Frequently asked questions

I charge $180 for 60 minute individual sessions, $150 for 45 minute individual sessions, and $100 for 30 minute individual sessions. I charge $220 for 60 minute couples or family sessions. An initial intake assessment is $250.

I am currently in network with Aetna, Anthem BCBS, Sentara, and United/Optum commercial plans.

I bill directly with the insurance plans listed above. For those not listed, I am covered as an out-of-network provider by many insurance plans. For out-of-network services, session fees are paid by the client at the time of session, but I can provide a receipt (“superbill”) that clients may use to seek reimbursement for services from their insurance provider.

There are some benefits for those who opt to self-pay. These benefits include: services not requiring a mental health diagnosis, a greater selection of therapists, more flexibility in the length of treatment or session times, as well as increased privacy and confidentiality.

Unfortunately, I am unable to offer sliding-scale fees at this time.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

• Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

• Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.

I may be a little biased here, but I believe that anyone can benefit from therapy. That said, the fact that you’re reading this is a good indicator that you, or someone you care about, may benefit from some professional support. Other indicators that therapy may be needed is if you are experiencing symptoms that affect your functioning in your day to day life—whether that is socially, academically, professionally, or personally. You may be noticing changes in your mood, motivation, energy, ability to focus, ability to manage your emotions, or you may be feeling noticeably different from your usual self. Clients often come to me feeling “off”, “burnt-out”, “lost”, “stuck”, or “overwhelmed.” Whatever your struggles, whether you consider them big or small, they are valid and worth addressing. I encourage you to reach out to see if therapy might be right for you!

Life can be so challenging. Therapy gives you a safe space to be able to process life’s challenges with someone who is professionally trained to help you explore your thoughts, feelings, beliefs, relational dynamics, trauma, and behavioral patterns. You will receive individualized support from a professional who has specialized training in teaching you to manage you symptoms and cope with life’s challenges. Therapy provides a valuable combination of processing and skill-building that will help you to overcome the obstacles you are facing. Areas of skill-building may include coping and relaxation skills, cognitive strategies (such as challenging or reframing negative/unhelpful thought patterns and self-talk), interpersonal skills (such as communication skills, conflict resolution, boundary-setting), anger management, problem-solving, organization and time management, and more.

Finding the “right” provider can feel a bit like shopping online for the perfect outfit for a special event. You can see the pictures, read the description, everything can look good on the website, but you won’t really know if it’s the right fit until you are able to try it on and see how it feels on YOU specifically. Finding a therapist is similar in that regard. Everything can look good on paper, but it’s hard to know if it’ll be the right fit until we get a chance to talk or have a few sessions to work on building rapport.

Sometimes people know right away after getting a good feeling from their free consultation, but it often takes about 3 sessions on average for people to feel comfortable with a new therapist. I’m a big believer in “shopping around” for the right fit as numerous studies have shown that the quality of the therapeutic relationship is one the biggest predictors of client success. If I am not the right fit for you, I would be happy to help you find another provider who is.

The “right” counselor will be someone who is knowledgeable in treating your specific concerns, someone whose treatment approach seems aligned with what you’re looking for, and someone who you feel like you can become comfortable enough to open up to.

Each therapy session is a safe, confidential space for you to be heard and supported. Sessions usually include:

• Weekly reflection: I typically start sessions with a weekly check-in. You’ll have time to talk about what’s on your mind, current challenges, and feelings.

• Exploring patterns and gaining understanding: We’ll work together to identify thoughts, behaviors, and experiences that may be contributing to stress, anxiety, or relationship difficulties.

• Learning tools and strategies: You’ll gain practical skills to manage emotions, improve communication, and navigate challenges between sessions.

• Reflecting and planning next steps: At the end of each session, we’ll talk about small, practical steps you can try before we meet again. When we check in next time, we’ll reflect on what felt helpful, what didn’t, and explore new ways to keep moving forward together.

Yes! Research shows that telehealth is just as effective as in-person appointments when it is provided appropriately. I have done numerous telehealth-specific trainings and have been fully virtual for several years with continued client success. Telehealth may not be appropriate for individuals in crisis, those dealing with more severe mental health concerns, those engaging in self-harm or who are having intense suicidal ideation, or those struggling with active addiction. It may also not be the best fit for those who struggle with technology or who lack access to a private space to do sessions. We will determine if telehealth is appropriate for you during our consultation or intake assessment

You will need: Reliable internet connection, a device with a webcam, headphones with a microphone (if your device does not have built-in speakers), basic computer skills (being able to troubleshoot common issues—for example, exiting and rejoining the session or turning the computer off and on if it freezes, etc.), and a private space to have the session. You will receive a link to access the session via the client portal or the app.

I offer appointments on a weekly, bi-weekly, and monthly basis. Typically, I recommend starting with weekly appointments to assist with establishing rapport and making some progress before dropping to bi-weekly sessions. However, some clients opt to start with a bi-weekly schedule based on scheduling needs or if they feel like they do not need weekly appointments. We can discuss scheduling during our consultation or intake session to determine if weekly or bi-weekly appointments would be more appropriate. We can always increase or decrease the frequency of sessions as needed. As we get closer to meeting all treatment goals and prepare for discharging from services, some clients opt to continue with monthly check-ins to see how they do with maintaining progress before deciding to end services.

A standard therapy hour is 50-55 minutes. Why not a full 60 minutes? The 5-10 minutes between sessions gives me time to complete the required documentation for your session (to submit for insurance) as well as giving me some time to process sessions between appointments so I can be fully present for each client. Occasionally, we may shorten sessions to 30-45 minutes as needed based on your scheduling needs.

The length of treatment really depends on the individual needs and goals of each client as well as the severity of symptoms. I have had some clients who only needed a few weeks, some that needed a few months, and some that I have worked with for several years. That said, The American Psychological Association (APA) has found that it can take 15-20 sessions on average for people to feel recovered from their mental health struggles (which would be about 3-6 months if attending weekly); though, many report significant improvement within 8 sessions.

We will collaborate on creating a personalized treatment plan that will have goals with measurable objectives. I will review this treatment plan regularly, using objective measures as well as my clinical judgment, to assess if progress is being made toward your identified goals. I will also check in with you regularly to see if you feel like you are making progress on your goals and whether or not we need to add/change goals. Therapy is considered successful once treatment goals have been met to your satisfaction. Some signs that therapy is working might include: having a decrease in the frequency or intensity of your symptoms, having more control over your thoughts, an improved ability to identify and manage triggers, and increased confidence in your ability to cope with challenging feelings and situations

Absolutely! Therapists are bound by HIPAA to keep all of your information confidential and secure. Keeping your information private will always be a priority. All systems utilized at Lotus Counseling Services are HIPAA-compliant and measures have been taken to protect your information. There are some limits to confidentiality, such as if there is an imminent threat of harm to yourself or others. If you have any questions or concerns about confidentiality, feel free to reach out and I would be happy to discuss this with you or send a copy of my informed consent for your review.

You can reach out to schedule a free 15-minute consultation or, if you’re ready to jump in, we can skip that step and schedule an intake assessment. You can either fill out a contact form on this website and I can get in touch or you can reach me directly at (757)262-3039 or abutler@lotuscounselingservicesva.com. You also have the option to book an initial appointment in my Client Portal. I look forward to hearing from you and am honored that you are considering working with me!