The therapy I practice, ISTDP, is probably different from any other therapy that you might have had, that friends or family have described to you, that you have read about, or seen on TV or in movies. While it is “talk therapy,” and while insight is an important component of the work, ISTDP recognizes that insight alone often does not generally bring lasting therapeutic change. As a result, a central focus of the therapy involves helping patients to face aspect of their inner lives that they avoid, including a visceral experience of avoided feelings. Without this key component, the talking of “talk therapy” runs the risk of being a form of intellectualized avoidance.
Changing longstanding habitual patterns of thought, feeling, and behavior is not comfortable. It does not need to involve excruciating pain or overwhelming anxiety—in fact, those get in the way—but ISTDP recognizes that change will inevitably have uncomfortable aspects. If your goal in therapy is to have a soothing “time out” from your difficulties, this is probably not the therapy for you. If your goal is to face your difficulties and move beyond them sooner rather than later, it is probably worth a try.
In most forms of therapy, the first session is primarily focused on gathering history and perhaps making a diagnosis. The initial ISTDP session, known as a “trial therapy,” lasts 2-3 hours, so that you can try out ISTDP and see whether it might be helpful for your difficulties. Subsequent sessions are typically 45 minutes once a week, though some patients benefit from longer sessions, typically 60-75 minutes.
“Short-term” does not refer to specific number of sessions, but to a commitment to bring meaningful change as rapidly as possible. ISTDP therapies tend to run about 20 to 60 sessions, though some are shorter and some are longer.
I am an in-network provider for Tufts and Blue Cross Blue Shield HMO Plans. This means that I can take almost any Tufts and Blue Cross insurance, but please note the following:
- I am “out of network” for BCBS PPO plans, so the out-of-pocket expense will be higher than for an “in-network” PPO provider
- I am not a provider for BCBS “EPO” plans
- I am not a provider for Tufts “Network Health” plans
If you are using insurance, you should check with insurer before the first session to find out whether you need prior authorization or referral; typically there will be a “mental health” phone number on your insurance card. Please let me know how many sessions are authorized before re-authorization is required. I will work with you on obtaining re-authorization, which is generally fairly straightforward if it is done in a timely way. I am also a Medicare provider, though I have had to limit the number of slots I have for Medicare patients. For patients using insurance, I send out a bill at the beginning of the month for copays from all sessions which have been processed by your insurer.
I am not in-network for any other providers (e.g., MassHealth, Harvard Pilgrim, Aetna, Cigna, United HealthCare). However, if your insurance has an out-of-network benefit (e.g., a PPO plan), it should cover a significant portion of the cost. In considering this, you should know that if your insurer says that they will “pay 80%,” they are referring to 80% of what they deem “usual and customary” for the services I provide, which is generally less than what I charge; you will be responsible for 100% of my fees above whatever their number is.
If I am out of network for your insurance, I can provide you with a receipt that you can submit to them and get reimbursed directly. The one exception this is Blue Cross, in which case I will submit the claims. Blue Cross is supposed to send the payment to you, but for some patients they send it to me
Please note that some insurers have incorrectly told patients that I am “in-network” because of my affiliation with Beth Israel Deaconess Medical Center (BIDMC), where I periodically do consultation work. To be in-network for treatment in my practice, I must be listed under my office address, 68 Leonard St in Belmont, MA (or my previous address, 5 Watson Road in Belmont).
The full ISTDP initial psychotherapy evaluation session last from 2-3 hours. In-network insurance plans does not cover as session of that length, so that there is an additional charge of $250. This is a one-time charge since in-network insurance typically does cover weekly 50-minute session.
Some patients with insurance choose to pay out of pocket either because because they prefer to avoid using insurance to cover mental health care, or because they’re not able to find someone in their provider network that seems like a “good fit.”
For patients paying out of pocket, I charge $225 for a 45 minute session (usually CPT codes 99213 and 90836), and $315 for a 60-75″ session (usually 99213 and 90838). For the initial ISTDP trial therapy, I charge $575 (usually 99204 and 90838). For medication follow-ups, which generally last 10-20 minutes, I charge $120 (usually 99213 or 99214).
Cancellations and Lateness
For cancellations with less than 24 hours notice, I charge my full fee, generally with exceptions for significant illness, family emergencies, and weather that makes travel dangerous. If you contact me before your appointment time and we are able to reschedule, I generally do not charge even if it is within 24 hours. Because I can only bill insurance for the time a patient is with me, insurance does not cover missed sessions.
By the same token, patients are sometimes late enough that I can only bill for a shorter appointment. In that situation, I bill the patient for the difference between what the insurance pays for the shorter appointment and what they would have paid for the full-length appointment.
Intake and Other Forms
As of September 2018, new patients can fill out intake forms through my secure patient web portal. If you wish to do so, please provide me with your email address and I will have the portal email instructions to you.
The following forms are not included in portal intake. I generally provide these at the office, but they are also available here:
If you do not wish to enroll through the portal, you can come early to their first appointment and fill out the forms in the waiting room (I recommend allowing half an hour). You can also print out my nine-page packet for new patients. This packet includes both of the forms linked to above. If you need more than one copy of the Authorization to Release Information form to cover various treaters (e.g. primary care doctor, former therapists and psychiatrists, etc.), use the link above.
In addition to the links above, these two forms are also included in the packet:
- A two-page summary of my policies on Privacy, E-mail and Phone Calls,Cancellation and Lateness, Payment and Outstanding Balances, Pharmacy Renewals, Incidental Contact, and Ancillary Work
- My four-page New Patient Information form
My full three-page Notice of Privacy Practices is available here.
When a third party is taking financial responsibility for a patient’s treatment, they should fill out this form, which is not included in the new patient packet.
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