Common Questions
Frequently Asked Questions
Getting Started
How do I know if therapy is right for me?
Many people believe they need to be in a state of crisis to start therapy, but this is a misconception. Therapy is right for you if you feel ‘stuck,’ even if your life looks ‘fine’ on paper. You might benefit from therapy if:
Common stressors like work, relationships, or parenting are feeling harder to manage than usual.
You are navigating a breakup, a career change, or a loss and want a neutral space to process it.
You keep ending up in the same types of relationships or reacting to things in ways you later regret.
You aren’t necessarily in pain, but you want to grow, improve your self-esteem, or find more meaning in your daily life.
What should I expect in the first session?
The first session is an initial diagnostic evaluation and “getting to know you” appointment. You can expect to be asked about your personal history and background, previous mental health history, and current symptoms you are experiencing. This allows your clinician to design a treatment plan tailored to your needs.
What issues do you specialize in?
This will vary somewhat based on the clinician, so please check out our clinician profiles for more detailed information. In a general way, we are an outpatient generalist practice and work with clients who are looking for outpatient services. Common issues we treat include relationship challenges, career and financial difficulties, self-esteem and identity issues, life transitions, and grief and loss. Anxiety and depression are the most common diagnoses that we see, but we also work with clients who have non-acute PTSD, bipolar disorder, OCD, and trauma history. Issues that might require someone with specialized training include eating disorders and diagnosed personality disorders.
Is my information kept confidential?
Explain HIPAA compliance and mandated reporting limited exceptions.
How does scheduling work?
During your consult call, your clinician will ask you about your scheduling needs and constraints to find a mutually available time. Most clients who have a regular work/school schedule prefer to have a standing weekly appointment at a particular day and time. If your schedule is more variable, you can elect to schedule week to week.
Insurance & Payment
Which insurances do you accept?
We are in network with:
- Anthem Blue Cross/Blue Shield
- Blue Cross/Blue Shield
- CIGNA
- Sentara
- United Health Care
- Medicaid (all carriers except Aetna)
- Medicare
Please note that not all providers are in network with all carriers. Including your insurance carrier in your inquiry will help us match you with a provider who is in-network.
Why do you need a credit card on file?
Having a card on file allows us to provide services seamlessly and without having to deal with payment issues in session, reserving your valuable time for therapy services. If your card is declined, our practice manager will contact you for an updated payment method. Please update your payment information expeditiously, as services will be paused if you are carrying a balance.
How does the payment process work?
Our office manager will verify benefits ahead of your first appointment if you are using insurance. Your copay, coinsurance, or deductible amount will be determined and you will be notified of the amount. This amount will then be charged to the card on file on the day of each appointment.
What should I do if my insurance information changes?
If your insurance changes, please either let your clinician know as soon as possible, or reach out to our practice manager [include contact info?]. If your new insurance will not be in network, we can work with you to make self pay doable, or we can provide referrals who will be in network with your new insurance.
Appointment Questions
What should I do if I need to cancel an appointment?
Periodic cancellations are expected, and are not a problem. Please reach out directly to your clinician via email, text, or via the client portal to let her know. The more notice you can provide, the better – it is never too early to mention a date when you know you will be out of town or on vacation. This will allow your clinician to offer the slot to another client who might need it.
Is there a fee for cancelling an appointment?
Our practice policy allows for cancellations at least 24 hours in advance of the appointment without penalty. More notice is always appreciated, if possible. If you need to cancel an appointment less than 24 hours ahead, there is a $100 cancellation fee. This fee is waived once as a courtesy, and can also be waived in case of a documentable emergency. The fee also will be waived if the appointment is rescheduled within the same calendar week.
How do I reschedule an appointment?
Please reach out directly to your clinician via email, text, or the client portal to reschedule your appointment. Reschedules are subject to availability but we will make every effort to work with you to find a mutually available time. If you need to convert an in-person appointment to virtual, this is also an option.
What is your inclement weather policy?
In the rare event that road conditions are unsafe due to inclement weather, your clinician may convert in-person sessions to virtual for that day. She will provide as much advance notice as possible when this occurs. In addition, if your clinician will be in office but you feel that road conditions are unsafe, you always have the option to have a virtual session instead.
Do you offer evening or weekend appointments?
Many of our providers offer at least a few evening appointments, please be sure to include this request in your inquiry if it is important to you so we can match you with a provider who has an evening opening. Aregnaz Malaykan offers weekend appointments.
How Therapy Works
How long does therapy take?
There is no one size fits all answer to this question. The length of therapy will vary based on the client’s needs, goals, diagnoses, and presenting issues. On average, people tend to stay in therapy for a period of months, but some clients will need or want to keep going past the year mark, and we welcome clients who hope to form a longer term partnership with their clinician.
What do sessions look like?
At base, a therapy session is a dynamic, collaborative conversation held in a comfortable, confidential space (whether that’s in an office or via a secure video link). While every session is tailored to your unique needs, most follow a similar, natural flow:
1. The “Check-In”
We usually start by touching base on your week. This isn’t just small talk; it’s a chance to highlight any “wins,” new stressors, or reflections you’ve had since we last met. We’ll also check in on any “homework” or new tools you tried out during the week.
2. Setting the Agenda
Therapy is your time. We’ll decide together what the “priority” is for the day. Perhaps there is a specific conflict you want to untangle, or maybe you want to dive deeper into a long-standing pattern we’ve been tracking. You are always in the driver’s seat.
3. Exploration
This is the heart of the session. We’ll explore the thoughts, feelings, and body sensations connected to your current challenges. Your therapist will offer reflections, ask clarifying questions, and help you connect dots that might be hard to see on your own.
4. Practical Integration
Before we wrap up, we transition from “exploring” to “applying.” We might practice a grounding exercise, role-play a difficult conversation, or identify one small, manageable goal for you to focus on before our next meeting.
5. The Closing
We take the last few minutes to “land the plane.” We’ll summarize the session, ensure you feel grounded and regulated before stepping back into your day, and confirm our next appointment time.
Why do you recommend weekly therapy appointments?
One primary reason: momentum. Think of therapy like learning a new language or starting a fitness routine. If you only practice once every few weeks, you spend most of your time “re-learning” what you covered last time. By meeting weekly, we can spend less time “catching up” on the events of your week and more time doing the deep, transformative work you came here for.
The benefits of a weekly rhythm include:
Building the foundation: In the beginning, we are building a “therapeutic alliance.” Meeting weekly helps us establish trust and safety much faster.
Consistency for the nervous system: For those working through anxiety or trauma, a consistent, predictable schedule helps signal to your nervous system that support is a reliable constant in your life.
Faster integration: Weekly sessions allow us to check in on your progress and tweak strategies in real-time before old habits settle back in.
Accountability: It is much easier to stay committed to your personal goals when you know you have a dedicated space to check in every seven days.
Does it stay weekly forever? Not necessarily! As you begin to feel more grounded and reach your initial goals, we often discuss “titrating” or tapering down to bi-weekly or monthly “maintenance” sessions. Our goal is to eventually give you the tools to be your own therapist—but weekly sessions are the most effective way to build that toolkit.
What therapy modalities do you use?
This will vary somewhat by clinician, but in a general way, our practice employs an eclectic or integrated approach in which principles from various modalities, such as CBT, DBT, ACT, EFT, psychodynamic therapy, and attachment based and relational therapy, are utilized based on the needs and goals of the client.
What should I do if I feel my clinician is not a good fit?
The therapeutic relationship is the most important factor in the success of therapy in helping people feel better. Not every therapist is going to be the right match for every client, and that is okay! Please do not hesitate to bring up any reservations you are having with your clinician directly. We promise, it does not hurt our feelings! Our goal is for you to get the best care possible and to achieve your therapy goals. If there is something you were hoping to get from therapy, such as structure, weekly homework, having your thinking challenged, etc., your clinician would welcome the opportunity to offer it. Or, if after a candid conversation, you mutually decide that it is not a good fit, your clinician can work with you to find a referral either within or outisde our practice who will be able to better meet your needs.
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