Frequently Asked Questions of Dr. Kathy Nickerson, Irvine Psychologist Marriage Family Counseling

Frequently Asked Questions About Therapy and My Practice

1. How much does therapy cost?
1.1. How long will we need therapy for?
1.2. Why shouldn't I just go see the $30/hr therapist?
2. Do you take insurance?
3. Why don't you take insurance?
4. What kind of therapy do you do? How could you help me?
5. Tell me about your practice: what kinds of things do you specialize in?
6. What happens in the first couples counseling session?
7. What are your office hours?
8. Where can I read more about your office policies?
9. Where can I learn more about your background and training?

1. How much does therapy cost?

My fee is $200 for a 50 minute session; the coaches in my practice charge $100-125 for a 50 minute session. I offer both longer and shorter sessions as well, so we can customize the length of a session to meet your needs and budget. Nearly everyone I take care of comes for a 50 minute session; some new clients desire a longer session to jump-start their treatment, others want a shorter session for a quick tune-up.

Worried about the cost of therapy?
Click here to learn more about the "therapy scholarships" we offer to make counseling more affordable.

The cost of any type of health care depends on what type of services you need and how long you will need care for. My goal is always to help you feel better as quickly as possible. Most of the people I take care of spend between 12-25 sessions working with me on a weekly basis; some take a little longer, some take a little less time. Your individual needs will vary. For a complete listing of costs of my services, please see the services page.

1.1. How long will we need therapy for?

This is a tricky question to answer without knowing much about your situation. I can tell you that my goal is always to help you feel better as quickly as possible! Most of the people I take care of spend between 12-25 sessions working with me on a weekly basis; some take a little longer, some take a little less time. Your individual needs will vary.

What I would like you to keep in mind is that lasting change happens slowly. People are much more like crock-pots than frying pans; we take a while to heat up and a while to simmer before something starts to really cook. For most couples who are having serious challenges, the magic number seems to be about 9 months to see significant change. I am sure this is longer than you'd like and I share that frustration, but all of my experience and over 30 years of research shows this to be true. Think about this: we have all heard that the secret to losing weight is to eat less and exercise more. Simple, huh? The advice is good and is really simple, but implementing it, that's a challenge! Changing your relationship isn't magic; it just requires changing some of the old habits you have. I could probably teach you everything I know about how to heal your relationship in a couple of hours. But there's the rub, knowing the strategies and applying them are two very different things. I see my role as both teacher and coach. My first job is to teach you how to play the game; then I need to watch you and coach you as you play so I can help you with form, style, and technique.

Don't worry, it won't be months and months until you see some really good changes. You should start to notice some improvement after just a couple sessions, things should be much better after 10 sessions, and things should be great by around 20-24 sessions.

1.2. But Dr Kathy, therapy is expensive! And I heard that there's someone down the street who only charges $30 per hour, why shouldn't I just go see them?

I hear you and I understand that therapy is expensive, but instead of focusing on the costs, I'd encourage you to look at therapy as an investment.

If you are worried about the cost of therapy, please click here to learn more about the
"therapy scholarships" we offer to make counseling more affordable.

If we're thinking just about the money, I'd like to share a story with you: I was chatting with a friend recently - this friend happens to be a family law attorney - and he shared that the average cost of a divorce in the state of California is about $20,000. I responded, "Oh really? That's 100 therapy sessions!" To which my friend said, "Yeah, and you get to keep your house!" This is a silly story, but I hope it illustrates an important point: investing in 20 therapy sessions will cost you much less - both financially and emotionally - than a divorce. Ideally, you will learn skills and tools from therapy that would take you a long time to acquire without professional guidance.

Now, as to what you should pay for a therapist. My hunch is that good therapists and counselors can be found in almost every price range, but I suspect that the best therapists charge more for their services. Most amazing therapists have years of graduate training, lots of professional expertise, publications, supervision, and all sorts of experience that takes a lot of time to acquire. Just as with attorneys, surgeons, and anyone who is in a specialty field, my general observation is that the better you are at what you do, the more you charge for your services. I am sure there are exceptions to this general rule, but typically, the more specialized and experienced the practitioner, the more they charge.

So, you absolutely could go to a therapist who charges $30 per hour. And you might even have a great experience with this therapist; that would certainly be my wish for you! However, I would be concerned about two things if I was considering going to a super low-cost therapist: (1) How skilled is this person? and (2) How motivated is this person to help me get better fast?

In the case of how skilled is this person, I would want to know about education (are they a PhD, an LCSW, an MFT, a CLC?), years of experience, level of licensure (are they fully licensed or are they still in training as an intern?), what do they specialize in (if it's everything from soup to nuts, that's not good), have they published their work, have they written any books, do other therapists consider them to be experts and someone they would send a family member to? I would also ask about results and methods - how many of their clients get better, do they track outcomes, do they base their practice on science, and how do they help couples?

As to how motivated a therapist is, this is a very interesting question. Having never worked with or for any insurance companies, I really can't tell you how taking insurance would affect my practice. That said, I can tell you what I have heard. I have heard that many therapists who take insurance have "limited" motivation to help you get better as soon as possible. The reason being that they get paid for as long as you come see them, not by how much better you are doing after 10 weeks. So, is there really much incentive for them to help you get better? No, actually, there is a disincentive: the worse you do, the more you will come back, the more money they make. Now, I am sure this is not true for all therapists who take insurance, but it does make me wonder. Since I work for you - not the insurance companies - I am extremely motivated to help you get better as fast as possible. The reason why is that if I help you get better quickly, you will tell your friends how happy you are and you will say, "Oh, you have to go see Kathy, we love her." This is advertising money can't buy. If I don't help you or if I work very, very slow, you will tell people, "Yeah, we know a therapist, but she's not very good, try the phonebook for a referral." This would be awful. So I am being very, very honest when I tell you that I am motivated because of a couple reasons: (1) I really do love what I do, nothing makes me happier that repairing marriages, (2) It's good for business for me to take great care of you, (3) It's a win-win situation for me to help you get better as fast as possible, (4) I have a lot of pride in being a good therapist, so I will knock myself out to help you.

2. Do you take insurance?

No, I do not take insurance. However, many PPOs and HMOs will cover all or a portion of my fee. If you would like to use your insurance, please contact your insurance company and ask what coverage you have to see an "out-of-network provider." They will tell you what your coverage is; if possible, ask them to fax you or email you a copy of your coverage so that you can use this when you submit any documents to them in the future. I will then start to provide care to you, you will pay for the sessions as we go, and once a month I will prepare a superbill for you that you can submit to your insurance company for reimbursement.

3. Why don't you take insurance?

Thank you for asking this. I decided not to work directly with insurance companies for several reasons. The first is that they require me to give you a mental disorder diagnosis; many people that I work with would just like new skills or some different strategies to try at home or work, they do not necessarily have a diagnosis. Secondly, many insurance companies put profound restrictions on what types of services they will cover. For example, many insurance companies do not cover marriage counseling or family counseling. The third reason is that I want you to be actively involved in determining what type of care you are receiving, with insurance, many of your choices and my treatment options are limited. The fourth and most important reason for my not taking insurance is that it severly jeopardizes your confidentiality. If I submit a bill to the insurance companies on your behalf, your confidential information is processed by the insurance company and then stored in a database. Anyone who is involved in the processing or handling of your claim may have access to your records and anyone who has a legitimate reason to access the medical database, such as insurance companies and future employers, can view your confidential records. For all of these reasons, I've decided that I would rather provide care to you at rates that are reduced and comparable to your insurance company's negotiated prices instead of accepting insurance directly.

4. What kind of therapy do you do? How could you help me?

What a great question! In marriage counseling and premarital counseling, I use a blend of Gottman Marriage Counseling techniques and Emotionally Focused Couples Therapy emotionally focused couples therapy, also known as EFT. The goal of this approach is to explore your emotional responses to each other, to identify the "cycle" that goes on when things get tough, to change how you respond to your partner, and to initiate new cycles of interaction. The end result is that you will feel closer and more connected to your partner. I use this approach because it really works - research now shows that 70-75% of couples move from distress to recovery and approximately 90% show significant improvements with EFT. This result is much, much better than traditional couples therapy. If you'd like to learn more, please visit http://www.eft.ca/about/about.htm.

With families and individuals, I customize my approach based on individual needs. I use techniques from cognitive behavioral therapy (CBT), interpersonal therapy (IPT), narrative therapy, and family systems therapy. CBT is a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. IPT is a form of psychotherapy in which the focus is on a patient's relationships with peers and family members and the way they see themselves. Narrative therapy is an approach that seeks to help us understand the meanings we assign to a particular chapter, or story, in our life and make sense of it. Family systems therapy looks at the entire family as a complex system having its own language, roles, rules, beliefs, needs, and patterns. Each family member plays a part in the system and family systems therapy helps an individual discover how their family operated, their role in the system, and how it affects them in their current family and in relationships outside the family. All of these approaches are highly effective, brief forms of treatment. If you'd like to learn more, I recommend: http://www.psychologytoday.com/pto/methods.html

5. Tell me about your practice: what kinds of things do you specialize in, what are your success rates, how do these compare to other therapists, and why should I choose you?

I specialize in couples counseling and family counseling. I limit my practice to 25 clients per week because I want to be able to spend ample time with each person I take care of, respond to emails, read, and research. This is quite different from most therapists who work for insurance companies and medical corporations - many of them see 35 clients per week and carry a caseload of 100 clients or more at any one time. I feel that this is not the proper way to care for clients; with such a heavy caseload, many therapists can only see a client once every 3 weeks and this greatly compromises your care.

Of the 25 patient hours I have per week, about 70% are couples, 20% are families, 10% are individuals. My success rates are very good: although I cannot promise or guarantee any result, I'd invite you to take a look at my testimonials page and I can tell you that if all involved are willing to do some work to change and take responsibility for what they're doing to make a situation difficult, there's no limit to what can be achieved! From what I have read, my success rates, 89-93% for all the clients I see, are very high. To read more about the success rates of therapy, please review these links: marriage counseling statistics, Marriage Counseling Success Rates - UCLA Study, and the Consumer Reports Therapy Effectiveness Report.

Why should you choose me? This is a fun question to answer! One of the things that I think is really different about me is that I am classically trained as a scientist. My undergraduate major at UCI was Chemistry and I have blended my love of science with the practice of psychology. I believe that all therapy should be based on strong scientific evidence and research, so I only use methods that have been proven to work. This is very different from many therapists who value insight and professional "hunches" more than data. I am all for insight and instincts, but when a marriage is on the line, I don't like to leave things to my imagination. A more personal reason to choose me: I can promise to be honest, caring, attentive, and work very hard to help you. Feel free to read more: About Dr. Kathy Nickerson.

6. What happens in the first couples counseling session?

Good question! Here is the rough agenda that I have for the first meeting with a new couple:
1. Quick History – I want to know how long you’ve been together, how you met, are you dating/married/engaged, and how your life together has been.

2. Overview of Current Problems – I want to know what’s going on now, what made you decide to come in for therapy, what have you tried to do to make things different.

3. Therapy Wishlist – What do you want me to help you do differently? If we are successful in our work, how will we know it?

4. Container Exercise – if time permits, it’s a communication activity that teaches both members of the couple how to listen to each other in a different way.

5. Overview of how relationships get better and HW – I give everyone a handout that goes over what I know about how relationships get better and get worse. I then talk about what stage I think the couple is in and what I think we need to do to make things improve.

Finally, I assign some communication homework so that therapy can continue while at home.

7. What are your office hours?

I see clients Tuesday through Friday; my first appointment starts at 10am and my last appointment starts at 6pm. On Mondays, I teach and work with corporate clients. Other times may be available by special arrangement. If you have a difficult schedule, don't worry, just give me a call and we can work something out. Or if you feel ready to make an appointment, please click on the schedule now button below:

8. Where can I read more about your office policies?

I'm glad you would like to know more about this. To read more about my office policies and practices, please click on the following link: Office Policies and Informed Consent Page

9. Where can I learn more about your background and training?

I am excited you would like to know a little bit more about me, please click this link: About Dr. Kathy to learn more. You can also review my graduate school transcipts by clicking here: Dr. Kathy Nickeron's Transcripts; you can verify my licensure with the California Board of Psychology by clicking here: Verify Dr. Kathy Nickerson's License.

Have a question not answered here? Please email me your question and I will respond just as soon as I can.