FAQs
The questions clients ask most often before booking. If yours isn't here, the free 15-minute consultation is the easiest way to get a specific answer, or email me anytime at contact@sagebrushcounseling.com.
What I do and how
The kind of work, who it's for, and what working together looks like.
My practice is intentionally specialized around five areas, each treated with a named, evidence-based protocol:
- OCD: ROCD, scrupulosity, contamination, and perfectionism and "just right" OCD, treated with I-CBT and ERP (learn more)
- Anxiety and phobias: panic and agoraphobia, social anxiety, emetophobia, driving anxiety, and misophonia, treated with ERP and exposure-based work (anxiety · emetophobia · misophonia), plus depression
- Hair pulling and skin picking (BFRBs): ComB-based, shame-free treatment (learn more)
- ARFID: CBT-AR and ERP, gentle and never forced (learn more)
- Neurodivergent adults: late identification, burnout, and executive function (learn more)
- Neurodiverse couples: AANE-informed therapy for ND and mixed-neurotype partnerships (learn more)
Direct, warm, and structured. You'll always know what we're working toward, and sessions hold space for emotional depth while still moving. Each specialty runs on a specific method:
- OCD and anxiety: I-CBT and ERP. Gradual and collaborative; nothing is sprung on you. I also offer ERP for Autistic individuals, with specialized training in Autistic-Affirming ERP.
- BFRBs: the ComB model for hair pulling and skin picking.
- ARFID: CBT-AR, built around sensory needs and never about weight.
- Neurodivergent adults: ACT and solution-focused work in structured arcs.
- Neurodiverse couples: AANE-informed training in Autism and ADHD in relationships, drawing on attachment-informed work, somatic approaches, and psychoeducation.
You can read each method explained in plain English on how therapy works.
The first session is a full intake appointment. We build a clear picture of what's bringing you in, the patterns contributing to your current situation, what you're hoping changes, and what working together might look like. By session three you'll know your plan, its phases, and roughly how long the work takes. You don't need to have it figured out beforehand.
Neurodivergent needs and preferences are welcome. You're invited to bring something to fidget with, avoid direct eye contact if that's more comfortable, wear headphones, bring a favorite drink or snack, or show up in whatever way feels most regulating for you. Therapy is meant to adapt to you, not the other way around.
Every specialty follows a structured protocol with a clear arc, and by session three you'll know your plan. Typical courses:
- OCD: 14-25 sessions
- Panic and agoraphobia: 14-20 sessions · Social anxiety: 16-20 · Driving anxiety: 10-16 · Emetophobia: 20+
- BFRBs: 10-16 sessions
- ARFID: 12-20 sessions · Misophonia: 12-16
- Neurodivergent adult arcs: 10-12 sessions
- Neurodiverse couples: 10-20 sessions
The full table is on how therapy works. These are typical courses, not rules. Some clients pause therapy, return when something new comes up, and pick up where they left off. Therapy doesn't have to be all-or-nothing.
Neurodivergent-affirming therapy treats Autism, ADHD, and AuDHD as differences rather than disorders to fix. Whether you're formally diagnosed, self-identified, questioning, or somewhere in between, you are welcome here.
I work to understand your specific needs (including sensory and communication preferences) and help you build a life and relationships that fit how you function, not how the world expects you to.
No, you don't need a diagnosis to start therapy. You don't need one to reach out, and you don't need one to know something feels off.
If you plan to use insurance, a billable mental health diagnosis is required, since insurance companies won't reimburse sessions without one on the claim. For concerns such as anxiety, depression, and OCD, that assessment is part of our normal intake process. Private pay is always an option if you'd prefer to work without a diagnosis on file.
For neurodivergence specifically: self-identified, questioning, late-identified, and formally diagnosed clients are all equally welcome. I don't conduct formal diagnostic evaluations for Autism or ADHD, but I'm happy to refer you to a specialist if an evaluation is something you want.
How payment works
Insurance, private pay, rates, and what to verify with your insurance company before your first session.
Yes, I'm in-network with several major insurance plans across the states I'm licensed in. Plans vary by state.
One important note: many insurance plans don't cover couples therapy or relationship-focused therapy, since they typically require a mental health diagnosis for the individual being treated. Please call your insurance company directly and ask whether code 90847 (couples/conjoint therapy) is covered under your specific plan.
If your insurance doesn't cover what we want to focus on together, or if you choose not to use insurance, private pay is always available, whether you're an individual or a couple.
I'm currently in-network with the following plans. Coverage varies by state; the tags below each plan show where I'm in-network with that plan.
- Carelon Behavioral Health
TexasMaineNew HampshireMontana
- Cigna
TexasMaineNew HampshireMontana
- Aetna
TexasMaineNew HampshireMontana
- Providence Health Plan
TexasMaineNew HampshireMontana
- Harvard Pilgrim / Tufts Health Plan (Point32Health)
MaineNew Hampshire
- Blue Cross and Blue Shield of Texas
Texas
- Anthem Blue Cross and Blue Shield
MaineNew Hampshire
- Ascension (SmartHealth)
Texas
Please contact your insurance company directly to verify your specific benefits before scheduling.
Private pay rates are:
- Standard session: $200 for 50-55 minutes (individual or couples)
- Check-in session: $120 for 30 minutes (established clients)
The same rates apply to individuals and couples. Couples therapy coverage varies by plan, so check with your insurer to confirm before your first session. Full details on the services page.
Yes. Some clients prefer to use private pay even when they have coverage. Reasons can include privacy preferences (no diagnosis is submitted to insurance), wanting to use a session length or treatment focus that insurance wouldn't cover, or simply preferring not to involve a third party in your therapy.
24 hours notice is required to cancel or reschedule. Late cancellations and missed sessions are charged a $50 fee. The fee is set below the session rate because life happens, and for many clients managing ADHD or a demanding schedule, flexibility around cancellations matters. The policy is meant to support accountability while staying realistic.
Sessions, scheduling, and online therapy
Where, when, and how sessions work.
I'm licensed in Texas, New Hampshire, Maine, and Montana. All sessions are conducted via secure, HIPAA-compliant telehealth. You can join from anywhere within these states at the time of session.
- Texas: LPC #92348
- New Hampshire: LCMHC #5711
- Maine: LCPC #8561
- Montana: LCPC #87815
The first step is a free 15-minute phone consultation. You can book through the contact page. I'll call you at the time you schedule; no need to call me. The consultation is a no-pressure conversation to see whether we're a good fit and to answer any questions you have before committing to a session. If we decide to move forward, we'll schedule your first full session from there.
Two formats are available:
- Standard session: 50-55 minutes (individual or couples)
- Check-in session: 30 minutes (established clients, later phase of treatment)
Most clients meet weekly at the start to build momentum, then some phases can shift to biweekly once momentum is established. We decide together what pace supports the plan best. Appointments are available Monday through Friday: ME & NH 8am-6pm ET, TX 7am-5pm CT, MT 6am-4pm MT.
Yes. The research is consistent on this point across more than two decades of studies. Online therapy produces comparable outcomes to in-person therapy for anxiety, OCD, relationship difficulties, and more. The most important factor in therapy outcomes is the quality of the relationship between client and therapist, not the format.
Many clients find virtual therapy preferable: it fits around demanding schedules, removes the commute, and lets you join from wherever feels most comfortable. Full details on how online therapy works.
Three things:
- A device with a camera (smartphone, tablet, or laptop)
- A stable internet connection
- A private space where you can speak openly without being overheard
Sessions are held via a secure Zoom link sent to you before each appointment. No app to download, no complicated setup.
Online therapy works well for the majority of adults and couples. It's not the right fit for everyone. If you're experiencing a psychiatric emergency requiring immediate intervention, active psychosis, or need a higher level of support such as intensive outpatient or inpatient services, in-person or higher-level care is more appropriate. The resources page has options for higher levels of care.
If you are in crisis or need immediate support, please call 911 or the 988 Suicide and Crisis Lifeline (call or text 988).
Confidentiality is a foundation of our work together, and what you share in session is protected. There are limited exceptions required by law, including situations involving imminent risk of harm to yourself or others, suspected abuse or neglect of a child or vulnerable adult, or a valid court order. I'll review these limits clearly during your first session so you know exactly what to expect.
Clients have the right to file a complaint with the Texas Behavioral Health Executive Council at bhec.texas.gov or by calling (800) 821-3205.
Is this the right place for you?
How to know if we'd work well together, and what to expect at your first consultation.
The free 15-minute phone consultation exists for exactly this. We talk through what's going on and whether this is the right match. No commitment, no forms required beforehand. If it's not the right fit, I'll tell you and point you toward someone whose training better matches your needs. You can also read more about my approach on the about page.
Yes. My practice is fully affirming and welcoming of all identities, orientations, and relationship structures, including open relationships, polyamory, and non-traditional arrangements. Whatever your relationship looks like, you're welcome here.
Yes, reach out. Availability varies month to month, so the contact form is the best first step. If I'm at capacity or have a waitlist when you reach out, I'm happy to send referrals to other therapists whose training fits what you're looking for.
I'm currently accepting new clients in Texas, New Hampshire, Maine, and Montana. The free 15-minute phone consultation is no-commitment; we'll talk through what you're looking for and either schedule from there or I'll point you toward the right resource.
That's a common experience. Many people feel anxious before their first session. I aim to make the process as clear and low-pressure as possible, and most clients report feeling a sense of relief after the first session simply from having space to talk things through.
Neurodivergent needs and preferences are always welcome. You're invited to bring something to fidget with, avoid direct eye contact if that's more comfortable, wear headphones, or show up in whatever way feels most regulating for you.
Still have a question?
The consultation is free and short. We'll talk by phone (I'll call you at the time you schedule) and see if we're a fit. No pressure, no commitment.