Frequently Asked Questions

Whether you have been in therapy before or this is your first time considering some extra support, it’s normal to have questions. Here are answers to some common questions we have come across. If you don’t find the answer to your question or questions here, feel free to  contact us. We look forward to connecting with you.

How can therapy help me?

Many people find therapy to be a helpful source of support. Working with a therapist can help you take real steps towards achieving your goals. It can help you manage distressing symptoms, process grief or trauma in a safe environment, explore your identity, connect more fully with your authentic self, strengthen your relationships, and feel better overall.

What should I expect at my first appointment?

Your first appointment is called an Intake Appointment. In this appointment, you will meet your therapist and start getting to know one another. Your therapist will ask questions to help them get to know you, your history, and any problems you are struggling with.

You are encouraged to ask questions that you may have about therapy, our policies, and your therapist. Your therapist wants to help you feel comfortable, and they understand that it takes time to build trust. They won’t pressure or push you to talk about anything that you aren’t ready to.

In this appointment, you and your therapist will also work together to determine some goals for therapy. Goals vary from person to person, and capture what it is you would like to get out of this process. These are flexible and can change as time goes on, so there is no pressure to know everything you would like to work on in the very first meeting.

A lot of information gets covered in the first appointment, so plan to meet for 60-90 minutes.

What is therapy like?

Oftentimes, talking with a therapist feels like having a conversation. Your therapist will actively listen to you and ask questions to learn about your experiences. They may invite you to explore new ways of thinking about or approaching problems, or they may support you in learning new skills or strategies to help you reach your goals. Above all, they will work hard to meet you where you are at. Their goal is to help you feel comfortable and safe, and to develop a trusting relationship with you. After your intake appointment, you will likely meet with your therapist once a week, depending on your needs and preferences. Your sessions will be around 55 minutes long.

Therapy is customized to the individual and their development. To younger clients, therapy often looks like play. They will be invited to express themselves and learn new skills through fun, creative interventions and interactions with their therapist. Parents and caregivers are an important part of this process. If you are seeking services for your child, you can expect to be offered opportunities to connect with their therapist to discuss your child’s development, strengths, challenges, and treatment.

Your therapist is here to help you, but there are no miracle cures or quick fixes to most of life’s complex problems. Real change takes work and time, practicing new skills and ways of thinking and being - outside of the therapy room as well as within it. It isn’t always an easy process. Sometimes therapy can bring up uncomfortable or distressing feelings or memories, and sometimes some symptoms may get worse before they get better.

You may be challenged at times in therapy, but you won’t be pressured or pushed to take steps or talk about topics that you aren’t ready to. Your therapist will support you every step of the way and ensure that you have access to the level of care you need in order to work through these challenges and take real steps towards growth and change.

What if I don’t feel that my therapist is a good fit for me?

Therapy works best when you and your therapist develop a comfortable, trusting relationship. This can take some time as you get to know each other. We recommend meeting with your therapist two or three times before deciding whether they feel like a good fit or not.

Each therapist has their own personality and background, different training, and their own unique perspective. There are many ways to approach treatment, and if you feel that your therapist’s approach is not working well for you, you have options. If you’re comfortable doing so, it is always recommended that you discuss your concerns with your therapist. They will not take your feedback personally or react in a negative way. They want to be sure you feel comfortable and supported. There might be other approaches they can explore with you, to find a way of working together that feels like a better fit.

If you are uncomfortable discussing your concerns with your therapist, or if you and your therapist have tried different approaches and still feel like this is not a good fit, then you are absolutely welcome to connect with someone new. Your therapist will be happy to support your transition to another therapist within the practice if one is available, or to refer you to someone outside Affirming Pathways.

If you have insurance, you can request a list of in-network therapists in your area. You can also browse for a new therapist online.  Psychology Today and  Therapy Den are both helpful, easy-to-use websites to search for therapy options near you.

What is “neurodiversity-affirming”?

Neurodiversity-affirming encompasses much more than a simple approach or perspective. It is a recognition and celebration of the diverse neurological conditions and cognitive styles that exist within the human population. It embraces the idea that differences such as autism, ADHD, dyslexia, and others should not be viewed as flaws or pathologies.

At its core, a neurodiversity-affirming perspective promotes acceptance. It fosters respect for individuals with neurodivergent conditions, understanding that their unique perspectives and abilities are as valuable as anyone else's. It aims to create inclusive environments that support and accommodate neurodivergent individuals, allowing them to showcase their extraordinary contributions.

This perspective advocates for equal access to education, employment, and social opportunities for neurodivergent individuals. It strives to challenge the stigma associated with these conditions, dismantling negative stereotypes and misconceptions.

Furthermore, it grants neurodivergent individuals the autonomy to make choices about their own lives and treatment options. Personal decisions regarding therapies or interventions are left to the individual.

Above all, this perspective recognizes and celebrates the beauty of cognitive differences. It embraces the diversity of human cognition, understanding that what may be considered a "disability" in some contexts can be a strength in others. Every unique wiring of the brain is a testament to the brilliance of the human mind.

The impact of a neurodiversity-affirming perspective extends beyond autism, encompassing all neurological and cognitive differences. It encourages us to move away from a deficit-based model of neurodiversity and embrace a world where the richness of human neurological variation is appreciated by all.

What is “LGBTQ+-affirming”?

LGBTQ-affirming encompasses empathy and understanding towards individuals who identify as lesbian, gay, bisexual, transgender, queer, or any other non-heteronormative orientation. It champions their rights, identities, and overall happiness. This perspective acknowledges and affirms their existence and experiences. It stands for equality, inclusion, and respect for their rights and identities, making a positive impact.

Key elements of this perspective include utmost respect for individuals and the validation of their self-identified gender and sexual orientations. It advocates for equal rights, opportunities, and safeguards in all areas of life, while fighting discrimination, prejudice, and violence rooted in sexual orientation or gender identity.

Picture nurturing environments where LGBTQ+ individuals can express themselves fearlessly, shielded from harassment or discrimination. This perspective fosters such safe and empowering environments where individuality is celebrated.

Education and awareness are powerful tools within this movement, shedding light on the challenges faced by LGBTQ+ individuals. Through advocacy and allyship, it seeks to amplify and support their voices. Cultural sensitivity is crucial, enveloping interactions with LGBTQ+ individuals and communities with understanding and compassion.

Within this tapestry of inclusivity is a commitment to ensuring LGBTQ+-friendly healthcare access, sensitive to their unique needs. By embracing their healthcare requirements, an affirming society illuminates a path towards holistic well-being.

Ultimately, being LGBTQ-affirming signifies the emergence of a transformed society, embracing inclusivity, acceptance, and moving away from discrimination and stigma. It recognizes diversity in sexual orientation and gender identity as a facet of the human experience worthy of celebration and respect. Guided by this perspective, we pursue social justice, mental health, and the overall well-being of LGBTQ+ individuals and communities.

What is trauma therapy?

Trauma therapy is a specialized form of counseling designed to help individuals who have experienced traumatic events. Trauma can result from various experiences, like physical or sexual assault, accidents, natural disasters, combat, childhood abuse, or other distressing events. The main goal of trauma therapy is to address the psychological and emotional impact of these experiences and assist individuals in processing and healing from the trauma.

Here are some key components of trauma therapy:

It's important to note that trauma therapy is highly individualized. Therapists adapt their approaches to the unique needs and experiences of each client. The specific type of therapy used may vary, and treatment can be short-term or long-term, depending on the severity of the trauma and the individual's progress.

A trauma-informed treatment approach honors individual boundaries and comfort levels regarding when and how painful memories and challenging emotions are explored. Seeking help from a qualified and experienced trauma therapist is essential for those who have experienced trauma and are struggling with its effects.

Do you take my insurance?

We are in the process of paneling with several major insurance companies, including Blue Cross Blue Shield, Blue Care Network, Priority Health, Cigna, and some Medicaid plans. We'll update the site with more information soon!

At Affirming Pathways, we offer private pay options for our psychotherapy services. Private pay means that you pay for your therapy sessions directly, without involving insurance companies.

More information about private pay can be found on our  insurance & fees page.

Can I seek reimbursement from my insurance company for services?

Some insurance plans may allow for partial reimbursement of the cost of mental health services with an out-of-network provider if a superbill is provided. A superbill is a document provided by your therapist that allows you to seek reimbursement from your insurance company. Here's how it works:

Payment Upfront: You pay for your therapy session in full at the time of the appointment.

Receipt and Superbill: After each session, your therapist will provide you with a receipt that includes all the necessary information, such as the date of service, diagnosis code (if applicable), and treatment codes.

Submit to Insurance: You can then submit this superbill to your insurance company for potential reimbursement. Depending on your insurance plan, you may receive partial coverage for out-of-network mental health services.

Reimbursement: Your insurance company will review the superbill and process your claim. Reimbursement amounts vary based on your specific plan and deductible.

It's important to check with your insurance provider to understand their policies regarding out-of-network mental health services and reimbursement rates. Keep in mind that some insurance plans do not cover out-of-network services, while others may provide partial coverage.

At Affirming Pathways, we are committed to making therapy accessible to everyone. We are happy to assist you in navigating the superbill process and answering any questions you may have about private pay, sliding scale options, or insurance reimbursement.

Can I use my HSA card to pay for therapy?

Yes, almost definitely! Mental health care is generally an eligible expense, but every insurance plan is different, so you should confirm it with your insurance company first.

Affirming Pathways is unable to check your benefits for you. It is important that you check the details of your insurance plan or contact your insurance provider to ensure that mental health therapy appointments are an eligible expense before paying with your HSA card.

What if I need to cancel or reschedule an appointment?

At Affirming Pathways, we are committed to providing you with the best possible mental health care. In order to ensure the availability of our services to all of our clients, we have established the following Missed Session/Cancellation Policy:

  1. Appointment Cancellation:
    We understand that life can be unpredictable, and there may be times when you need to cancel or reschedule your appointment. We kindly request that you provide at least 24 hours' notice if you need to cancel or reschedule an appointment. This allows us to offer the time slot to another client in need of our services.
  2. Ending An Appointment Early:
    Attending your full appointment is important to ensure that you get the most out of your therapy. It also allows your therapist to offer consistent time slots to you and other clients. If you must end early and your session ends up being shorter than the scheduled time, you will still be responsible to pay the full session cost.
  3. Missed Appointments:
    If you fail to attend a scheduled appointment without providing at least 24 hours' notice or do not show up for your appointment, it is considered a missed session.
  4. Fees for Missed Sessions:
    Clients will be charged a fee for missed sessions or sessions canceled with less than 24 hours' notice, which will be equal to the full cost of the session. This fee is not covered by insurance and is the responsibility of the client. This fee must be paid in full before further sessions can be scheduled with your therapist.
  5. Exceptions:
    We understand that emergencies and unforeseen circumstances can arise. If you have a legitimate reason for missing your appointment, such as a medical emergency or a sudden family crisis, please  contact us as soon as possible to discuss the situation. In such cases, we may waive the missed session fee.
  6. Payment of Fees:
    Missed session fees will be billed to the client and must be paid before scheduling any future appointments. Payment can be made through our secure online payment portal.
  7. Continuous Missed Sessions:
    If a client repeatedly misses appointments without adequate notice and does not comply with our cancellation policy, we may need to reevaluate the client's ongoing treatment with our practice.
  8. Communication is Key:
    We value open and honest communication with our clients. If you anticipate any challenges in attending your scheduled appointments, please reach out to us as soon as possible. We are here to support you in your mental health journey.

By scheduling an appointment with Affirming Pathways, you acknowledge that you have read and agree to abide by our missed session/cancellation policy outlined above.

Thank you for choosing Affirming Pathways for your mental health care needs. If you have any questions or concerns regarding this policy, please do not hesitate to  contact our office.

How does the sliding scale structure work?

Determining Your Sliding Scale Fee

Income Assessment: To determine your sliding scale fee, we will request documentation of your annual income. This may include pay stubs, tax returns, or other relevant financial documents. If you are unable to provide documentation, we will work with you to establish a reasonable fee based on your self-reported income.

Sliding Scale Fee Levels: Based on your income and the availability of slots, you will be assigned to one of the following fee levels:

Payment Process


We understand that disclosing your income can be sensitive. Please be assured that all financial information you provide will be kept strictly confidential and used solely for determining your sliding scale fee.


We will periodically review your sliding scale fee based on any changes in your financial situation. If your income experiences a significant increase or decrease, please inform us so that we can adjust your fee accordingly.

Questions or Concerns

If you have any questions or concerns about our sliding scale fee structure, please don't hesitate to  contact our office. We are here to assist you in accessing the mental health services you need.

Thank you for selecting Affirming Pathways for your mental health care. We firmly believe that everyone should have the opportunity to prioritize their mental well-being, and our sliding scale fee structure reflects our dedication to this principle.