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Common Questions

 Logistical questions

Do you accept insurance?

Our therapists are in-network providers with Moda, Blue Cross / Blue Shield / Regence, PacificSource. For all other insurance companies, we offer complimentary billing as an out-of-network provider.

Do you accept credit cards?

Yes. We accept MasterCard, Visa and most health savings account (HSA) cards. We also accept personal check and cash. Payment is expected at time of treatment.

What if I'm having a mental health emergency?

We are not available on-call and do not keep emergency hours. In order to provide consistently good service to our clients, we set limits on availability. We will always try to return phone calls or emails within a few hours when possible, however, for true emergencies, such as contemplating suicide, we advise people to call 911, or the Multnomah County Crisis line at 503-988-4888 or go to their nearest emergency room for safety, and ensure they get immediate attention.

What is the best way to contact you?

Contacting us by phone is the best way because it is more secure than email. You can call us at 503-349-2281. However, you may also email us [email protected]

When you start working with a counselor at our center, you will be able to contact them directly at their email and voice mail extension.

Do you have weekend and evening hours?

Yes. Many of our therapists have weekend and evening hours. Please ask when scheduling your first appointment.

What is your cancellation policy?

If you cancel an appointment with more than 24 hours notice, this provides us time to fill the space, and you will not be charged. However, if you cancel an appointment with less than 24 hours (excluding weekends) or do not show up to your appointment, you will be charged the full cost of the session for the missed appointment. Also, your insurance cannot be billed for missed sessions.

Monday appointments must be canceled on the preceding Friday. We do not accept cancellation calls over weekends or holidays for the following day.

The only exception to our cancellation policy is if you are sick or have emergency.

Please note that if you are doing couples counseling and only one of you cannot come, the other is still expected to come for the session.

What if I show up late to my appointment?

Appointments that start late will typically end on time.

General counseling questions

I’ve never been in counseling before, what is it like?

Counseling is an opportunity to feel safe sharing anything you want with a caring person who is also a trained professional in the art of change and growth.  The relationship you form with your counselor is collaborative.  It feels a lot like having someone on your team.  Together, you decide what goals to set, what pace to take, and what to explore.

There’s strong research that shows the number one factor for clients changing through counseling is the relationship formed between client and therapist.  It is just that important. To have someone there for you you who does not judge your, criticize you, or belittle you is no small thing.  That “unconditional positive regard,” as a well-known counselor once called it, is the medicine that will help you have the courage to face what you need to face in order to meet your life goals.

In counseling, you will be invited to grow in new ways, too.  Ideally, you are nudged to grow in ways that you have been wanting to for a while, but haven’t had the right support or tools.  Counseling can give you those things or can help find where to get them for yourself. 

How might this be different from past counseling experiences?

Our approach to counseling at Family Ties Counseling Center is relationship based.  What does this mean?  First and foremost, this means that your therapist will meet you right where you are. And not where they think you should be.  The only way for you to move forward in your life is through figuring out right where you are.

We have chosen our therapists with great care.  The therapists at our center know a lot about how to be in relationship.  Just as important as their education and training is their capacity to be authentic, compassionate and insightful.

A relationship-based approach to counseling also means that you look at your relationships.  It might start with your relationship with yourself or it might entail exploring the formative relationships in your life, either past or present.

How often will I need to come to therapy?

Counseling requires an ongoing commitment to creating lasting change. Best results are achieved through consistent (typically weekly) appointments with your counselor.  However, you can discuss with your therapist at your first appointment how often you should come, based on your current situation, your goals, and any financial constraints.

Why is confidentiality so important with counseling?

Confidentiality is the foundation that makes counseling safe and effective. If you are 18 years old or over, we cannot and will not reveal to anyone what you talk about in therapy, or even the fact that you are in counseling without your permission.

One way this wouldn’t be true is if you choose to decide to sign a release of information, which is a written authorization form that meets certain legal standards.  There are certain circumstances where doing this would be helpful to you.  All our therapists have an ethical duty to assure you of your privacy and confidentiality.

There are five exceptions to the privacy standard that include: 1) Reporting suspected child or elder abuse; 2) Reporting imminent danger to client or others; 3) Reporting information required in court proceedings; 4) Providing information concerning case consultation or supervision; and 5) Defending against claims brought by a client.

Your counselor will talk more about confidentiality with you in your first session.

How will I know when I don’t need to come to therapy anymore?

When establishing goals, you and your therapist will define criteria for improvement. Once you have a vision for improvement, both you and your therapist can monitor your progress toward your goal. Once you have reached your goal, you are welcome to establish new goals or you can end your work with your therapist. Counselors at our center always welcome conversations about whether or not you feel your work is effective. If your work together is not meeting your needs, your therapist would be happy to take your work in another direction and if your challenges continue, your therapist would be happy to refer you to another therapist at our center or outside our center.

Couples counseling questions

What if my partner is unwilling to come to counseling?

You can certainly impact your relationship without your partner coming to counseling.  It is nearly impossible to change someone else, but very possible to change yourself.  So, that’s where you start without your partner.  You can also discuss with your counselor about productive and effective ways to talk with your partner about them joining you in therapy. 

What if my partner and I aren't married. Can I still do couples/marriage counseling?

Definitely.  Couples or marriage counseling is open to anyone in an intimate relationship.  Opposite-sex and same-sex partnership are both welcome.  Even though it’s sometimes referred to as “marriage” counseling, you do not need to be married.    

Child & family therapy questions

How old do children have to be to participate in Family Therapy?

Children as young as 3 or 4 can participate in family therapy.  With toddlers or preschool age children, it is sometimes helpful to do some sessions with the child/children present and some without.  Our practitioners have a variety of techniques they use depending on the age of the children and the family goals.

I know which one of my children has a problem- why should their siblings have to come to therapy?

Our culture often views attending therapy as something to be ashamed of.  We view therapy as an opportunity to teach your children about their ability to be powerful in their lives.  In therapy, children learn communication skills, collaboration skills and self-soothing skills.  With these skills, children are more able to communicate their needs and feelings.  Often skills from therapy have helped children (even the siblings of a child with mental health challenges) get help when they are being bullied, ask adults to advocate for them and to act a leader within their peer group.

Does my spouse have to come to Family Therapy sessions?

The most effective way to create change in a family is to have all family members present for the initial session.  It is very helpful to get everyone’s perspective about the family’s challenges.  Often family members are surprised by other member’s perceptions and contributions.  Upon establishing your goals, you and your therapist can determine who should be present for the rest of the counselor work.

What if I want to talk about something that I don’t want my children to hear?

We welcome parent-only sessions. Often parents will attend the first session without their children to discuss the family challenges, give some background information and determine if it’s a good fit to work together.

How many sessions will we need to attend?

This will vary depending on your family’s goals. Typically families will attend between 4-7 sessions to address their initial goal. Once the family and the therapist agree the initial challenges have been resolved, you can discuss whether or not you’d like to establish another goal and continue the counseling work together.

I’d have gone to therapy a long time ago but I just don’t want to be told what I’m doing wrong. How do I know that won’t happen at your counseling center?

Many parents say or do things to their children that they feel ashamed of and don’t want to discuss with anyone- especially a stranger! We truly believe that each of us is doing the best we can with what we have.  Often, counselors enjoy the detective work to figure out what is motivating our behavior. It’s most effective to do this with curiosity rather than judgment. If you even do feel judged or criticized in your work with your counselor, we invite you to talk directly with them about it.

My son’s teacher and school counselor are recommending we find a therapist because of his behavior at school. Everything is fine at home. What should we do?

It is important for children to feel confident and capable within their families, at school and in other environments. It is not uncommon for a child’s behavior to vary greatly between the home and school environments. In our work with families, our therapists often collaborate with and communicate closely with school counselors and teachers. It can be very helpful to have an open dialog with school folks, your child and other caregivers about how to address the challenges. Our therapists have often facilitated such meetings. We welcome this opportunity.

I know some therapists meet with children without their parents, why don't your counselors do that more frequently?

Our priority is to build a relationship between child and caregiver so that your family can be more harmonious and connected. Your therapist could focus on building a relationship between the child and them, but they will not be in your child’s life forever (and that would get a little expensive).

We focus on the relationship between caregiver and child because the longevity and strength of that relationship is much more important than the relationship between the child and their therapist. For this reason, we include caregivers more often than not in the work we do with children. We find this work to be more powerful and create more long-term change.

I don’t want to tell anyone my family is seeing a therapist. I especially don’t want my children telling others. Would you tell anyone else that you’re in therapy with my family?

Our practitioners are legally bound to honor your confidentiality. They will not discuss your work with anyone with a few exceptions that they will discuss with you in your initial consultation. We encourage parents to talk with their children about therapy and establish clear boundaries about the content of therapy. If you are concerned with your child sharing specific information about the family, don’t share the information with them.

Getting everyone in the family together at once is like herding cats! Good luck finding a time when we can all meet!

This is often a challenge for families. To meet your needs, our center has both daytime and evening hours available, in addition to weekends. The exact availability depends on your therapist. When scheduling is extremely challenging for a family, it can be useful to adjust your sessions accordingly.  You also can adjust your therapy to accommodate those family members who are available for sessions.  It is good to have at least a few sessions with all family members but sometimes the complexity of scheduling prohibits this.

Will you participate in legal/custody disputes?

“We will not voluntarily participate in any litigation, or custody dispute in which a client is involved. Because the client-therapist relationship is built on trust with the foundation of that trust being confidentiality, it is often damaging to the therapeutic relationship for the therapist to be asked to present records to the court, testify whether factual or in an expert nature, in court or deposition. We will also not make any recommendation as to custody or visitation regarding our clients. We will generally not provide records or testimony unless compelled to do so by a court.”

Teens & counseling questions

Why do you welcome individual sessions with teenagers when you are a family therapy center?

Part of an adolescent’s job is to push against their caregiver’s limits to establish more independence on their path to adulthood.  Sometimes an important aspect of their process is to have time and space to reflect on their needs and feelings.  Often adolescents are more open to skill building and new information when their parents are not present.  Our counselors will always encourage teens to have some sessions with their parents present but it often is the choice of the teen and their parent.

I want my teenager to feel safe sharing information about themselves in therapy but what if my teenager shares something in therapy that I should know about? Or, what if I have concerns about my teen that come up and I don’t think they’ll tell you about them- can I call you and tell you?

In the state of Oregon, adolescents are entitled to seek mental health services without their parent’s consent.  Teens who are 14 and older can request that their counselor not share any content of their sessions with their parent and their counselor will comply.

If teens share information about risky behavior or experiencing abuse, their counselor will discuss the importance of sharing this information with a parent and give them options for how they’d like to share this information with a parent/caregiver.

Beyond these guidelines, we welcome your family’s unique requests for privacy as long as they feel safe and comfortable for teen, parent and the therapist.  Once your teen’s therapist has a signed agreement between the teenager, parent and the therapist, everyone can all move forward with a clear understanding of privacy and confidentiality.

I’ve had a bad experience with a therapist before. How do I choose a therapist that won’t turn my teen off of therapy forever?

Therapy is like anything else, if you want to find a product or service that fits best for you- shop around.  We invite you and your teenager for a first session with one of our counselors.  If you don’t think they work well together, we’d be happy to refer you to another counselor at our center.

My teenager is opposed to almost anything I suggest. How do I get her into therapy?

We encourage parents to engage their teen in the process of entering therapy.  We encourage you to talk about how you view the current challenges and your hopes for how therapy would help.  Encourage them to reflect on any changes they’d like to see in their lives or their relationship with you.

Then, find a therapist who can help you both move toward your goals.  If your teen is adamantly opposed to being in therapy, it probably won’t be useful to them anyway.  Sometimes parents and teens agree to a three session trial run.  If after three sessions, the teen still does not want to be in therapy, the parent will agree to either try another therapist or drop it for the time being.

Even if the teen refuses therapy, it can be helpful for the parent(s) to attend a few sessions to gain some strategies and resources for parenting teens.