Affirmative Heart Counseling | Therapy that's a work of heart

FAQs – Affirmative Heart Counseling | Michelle Martinez, LMHC

Q: Where is your practice located?
A: My practice is based in Washington State, and I provide therapy services exclusively online using Google Meet.

Q: Do you accept insurance?
A: No, I do not accept insurance. All services are out-of-pocket and payment is due at the end of each session. I will provide superbills for you as part of your receipt of payment if you know your insurance will reimburse you for out-of-network services. However, I will not interface with any insurance company, nor spend additional time providing extra documentation to justify the services you have received. You should prepare for the risk of not being reimbursed and plan accordingly.

Q: Why don’t you accept insurance for your therapy sessions?
A: Please see Why Michelle Doesn’t Take Insurance for an answer to this question.

Q: What are your session fees?
A: The regular session fee is $165 for a 45-minute session. Please note that fees may increase by 10% annually to adjust to inflation and cost of living.

Q: Do you provide sliding scale services?
A: I strongly believe in making therapy accessible for everyone, which is why I do offer a certain number of sliding scale slots. I have recently re-opened some spots. The fees for sliding scale range from $110 to $145.

Q: How and when do I pay for sessions?
A: Payment for each therapy session is due at the end of the session. To ensure a seamless and secure transaction, I use a HIPAA-compliant payment processor, Ivy Pay, specifically designed for therapists. At the conclusion of our first session, Ivy Pay will send you a text message with a link to set up and securely store your payment information, be it a credit card, debit card, or HSA card. Once your payment information is set up, payments for future sessions will be processed automatically at the end of each session, requiring no additional action on your part. This allows us to focus on your therapeutic journey without any interruptions or concerns about handling payments.

Q: What if I need to miss a session?
A: I understand that unexpected events can occur. If you need to miss a session, please provide at least 48 hours notice to avoid being charged a cancellation fee (which is equal to your regular session fee). If you can reschedule within the same week, I will do my best to accommodate you depending on my availability and you will avoid the cancellation fee. I do provide one cancellation fee waiver per calendar year to each client.

Q: Who is an ideal client for your practice?
A: I can best serve adults who are looking for long-term, depth-oriented therapy and have low to medium support needs. Unfortunately, I cannot accept clients with high support needs such as those actively experiencing suicidal intent, eating disorders, personality disorders, or those in crisis.

Q: What therapeutic techniques do you use?
A: My approach to therapy is client-focused and integrative, meaning I draw from a range of therapeutic techniques to best support your individual needs. I see similarities in my philosophies and the established technique called Acceptance and Commitment Therapy. I also offer EMDR (Eye Movement Desensitization and Reprocessing) in an adapted form for suitable clients.

Q: What is the frequency of sessions?
A: Weekly sessions are the ideal. However, the minimum frequency of sessions that I believe to be therapeutic is every other week. After some time, and if you feel you have reached many of your goals, I am open to meeting less frequently, usually monthly.

Q: How can I get started?
A: The first step is to email me to schedule a free 20-minute phone consultation. During this consultation, we can both ask each other questions and assess whether we would work well together.

Q: What happens if my needs are beyond your capacity?
A: If at any point I determine that your needs exceed my capacity, I will help you find a suitable referral to a trusted colleague who can better serve you.

Q: How will I know if therapy is working?
A: Progress in therapy can sometimes be subtle and slow. It often involves shifts in your thoughts, feelings, and behaviors that gradually lead to significant improvements in your well-being and quality of life. Regular check-ins during our sessions will help us assess your progress and adjust our approach as necessary.

Q: Can you provide me with a gender-affirming surgery support letter?
A: Yes, I can provide support letters for gender-affirming surgery. In line with the World Professional Association for Transgender Health (WPATH) standards, we will engage in a several sessions to ensure I have a comprehensive understanding of your history and current situation. I am aware of (and understand) the criticisms of the length of this process, but for my own sense of ethics and concerns for my license requirements, I feel it is essential that I know you well enough to write a comprehensive and supportive letter that backs up my diagnosis. It is also a requirement from many surgeons that I document and prove we have an established relationship, and indicate that we will be continuing supportive therapy throughout your surgery and physical healing process. I urge you to work with your surgeon to find out exactly what information they require in order to approve your treatment.