Therapy F.A.Q.’s

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Frequently Asked Questions about Therapy.

Thanks for asking. It’s pronounced DEER-dree STAY-ten.

I often tell people, “It’s like writing a letter: Dear Dree,” and I’ve had several, visually-oriented people tell me, “Oh, I just picture a deer and a tree.”

Our names are important to us and I will confess that I enjoy hearing mine said correctly but I promise I will answer to anything close.

I know it can feel awkward when we’re unsure how to say someone’s name. Please know I’ll be gracious.

Please call me at (434) 760-9935 or email me through my website.

We can arrange a free phone consultation during which I can get a better idea of what you are seeking and you can ask me any questions you might have.

Having a phone conversation helps us assess whether we might be a good fit working together, which is critical for successful therapy.

I look forward to talking with you!

Over the years, I’ve found that often below this question is the spoken or unspoken worry, “Are you going to just look at me and expect me to talk?” So, let me start by assuring you, no, that is not my style.

I am very engaged and interactive in sessions, trying to facilitate what are sometimes difficult conversations in as safe and comfortable a manner as possible. If you tend to be quiet, I can help draw you out with questions. If you are more loquacious, I will follow you with occasional guiding nudges or clarifying questions.

I see my role as an ally or partner and I will try and balance my energy and efforts to match yours.

If you show up ready to dive deep into an issue or are eager to learn a new skill, I will be ready.

If you feel drained, perhaps having had urges to not even show up, we can focus more on the present moment and helping shift your energy and mood.

If you arrive feeling emotionally overwhelmed or dysregulated, I will probably offer to guide you in some skill or meditation to help you settle before moving into the session.

If you come to session and just want to chat and stay on the surface, we can do that. However, if you do that often, I will gently remind you of your previously stated goal(s) and help you explore what’s making it difficult to take steps in the direction you want to head. I wouldn’t be much of a partner on the journey if I let us camp out indefinitely at a scenic overlook without reminding you of where we were headed to begin with.

I have found that I can be more mindful and fully present with my clients if I’m not watching the clock, so I use a meditation timer in sessions. When the ending chimes ring, it’s not intended to communicate, “BING! TIME’S UP!” Please don’t leave! The ending chimes are just a gentle reminder for us to move toward wrapping up.

There are a variety of reasons my clients may need or simply feel more comfortable with an interpreter. This service is available at no additional cost to you.

The following interpreting services are required by law to protect your confidentiality.

Phone Sessions:  If you are deaf, hard of hearing, deafblind, or speech disabled, you are likely familiar with Virginia Relay, a free public service within the Commonwealth of Virginia. Services are available 24 hours a day, 365 days a year, with no limit on the number or length of the calls. Anyone can make a Virginia Relay call by dialing 7-1-1.

Telehealth/Video Sessions: I use Voyce, real-time interpretation services in over 240 languages and dialects including American Sign Language (ASL). The service is available 24 hours a day and an interpreter can be invited into our session usually in less than 30 seconds.

As a Licensed Clinical Social Worker (LCSW), I am licensed to see clients anywhere within the Commonwealth of Virginia. All therapy sessions are conducted via telehealth using a secure, encrypted, HIPAA compliant platform.

I do not accept insurance but am willing to create a Superbill, an itemized receipt listing the services provided, which you can submit to your insurance for possible reimbursement. In all honesty, some clients receive partial reimbursement but many are not reimbursed at all.

If using your insurance for therapy is financially necessary, I recommend that you contact your insurance provider and ask whether you can be reimbursed for seeing an out-of-network provider and at what rate. If your insurance provider does not reimburse (at all or enough), please ask them for names of providers in their network.

Understandably, clients sometimes wonder why I don’t accept insurance. These are my primary reasons:

  • Insurance companies require therapists to diagnose their clients. It is a condition of the therapist getting paid. These labels or diagnoses become a part of the client’s permanent medical record even when the individual improves and no longer meets criteria for that diagnosis. There are also times that I see clients who do not meet criteria for any diagnosis. I believe it is unethical to label someone in order to appease the insurance company.
  • Insurance companies can dictate the treatment that occurs (i.e., focus, treatment plan, number of sessions, etc.) rather than this being an independent collaboration between client and therapist.
  • Your records are not private. Just as insurance companies review your medical records, insurance claims specialists can request and review your therapy records. It is my understanding that information seen by your insurance company can impact clearance for certain types of jobs and some clients feel more protective of the information shared in therapy compared to information shared with their physician.

I accept payment by credit card or PayPal. Clients receive a receipt of payment via email.

Therapy routinely involves the sharing of sensitive information and I take the steps necessary to protect your confidentiality. I use state-of-the-art services for scheduling, records, messaging clients and online video/telehealth sessions. The platforms are HIPAA compliant, all traffic is secure, all sensitive data is encrypted, and no sensitive data is sent via email.

Legally, information from sessions and records cannot be disclosed without your written permission and my Release of Information form allows you to specify what you do and do not want shared. However, the Code of Virginia does state that a clients’ information can be shared without their consent under the following circumstances:

  • If a client shares an intention to harm themself. In such cases, I will make every effort to enlist their collaboration in developing a safety plan. If the client is unable or unwilling to cooperate, I will take further steps, as provided by the law, to ensure their safety.
  • If a client threatens to kill or seriously harm another person(s), I must notify the police and intended victim(s).
  • As a Licensed Clinical Social Worker, I am mandated to report to the Virginia Department of Social Services any known or suspected abuse, neglect, or exploitation of children, the elderly or disabled adults.
  • If a court of law subpoenas clinical records and/or testimony.

Finally, I think it’s also worth touching on the steps you can take to protect your confidentiality. It’s important to think about where you will be physically located during the session.

Home is generally best, and we will discuss strategies for soundproofing if you live with others.

Meeting at your workplace or school is problematic. There is a risk of interruptions or being overheard and you should never use a work computer for a telehealth session as there is no way to ensure it is private. If you choose to meet while at your place of employment, please protect yourself by using a personal computer or personal cell phone/tablet.

Having a session while in a car or outdoors is also risky and can cause technology/connection headaches as the Wi-Fi or cellular signal is not as reliable. If you feel the need to meet in your car for privacy, it should be parked as closely as possible to a strong Wi-Fi signal.

Even if you feel comfortable with the people near you (e.g., family, roommates, colleagues, etc.), it is still important to protect your privacy. You might selectively share personal information with these people, but you cannot predict where the conversation will go in session. I don’t want any clients to worry about being overheard or feel that they must censor what they are saying.

If you would not invite someone into an in-person therapy session in an office, they should not be hearing you during a telehealth therapy session.

If you are having a mental health crisis and/or thoughts of self-harm/suicide, please do one of the following:

While I enjoy children, I do not have training or experience to provide therapy to them. Therefore, I work with adults 18 years old and older.

There are talented therapists who specialize in working with couples and families and I do not count myself among them. My strengths are in individual and group therapy.

Talking to a trusted friend who really gets you feels great, yet despite supportive friends, people sometime realize that their struggles are not improving. Talking to a therapist differs from talking to your best friend(s) in these ways:

  • Therapists are trained professionals. We have advanced degrees and training in human behavior, relationships and effective interventions. As a social worker, I use a biopsychosocial-spiritual perspective, assessing the many variables that influence my client’s life and wellbeing. I also use evidence-based treatments to guide my therapy practice.
  • Therapists are objective. Sometimes, we need someone who can provide a neutral, non-judgmental perspective. Friends and family have a vested interest in your life and choices whereas a therapist does not. Of course, therapists lose objectivity with their own friends and family and cannot ethically counsel them.
  • Therapists don’t offer advice. This surprises some people and I’ve even had clients say, “Just tell me what to do.” My role as a therapist is to help you clarify your own goals and values, learn to listen to your inner wisdom and perhaps teach you the skills you need to move toward your desired goals. I’m not here to tell you how to live your life, just help you be as successful as possible in living life your way.
  • Therapy is confidential. There are actual state and federal laws dictating that I protect your privacy. This is part of what makes it safe to explore and work through those more vulnerable parts of your life. Confidentiality helps create a secure environment to learn how to and practice talking about emotions and tough topics.
  • Therapy focuses on you and comes with clear boundaries. My only agenda is to help you identify and align with your best and highest self. Even if I choose to share personal information or a story, it is with the goal of trying to help move you forward on your path.

I do not accept friend or contact requests from current or former clients on any social networking sites. I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.

Although born in North Carolina, I grew up as a Third Culture Kid (TCK), which means I spent my formative years growing up outside of the United States in Ethiopia, Kenya, and Tanzania. As a TCK, I moved often, experienced a variety of cultures, witnessed war, famine, and many challenges of third world cultures, saw some of the most breathtaking sights in the world, and had some thrilling adventures.

A common experience for TCK’s is being able to fit in anywhere but lacking a sense of belonging. I wasn’t African and I didn’t feel like an American. It’s kind of embarrassing to admit this, but I thought I invented a term to accurately describe my in-between-and-not-fully-one-thing-or-another status. I thought of myself as “African American.” Only when my family moved back to the States in the early 1980s did I realize my gaffe and stopped using the term.

While living in Virginia (Richmond, Charlottesville, Harrisonburg) for 36 years, I established a sense of roots and a feeling of being at home. As a therapist, I of course now understand that the experience of fitting in but not belonging can also be true for people who have lived their whole lives in the same place. I had to do my own personal work around creating a sense of belonging and I enjoy helping others do the same in their lives.

As of 2023, I am on a new global adventure. A silver lining of the pandemic for me was realizing I have flexibility with where I work. While I am continuing my full-time private practice in Virginia, I am physically living in Uruguay for now where I am exploring and enjoying a peaceful, slower pace of life.

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