General Topics

What’s the purpose of therapy?

The purpose of therapy is to have a “safe” place to discuss your inner most thoughts and feelings and to find resolutions to your problems.   Psychotherapy can be helpful in treating most mental health problems, including:

- Anxiety disorders, such as obsessive-compulsive disorder (OCD), phobias, panic disorder or post-traumatic stress disorder (PTSD)​
- Mood disorders, such as depression or bipolar disorder
- Addictions, such as alcoholism, drug dependence or compulsive gambling
- Eating disorders, such as anorexia or bulimia
- Personality disorders, such as borderline personality disorder or dependent personality disorder
- Schizophrenia or other disorders that cause detachment from reality (psychotic disorders)

Not everyone who benefits from psychotherapy is diagnosed with a mental illness. Psychotherapy can help with a number of life's stresses and conflicts that can affect anyone. For example, it may help you:

- Resolve conflicts with your partner or someone else in your life
- Relieve anxiety or stress due to work or other situations
- Cope with major life changes, such as divorce, the death of a loved one or the loss of a job
- Learn to manage unhealthy reactions, such as road rage or passive-aggressive behavior
- Come to terms with an ongoing or serious physical health problem, such as diabetes, cancer or long-term (chronic) pain
- Recover from physical or sexual abuse or witnessing violence
- Cope with sexual problems, whether they're due to a physical or psychological cause
- Sleep better, if you have trouble getting to sleep or staying asleep (insomnia)

In some cases, psychotherapy can be as effective as medications, such as antidepressants. However, depending on your specific situation, psychotherapy alone may not be enough to ease the symptoms of a mental health condition. You may also need medications or other treatments. Source: Mayo Clinic

What is my role in the therapy process?

In therapy, the more of an active participant you are, the greater the benefit will be. You will be asked to identify goals for yourself, which will provide the framework for our therapy work together.  It is important for you to express your feelings and thoughts openly. With that said, being able to get your thoughts and feelings out is generally not a sufficient condition for successful therapy.

The work you do outside of therapy is often as important as the work you do in therapy. You will most likely need to be open to changing some patterns of thought and/or behavior in your life.  You may be assigned reading material or homework to assist you with your goals to complete between sessions. You may spend the week processing what was discussed in session. Through the therapy process it is not unusual to have “light bulb” experiences where you gain insight into problems that have had you stuck. We will work together on uncovering what changes in thinking or behavior may be of benefit to you.

What is my therapist’s role in the therapy process?

Your therapist should provide a safe place for you to express your thoughts and feelings and for you to work toward resolving your problems; allow you the major responsibility for determining the content that is discussed during your sessions; listen as you discuss your concerns and experiences; try to understand you from your point of view; explore alternative points of view with you; help you make connections between different aspects of your experience; and clarify the interconnections between your immediate concerns and the complexities of your personality and history.

When will I know if I have completed therapy?

Sometimes therapeutic goals may change or you may add different goals once others are achieved. You will know you have treated a course of therapy when you have adequately resolved what you came in for or reached your therapeutic goals.

How long before I begin to feel better?

You may feel some relief after the first few sessions, however therapy may take some time to be optimally beneficial. Just as the issues you may have most likely did not begin yesterday, processing and working through takes time. With that said, therapy does not have to be “long term” to be effective.

Who will know I am in treatment?

Clients often wish to allow their therapist to have contact with a family physician or family member, however this decision is up to you. Typically, the only way others would become aware of your choice to seek therapy is if you decide to tell them. Therapy is completely confidential unless you sign a release of information allowing your therapist to communicate with another individual about your treatment, with a few exceptions. See below for the limits to confidentiality found in Iowa Code Chapter 228, which are also listed in the Informed Consent and Notice of Privacy Practices (reviewed at your first appointment).

1. Suspected past or present abuse or neglect of children, adults, and elders must be reported to the proper authorities, including the Department of Human Services and/or law enforcement.
2. If we believe that you are seriously in danger or harming yourself, or you have threatened to harm another person, we must contact the proper authorities and make a reasonable effort to contact family members and anyone who might be in danger.
3. If you use your health insurance to pay for services, the health insurance provider and other third-party payers have the right to review your records.
4. When a court orders the disclosure in a civil, criminal, or administrative proceeding or as otherwise required by state or federal laws.
5. In natural disasters whereby protected records may become exposed.
6. When otherwise required by law (public health or national emergency).

Can I talk to you about anything?

Yes, you may speak about any topic that you feel is creating emotional hardship for you. We treat a wide range of presenting problems. Infrequently, we may suggest referring a client to an additional provider who specializes in the specific problem the client is struggling with.

Who goes to therapy?

Some people receiving therapy are very emotionally disturbed; most are not. Most healthy individuals experience some emotional troubles at one point or another in their lives. Seeking therapy as a step in dealing with them is no indication in itself of having a psychiatric disorder. On the contrary, it often represents a strong, self-caring, mature and responsible decision for yourself and often for those you love.

Does insurance cover treatment?

Most insurance plans have mental health benefits. Often times a client will owe a co-pay or deductible for each session, similar to a visit to your physician. It is also important to ask if you owe a deductible or co-pay and what the cost will be to you. Additionally, it is important to know if the particular clinician you would like to see is listed as "in-network." Your clinician will know the answer to this. If the provider is not "in-network," ask your insurance company what your "out of network" benefits are - as sometimes it is still very affordable to see the clinician of your choice. You may also contact your Human Resources department if you are employed to see if your employer offers EAP (Employee Assistance Program) benefits, which are no cost visits through an EAP program. We do not offer EAP services.  If you do not have insurance you can elect to pay out of pocket. For rates or more information, please contact any of our providers or our admin at (515) 402-4395.

What type of payment is accepted?

All payments are due to the clinician at the time of service. Cash or credit is accepted.

What if I begin to question the effectiveness of therapy?

Talk to your therapist. Successful therapy can be expected to have ups and downs. Sometimes you may move rapidly; at other times you may progress more slowly. It is important that you let your provider know if you are not getting what you need out of treatment. Perhaps your treatment goals need to be re-evaluated or a different approach needs to be taken

If therapy is supposed to help, why do I sometimes feel exhausted and drained following a session?

You need to keep in mind that therapy is hard work but on the flip side therapy can be a life changing experience. Often times, emotionally laden and difficult issues are brought up in therapy, as they are usually the very issues that bring you in the first place. You can expect to have some mixed feelings about attending sessions from time to time. This does not mean that the therapy is not effective or that you should discontinue treatment. What it does mean is that you are getting at the heart of issues and closer to resolving your problems. Please, talk to your therapist about your emotions as therapy progresses. Keep in mind that just as you may have some difficult sessions, you will leave some sessions refreshed and with new insights, perspectives and solutions to your problems.

Do I have to explore my childhood during therapy?

Who we are today is often a result of cumulative experiences from our past.  Frequently, successful therapy involves understanding how your childhood may have contributed to the problems you are currently experiencing.  It may involve looking at problems your parents may have had, what role you played in your family, the hurts and losses you may have experienced, your early attachments, etc.  However, therapy that gets stuck in the past and never moves to resolving the problems in the present is often not successful

How do I choose a mental health provider?

There are several different types of mental health professionals. Some provide psychotherapy (talk therapy or counseling), some provide psychological testing, and others prescribe medication. Before working with a provider, check his or her background, education, certification, and licensing.

Trained mental health professionals can have a number of different job titles, depending on their education and role. Most psychotherapists or counselors have a master's or doctoral degree with specific training in psychological counseling. Examples of psychotherapists include psychologists, licensed mental health counselors (LMHC), licensed independent social workers (LISW), and licensed marriage and family therapists (LMFT). Medical doctors (psychiatrists) or psychiatric mental health nurse practitioners (ARNP, PMHNP) specialize in medication management.

It is important you feel comfortable with your mental health provider.  Do not be afraid to ask questions prior to selecting a clinician to find one who best matches your needs.

Telehealth Topics

Telehealth (also called Online Therapy, Teletherapy or Telepsychiatry) is a secure, electronic way to connect with your provider and hold your appointments via a secure video system.

How to get connected to your session

Login to the secure client portal.

Your upcoming session will be displayed on your Home page. Click any of the details of your upcoming session to open the Session Details page, then click the Start Video Session button- a new window will open. If you have completed the preparatory steps listed in the tech setup section above, you should be taken directly to the virtual meeting room where you and your counselor will conduct your session. A display of what your clinician sees will show in the bottom left, while the rest of the screen will fill with your clinician's camera view. Use the volume and microphone sensitivity dials to adjust sound settings as needed. When the session is finished, close the window to end the connection.

Troubleshooting your session

To ensure the best possible telehealth session, pleasure ensure the following:

- Test your connection using the secure connection system at least 15 minutes prior to your appointment.
- If you are using your phone, try to have headphones to assist with volume control.
- We have found that Google Chrome (vs Internet Explorer), is the best for solid connections if using a laptop or desktop.


- Be sure you are in a private secure location. Your provider reserves the right to reschedule if there are others, including friends or unauthorized family members within earshot of the visit.
- Wearing headphones can reduce the potential for others to hear details of your session that would otherwise be projected from speakers. However, wearing headphones alone does not replace being in a private location.
- Turn off notifications on your computer and phone once you are connected.
- Bring tissues. If you were in our office, we'd provide them for you.
- You may be extra cozy because you are somewhere familiar. Remind yourself prior to the session that you are here to do the meaningful work of positive change. Do not use any mood altering substances during our sessions.

When can I use it?

Many people enjoy the flexibility of telehealth. It can be used in a variety of situations, including inclement weather, convenience in your workday, transportation issues, mild illness, etc. Feel free to reach out to your provider if you wish to switch an in-office session to telehealth. Most insurance companies cover telehealth, however a few do not. We encourage you to contact your insurance company to inquire if telehealth services are covered. When calling, please ask your insurance if telehealth is covered for 515 Therapy and Consulting (an out-patient mental health office) and what you will owe (co-pay, deductible, or coinsurance).

Does it have to be video?

Yes, according to the requirements by insurance companies, it must be done via video connection. If there is disconnection, and we are unable to maintain a stable connection, the provider may either reschedule your appointment, or switch to audio under this circumstance.

What happens if I lose connection?

- When connection is lost, you may use the reload button located at the bottom of your screen along the menu bar.
- If connection continues to remain lost, try closing completely and logging back in.
- If connection continues to not stay, your provider will reach out to you via phone to either finish your session or reschedule if necessary.
- See below for trouble shooting tips.

Does it have to be video?

Yes, according to the requirements by insurance companies, it must be done via video connection. If there is disconnection, and we are unable to maintain a stable connection, the provider may either reschedule your appointment, or switch to audio under this circumstance.

Can I do telehealth anywhere?

To ensure your privacy, and ability to fully utilize your session successfully, you need to be in a private, secure area. Although you can be in a car for privacy, you may not be driving the vehicle while on the session.

Can I do telehealth if I am out of state?

If you are not in the state in which your provider is licensed to practice, then your clinician will be unable to meet with you. You may review this information with your provider.

Do I need my camera on while we participate in a telehealth visit?

Yes. Most insurances require both audio and visual telehealth connections.

Can I do housework or other activities while on telehealth with you?

It is recommended to not have any other activities or distractions occurring while participating in telehealth so that both you and your clinician can fully invest in your session.

Can you just call me?

Insurance companies require both audio and visual connections for telehealth.  In the event of lost connections, telephone could be accessed after attempts to trouble shoot.  See below for trouble shooting tips.

Do I have to be present for my child's telehealth session?

Please discuss this with the provider prior to the appointment. Similar to in-office appointments, an adult may not need to be present for the entire visit. We ask that you treat telehealth just as you would in-person sessions, where the client is allowed personal space to process their thoughts and feelings privately. Alternatively, sometimes parents are a significant part of the visit. This depends on the age of the child and the situation.