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Frequently Asked Questions

When should I seek help?

Have you noticed yourself:

  • Feeling unhappy for longer periods of time
  • Feeling unsatisfied with life
  • Avoiding the people who care about you
  • Unable to keep up with your normal routine
  • Experiencing significant changes
  • Constantly worried or unable to stop your racing thoughts
  • Feeling hopeless or worthless
  • Having trouble at school, work, or home
  • Reacting with excessive fear, anger, or tears
  • Grieving (i.e. death, loss of job, disability, empty nest)
  • Covering your pain with substances, shopping, or electronics
  • Feeling constantly stressed
  • Lacking the energy or motivation to do your favorite/normal activities
  • Constantly thinking about a past trauma
  • Thinking about suicide

You may need help when you encounter problems and challenges that are greater than your abilities, resources, or perspective.

How can counseling help?

Counseling can help people recognize problems, learn specific skills to cope with or address the problems, and develop supports or resources to keep them going strong when they face new challenges.

Counseling can offer people the safety to name a problem without judgment, a place to feel known, explore motives or influences, speak with openness, identify values and goals, practice skills, and create a plan.

Counseling can offer people the opportunity to talk about and see their problems in a different light. It is also a place to obtain education and a non-biased perspective that can speak into the situation as well as a place to receive hope and support and identify the sources of the problem.

Counseling can help foster and facilitate relationship reconciliation and repair. Sometimes our greatest hurts happen in relationship and it can also be a place of great healing.

Is counseling confidential?

In general, counseling, counseling notes, and your private healthcare information (PHI) is private and confidential.

There are some important exceptions to confidentiality which may require us to share some of your information. When we are required to break confidentiality, we use the least amount of information necessary in order to protect your privacy as much as possible.

Exceptions to confidentiality:

  • If you are using insurance
  • If you have signed a written release of information
  • If there is suspected abuse of a child, older adult, or a person who is developmentally disabled
  • If you are an immediate risk to yourself or others (suicide or homicide)
  • If you are a minor
  • Other exceptions identified by HIPAA and Washington State law

How often do I go to counseling?

Determining session frequency will be between you and your counselor. Factors to consider will be the stage of counseling (beginning, middle, end), the severity of your problems, assessment of any crisis or safety concerns, your availability, and any other concerns (i.e. finances, insurance).

  • Intensive counseling is twice a week and is offered to those who are in crisis or intense distress.
  • Regular counseling is once a week and is appropriate for beginning and continuing counseling, problem assessment, goal identification and progress, skill building, and seeking relief.
  • Semi-regular counseling is every two weeks and is appropriate for those who have met many of their goals and are applying their skills more independently.
  • Maintenance counseling is available once a month or every couple of months to address any remaining concerns, maintain goal awareness and focus, or review progress.

How long will I be in counseling?

In the first session you will be able to work with the counselor to identify the problems, symptoms experienced, and your goals. You will create a plan with the counselor outlining what you want to address, the frequency of sessions, and the estimated length of time to reach your goal.

Counseling can be short-term, 2 to 6 weeks, to address a specific problem.

Counseling can also be long-term, 2 months to 2+ years, to address larger and more complex issues (i.e. self-esteem, identity, restoration, addictions, trauma, abuse).

You may not want to address ALL of the possible problems, as you may notice relief once you start to address SOME of the problems.

What insurances do you take?

OUT-OF-NETWORK benefits with most insurances can be used by all of the counselors with Lacamas Counseling, not including graduate student interns.

IN-NETWORK benefits – Some counselors have completed the credentialing process with specific insurance companies to become in-network. Please refer to the individual bio pages for an up-to-date list or contact our office.

What is the difference between in-network and out-of-network insurance benefits?

In-Network Benefits:

  • If the counselor is “in-network”, you will only need to pay your co-payment, co-insurance, and/or deductible at each of your appointments. The rest of the fee will be billed to your insurance.
  • Check with Lacamas Counseling, your individual counselor, or your insurance company to determine if we are “in-network.”
  • Please provide your insurance information when you schedule your first appointment so that we can verify your mental health/behavioral health benefits.

Out of Network Benefits:

  • If “out-of-network” benefits are allowed with your insurance company, then you will pay the full session fee and we can generate a receipt for your paid service so that you may request reimbursement from your insurance company.


  • Deductible – the dollar amount that you must meet before insurance will start to reimburse for expenses
  • Copayment – a flat rate (i.e. $10, $20) that you pay for each session
  • Co-insurance – a percentage (i.e. 10%, 20%) of the cost of each session that you pay for each session
  • Employee Assistance Program (EAP) – a benefit through some employers that offers employees and their dependents a certain number (usually 2-12) of free counseling sessions per year

What if my counselor is subpoenaed to court?

In general, clients are discouraged from having his or her counselor subpoenaed or providing records for the purpose of litigation as this can negatively impact the therapeutic relationship. Professional counselors can only testify to the facts of the case and professional opinion, which may not be solely in your favor. As counselors, we would rather not damage the trust we have built in the counseling relationship.

Clients are be responsible to reimburse the counselor for all of the time required for preparation, attendance, and follow-up; including time for driving to court, waiting to testify, giving testimony, as well as preparation and/or research time that is required. A retainer is required in advance.

Can counselors prescribe medications?
No, the counselors at Lacamas Counseling are not trained or certified to prescribe psychiatric medications. Lacamas Counseling has established relationships with several local doctors, prescribers, and naturopaths who are trained in psychiatric medication management. Counselors may ask you about your current medication management and offer recommendations for further evaluation. We will work with you to find referrals for providers who have availability to meet your needs and requests.
Are there any Christian Counselors at Lacamas Counseling?

Yes, there are several providers at Lacamas Counseling who have a Christian faith background and have been trained in the skills of spiritual and faith integration. Some of our counselors have been vetted through Focus on the Family, His Heart Foundation, and local churches as trusted Christian Counselors.

All counselors will respect the rights, requests, and preferences of every client who seeks counseling, including the degree of faith integration in session (e.g. acknowledging, addressing, incorporating, reflecting, aligning). It is our goal to support you and not to impose our beliefs. All clients have the right to request or decline the integration of faith and spirituality in their counseling sessions.

Please contact us if you would like to request a Christian Counselor or have more questions.


Learn More about Christian Counseling Here

Can counselors give me a mental health diagnosis?
Yes, the counselors at Lacamas Counseling are trained in assessment and diagnosis of mental health conditions. An accurate diagnosis is helpful in identifying the appropriate recommendations and treatment goals, as well as creating a common language among the medical professionals who are supporting you. A mental health diagnosis is also required to justify medical necessity for anyone who wants to use their health insurance benefits.
Can I request an exemption from notes and a diagnosis being recorded in my file?
Yes, according to Washington Administrative Code, WAC 246-809-035, “If a client being treated by the licensed counselor requests in writing that no treatment records be kept, and the licensed counselor agrees to the request, then the licensed counselor must retain only the following documentation: Client name; fee arrangement and record of payments; dates counseling was received; disclosure statement signed and dated by licensed counselor or associate and client; and the client's written request that no treatment records be kept.”

Please contact your counselor to discuss the risks and benefits of record keeping.

How do I choose a good counselor?
Choosing a good counselor will lead to significant benefits and progress in your personal and counseling journey. It is important to find a counselor who has skills, experience, or training to address your areas of concern, as well as finding a counselor with whom you feel a connection. Lacamas Counseling will try to gather relevant information at your initial request to begin counseling and match you to a counselor who has the best possibility of being a good fit. It is helpful if you can think about your top priorities and preferences (e.g. laid back, easy going, calm, directive, leader, confrontive, collaborative, humor, peaceful, male or female, younger or older). Sometimes you may specifically want someone who has gone through a similar life experience (e.g. mother with kids, homeschooling, men’s issues) and other times you may feel open to learning from a range of perspectives. If you’ve had experience in counseling then you may know what specific counseling theories and approaches best fit you (e.g. CBT, SFT, DBT, EMDR, somatic, existential, Socratic) or you may be a newcomer and not know what you need.

We encourage you to think about your needs and priorities, and we will support you in advocating for the right fit. We want to offer freedom to “try out” a counselor and even request a different counselor if the fit is not right. Our goal is to help you get better no matter if that is with the original counselor assigned or with another counselor.

How much does counseling cost?
Counseling session costs will vary depending on the type of session requested and the counselor’s licensure.

Post-Graduate Fully Licensed Mental Health Counselors rates per session are:

  • $160 for Individual Counseling Sessions
  • $190 for Couples and Family Sessions
  • $210 for Diagnostic Assessments

Post-Graduate Associate Licensed Mental Health Counselor (counselor is under required supervision) rates per session are:

  • $150 for Individual Counseling Sessions
  • $180 for Couples and Family Sessions
  • $200 for Diagnostic Assessments

Graduate Student Counseling Intern (graduate student is in process of completing training and is under supervision at their graduate school and at Lacamas Counseling) rates per session are:

  • $90 for Individual Counseling Sessions
  • $110 for Couples and Family Sessions
  • $210 for Diagnostic Assessments

How effective is online counseling?
Online counseling is an effective way to access counseling when you are limited by your location, schedule, health, family, or life circumstances. Online counseling is effective to treat mild to moderate mental health concerns. A private and secure telecounseling link is created that provides audio and visual connection. The counselor is able to hear your concerns and work with you to achieve your counseling goals.

Refer to for more detailed information about online counseling.

What are the risks of counseling?
It is important to know that counseling does have its risks. People may notice that their lives get worse before they get better. This can happen for a variety of reasons. Issues that used to be “tucked away” and ignored are brought forward and remembered. It can feel painful to spend time noticing and remembering our weaknesses, pains, traumas, and grief. Our brains may fight us to maintain old unhealthy known habits versus changing to unknown good habits. Creating healthy new habits can take more energy, time, and resources than we planned. Unhealthy or abusive relationships may work harder to resist your changes and keep you stuck.

It's important to talk with your counselor about any concerns or risks about starting counseling so that you have informed consent. You may consider postponing counseling to another time in your life or addressing one or two issues at a time and leaving other issues to be addressed at another time. Your counselor will be able to support you in creating a strategy and treatment plan.

What is it like to be a counselor?
It is both an honor and challenge to be a counselor. It is energizing and exciting when we see people heal, lives change, and growth happen. We love sitting with people, fostering authentic conversations, increasing self-awareness, creating healthy relationships, repairing wounds, teaching assertive communication, advocating for healthy behaviors and self-care, and so many other things. And it’s so painful to see and hear the tragedies that exist, the broken relationships, the family patterns, local and world events, and so many other personal stories of loss. We have so much care for our clients and are constantly navigating the course of trying to be the best help and advocate for each person. We do think about our clients and we do miss our clients when they finish treatment or stop coming.
Is it okay to bring a friend or family member to my counseling session?

Yes! There are times when you may need a friend or family member to come with you to your counseling sessions for your own comfort or to offer another point of view. Sometimes your friend or family member may have insights or opinions that are valuable in meeting your counseling goals, they may be a key player in your recovery, or you may want to address relationship issues or goals with the other person in the session. We will honor your right to decide whom you want to be in your sessions.

On the Parenting Skills specialties page - this link at the bottom is broken and can be removed

Children’s Home Society of Washington Resource List (Parenting classes, workshops, resources, supports, play groups, disabilities)


Here are some ways to contact us


You can contact any counselor directly by email or through the contact form on their profile page.

You can also contact Lacamas Counseling through the Contact page.


You can contact any counselor directly by phone or text.

You can call Lacamas Counseling at (360) 975-0512