Here’s one question I suggest asking yourself in our consultation: Do you feel safe, respected, and understood?

And, if and as work together, continue to ask yourself:

• Do I feel at ease with Debbie, such that you can be honest?

• Do I feel like Debbie is tracking what matters to me, emotionally and practically?

You don’t need to have complete certainty right away, but you should feel a baseline level of safety and attunement developing, especially over time.

That said, I may at times challenge you and our work may sometimes feel uncomfortable, for instance when exploring past traumas.

On my end, I will be assessing whether I have the skills, expertise, and capacity to help you achieve your goals.

For example, in some cases, I may feel like the level of acuity requires a clinician with more specialized knowledge or experience.

That’s completely okay. Fit matters, and if you don’t feel comfortable or understood with me, it will be hard for me to be effective.

I will generally let you know by the end of the consultation if I think I am not the right counselor or coach for you. Otherwise, I’ll invite you to book an intake session and if you don’t, I’ll assume that you decided there wasn’t a fit.

If we’ve already begun working together, just shoot me a quick email, e.g. “Hi Debbie, I wanted to let you know that I don’t think this is the right fit for me, and would like to discontinue our sessions.”

If you are feeling understood during a sesion, I encourage you to tell me. In general, I welcome live or written feedback. If you’re open to it, I’m happy to talk about what’s not working for you and see whether I can adjust my approach in a way that better supports you.

And if you’d prefer to move on, I can help you clarify what to look for next.

Practically, telehealth lets me keep overhead low (for example, not renting an office), which helps me offer more accessible pricing, especially during my training period. Clinically, many clients prefer it, and telehealth also allows me to serve clients across a wider geography.

My intention is to offer limited in-person availability in San Francisco and Stockholm in 2027, and I’ll share updated options here on this site, at that time. However, I will always offer telehealth as an option.

Yes. I’m happy to do consultations and sessions by phone when that’s the best option for you.

The most important question is: Which format helps you feel safest and most able to show up? I’m comfortable working in all three formats.

• Video (telehealth): Often offers the best balance of convenience and connection. We can see facial expression and body language, and many clients find it easier to attend consistently.

• Phone: Can feel lower-pressure and more private for some people, especially early on or when video feels exposing. It can be easier to talk freely, though we lose visual cues.

If you’re unsure, we can start with what feels easiest and adjust over time.

I’m glad you asked. In general, what you share with me is confidential, but there are a few important legal and ethical exceptions where I may have to share information. These include:

• Imminent risk of serious harm to yourself or someone else

• Suspected abuse or neglect of a child, dependent adult, or elderly person

• Court orders or other legal requirements that compel disclosure (to the extent required)

I’ll review these limits to confidentiality as part of your intake.

And if a situation ever comes up that may require reporting, my aim is to be as transparent with you as possible, so that you’re not surprised and so we can talk through next steps.

Legally, I can only offer counseling in Missouri because counseling is regulated at the state level. Clinicians must be authorized to practice in the state where the client is physically located at the time of session, including for telehealth. In some cases, clinicians are also regulated based on which state they are located in themselves.

The supervisor I wanted to work with (someone whose practice and leadership I deeply admire) is in Missouri, thus my clinical training is set up in Missouri and I can provide counseling only to clients located in Missouri.

Unfortunately, this means that, at this time, I will not be able to provide counseling services to you while you are not physically in the state of Missouri.

For clients outside Missouri, I do offer coaching. Legally, it is more limited in scope than counseling and it is also not covered by insurance, so this is something you’re considering, we should discuss if it’s the right option for you.

States regulations do not apply if you are out of the country. So I am happy to work with you while you are traveling or living abroad, subject to the laws and regulations of the country you are in. Note that I can still only accept Missouri insurance plans.

I anticipate expanding counseling services to California, New York, Colorado, and Florida starting in 2027.

While I cannot prescribe medication, it is common for clients to work with both a psychotherapist can be prescribed by qualified medical providers (for example, psychiatrists  and some other licensed prescribers). If medication might be helpful, we can talk about how to coordinate with your primary care physician or a psychiatrist.

No, you can come for as few or as many sessions as you find helpful. I don’t require that clients commit to a fixed number of frequency of sessions in advance, though I can make recommendations based on your particular case. In addition, note that the No Surprises Act mandates that healthcare providers, including mental health therapists, provide a "Good Faith Estimate" (GFE) of expected charges to uninsured or self-pay patients.

That said, as you might expect, there is a lot of variability, and it really depends on the work you’d like to do.

In terms of number of sessions, some clients may come for a few weeks to do focused work, like navigating a specific transition, relationship challenge, or decision point. Others might work with me for years, to explore deeper issues, strengthen relationships, or sustain ongoing growth. For coaching, clients may come for just one session, for instance to do a resume review or interview prep. I also sometimes offer one-off group workshops on specific topics, such as career transitions, anger, etc.

In terms of frequency, most clients start weekly, then adjust to more or less over time, based on goals, their own schedule, and progress. Note that some insurance plans may limit you to no more than one 60-minute session per week.