Individual & Couples Counseling


FAQs:

What is your approach to treatment?

I have a very relaxed and open style, whether in-person or virtual. One very important thing to know about me is that I’m not just an active listener. I believe in the power of dialogue and use Trauma-Informed-CBT as my primary therapeutic modality. This modality includes analyzing and challenging the validity of thoughts and the thought-life, identifying toxic thought patterns or cognitive distortions, and engaging clients in specific, directed journaling activities as coping mechanisms for stress, trauma, and/or abuse. I also use elements of DBT to improve emotional regulation, increase mindfulness, develop self-soothing coping skills, and encourage a deeper level of awareness of the mind/body connection. Additional exercises used include yoga, breathing exercises, and formal meditation as they have been proven to decrease anxiety, PTSD, stop oncoming panic spirals, and improve regulation of the nervous system. For my couples, I use the Gottman Method to assess the relationship and integrate research-based interventions based on the Sound Relationship House Theory. This modality includes assessing and improving the seven principals for making marriage work including getting to know each other better by creating love maps, nurturing the fondness and admiration of each other,  turning toward each other instead of away, letting each member of the couple influence the other, solving solvable problems, overcoming gridlock, and creating a shared sense of meaning.  The goals of couples therapy are personalized, but typically include disarming conflicting verbal communication, increasing intimacy/respect/affection; removing barriers that create a feeling of stagnancy, and creating a heightened sense of empathy/understanding within the context of the relationship. Ultimately, the big picture of couple’s therapy is learning to  radically accept, reframe, or change the dynamics of the couple as a system.

 What are your session options?

For those who can pay cash, I currently offer 2 session lengths. This has come out of clients truly needing more than 60 minutes, especially on intake. My hourly rate is $100, so my 2 session options are 60 minutes for $100 and 90 minutes for $150. Due to treatment planning, the first appointment (initial intake) is always 90 minutes. After that, feel free to book either 60 minutes or 90 minutes depending on your mental health needs and financial situation.

For those who are using insurance, unfortunately, I have no ability to offer a session length beyond what your insurance will allow. Sessions paid for by insurance are typically 45-50 minutes long. I recently began taking insurance bc of inflation and how difficult it has been for all of us to afford self-care. I hope this will help some of you who couldn’t come otherwise be able to schedule an appointment with me.

 What are your virtual and in-office times?

I am currently working Monday-Friday and I have in-office times one day p/week on Wednesdays. My Wednesday office hours are 11-7 (I take my last appointment at 6:00). Monday, Tuesday and Friday are exclusively virtual with hours that vary dependent on the client’s need and this is for several reasons. Most of my clients are virtual, primarily because they live all over the state.

What is your primary specialty?

I specialize in Covert Narcissistic Abuse, a specialty that is evidently very difficult to find, even within each state. I am open-minded and would never diagnose NPD in a client I have not formally worked with and assessed. I am aware that Narcissism itself exists on a continuum, with some level of Narcissism being healthy as it propels you forward in life and helps you advocate for yourself. I work with many survivors of Narcisstic Abuse, and this work is a specialty regardless of whether the perpetrator fully met criteria for NPD or whether a lesser trait-based profile is described to me; either way, Narcissism, if too high on the continuum towards pathology, can result in its own unique brand of psychological abuse and indoctrination that typically includes both verbal and emotional abuse. I am also a lifecoach in order to help those who are outside the state of TN. Please note: I cannot engage in therapy with anyone outside the state of TN; however, I do help clients outside of the state in the capacity of a life coach, utilizing the modality of trauma-informed practical application and pulling from all various life and education experiences. For me, every woman I work with who manages to break free and stay free from a covert or overt narcissist is true fulfillment and the reason why I do what I do. Freedom from a narcissist is absolutely invaluable in being the healthiest version of yourself that you can be.

Although Narcissistic Abuse is my primary specialty, this specialty has far-reaching mental and emotional consequences and has led to me becoming well-versed in treating most mental/emotional/psychological pathologies. I also did a 2-year residency in addiction, which is much like trauma bonding. Most clients who are survivors of Narcissistic Abuse typically have at least 2 additional mental health diagnoses, whether it be depression, anxiety, grief/loss, stress/coping, adjustment disorder, substance abuse, etc. By specializing in Narcissistic Abuse, I have become a strong generalist and am competent and willing to help most all mental health conditions.

I also specialize in helping victims who share children with a covert or overt. There are specific techniques that help diffuse the situation and create emotional distance even while co-parenting. I do need to emphasize that Narcissists in general do not do much of the heavy lifting when it comes to parenting, so the primary caregiver is and always will be the victim. This is even more of a reason why it’s important to set healthy boundaries when co-parenting with a Narcissist.

Lastly, I always have a few clients who have decided to stay in the relationship with the covert for personal reasons. In this case, I am still able to treat any abuse that has or is occurring while offering techniques and support to help the victim curate, develop, and find fulfillment through friends, career, hobbies that can lead to passions, and many other areas of their life beyond their relationship with the covert. Training clients in “deliberate living” is balanced with diffusion techniques such as “not taking the bait,” “grey-rocking,” and others to create as much emotional safety as possible and navigate the high-conflict nature of the relationship. Some of these techniques include learning how to live proactively and deliberately rather than just letting life “happen.”

Do you ever see men?

I do actually work with some men who are victims of narcissistic abuse, particularly if they are willing to primarily do virtual statements. While narcissistic personality disorder is a majority male disorder, there are absolutely female narcissists or females with traits that exist high on the narcissistic continuum. In this case, I will definitely treat anyone, women or men, who are victims of narcissistic abuse.

 Do you take insurance & what is your rate/length of session?

I do! I take most insurance, including TennCare, Cigna, BCBS, Anthem, Aetna, Cigna, and most others. The only one I’m not yet able to see via insurance is medicare/medicaid.  For those who can afford to pay out of pocket, I have the full 60 and 90 minute options. I will also allow about 10 minutes in case we happen to go over a bit, so it won’t affect the next client’s appointment. For those who are using their insurance, while I am bound to the 45-50 minute session length, I believe any amount of quality care is much better than nothing at all!  Regardless of your particular situation,  I will let you know when you have about 10 minutes left in case there’s some homework I’d like to share or there’s another concern you’d like to go back to.

How often would I see you?

It’s really dependent on the client’s specific situation. I will say, most of my clients see me every other week, as there is usually some journeling homework as well as physical “body” homework and thought-watching or mindfulness work. Some of the most important work is done outside of session. The key to seeing these elements come together and result in healing is cumulative and based on the competency of the therapist, the level of involvement/vulnerability of the client in session, and the consistency and thoroughness of performing the assigned homework outside of session. If a client feels she needs weekly sessions for extra support or accountability, I totally support that. In all, how often a client comes to therapy is dependent upon their individual pace to complete the homework thoroughly and their emotional brain’s speed to fully process as we “break up” and symbolically close traumas. I consider every other week (unless a specific situation calls for it) within the confines of “best practice” along with the specific homework.

 Do you do sliding scale?

The primary reason why I don’t do sliding scale is the science behind how clients view the quality of their investment. If a client has invested $100 or $150 in a session, they are much more motivated to do the work that it takes to recover than if they had only invested $60 in their recovery. This reason alone would be enough for me to not take sliding scale. However, I do understand that not everyone can afford $100 or for 60 or $150 for 90 minutes, so in that case, we can definitely use insurance or could work together less, but I’d still be checking in on you regularly and you can reach out to me anytime via email! I’ll try my best to help you or answer your question without the fee of a session! I do check in on my clients during the weeks we aren’t in session, primarily just to see how they are doing and how the work is going. This is quite unique to my practice and part of my approach to keeping the therapeutic relationship strong and growing between sessions.

 What is your cancellation policy?

I have a 24 hour cancellation policy. If clients cancel after the 24 hour window it may result in a charge. A first time warning will be issued.

Do you communicate with clients outside of session?

Yes. All of my clients have access to my email so they can reach out to me if they need support and know that I will do my best to respond within a few hours. I absolutely want all clients to feel comfortable reaching out to me and if I can send back a response that will bring them clarity, offer additional reading materials, or answer a quick question without it costing them a session I’m happy to do. If a client communicates with me that they need to be seen asap (except for Wednesdays) I can usually find them a virtual session right away as opposed to waiting a week or a week and a half to get back into the office. I’m happy to meet in-office with clients on Wednesdays, at least for the first time, the first few times, or ongoing if you’re just not into virtual. If you’ve never tried it, I’d suggest you at least give it a chance! It’s very much like in-office but with much more flexibility, some evening hours depending on individual client needs, and no dealing w traffic!

My only request is that if you reach out with a question, think about the time it will probably take me to answer it. If a question takes more than 15 minutes to answer or there are multiple parts to the question, it’s probably best to schedule a session to give those issues the time they truly need and allow me to practice what I preach (healthy boundaries). If the way I conduct my sessions sounds like a good fit for you, please don’t hesitate to reach out!


Thank you again for checking out my site!

Anna LPC-MHSP, FNP-C