Availability

Please see the contact me page of my website for my current availability to take on a case.  I do not maintain a wait list. 

 

I regret that I may not be able to respond to inquiries if I do not have current availability.

Family Reintegration Therapy

Family Reintegration Therapy: I offer a specialized kind of family therapy which is often referred to as "Family Reunification Therapy" or "Family Reintegration Therapy" or "Family Reconciliation Therapy."  Note that in my appointment order and with clients I use the simpler language of "Family Therapy" to refer to this service.

 

This service is available for families with minor children.  For adult children and parents, please see the Family Therapy page.

Requirements

I have prepared this section so that you will understand the nature of my work and requirements for appointment, and to answer some frequently asked questions.  

 

My work is aimed at helping build or rebuild healthy family relationships.  Please do not engage me if it is not each parent’s stated goal that the children are able to have a healthy relationship with each parent. If you are wanting a professional to assess and/or justify why a child should not have contact or relationship with a parent, you likely want a custody evaluation, not family therapy.

 

Court Order: I require a court order that both orders the family to participate in family therapy and appoints me as the family therapist.  I have a model order which I share with counsel upon request. I require that you send me a redlined copy of the order so that I can review any changes you made.  If you do not send me a redlined copy, I charge my hourly rate for my line by line review of the order.  I do not work pursuant to an order entered without my final review and approval.

 

Whole Family: I treat the whole family, meaning at minimum legal parents and all minor children. Some people imagine that family reintegration therapy occurs only between the child/ren and the estranged/resisted parent (RP); research has demonstrated that this approach is not successful, and that instead, treating the entire family system is required.  Parent-child contact problems are considered a systemic issue, meaning that very likely each member of the family plays a part in the creation and/or maintenance of the problem, therefore each member of the family must participate in its remedy.  Counsel for the aligned parent (AP) should explain to that person that they are also a client in the therapy. Each parent, and all joint minor children, should be ordered to participate in family therapy, and specifically named in the order. I encourage, but do not compel, coparents to participate in therapy together whenever possible.

 

Readiness:

 

     I strongly prefer that there has been a custody evaluation prior to my engagement.  This means that a separate mental health professional has fully assessed the family system and made a determination that renewed or continued contact between the parent and the child is appropriate and in that child’s best interest.  This avoids putting the therapist in the position of being lobbied by parties about whether or not that is true. If there has not already been a custody evaluation in your case and that becomes problematic, I will make a recommendation that one is ordered, and may pause treatment until it is completed.

 

     I will accept cases in which a custody evaluation has not been completed if the parents and the children agree that family therapy is in the children's best interest, and are ready and willing to participate constructively in family therapy.

 

     My model court order also includes language that the court has made a finding that family therapy is in the children's best interests.

 

 

Step-Up Parenting Plan: I only accept appointments in which there is an existing parenting plan which is being exercised, or, if parenting time is not being exercised, that there is a concurrent step up parenting plan. I can provide you useful materials to help you prepare one.  It should begin with the amount of time that the children are currently seeing the parent and “step up” in stages to the previously ordered parenting time or a new distribution of parenting time agreed upon by the parties, recommended by a custody evaluator, or ordered by the court. I cannot create the step up parenting plan, but I can advise if there is a clinical reason to remain at a given step for a time. The plan often commences with supervised parenting time, and I typically recommend that this person be a professional supervisor at least at the beginning, rather than a family member; I confer with this person about what they are observing and it is best to have someone objective in this role. I recommend that the plan have self-executing sanctions for failure to comply with its terms.

 

Parent Coordinator/Therapeutic Interventionist: I prefer cases for which there is a Parent Coordinator or Therapeutic Interventionist appointed as that protects the family therapist from being lobbied to make and manage forensic decisions, which is outside of the role.

 

Fees: Current fees are available on the Fee page and are subject to change, typically annually on July 1st.  

 

  1. The rate is $190.00 per 50 minute therapy session ($230.00 for 51-60 minutes; other durations posted on my website) and all other work I do on the case. Fee increases typically occur at the new year. Please make sure that your clients are prepared to pay for therapy before we begin.  It can do more damage to begin therapy and then end it abruptly due to inability to pay.
    1. Insurance: I do not accept insurance for court-ordered family therapy.  In order to obtain insurance reimbursement, one person must named as the “primary patient” and given a mental health diagnosis and family therapy deemed “medically necessary” for the treatment of that diagnosis.  In family systems therapy, each member is considered to have contributed to the current state and each is needed to contribute to healing. 
    2. These cases often require fair amount of work outside of the therapy sessions, especially at the beginning and then again when preparing for a hearing or trial.  This can include document and other review, consultation with counsel, consulting with other treating therapists or other professionals who are or have worked with the family, case management, preparation of reports, and testimony. All of these are charged at the regular therapy rate prorated for the time spent, and due on the date of service. Please make sure your clients are aware of this and prepared to cover these costs.
    3. Fees and Credit Card on File: Fees are owed on the date of service, and I require each client to have an active credit or debit card on file with me.
    4. Failure to Pay: Failure to pay promptly will result in suspension of services; if the fee is not paid I will terminate services and that may be considered contempt. I will notify counsel should this occur. If a party fails to pay and the other party covers the non-paying party’s obligation in order that therapy may continue, that paying parent should be able to seek recompense from the other, typically with assistance of counsel. 
    5. Sharing of Fees: I strongly recommend that both parents share the out of pocket costs of therapy equally in order to support their “buy in” of the therapeutic process, however individual circumstances may require another arrangement.  Arrangements that are very complicated (eg “After an applicable insurance pays, remainder paid 72.5% by Parent A, and 27.5% by Parent B for all sessions in which only the child is present, and for any session with one parent and a child; sessions with just one parent is paid 100% by the attending parent, and sessions with both parents are split equally between parents”) and may require extra administrative time for me to manage, which time is billed to the client(s).  Please ask me if you need help with this. And please do not refer clients who do not have the ability to pay; it is often injurious for a family to begin a course of therapy and then have it abruptly terminate for failure to pay.

Fee Policies: Parents must keep a working credit card on file at all times.  Fees are due on the date of service, except court preparation fees which are due in advance.  Fees are due for herapy session time as well as consultation time with counsel, collateral sources, review of materials, reading and responding to emails, and all other case related work.

 

Insurance: I do not bill insurance for these services, nor do I provide a superbill.  In order to bill insurance, one member of the family must be identified as the primary patient and given a mental health diagnosis for which family therapy is considered a medically necessary treatment.  This is rarely appropriate or even possible in these cases, hence my policy to not bill insurance.

 

Attorneys for Children: I only provide services in cases where any attorney appointed for the children takes a best interest approach to that representation, rather than a traditional advocacy approach, as that is what is best in these cases.

 

DHS/CPS: I require that all DHS investigations be completed prior to commencing family therapy.  If there is an investigation underway, please await appointing me until there has been a finding.

 

Domestic/Interpersonal Violence: I do not accept cases in which there has been an affirmative judicial finding of violence between the parties which involved lethality (use of a lethal weapon, manual strangulation, and the like).

 

Criminal Proceedings: I require that all criminal proceedings be completed prior to commencing family therapy. I do not accept cases if there are criminal charges pending against a parent related to behavior in the family.  Please await adjudication before engaging me.

 

Oregon: I am licensed in the State of Oregon, and parties must verify that they will be physically present in Oregon for therapy sessions, whether those sessions are conducted in person or virtually.  If a party will be outside of the State of Oregon for an extended period, I may be able to get permission from the foreign locale to provide services; this requires ample advance notice to verify (California and Washington do not). 

 

Virtual and In-Person Sessions: I have a dedicated HIPAA-compliant Zoom room from which I conduct most sessions.  In many of these cases, it is appropriate to have some in-person sessions. I can meet with clients in person or remotely, or a combination thereof, as is appropriate in their case.I have a dedicated HIPAA-compliant Zoom room from which I conduct most sessions. In many of these cases, it is appropriate to have some in-person sessions. I will take client preferences and circumstances into consideration; and ultimately, the venue for therapy is at my discretion. My physical office is in SE Portland.  Where clinically appropriate we may have “normalizing interaction” outings in the community, and have a session at a park, or restaurant, etc. I do not transport clients in my vehicle. 

 

Progression: To begin, I meet with each parent separately, and then each child separately.  Thereafter, I meet with different combinations of family members, which is typically each child and the resisted parent, each child and the aligned parent, any family member separately, 

 

Confidentiality: This therapy is confidential in the same way all therapy is confidential, but in addition to the usual exceptions (eg child, elder & dependent adult abuse, threats of harm to self and others) the appointment order should allow me to talk freely with counsel and the court, as well as any other professionals with whom the family members have been or are engaged.

 

Communication: I will communicate via email and text with clients and with counsel unless the clients request that I restrict identifiable personal health information in electronic communication. If, however, they do so request, then clients can communicate with me via my HIPAA-compliant client portal via my website. 

 

Team Approach, Consultation with Counsel: 

 

I will have periodic consultations with counsel to share the family’s progress in therapy and occasionally make requests of counsel in support of the therapeutic goals.  It is a best practice to have those meetings jointly with both parents’ counsel, and minor’s counsel when applicable, to ensure you are both/all hearing the same information at the same time, can each ask any clarifying questions you have, and to avoid the appearance of bias.  I may contact counsel separately at my discretion, typically if I want to clear up something a client told me their attorney told them, or occasionally on a scheduling matter. Mondays and Thursdays are my preferred days for such team meetings.

 

If you engage me, I expect us to work together as a collaborative team (this includes all attorneys, the judge, the family therapist,  individual therapist(s), parent coordinator, other professionals engaged by the parties, and the parties themselves), working together for the well-being of the entire family.

 

I expect you to treat me as a fellow professional and not as an adverse party.  It is normal and to be expected that as I work to change the unhealthy dynamics in a family, one or more of the members will feel challenged.  If your client expresses upset with me, I expect you to redirect them to me to try to work through the issues as part of healthy conflict resolution.  If you have concerns or questions about something you hear is happening in therapy, please contact me to discuss it directly.  It is very important for the professionals not to engage in “triangulation” - a dynamic common in many of these families. Rather, when the engaged professionals work collaboratively and constructively, we model for the family positive ways of being which support the common goal of healthy family relationships. If you are not able and willing to do this, please do not hire me.

 

  1. Your clients will set a regular, recurring appointment time with me, typically weekly unless there is a clinical reason for more or less frequent appointments. My availability is generally on Fridays and Saturdays. At the beginning of treatment while doing the initial interviews I may be able to accommodate additional appointments in a given week.

 

Status Conferences with the Judge

  1. I audio and/or video record all client contact for clinical purposes only.  These recordings are not subject to discovery and you agree not to seek their production for litigation purposes.  I will happily provide treatment summaries, prepared at my regular rate, if necessary.
  2. Status reports: I also require that you agree not to compel production of progress notes or other parts of the record during the course of treatment.  This can be overly burdensome and viewing content during the pendency of a matter can be counterproductive to the treatment, and can even be harmful to the parties.  I will provide information about treatment progress and my assessment to the parties, counsel, and to the court as needed during the treatment, either orally in session or conference, or in writing.  My proposed order outlines the typical elements of such a summary. In some cases it can be helpful to schedule a regular recurring consultation call with counsel on a monthly or bimonthly basis.
  3. Appointing a family reintegration therapist indicates that there are dynamics that are unhealthy and/or not working in the family, thus that I will be asking your clients to make changes in their thoughts, emotions and behaviors.  This is not easy.  You should prepare your client for that expectation.  You also understand that my job is to assess the family’s functioning and to make recommendations for improvement. You should prepare your client that they might not like all of my clinical assessments or recommendations, but they are agreeing to follow them.
  4. If there is a child in the family system who, typically by virtue of size relative to a parent, or violent or destructive behaviors, is not able to be managed by the AP to physically arrive at and/or participate in therapy, I will not be able to work unless there is a separate individual therapist who can both support the parent in getting the child to therapy and be present in the sessions with the child until the child begins to participate constructively.
  5. This therapy can take a long time.  You should set your clients up for that expectation.  Typically one parent wants the process to go very quickly, and the other wants it to go very gradually.  I will recommend a clinically appropriate pace given the dynamics of each individual case.  I typically request a duration of at least two years, or until the child/ren in question reach 18, or until all therapeutic goals have been reached.
  6. My work is clinical, not forensic, meaning that I will offer clinical assessment and recommendations, but, for example, I do not design the parenting plan.  Once a step up parenting plan is in place, I can make clinical recommendations about holding at a certain step, but please do not include elements such as “the therapist will decide how much parenting time a parent will exercise” in the plan.
  7. I also do not provide parenting time supervision. This is a separate service, typically less expensive than therapy, provided by other professionals or friends or family members. 
  8. I will work with children as young as 4 in family therapy, and at any age (younger than 4 or 18 or older) as part of a sibling group in which one or more siblings is 4-17, if I determine that that is clinically appropriate.
  9. I am able to offer testimony if needed, however I request that you consider this carefully. First, testimony of the therapist can cause rupture in the therapeutic relationship, which may be irreparable. Second, I have a busy schedule and it can be difficult to arrange a time; I request as much advance notice as possible for any appearance.  Third, I require a subpoena for my testimony as that best protects me ethically; I will accept subpoenas by email.  Lastly, I do not charge a higher rate for testimony, but I do charge for travel (if I am required to testify in person) and preparation time as well as for actual time in court. Mondays and Thursdays are my preferred days for testimony.
  10. I strongly prefer that prior to the entry of the order we have collectively determined the regular, recurring weekly appointment time that will work for the parties. As you can imagine, trying to determine this with the parties can cause delays in commencing treatment. 
  11. I can provide additional resources if you’d like to learn more about family reintegration therapy and resist-refuse cases.

 

Regular, recurring weekly appointment time. You will set a regular, recurring weekly appointment time with me, unless there is a clinical reason for more or less frequent appointments. I have client appointments on Tuesdays, Wednesdays, Fridays and Saturdays. At the beginning of treatment while doing the initial interviews I may be able to accommodate additional appointments in a given week. 

 

If, after reading this, you would like to move forward, please set up an introductory joint phone call with both/all attorneys present.  In this phone call I’ll want to hear from each of you the significant issues in the case in order to determine if the case is a good fit for my expertise, and you can get additional questions answered as well.

 

 

 

 

 

 

 
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