Frequently Asked Questions

Yes! I offer telehealth services throughout Ohio. 

The convenience of cell phones means that I can be virtually with you while you do exposures out in the world. If you fear grocery stores, we could have a cell phone conversation while you do your shopping, and I can talk you through your exposure that way. 

My first session is always 90 minutes or longer (I allow 2 hours in my schedule). This gives me time to give you some important background questionnaires, hear about how your anxiety came about and how it affects you, and do a careful review of other potential reasons for your anxiety. 

 In the first few sessions, I will have lots of questions to ask so we can understand how to attack your OCD, first with tasks that are kind of easy and going up to tasks that may be impossible for you now. Those sessions typically last 45 minutes to an hour. After that, when we are doing exposure sessions, a typical session lasts 90 minutes. 

The therapy for OCD works by pushing your anxiety up to a high level, and then getting you to face the trigger of that anxiety without using any escape tactic, like distracting yourself or picturing yourself in a safe place. There is a natural emotion regulation process that makes this treatment works, and that process usual takes about 90 minutes to achieve its result. 

It really helps if you download and complete the intake packet before you come for your first session. You can also download and read my treatment contract, and download and read my Notice of Privacy Practices. You can bring any questions to your first session with me.

 I am in-network with some insurance companies. This list changes from time to time. Some insurance companies refuse to pay for the critical parts of this treatment. They typically will not pay for 90 minute sessions in real world settings, and they also typically refuse to pay for sessions three to five times per week, which is ideal for attacking your OCD head on. 

The version of my therapy that they will pay for is typically far less effective than the version you really need. To know whether your insurance company will cover me as an in-network provider, you should call the behavioral health or mental health number on the back of your insurance card.

Unfortunately, most mental health insurance companies do not yet realize that it would be far cheaper for them in the long run to cover the treatment I offer (in vivo, meaning in real life, exposure therapy) fully. It would probably save you many years of future therapy, and it might even reduce your future medical care expenses. OCD is hard on the body as well as the mind.

The best way is to call me or text me at 614-254-9122. If you leave a message, leave your number, a good time to call, and a brief description of why my practice is appealing to you.

Because I offer time-limited therapy, patients are always graduating from my practice, which makes room for new patients. Usually I can see a new patient within 2 weeks of the initial call.

Yes. My office has free parking, and. plenty of it, within a short walk of my office door. My office is on the first floor, so people with mobility issues only have to get up a curb. There are no stairs to climb.

When I set aside time for your therapy, I cannot offer that time slot to other patients. If you call me or text me the day before a scheduled session to cancel, there is no charge to cancel. 

However, this treatment makes people want to cancel as a way to avoid anxiety. When you cancel because of your anxiety, you are giving in to OCD, and your OCD gets stronger. 

If you do not cancel at least 24 hours in advance, I ordinarily charge a missed appointment fee of $100. 

However, if you are sick and believe it is contagious, I don’t want you bringing your germs into my office to potentially make me and other patients sick. For that reason, you may cancel at no charge or even miss an appointment at no charge and call me later if you have a genuine illness that might be contagious. 

You are on your honor here – I do not require a doctor’s note. 

If your health requires you to miss a session (example: you are in the ER with cardiac symptoms) please take care of yourself first and let me know when you are able to safely. I will not charge you. 

I am in-network with some insurance companies. I do not accept Medicaid.

I carefully choose which companies I can partner with as an in-network provider. Many companies, and Medicaid, simply do not offer a fair payment for the services I spent many years of schooling and training to master. Others create too much bureaucracy before I can get them to pay. Other health insurance companies seem to be run by deadbeats who don’t believe in paying their bills. 

I sympathize, but I have no control over the insurer policies. A lot of their rules were written without considering treatment breakthroughs that need different ways of paying. Let me tell you a story about insurance. Years ago, I had a minor car accident. My insurer told me to go to a particular auto body shop for the repairs. The shop owner insisted that the insurance company pay, up front, for the work before the repairs would begin. 

If your insurance company would pay me that way – full payment in advance of my services to ensure I won’t get scammed and would get paid without a pile of pointless paperwork – I would work with them, assuming they would also pay a fair market rate that reflects my training and experience. That would allow you to get care covered.

The long run answer would require the State and Federal governments to hold insurance companies accountable and make them pay all of their financial obligations to the doctors who provide care for their members. Write your representatives in Congress and demand that if you'd like to do something that helps a little. Or better yet call them. If you have OCD, this would be a healthy obsession to derive a compulsion from.

Here are the things I do in a typical course of treatment, how long they take, and how much they would cost at my out of pocket fee of $220 per 45 minutes, $294 per hour.

o Initial evaluation (90-120 minutes): $440-$586

o Four 45 minute sessions to set up the tailored treatment for your OCD: 4 x $220 = $880

o Fifteen 90 minute exposure sessions to extinguish your OCD: 15 x $440 = $6,600

o Two 45 minute sessions of post-treatment relapse prevention: $440

o Total: $8,360 to $8,606

Consider this: your OCD is not likely to get better without specialized treatment. Suppose you go to therapy twice a month for the next ten years. That is 240 therapy sessions. And let’s imagine those sessions cost only $50 per session, after your insurance pays its part. The full cost of that is $12,000. And you are likely to have OCD the whole time, and long after that. The full cost is $12,000 plus whatever joy in life you lost because your OCD was not fully treated. I haven’t even started on the lost income. OCD has a monetary impact on people’s careers. It is not small.

My treatment is expensive in part because I do real world exposures, which means a lot of tailored planning and sometimes a lot of driving time for me. You are also paying hidden expenses, such as my rent, malpractice insurance, and the costs I bear and time I spend keeping my skill set sharp and keeping up with advances in OCD treatment and CBT more generally.  

I offer sliding fees to certain individuals in well defined groups. If you are a full-time student, I will discount my fees. Likewise, if you are a teacher or creative professional, I will discount my fees. These groups involve people who sacrifice their own income potential to serve the public good, and for this reason I offer them discounts. If you are in one of these groups, or another group that serves the public good through self-sacrifice in terms of income, call me to find out exactly what I could do for you given your situation. I do have to limit the number of reduced fee slots I offer, so it might mean waiting a little longer to start if you qualify for a discount.

You know what makes this so expensive? Most people with OCD can’t force themselves to do all the exposures alone, and in the correct way. It’s critically important to push your anxiety up and keep it there as you face your fears. 

If you have a partner or family member who is able and willing to help you on the path, I can work with both of you in sessions. I can train and consult to your partner so they can help you through the exposures. Finally, if you are super tough, you may be able to do the exposures on your own with coaching. When I work this way, the costs are sometimes much less. However, this usually takes longer, and sometimes it is less effective. No matter how much your partner wants to help, it takes deep training to know how to do the exposures right for maximum impact.

I have a Ph.D. in clinical psychology from the University of Southern California, and I completed my clinical internship at the Veterans Administration Medical Center of San Francisco, a training site affiliated with the University of California. I am actively licensed in the State of Ohio as a psychologist, and I have an inactive license from California to practice psychology there. My training in Exposure and Response Prevention was completed through direct small group training by Dr. Joel Becker at Cognitive Behavior Associates of Beverly Hills. In addition, I have completed training workshops with Marsha Linehan (in Dialectical Behavior Therapy) and Steve Hayes (Acceptance and Commitment Therapy). I am indebted also to my clinical mentor and friend, Dr. Gerald Davison, author of one of the foundational texts in CBT, Clinical Behavior Therapy. He is one of the giants who ushered in our new era of highly effective, science-based CBT.

I work with clients from 15 to 115. In the past, I worked with children for several years. However, child therapy has become a specialized are of practice that requires additional certification and training. 

I am happy to work with anyone who is committed to overcoming their anxiety through cognitive behavioral therapy. I have lived and worked in the United States, Denmark, and Hong Kong. I lived in Saudi Arabia as a child and traveled widely. I believe this gave me a broad multicultural awareness from a young age. I am a member of the LGBTQ community. I have worked with many transgender and gender non-binary clients, and I strongly believe that diversity makes us stronger. 

The first session involves a review of all areas of your life (child history, work and school, relationships) and the history of your symptoms. I do a careful workup to make sure the diagnosis of OCD is the right one and develop an overall plan for your treatment. This session lasts an hour and a half to two hours. If you have another anxiety disorder, the treatment could look different.
 

Following that there are about three sessions, each 45 minutes to an hour, in which you teach me everything you can about your specific obsessions and compulsive rituals, and I ask you many questions to fully understand. In these sessions, I will help you develop a hierarchy or ladder of real world situations you need to face in order to overcome your OCD. I will get you to rate how much anxiety you feel when imagining yourself in those situations, too.

If you have another anxiety disorder, we will plan your treatment during those first few sessions.

That’s when the real work begins! For up to 15 sessions, each lasting about 90 minutes, I will work with you to guide you through the exposures on your ladder of feared situations. We will work slowly up, and I will ask you frequently how anxious it makes you to face your fear in real life. We will observe as the work first makes you much more anxious, and then burns out the neural circuits that maintain your anxiety. At that point, you will be amazed to find out that a situation you thought you could never face no longer bothers you much at all. Sometimes people are better after 10 sessions, but that is usually the minimum in my clinical experience.

If we are doing exposure therapy for another anxiety disorder, your exposure sessions may be shorter, and you may need fewer of them. 

After those 10-15 sessions (which are ideally bunched up into three to five weeks of three to five sessions per week), we will meet three more times to plan the exposures you will continue to do in real life, on a daily basis, to keep your OCD in remission. 

Great question! Does your OCD make you do homework? It does, doesn’t it? It takes work to focus your mind on the dangers that worry you. And it takes even more work to do the rituals that your OCD requires of you. 

If you have OCD, I give you lots of homework, very particular homework that helps you fight your OCD. You might do something that makes you anxious, like touch an object that is a little bit dirty and leave the germs on your hands for a while. Or you might imagine something that makes you anxious, such as getting very sick from the germs. This work dramatically improves the effectiveness of the therapy for OCD.

If you have an anxiety disorder other than OCD, you will still have homework. The more homework you do, the more energy you put into it, the faster you get better. You can lower the cost of treatment a lot by working zealously on homework between sessions and using sessions for coaching on the work you do outside. 

There are a lot of therapists who think this is torture too, which prevents exposure therapy from being offered to many people who would find it deeply healing. 

Living with untreated OCD is also torture. Your mind is at war with itself when you have OCD. That’s true torture. My treatment can help you end the war, and win the war, and heal the division inside of you. 

Exposure still feels hard if you have PTSD, a phobia, agoraphobia, or panic disorder. But each of those disorders feels even harder over time than the brief and difficult treatment would.

This depends on your particular case. Many clients feel so much better they don’t feel a need for anything else. Other clients get curious about why their OCD came to be in the first place, or they find that it really helps to have a therapist to talk to on a regular basis. Those clients often choose to continue the therapy. But they continue the therapy without OCD ruling their lives, in most cases. 

No matter which anxiety disorder you have, staying in remission after treatment requires a shift in your habits. You will have to continue to expose yourself, on your own, to people, places, things, or images that have been a source of anxiety. In the last few sessions of treatment, I will teach you how to do this.

In one of my early cases, while I was training therapists at Hong Kong University, I helped my client touch some germy things, and I touched them too. One way or another, I got a bad head cold. I persisted in doing the therapy, though, and my client got more and more worried that I was going to die, just as his OCD told him. Instead, I got sicker for a few days, stayed sick for a few more, and then got better. This was not what his OCD let him to expect. My illness followed by my recovery was part of what helped him overcome his own OCD.