THE NO SURPRISES ACT

A Good Faith Estimate will be provided to patients for recurring services scheduled within the calendar year.   More on this at the bottom of this site.

Individual Counseling

You deserve to be happy, loved and respected.  

 Are you frustrated, angry or hurt because you 

  - Feel "ignored", "put down, or "not good enough"? 

  - Have to "walk on eggshells" or fear confrontation with your partner?

Do you want to be "empowered" in your relationships and be appreciated for who you are?  

Call me for a free consultation at 760-766-1622

Couples Counseling

Do you and your partner struggle with:

   - Hurt feelings, anger, depression, anxiety, frustration or a lack of intimacy 

   - Criticism, contempt, blame, defensiveness or the "silent treatment" 

It doesn't have to be that way.  

Open communication, loving and caring are much better ways to show someone how you feel even when you are upset.  

Let me teach you about boundaries and communication skills and show you how to create healthier and more satisfying relationships.  

Call me for a free consultation at 760-766-1622

Children and Teens

Does your child or teen feel frustrated or angry in school, or at home?   

Are homework and grades a struggle? 

Is your child or teen defiant?  

Does she or he get angry when they don't get what they want?

Is your pre-teen or teen exploring or questioning their sexuality and struggling with who they are, or, are they already farther down that path?  

I am supportive of the LGBTQ+ community and sensitive to the family and societal issues that can arise.  I go by "he" "him" and "his."

Call me for a free consultation about what is happening at 760-766-1622.

New Client Forms

Please download and print the appropriate Adult, Couples or Minor's forms along with the Telehealth Informed Consent form.

Complete them and scan or send them to me prior to your first appointment.

If you have any questions, we can discuss them at this session.

                      Child-Rearing in the Twenty-First Century  

  Do:

• Develop a system for Chores, Rules, and Consequences with your child/teen

• Create opportunities to earn rewards for the completion of extra or unusual behaviors or tasks

• Praise your child for “just being”, not only for “doing” or performing - loving someone for just being who they are)
• Most important: Listen to your child.  You don't have to agree but listening validates and builds character

  Don’t:

• Criticize or blame – instead, provide consequences (discussed and agreed to in advance)

• Offer money or gifts for desired behavior

• Fall into “name-calling” - (this can trigger melt-downs or emotional outbursts)

• Resort to physical punishment out of frustration or anger - instead, use consequences instead and give consequences quickly so that you don’t become frustrated or angry

5 Hard-To-Admit Things I've Learned From 15+ Years of Therapy

by Eleni Stephanides

Like a guard “escorting patients through the rooms of their own house.” 

This is how psychotherapist Irvin Yalom has described his role in the therapy process.

“What a treat it is to watch them open doors to rooms never before entered, discover new wings [of their house] containing parts in exile—wise, beautiful, and creative pieces of identity,” he wrote in his memoir.

With my therapist in high school, I, too, felt like I was unlocking doors to rooms inside my mind I’d never felt safe entering before.

As I lay on her sofa during our weekly sessions, we worked through depression, social anxiety, and unwanted same-sex attractions.

Seeing her through adolescence helped me through these highly uncertain and conflicted years. I felt valued and understood; she’d tell me better times were ahead and that life would feel more navigable as I grew into myself. She wasn’t wrong.

Our climate now is so different from just one or two generations ago, when most thought of therapy as existing only as a resource for crazy people or the seriously disturbed.

It's now far more acceptable to admit to mental health struggles, and I hope these attitudes will only continue growing stronger. The collective healing of our flawed and deeply wounded world depends on it.

Here are five hard-to-admit truths I’ve learned from 15+ years of therapy:

1. There’s no before and after narrative; healing is ongoing.

Life would be going well. I’d feel like I’d finally overcome a situation or setback and that my recovery house was solid. The stairs had achieved great heights and were continuing their ascension— only to be blasted by memories back down into scattered pieces suddenly.

Sometimes to create distance from our pasts, people unconsciously divide ourselves into two versions: “Who I am Now” versus “Who I Used to Be.” As Cheryl Strayed  wrote, “We want to believe healing is purer and more perfect, like a baby on its birthday. Like we’re holding it in our hands. Like we’ll be better people than we’ve been before.”

Aspects of this can be healthy; I think it’s important to acknowledge progress and believe we’re all capable of remarkable growth. And yet I also think that much of the time, this growth is a messy, gradual, and nonlinear process.

Even when we make significant progress, the potential for slipping back into old ways is always present.

When we know that this person isn’t a constant or given — but rather, results from our daily actions and decisions—it motivates us to continue making healthy and conscious choices every day. Making them helps us to embody the best person we can be.

On my part, I recognize that mental health struggles may never be strictly a remnant of my past. And yet I rest easier knowing I now have the tools, confidence, and wisdom gained from experience to take on challenges as they come.

2. Therapy is a non-judgmental space for growth and healing.

I appreciated the therapists who encouraged greater focus on identifying feelings than on applying labels. Labels can be helpful. Adopting one can provide belonging, help us feel less alone, and connect us to the resources we need and a larger community. And yet there’s such a thing as over-diagnosing. Certain labels also carry a stigma and can, ironically, make getting to the real root of the issue more difficult.

As Mark Hyman put it, “These descriptions (in the DSM) tell us nothing about why those symptoms occur, or how people with exactly the same symptoms may have them for many different underlying reasons and need different and individualized treatment as a result.”

It’s primarily in stigma-free climates that people feel safe enough to acknowledge and confront their issues. It’s within them that they feel freer to become their better selves.

3. Therapists help you be gentle with yourself while acknowledging your progress.

Growth and recovery are challenging and nonlinear. Maybe you’re still finding yourself swept up in the chaos of before when you thought you’d left it all behind. The past gets its claws into us. It can be hard to separate the past from the present. For example, I used to feel ashamed whenever I had negative thoughts.

I think part of why those feelings were deeply uncomfortable was because my mind had learned to associate them with the consequences that at one point followed them. At an age when I couldn’t tolerate these feelings, I’d act out on them, which would lead to consequences. Years later, when I experienced similar feelings, my brain re-experienced the consequences of those behaviors. It re-experienced the reality of actually being abandoned or of actually having harmed a relationship.

Stepping back lets me see more objectively — that the same past scenario isn’t playing out again. Here in the present, I’m not acting on my feelings. Or rather, I can choose to act on them in a different way. And this has made an incredible difference.

We don’t always see the progress we’ve made. Feeling the way we did in the past doesn’t mean we are behaving the way we once did — or even that we’re about to.  So, I’ve learned to have patience and compassion. To understand that I’ve made progress and am where I need to be, even when it feels like I’ve taken a bunch of steps back.

Truthfully, my ideal headspace would be one wherein I never harbor a negative thought about another person and always rush to the most positive and benevolent interpretation of another’s action. Until then, though, I remind myself: it’s not our feelings but our actions that matter most because it’s only our actions that we can control.

My therapists, through the years, have helped me see this.

4. Therapists will help you see the role that you played in situations that were hurtful to you, as well as how internalized lessons taken from past events influence our present-day behaviors.

Years ago, I didn’t see this; I only saw how people had harmed me. When my feelings were hurt, or I felt let down by a friend, for instance, I’d lash out in response (rather than communicating my feelings vulnerably and directly). I might have consciously been able to pinpoint my contribution to the painful situation at the time. Still, I wasn’t at the level of awareness yet where I could begin really viscerally understanding the entire dynamic, piece by piece.

Whatever we’re feeling always deserves recognition. But the behaviors that those feelings translate into the matter. They have a bigger impact than we realize. “It is one thing to think horrible thoughts; it is another to behave atrociously,” wrote Lemony Snicket.

Close friends and people who care will forgive occasional slip-ups, but if it becomes a pattern, continual forgiveness of harmful behavior and communication is akin to enabling. It’s the kind of unconditional support that only a parent can offer their child. Therapy helped me see this.

5. Therapists help you reckon with the uncertainty of maybe never knowing “the truth.”

I was diagnosed with Celiac in October 2020. A person can be born with Celiac, or they can develop it later in life.

I have no way of knowing whether mine developed later in life or if I’ve always had it. All I can do is speculate.

It was hard for me, at first, not to have that answer. It made it difficult to form a coherent narrative when looking back on my life.

Since I couldn’t be sure, it was like I had two alternative stories (therefore interpretations) taking place side by side. I had more than my share of emotional and behavioral struggles as a child. Undiagnosed Celiac makes these issues more pronounced, as the child suffers but doesn’t know how to put the what or the why into words.

Knowing would have put earlier struggles into context. It could have changed the way I viewed my childhood. Many of us crave that context when reflecting on our lives. Perhaps we can view our experiences in a more compassionate and forgiving light if it becomes clear that a hidden beast was lurking in the dark corridors (in my case, the Celiac) and holding us back. Causing us to struggle so much more than we would have had someone think to shine a light on it.

My mentality was that If I wasn’t born with it, I could blame myself or my life choices. The alcohol I drank in my 20s. My diet, for many years, contained high amounts of sugar and processed foods.

Through therapy, I gradually arrived at the conclusion that the more I focus on making good decisions here in the present, the less the past matters. 

I recognized that maybe a (futile) search for a convenient albeit reductive explanation to explain my struggles had propelled this need to know. And maybe this search functioned to shield, partially, from having to do the work of healing the harm or living differently from there on out.

We can’t change the past, but the future is within our power to shape. We can make choices that will lead to healthier and more positive ones. If mistakes were made, we don’t have to keep repeating them.

How often will I come in for sessions?

That’s a good question. I have found that, in this work, just like trying to build strength or improve your golf game, you get better with more frequent sessions. That usually means weekly though, at times, there may be a need or desire to come in more often. Working on yourself less frequently than once a week doesn’t offer you the chance to make changes in your life; conversely, when you are in need, more frequent visits help you to get through a difficult period.

How long does it take?

This is difficult to predict. I ask clients to give the process at least 12 sessions for the process to start making a difference.  You should expect to feel somewhat better in the first 12 weeks and you will begin to notice changes and have more awareness.  However, most issues have deeper roots and dealing with those issues takes time.

Do you take insurance?

The answer to that question is complicated based on your situation. Insurance companies require a mental health disorder diagnosis to cover the costs of treatment. Many of my clients prefer to deal with their insurance companies on their own or not to submit my invoice receipts because they want to protect their personal information. There is no way I can guarantee the confidentiality of your personal information once it leaves my office.  

I am a provider for armed service members and their families through TRICARE. For all other clients, I provide a "super-bill" for my services, as an "out of network provider" that you can submit that to your insurance company for reimbursement.  If you have a PPO medical insurance, your reimbursement may be from 30%-60% of my fee for "out-of-network" providers.

What are my fees?

The fee for a 50 minute session is $200 for individuals, teens and family sessions.  Extended sessions are prorated based on the 50-minute fee (at $4/minute)..

Couples sessions are scheduled for 75 minutes at a fee of $300.

How do I pay you?

I take Zelle and credit cards to pay for the session at the beginning of each session unless otherwise agreed to.

How do I reach you if I have to?

The best way to reach me is to call our office voicemail [760-766-1622] and leave a message. I will be notified that you left a message and get back to you as soon as I can. I am not available after 10:00 pm or before 7:00 am. If you have an emergency, you need to call 911 or go to the nearest Emergency Room. When in doubt, please act in your best interests and for your own safety.

I have worked with thousands of children and teens since 1997 in school settings and in private practice.  I respect and enjoy these young adults and have learned much from them.

With over 30 years of experience in banking, consulting, financial services, manufacturing, marketing, project management, product development and technology, and 20 years as a licensed psychotherapist, I offer insight into dealing with business challenges and "difficult" people.  

My background in technology, aerospace, banking, financial services, operations and management includes:

• Technology (IT) and product/project development for a large California bank, an aerospace company and the largest credit card marketing associaion in the world
• Multi-year and multi-million dollar budget project responsibility
• Operations and Manufacturing consulting for multiple divisions of an international conglomerate producing business and military aircraft, space aircraft, consumer radio and television products, software development and building tools 
• Executive Director of a mental health organization
• Management positions in multiple and diverse corporate organizations in Southern and Northern California
• Increased productivity of IT professionals and improved processing of major systems in aerospace and banking environments
• Created a unique method to identify and terminate hundreds of millions of dollars of fraud for the largest worldwide credit card association
• Developed a reporting capability (i.e., "Big Data") to identify how billions of dollars of credit card purchases originate and flow from merchants worldwide by SIC code, city, state, country and product type
• Managed the development, technical support and marketing of a PC application for T&E expense and purchasing in multiple languages directing support teams in Tokyo, London, Toronto, Miami (for Central and South America) and the United States
• Managed multiple levels of employees in large corporate environments
• Dealt with internal corporate and "outside" attorneys in numerous contracts and served as a subject matter expert in a $100M lawsuit (which we won)
• Built data centers in Northern and Southern California for a large national banking institution and a processing center near Philadelphia for a new credit card business entity
• Served on the board of a $500M credit union for ten years and several boards of mental health professionals for the last 12 years
• Licensed as a Marriage Family Therapist helping clients ranging from 4 to 95 since 2001
• BA in Economics and an MBA in Marketing from UCLA; MA in Counseling from JFK University

More on the No Surprises Act:

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

The No Surprises Act (H.R. 133) went into effect on January 1, 2022,