Frequently Asked Questions
At Ampersand Counseling, we understand that reaching out for help can feel overwhelming, especially if you’re used to handling things on your own. Therapy, much like the unknown, can be scary when you have more questions than answers. This is why we’ve answered some of the most common questions people have asked us about therapy and our clinic specifically below.
Feel free to browse them all or jump to the section you’re most interested in to get started.
Common Therapy Concerns
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Absolutely not! We get it though. Many of us grew up being told this. Therapy isn’t a sign of weakness – it’s a sign of courage and self-awareness.
Choosing to ask for help can be an incredibly empowering decision. Life presents challenges for everyone at some point and you don’t have to deal with them alone. Getting help through therapy demonstrates a desire to truly heal and grow – to move through your struggles, not around them. Our team can help you face life’s challenges head-on and navigate them with insight, care and effective strategies.
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In short, therapists provide three things: objectivity, expertise, and confidentiality!
Everyone needs a support system and your friends & family can offer comfort and encouragement. It’s hard to be objective about those we love so sometimes their support comes with conflicting or unhelpful advice or what feels like judgement.
Therapists provide unbiased, professional support grounded in clinical expertise and training. Therapy gives you the space to explore your thoughts, feelings and experiences in a safe, confidential setting. Therapists offer an objective perspective, along with evidence-based strategies and structured guidance. Therapy isn’t just about venting, but about working toward meaningful change.
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Medication can be a helpful tool for managing certain, specific symptoms. However, it doesn’t address any of the underlying behavioral patterns that therapy explores.
Therapy helps you understand and work through the root causes of your challenges. For some clients, the combination of medication and therapy is incredibly effective, and others achieve their desired growth through therapy alone. Our team won’t push medication, but we do recognize its benefits for many. As with everything, we’ll collaborate with you to determine what feels right for your journey.
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Even if you’re not in crisis, we believe most people can benefit from therapy.
Let’s face it, life can be hard. We’re all dealing with a number of challenges and issues on a daily basis. Therapy can provide real benefits for managing stress, improving relationships, understanding yourself better, and managing the daily struggles of life. Some of our clients are dealing with a diagnosis or experiencing a mental health crisis, but most are just looking to grow and improve their life. Often times, dealing with struggles head-on when they’re still manageable can prevent a mental health crisis in the future.
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Yes. Therapy can be unsuccessful for a number of reasons. Often it’s because the timing, the fit with the therapist, or a specific method just wasn’t quite right. Not every method or therapeutic relationship is the right fit the first time.
Our team will take the time to understand what has or hasn’t worked in the past so we can offer a more tailored, effective experience. Our therapists draw from a wide range of modalities and tailor their approach to what would best support you and your unique journey to better mental health.
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Absolutely! Confidentiality is a cornerstone of therapy. What you share in therapy stays between you and your therapist.
Confidentiality ensures that your therapist will not disclose any details about your treatment, diagnosis, or personal information without their consent. If you are using insurance to pay for sessions, we do have to share certain details regarding your treatment as part of their billing process. Besides basic contact information, insurance claims require dates of service, types of service using medical billing codes, as well as at least one diagnosis code to prove medical necessity.
There are rare exceptions where a therapist may be legally or ethically obligated to break confidentiality, such as fearing for your safety or the safety of others, or suspicions of abuse or neglect. Therapists are mandated reporters. Our policies that all clients sign before treatment go into detail about these exceptions.
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You can rest assured that your privacy and personal health information is protected with Ampersand Counseling. We have a certified information security expert on the team who has vetted all of our technology and systems.
For all your Protected Health Information, we are required to follow strict HIPAA guidelines, just like your doctor’s office. All of our electronic health records and billing are maintained in SimplePractice, which also functions as our client portal and telehealth platform. SimplePractice is a fully HIPAA-compliant platform that has extensive security measures that cover everything from data privacy to network protection.
Additionally, our therapists are required to use Multi-Factor Authentication (MFA) for accessing their laptops, email, and SimplePractice. Our phone system, RingCentral, has end-to-end encryption, and includes a comprehensive set of security controls across phone, messaging, and video functionality.
Therapy Basics
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The vast majority of our clients come to us for “hour-long” sessions, which in reality last 50-55 minutes. This slightly shorter time is for a number of reasons. First off, it’s what insurance is willing to pay for (and most clients pay the same regardless). It also allows for our therapists to get a short break between clients, and our clients some time to process if the session was difficult. Most importantly though, it allows enough time for the therapist and client to work toward the treatment goals.
We do not regularly schedule new clients for the shorter sessions of 45 minutes or 30 minutes (which are typically also about 5 minutes shorter), because the client is still taking up a full timeslot and progress is slower.
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Weekly sessions are the most common frequency for new clients, but this often evolves as therapy progresses and your needs change
The vast majority of our clients come in once a week or biweekly (every other week). We do have some clients that come in two or three times a week for a short period of time. We also have clients who come in once a month or even once a quarter if they’re in “maintenance mode”. How often you come in will be something you’ll discuss and coordinate with your therapist during your first session. Important factors to consider are your availability, financial situation, and therapeutic goals. Your therapists’ availability might also play a role in how often you come in for sessions.
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Most clients seeking general mental health services are scheduled within 2 weeks from when they reach out.
Wait times may be longer for specific ages, clinicians, modalities, service types, limited availability, or insurance types. Appointments after 4pm on weekdays and weekend appointments are also in high-demand and might require a longer time before we could get you in. Currently, we have a waitlist for children under 10 and for couples counseling. When spots open up, we work from our waitlist first based on the date they were added.
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After your appointment has been scheduled, you’ll receive confirmation via text and email. You will also get a link to our new client paperwork to complete online before you appointment. We require this to be completed no later than the day before your intake. This gives us time to verify your insurance coverage and benefits, and let you know how much you can expect to pay.
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Your first session is also known as your intake. This first session with your therapist will be different from future visits. The initial visit is for you and your therapist to get to know each other to assess fit, discuss your goals to help determine a treatment plan, and make sure you understand the therapeutic process.
There will likely be some questions about your history, including your childhood, education, relationships (family, romantic, friends), your current living situation, and your career. Other common questions your therapist might ask you will revolve around your current symptoms, what brought you to therapy, what you’re struggling with in life, what you want to get out of therapy, etc. Don’t worry though, there’s no right answer It’s not a test. You and your therapist should also come to an agreement about the frequency of sessions, an estimated length of your treatment, methods to be employed, and the ins and outs of patient confidentiality.
Financial Basics
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Clients who are paying out of pocket and not using insurance are consider “self pay” clients. We have two sets of rates for “self-pay” depending on the level of the therapist you would like to see. For our fully licensed therapists (LCSW, LPC), the typical 50-minute ongoing session is $140 with the first intake session being $180. For our associate-therapists with provisional licenses (LMSW, LPC-Associate), the typical 50-minute ongoing session is $105 with the first intake session being $135. Contact us for a full list of self-pay costs for additional services.
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We require all clients to keep a card on file, which may be a credit, debit, HSA, or FSA card, to make payments as easy as possible. Typically, your card will be charged your responsibility the night of your session, or within the next few days. Clients can also log in to their portal to pay for any balance whenever they want. Payment is due at the time of service. Our billing team runs cards daily for copays and session fees. We do not offer payment plans.
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We do not. Most group clinics or individual therapists who offer a sliding scale don’t accept insurance. We believe that the best way we can make therapy more affordable is by accepting insurance.
If you would like some referrals to places that offer a sliding scale or discounted therapy sessions offered by graduate interns, please email us and we’d be happy to help.
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Unless you have Medicaid, anyone can choose to be a self-pay client. If you have Medicaid, we are contractually prohibited from charging any fees for our services.
If we aren’t in network with your plan, we recommend you find out if you have any out of network benefits for mental health. These benefits, if you have them at all, tend to come with a higher patient responsibility and/or deductible than if you were to use an in-network provider.
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Our clinic allows you up to 24 hours before your appointment to cancel without a fee, when many local therapists require 48 hours. If you cancel your session within 24 hours, we consider that a Late Cancel and will charge your card on file $90. If you don’t provide your therapist any notice and just miss your appointment, we consider that a No Show and will charge your card on file $120. These fees are spelled out in our Client Financial Responsibility Policies, which is part of our new client paperwork. All new clients or their legal representatives are required to agree with these prior to any service being rendered.
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While we understand that missed session fees can be concerning, please know that they are standard practice in therapy and most medical practices. We charge these fees primarily to ensure our therapists’ time is respected as professionals, to maintain healthy boundaries in the mutual therapeutic relationship, and to encourage the client’s commitment to therapy.
If you provide adequate notice, your therapist has the opportunity to schedule another client for that time. Instead, they’re unlikely to be able to see anyone during the hour set aside for you and thus we are not able to bill insurance for that time. While we try to be as understanding and flexible as possible, not being able to bill for an hour-long service impacts the financial health & viability of the clinic, as well as the therapists’ pay. The no show fee is more because this means that the client never communicated with the therapist that they weren’t coming in (or logging in) so the therapist was prepared, there, and waiting.
In order to avoid these fees, we highly encourage our in-person clients to switch to virtual when you’re unable to come into the clinic physically. This flexibility allows you to log in from your home, work, or anywhere you can access your phone. Our therapists will typically give a client one free pass while reiterating the boundary that has been established. We leave it up to their discretion if there is a major emergency that prevents you from providing adequate notice. Even with the fee, if a client is not consistent with sessions, progress toward their goals will be difficult and your therapist will discuss with you if the timing is appropriate to continue.
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EAP stands for Employee Assistance Program which, on top of other potential benefits, offer you a certain number of free-to-you therapy sessions per year per issue.
EAP is not meant for long-term care and is primarily for short-term, non-diagnosable issues like stress, relationship struggles, workplace problems, etc. Typically, these programs also extend to all employees and members of their household, regardless of whether you are on your company’s insurance.
We do accept Aetna EAP, Optum EAP, and Cigna EAP. Each one has distinct billing and service limitations. Before being able to use EAP, you must contact them directly in order to get three pieces of information that we require for billing: an authorization code, number of sessions, and dates that the sessions must fall within. We do require that clients keep their insurance information on file in case there’s an issue with your EAP claims or for after your sessions are done so you can seamlessly switch payers.
Using Insurance
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We are in-network with most major insurance companies, and a few smaller ones, which account for more than 90% of the market. The full list can be found on our Insurance & Rates page.
Please keep in mind that each insurance has various restrictions so it’s possible that your insurance might narrow down your options of providers. We verify each new client’s coverage and network status before their first appointment.
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If you’re using insurance, there’s no way we can know without getting your specific insurance plan details. What our client’s responsibilities vary widely from plan to plan, much less company to company.
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All ACA plans have to provide mental health benefits, whether a commercial plan you get through your employer, government plan, or a plan you bought on the marketplace. If you have an indemnity plan, those are not ACA and specifically exclude mental health.
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If you would like to use your insurance, what you pay with us would be the same at any therapist, group practice, or even the large online providers who market heavily a low average cost per session. This is because your plan determines your patient responsibility and, assuming the provider has similar credentials to our team and is offering the same service, this doesn’t change. We all sign the same contract with each insurance company that requires us to charge your patient responsibility, no more or less.
If using your insurance is more than you can afford, you can choose not to use your benefits and pay out-of-pocket. See our Financial Basics section for more details.
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Insurance will only cover services that you have participated in and that they deem medically necessary. No insurance, government or private, will cover fees you incur from missing sessions. For more details about those fees, check out our Financial Basics section in this FAQ.
Some plans have limitations on types of service but most cover all of our outpatient mental health services.
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Yes! If we are out of network, the biggest difference is that we can’t bill your insurance directly. We would charge you our self-pay rates and then you would submit receipts to your insurance directly to get a reimbursed. These receipts are also called “superbills” in this industry and by insurance.
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Yes, in limited cases. Secondary insurance only pays if your clinician is in-network with both plans.
If you have multiple plans, let us know before starting services so we can match you with a clinician who is in-network with all your coverage. If we are not aware, you may be responsible for the full session cost.
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To determine your primary and secondary insurance policies, the insurance companies use a set of rules called Coordination of Benefits (COB) to decide which plan pays first.
In general, your plan as an employee or main policyholder is primary, while a plan you are on as a dependent (like a spouse or a parent) is secondary. While the insurance portals might tell us which is primary or secondary, it’s best for you to call directly to find out.
For children with two plans from each parent/guardian, the primary plan is determined by which subscriber’s birthday comes first in the calendar year, regardless of year of birth. This is known as the "birthday rule".
The Therapeutic Process
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Therapy is collaborative & highly individualized process. There’s no one-size-fits-all solutions here.
Our therapists tailor each session to meet you where you are and help you grow in the direction of where you want to grow. Depending on your needs, we might focus sessions on identifying & processing emotions, uncovering how past experiences have affected our present, learning new coping skills and strategies, discussing unhealthy behaviors or patterns that might be holding you back, exploring solutions, and celebrating progress however small. Therapy relies on engagement and working together toward your goals, whatever those might be. And don’t worry if you’re not sure yet… that’s all part of the process.
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Most people begin therapy because they’ve identified at least one, often multiple, issues they’re dealing with or areas they want to change. That’s usually a good place to start.
Our therapists are trained to make you feel comfortable and safe enough to open up about what’s bothering you. If you’re not sure where to start, they’ll ask you some questions to begin guiding the discussion. You'll discuss what's causing you distress or what's on your mind, with the goal of gaining insight and strategies for change.
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There’s no easy answer here since the time varies significantly from a handful of sessions to several years.
The duration of therapy depends on the complexity of the issues you’re facing, your goals, and your level of engagement. Some clients find relief in just a few sessions, while others benefit from longer-term support. Our ultimate goal for all clients is that they reach their goals and no longer need regular therapeutic support. As part of the process, our therapists will regularly check in to make sure you’re moving forward in a way that feels right for you.
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After at least 4-5 sessions, you should start feeling like you’re making progress toward positive change. Progress looks different for every client. For some, it could be identifying what behaviors or patterns aren’t working for you, or gaining new skills and strategies. Gaining a different perspective on your problems is also an important marker that therapy is helping.
Keep in mind that therapy isn’t typically a quick fix and it requires a level of willingness to be honest with oneself and being open to learn & change. It’s often uncomfortable because change isn’t easy and healing isn’t linear. However, if you ever feel like your therapy sessions or your progress has become stagnant, we hope you’ll bring it up to your therapist. They are professionals and experts at this, so they can help determine if you simply need a new direction or if something isn’t working.
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The biggest factor in whether therapy will be successful for you is your commitment to the process.
The more you actively participate, by being honest, open, and willing to engage, the more you will benefit. Growth often comes from meaningful change, which we know is never easy. We encourage clients to practice the strategies and skills they learn during sessions in their daily lives to maximize their progress.
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In short, you don’t have to know what all the different modalities (or types of therapy) mean or even what you need…. that’s part of your therapist’s job.
During your first session, your therapist will take the time to understand your unique circumstances, challenges, needs, and goals. They’ll use this to put together an individualized treatment plan. Our therapists are all trained in numerous modalities, and use a person-centered approach to determine which type (or types) of therapy would be most effective for each client. Often times this involves a customized mixing of multiple modalities that is unique and feels seamless for our clients.
If you’re experienced in therapy or you’ve done research, and you know what modality you want to try, that’s wonderful! Or even if you know what you don’t want or hasn’t worked for you in the past, that’s great too! Please share so we can help make the best match.
Mental Health Providers
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To become a therapist in Texas, first you must earn a master's degree in a counseling-related field from an accredited university program. As part of the degree, students are required to complete 100 hours of supervised clinical experience, commonly referred to as an internship or practicum.
After graduation, they must pass two exams and a background check in order to be eligible for licensure. After this process, therapists apply to be an associate-level therapist, such as LMSW, LPC-Associate, or LMFT-A. These therapists remain under clinical supervision and must bill under a fully licensed clinician. This level of license requires approximately 3,000 additional clinical hours over a minimum of two years.
Once these hours and the clinical supervision is complete, these associate therapists must pass a national exam to become a fully-licensed therapist, such as LCSW, LPC, or LMFT. Therapists, regardless of exact licensure, are governed by Texas BHEC, follow strict guidelines for conduct and ethics, and requires ongoing continuing education hours in order to reapply for their licensure every few years.
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There’s really not much of a difference – therapists and counselors are pretty much synonyms of each other. They’re often used interchangeably. We primarily use therapist because it can feel more inclusive of all licensures, including our social workers. All of our therapists – regardless of their licensure - can diagnose and treat most mental health issues, but others require more extensive testing. To add in even more variety, you might also hear insurance companies or others refer to all licensed therapists/counselors as clinicians and providers.
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To find a therapist who’s a good fit, you will want to start by considering practical matters, like licensure, insurance coverage, location, type of service you require, specialties, and availability.
If you can identify what issues you are dealing with, that is helpful to specify to see if there is a match with their specialties. Some therapists also have extensive experience working with certain populations, such as veterans, LGBTQ+, women, college-aged students, first responders, and people of color, among others. Every individual, couple, and family will have some must-have’s and some preferences. You can learn more about our team on the About Us page.
Once you’ve narrowed down your choices, you might want to consider your goals for therapy, and ask for a free phone consultation to get a better sense of who might be the best fit personality-wise as well.
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A Psychologist is a provider with a PhD or a PsyD who typically offers extensive psychological testing for ADHD, bipolar disorder, autism spectrum disorder, etc. These are often the professionals you would go to in order for an official diagnosis for school or work accommodations.
A Psychiatrist is an MD who is able to prescribe and manage psychiatric medications. While your GP or PCP can prescribe many of the same medications, a Psychiatrist is more familiar with mental heath diagnoses and concerns, and meets with you for short sessions every 3 months to ensure you’re stable and making progress. Another type of provider that can manage medication are Psychiatric Mental Health Nurse Practitioners.
Both Psychologists and Psychiatrists can provide traditional talk therapy, but it’s rare as there’s a large demand for the other services that only they can provide.
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Of course but only with a signed ROI (Release of Information) signed by the client or their legal guardian. This is most often helpful when you’re switching therapists to/from us, or when you’re stepping up or down in care (in-patient, IOP, PHP, etc). Some clients will sign ROI’s for the therapist to coordinate care with a Psychologist or Psychiatrist, a social worker, or even a school counselor.
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A strong therapeutic relationships is crucial for successful therapy. Just like any other relationship, feeling safe, comfortable to be yourself, and trusting the other person can take time to build.
To determine if you're receiving the best care from your therapist, and it’s a good fit, you could consider the following questions:
Do you feel safe and heard during session?
Do they challenge you?
Are you learning from them?
Do they show you compassion and acceptance?
Are they helping you make progress toward your goals?
Do you generally feel better after a session, even when it’s tough?
No one can answer these questions except you. If you answered “yes” to all of them, you can rest assured that your therapist is a great fit for you. If you answer “no” to only one of these questions, that might be something to discuss during your next session. If you answered “no” to more than one of these questions, you might consider finding a new therapist.
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The therapeutic relationship is incredibly important for therapy to be effective and progress to happen. Sometimes it’s just not a good fit for any number of practical or personal reasons.
Our therapists are professionals and would not take this personally, as their focus is on what’s best for you. You should feel free to let your therapist know if you would like to consider another provider, a modality they don’t offer, etc.
We can often find you a better fit within the practice and transferring within the clinic saves you time and headaches with paperwork, insurance, client portals, etc. However, we are obviously happy to help you transfer to someone outside the clinic and would transfer records at your signed request.
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Honestly, the biggest difference is the human connection and the trust that comes with it. Our therapists live in your community, they’re your Central Texas neighbors, and they’re available to come see in person, even if you choose to see them virtually.
Many folks take comfort in knowing our clinic is locally owned and there’s a physical space you could come to if you want. Another reason folks tell us they’re looking for a local therapist is consistency in the therapeutic relationship. While there’s turnover at any company, our retention rate is much higher than the large online providers where you might get lucky or you might have to switch providers every month.
However, please know that we’re glad the large online providers exist because they’re helping to break the stigma of mental health & therapy. They’re also a good option if you’re unable to find someone locally who meets your needs, most often if your availability is limited or your insurance isn’t widely accepted.
In Person vs. Telehealth
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Our therapists can see anyone in the state of Texas via telehealth/virtually.
Due to our providers’ license restrictions and our insurance contracts, we cannot see clients who reside in another state, regardless of permanent address. Please note that if you travel often, you must be physically in the state of Texas during sessions, so you’ll just want to coordinate scheduling with your therapist.
If you bought your insurance off the healthcare exchange, it’s important to note that your coverage isn’t national like a typical group plan. Unless otherwise specified, those plans typically limit participants to only receiving non-emergency medical services within the state of your plan or in bordering counties to your state.
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Nope! We try to be as flexible with our clients as possible and meet you where you are.
Our in-person clients are always able to switch to virtual, even last minute, if something comes up that prevents you from coming into the clinic. We actually encourage this to prevent any missed session fees.
If you’re typically a virtual client but want to change to in-person for a week or longer, talk to your therapist. Some providers have “virtual only days” where they see clients from their home office so you might have to switch from your normal day & time.
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The vast majority of insurance plans cover telehealth and in person sessions at the same rate. This changed during the pandemic and we hope that this regulation continues. Insurance considers the difference to be a change in location but the services are the same.
We do have a few clients whose plan has different “patient responsibility” amounts between the two. For some, this means that it’s fully covered one way and a copay the other. While it’s possible that your plan has different copay or coverage between the two, but it is extremely rare. This is one thing we look for when reviewing your insurance coverage and benefits.
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All of our virtual sessions are held inside our client portal and EHR software, SimplePractice.
Their HIPAA-compliant platform has extensive security measures that cover everything from data privacy to network protection, ensuring confidentiality and security of health information. You will receive a link via your mobile phone and email. Your sessions are easily accessible from any computer with internet access or from their free app called “Telehealth SimplePractice”.
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The short answer is no. Most insurances require your therapist to visually see you. Even if yours allows it or you’re a self pay client, we typically don’t allow it in our clinic. Therapy is all about connection and our eyes are a huge part of that. Plus, our body language often communicates more than the words we say.
Couples & Families
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Yes! In fact, we have many clients where both partners come to us for individual therapy and together for couples, or various members of the family for both. It can be highly beneficial as the dual approach can offer a more comprehensive healing and accelerate progress in the overall health of the individual and the couple/family relationship.
The most important thing to consider is potential conflicts of interest. For each service, you would need to see a different therapist. If you see two or more therapists within our team, it can help coordinate care as they can consult with each other.
Other things for the clients to consider is the time commitment of multiple types of sessions, sometimes within the same week, and the cost of sessions (depending on your insurance). Additionally, if you plan on using insurance for both, most insurance will not cover individual and family sessions on the same date of service. Plans will typically have a limit of one session/service a day.
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Definitely not! We do require that both partners be over the age of 18, but we work with couples who are dating, with engaged couples, with long-term partners, with newlyweds, with married couples who’ve been married 20+ years, etc. If you’re partnered up and you want to improve your communication and the health of your relationship, we’re here for you.
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For many couples, virtual works just fine and gives them more flexibility with coordinating schedules. You can log into together from the same computer or you can log in separately. Both clients must be visible to our therapists during sessions.
For families, it depends on the number of participants as well as the ages. If there’s more than 2 or 3 participants, virtual can get complicated and progress can be more difficult. However, if this is something you’re interested in or your situation would require it, we would recommend having a phone consultation with your therapist ahead of time to discuss.
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For billing insurance, we must identify one individual within the family to bill under their name. That person is the “client of record” which means it needs to be someone listed on the plan you tend to use. It doesn’t really matter who since coverage & benefits don’t change within a plan, but it’s best to choose the person you can expect to be present in every session. It can be an adult or a minor. The “client of record” will officially be given a diagnosis for billing purposes only in order to prove medical necessity. This applies to couples counseling as well.
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Short answer: either one is fine so long as we’re in-network with both. We typically recommend whichever plan has better coverage so it’s more affordable.
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It’s highly likely. Most ACA plans cover these services at the same level as individual counseling so long as it’s deemed medically necessary.
From our experience, less than 5% of plans do not cover anything but individual sessions. Before your first session, we try to verify that we are in-network with your plan and what your coverage/benefits include.
However, it’s ultimately your responsibility to ensure coverage so we recommend calling your insurance company to ask. For that conversation, you are asking about your outpatient mental/behavioral health benefits for family counseling (billing/service code is 90846), which includes couples, in an office or telehealth setting.
Still Have Questions?
We know we didn’t cover EVERYTHING. If you have a question or two that we missed above, please email us. We’ll answer your question ASAP & then add it above for future curious humans.
Your mental health journey starts here.
We would enjoy the opportunity to work with you. Please complete our New Client Contact Form to get started today. A member of our team will contact you within 24-48 hours to answer any questions you might have & schedule you with one of our therapists. If we’re not able to serve you, we’ll happily provide you with some external referrals.