Payment is required at each session, and 24 hour notice is required for all appointment cancellations.

Cancellations and re-scheduled sessions will be subject up to the following charges if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you may lose some of that session time.

—More than 24 hours notice = No Charge

—Fewer than 24 hours notice = Automatic $50 charge

—Fewer than 6 hours = Automatic $75 charge

—No Show-no attempt to cancel = Automatic $100 charge

If you are an Oregon Health Plan member, please be aware that although a fee will not be assessed for late cancels or no shows, we reserve the right to remove you from our active client list if you have more than 3 late cancellations or no-shows within a 6-month period. Should that occur, you would be placed on our waitlist, behind anyone else who might already be waiting.

Trellis Counseling is currently contracted with the following, although not all clinicians are contracted with all insurances listed:

• Regence/Blue Cross/Blue Shield
• Aetna
• Cigna
• UnitedHealthcare
• Providence
• PacificSource
• Medicare
• Moda
• HealthShare
• Trillium Community Health Plan

What kinds of things do people seek help for?

People seek therapy for a variety of reasons including feeling unhappy, unfulfilled, worried, sad, or angry.  People also seek out therapy to help change behaviors that are troubling them including addictive or disordered behaviors or behaviors that affect their relationships at home or at work.  Some people seek therapy because they have a life goal that has been eluding them and they are ready to explore their barriers.  Other people seek out therapy because they know they are going through a difficult time or facing a difficult decision and they desire a place to sort through their feelings and move forward in their life with intention and clear thinking.

Do I really need therapy?  I can usually handle my problems.

Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you're at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.

How can therapy help me?

A number of benefits are available from participating in therapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that therapists can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:

• Attaining a better understanding of yourself, your goals and values
• Developing skills for improving your relationships
• Finding resolution to the issues or concerns that led you to seek therapy
• Learning new ways to cope with stress and anxiety
• Managing anger, grief, depression, and other emotional pressures
• Improving communications and listening skills
• Changing old behavior patterns and developing new ones
• Discovering new ways to solve problems in your family or marriage
• Improving your self-esteem and boosting self-confidence

What is therapy like?

Because each person has different issues and goals for therapy, therapy will be different depending on the individual.  In general, you can expect to discuss the current events happening in your life, your personal history relevant to your issue, and report progress (or any new insights gained) from the previous therapy session.  Depending on your specific needs, therapy can be short-term, for a specific issue, or longer-term, to deal with more difficult patterns or your desire for more personal development.  Either way, it is most common to schedule regular sessions with your therapist (usually weekly).

It is important to understand that you will get more results from therapy if you actively participate in the process.  The ultimate purpose of therapy is to help you bring what you learn in session back into your life.  Therefore, beyond the work you do in therapy sessions, your therapist may suggest some things you can do outside of therapy to support your process - such as reading a pertinent book, journaling on specific topics, noting particular behaviors or taking action on your goals. People seeking psychotherapy are ready to make positive changes in their lives, are open to new perspectives and take responsibility for their lives.

How long does a therapy session take?

Sessions are typically scheduled for 55 minutes and most people see their therapist once a week for consistent progress to be made.

How much does therapy cost?

A typical therapy session costs $225+.  While many clients are initially very concerned about whether or not they can afford therapy, most find that as their life and priorities change new ways of funding therapy appear--whether through less need to consume to distract from pain or through new means of income due to increased energy and investment in life.

What about medication vs. psychotherapy?  

It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness. Working with your medical doctor you can determine what's best for you, and in some cases a combination of medication and therapy is the right course of action. For those that need financial assistance, we do offer a sliding scale.

Does what we talk about in therapy remain confidential?

Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office.   Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone.  This is called “Informed consent”.  Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your Physician, Naturopath, Attorney), but by law your therapist cannot release this information without obtaining your written permission.

However, state law and professional ethics require therapists to maintain confidentiality except for the following situations:

• Suspected past or present abuse or neglect of children, adults, elders, and those considered disabled to the authorities, including Child Protection and law enforcement, based on information provided by the client or collateral sources.
• If the therapist has reason to suspect the client is seriously in danger of harming themself or has threatened to harm another person.

Do you take insurance?

We are currently credentialed with Regence/Blue Cross/Blue Shield, Aetna, Cigna, UnitedHealthcare, Providence, PacificSource, Medicare, Moda, HealthShare, and Trillium Community Health Plan although not all clinicians are credentialed with all insurances listed.

For other insurance panels we are considered "Out of Network". For these full payment is due at the time of service and we can then provide our clients with a “superbill”, a form that assists the client in seeking reimbursement by including what most insurances want: CPT (procedure) codes, diagnoses, etc. Most insurance plans do not cover 100% of all charges. It is the responsibility of the client to pay the full cost of services at the time they are rendered and to engage with their insurance company regarding reimbursement.

What happens during the first appointment?

If you decide to start therapy you can call us at: 503-659-3480 and set up your first appointment called the “intake session.” You will be provided with paperwork to fill out prior to the first appointment and you are asked to fill that out at least 48 hours prior to the scheduled appointment to give the therapist time to review the forms prior to meeting with you. If you are unable to fill the paperwork out at least 48 hours prior to the appointment, we must cancel your appointment. We will be happy to reschedule the intake appointment one time once the paperwork is completed.

It is important to understand that your first session is not really therapy. Like all clinics, therapy starts with the intake session. It is an intake session because your therapist has to “take in” information about you and your situation in order to begin to create your individualized treatment plan.  Sometimes the intake will be continued into your second session; it all depends on how much information is gathered in the first session. Your therapist will let you know if the intake needs to be continued for your second session.

Once the intake is complete, your therapist will come up with an appropriate diagnosis and create an individualized treatment plan to address your situation and work on healing. You and your therapist will go over your treatment plan and address any questions. After the intake session is done and the treatment plan is completed, therapy begins.

How long will therapy take?

Although none of us can predict the future, the treatment plan that your therapist creates for you will have a completed section regarding the “anticipated date of resolution” which is the estimated end date for therapy. This date may be 3-6 months of therapy for issues that are more minor (for example, “adjustment disorders”) or maybe 6-12 months for issues that usually take longer to treat (for example, abuse, trauma, depression, anxiety, marriage therapy, etc.). Depending on your therapist’s diagnosis and treatment plan, your therapist may recommend appointments be scheduled on a weekly, bi-weekly, monthly or bi-monthly basis. We believe that a good therapist is about empowering clients to work toward healing and thus no longer needing therapy.

What if there is a lapse in sessions?

If you or your therapist decides to wait longer than a month between sessions, your therapist will probably do a quick “clinical update” which consists of a few questions regarding current symptoms and other information. This update usually only takes about five or ten minutes to complete. Depending on the schedule you and your therapist have determined to be the best fit for meeting together, should you do not schedule or fail to attend sessions over a 3 session period (e.g. 3 weeks for weekly sessions, 6 weeks for bi-weekly sessions, etc.) it may be necessary to inactivate your file. Should that happen we will reach out to you with information via the client portal and/or the USPS about getting rescheduled. If we do not hear from you in the allotted time fame, we will assume you no longer wish to engage in therapy at this time. Should your situation change and you would like to re-engage in therapy, please call 503-659-3480 to discuss getting rescheduled.

Do you have a sliding-fee scale?

If there are financial difficulties interfering with your ability to pay, we are willing to set up a payment plan and, for those that need financial assistance, we may be able to offer a sliding scale. Please contact the office manager for more information before scheduling the intake session.

What do LCSW, LPC, CSWA stand for? And what is a Professional Counselor Associate?

LCSW are the initials to indicate a Licensed Clinical Social Worker and LPC indicate a Licensed Professional Counselor.  This means that the clinician has a Master's Degree in Social Work or Mental Health Counseling and has completed the necessary requirements to be fully licensed in the state of Oregon. Licensing requirements include completing 3,500 post-Master's level work hours under the supervision of an LCSW or LPC and passing the licensing exam in social work or a national counseling exam. CSWA and Professional Counselor Associate denote pre-licensed clinicians as they complete their post-Master's level work hours under the supervision of an LCSW or LPC and passing the licensing exam in social work or a national counseling exam.

What happens during inclement weather?

Our inclement weather policy is based on a philosophy that no one should feel they have to risk life and limb to avoid a cancellation fee. Therefore…

Telehealth sessions are a great option! If not...

If we don’t feel our staff can drive safely to the office or cannot work remotely, we will call and/or e-mail you and ask to reschedule. Please call your therapist and double check if you have not heard from them and the weather is questionable. Our therapists’ extensions are available on our staff page.

If you don’t feel safe and prefer to stay home, PLEASE call your therapist to ensure contact ASAP so that we can adapt our schedules (e.g., stay home, come in later, leave early, eat lunch, offer the time to others, etc.). If you do this there will be NO cancellation fee. If you no show, without making contact, then we will ask you to pay our regular no-show fee.

If we cancel counseling due to inclement weather (we follow the North Clackamas School District closure/late opening weather schedule), there is no charge to you for the cancellation. We post notices of the cancellation on our Facebook page and send out an email to everyone on the calendar. We may be able to offer Telehealth sessions when we have cancelled counseling hours at the office as an alternative.  We realize that there is nothing any of us can do about the snow or other types of inclement weather, so this is a viable alternative when a session needs to occur despite the weather. If we are only offering telehealth options due to inclement weather and that is not an option for you, with notice regarding this there there will be no charge for the cancellation.