few things:
  1. Being willing to practice new skills or ways of thinking outside of therapy.
  2. Doing some pre-planning for the session i.e. coming in with specific issues you’d like to discuss or observations you’d like to share.
  3. Writing down notes from each session.
Therapy content is a bit like the stuff of dreams: it can feel so vivid and real that you’re sure you will never forget that particular insight or realization but then — in the process of getting on with regular life — it can suddenly be hard to recall. Writing will help you solidify what you are learning and give you a record to come back to later. It can also serve as a reminder of how far you have come.