FREQUENTLY ASKED QUESTIONS
Questions you're probably
already asking.
We’ve compiled answers to the most frequently asked questions people have before contacting our Spokane Valley, WA office.
If you don't see yours here, give us a call. We're happy to walk you through it.
Before You Reach Out
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How do I know if I'm ready for therapy?
If you're asking that question, you're probably ready. Most people wait longer than they need to. You don't have to be in crisis to deserve support. If something feels hard and you're tired of carrying it alone, that's enough of a reason to reach out.
Do you take insurance?
We accept Premera Blue Cross Blue Shield, Cigna and Aetna, and we're always adding more. You can check your specific coverage on our insurance page, or just call us and we'll look into it together. We also offer private-pay rates and will never leave you guessing about cost. Give us a call to get our private pay rates.
What's the first therapy session actually like?
Low pressure. Your therapist will ask some questions to get to know you and understand what brought you in. You share at whatever level feels comfortable. There's no intake paperwork to stumble through in the room, and nothing is required except showing up.
Do you offer telehealth?
Yes. All of our therapists offer telehealth sessions for anyone in Washington State. It's just as effective and a lot more flexible, whether you're across town or just prefer your own couch.
Can I choose my own therapist?
Absolutely. You can browse our team and reach out to someone directly, or you can fill out our Get Matched quiz or view our list of therapists and we'll suggest the best fit based on what you're looking for. Either way works.
Is therapy confidential?
Yes. What you share stays between you and your therapist. There are a small number of legal exceptions (like if there's an immediate safety concern), and your therapist will explain those before you get started. You will also be able to read about them in our intake paperwork prior to your first session. Most people find that knowing the space is private makes it much easier to actually talk.
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How long does an ADHD assessment take?
Our full ADHD assessment typically takes two to three hours of direct testing and interview time, spread across two appointments. The written report usually takes one to two weeks to complete, followed by a debrief session where we walk you through everything.
Can adults get assessed for ADHD, or just kids?
Absolutely. Adult ADHD assessment is a big part of what we do. Many adults were never identified as children, especially women, and reach adulthood wondering why certain things feel so much harder than they should. It's never too late to get answers.
What if the assessment doesn't show ADHD?
That's still incredibly valuable information. Sometimes what looks like ADHD is anxiety, depression, a learning difference, or a combination. Our assessment helps identify what's actually driving the challenges you're experiencing, so you can get the right kind of support, whatever that turns out to be.
My child's teacher suggested an evaluation. What should I do first?
Reach out to us and we'll walk you through the options. Schools can do their own educational evaluations, but a clinical evaluation from a licensed provider like The Couch gives you a more comprehensive picture and is often needed for outside accommodations and medical decisions. Both types of evaluations have value.
Does a diagnosis mean my child has to take medication?
Not at all. An ADHD diagnosis opens options, it doesn't require any specific path. Many families choose behavioral therapy, skill-building, and accommodations as their first steps. Medication is one tool among many, and it's always your family's decision to make. We'll give you clear information and support whatever direction you choose.
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Is therapy really going to help my anxiety?
Yes, especially approaches like CBT, which has decades of research behind it for anxiety. Therapy works best when it combines understanding the root of your anxiety with building real skills to respond to it differently. Most people notice meaningful progress within 8 to 12 sessions, though everyone's timeline is different.
Do I need medication to treat anxiety?
Not necessarily. Therapy alone is effective for many people with anxiety. For others, medication combined with therapy offers the best results. We'll be honest with you about what we observe, and if we think a psychiatric consultation could help, we'll say so. That's always your call to make.
I've had anxiety my whole life. Can it actually change?
Yes, it can. Anxiety that's been with you a long time often has deep roots, and untangling that takes real work. But the nervous system is remarkably adaptable. People who have struggled with anxiety for decades do experience genuine, lasting change. It takes honesty, time, and the right support.
Does insurance cover anxiety therapy?
Many insurance plans do cover therapy for anxiety. Whether we're in-network with your specific plan depends on your provider. Contact us and we'll help you figure out your coverage before you commit to anything.
What if I feel anxious about starting therapy?
That's actually one of the most common things people tell us. It makes complete sense. You're sharing vulnerable parts of your life with someone new. We take that seriously, and we move at your pace. Your first session is just a conversation. Nothing is required of you except showing up.
Do you offer telehealth for anxiety therapy?
Yes. Telehealth sessions are available for Washington State residents and are just as effective for anxiety therapy as in-person sessions for most people. Some people actually find it easier to open up from a familiar environment. We offer both, and you can switch between them as life changes.
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Does couples counseling actually work?
Yes, and research backs it up. Couples counseling, particularly approaches like Emotionally Focused Therapy (EFT) and the Gottman Method, has strong evidence for improving communication, rebuilding trust, and increasing relationship satisfaction. That said, the outcome depends on both partners showing up honestly and being willing to do the work. We'll be straightforward with you about what's realistic for your situation.
What if my partner is reluctant to come to couples counseling?
This is really common. Sometimes one partner is ready before the other. If your partner is hesitant, individual therapy for you can still make a significant difference in the relationship dynamic.
Can we come to couples counseling even if things are really bad?
Absolutely. We don't think it's ever too late to try, and we've walked with couples through some of the most painful seasons imaginable, including affairs, broken trust, and long seasons of emotional disconnection. If you're here, that matters. Let's start there.
How long does couples counseling usually take?
It depends on what you're working through. Some couples come in for 8 to 12 sessions around a specific issue and feel ready to move forward. Others work with us longer, especially if there's been significant betrayal or long-standing patterns to unpack. We'll give you an honest sense of a realistic timeline after your first session.
Do you offer premarital counseling?
Yes, we love doing premarital work. Starting a marriage with good tools makes a genuine difference. We cover communication styles, conflict resolution, expectations, finances, intimacy, and more in a way that's honest, practical, and even a little fun. It's one of our favorite things to do with couples.
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What if I'm not sure what I'm feeling is really depression?
That's completely okay. You don't need a diagnosis to reach out. If something feels off and it's getting in the way of your life, that's enough of a reason to talk to someone. We'll figure it out together.
Will depression therapy actually help, or will I just be venting?
We're not just here to listen, though that matters too. We work with evidence-based approaches including Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and EMDR to help you understand and shift what's underneath your depression, not just describe it.
What if my faith is part of my depression struggle?
We welcome that conversation. We're partnered with Valley Real Life and are comfortable integrating faith into care when that's meaningful to you. We never assume or push, but if your spiritual life is connected to what you're carrying, we can hold that alongside the clinical work.
I barely have energy to get through the day. How will I make it to appointments?
We hear this a lot, and it's one of the most honest things someone struggling with depression can say. That's exactly why we offer telehealth. You can meet with us from your couch, in whatever you're wearing, and that's completely fine.
Do I need to be on medication to do depression therapy?
It depends. Therapy can be effective on its own for many people. If medication might be helpful for you, we'll talk about it honestly and can refer you to someone for evaluation. That decision is always yours.
How long does depression therapy take?
It depends on your history and what's driving the depression. Some people feel meaningfully better within a few months. Others benefit from a longer process. We'll check in with you regularly so you always know how things are progressing and what to expect next.
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Is EMDR safe?
Yes. EMDR is one of the most extensively researched trauma treatments available, endorsed by the World Health Organization and the American Psychological Association. We move at your pace and never push you further than you're ready to go.
Do I have to talk about every detail of what happened?
No. That's one of the things that make EMDR different. You don't need to retell the full story in detail. You hold the memory in mind while we work through it together, which many people find far more manageable than traditional talk therapy.
How long does EMDR take?
It depends on your history and what we're working through. Some people notice significant shifts in just a few sessions. Others with more complex trauma benefit from a longer process. We'll talk through what to expect after your first few appointments.
What if I tried EMDR before and it didn't help?
That's worth talking about. EMDR outcomes can be significantly affected by pacing, the preparation phase, and the relationship you have with your therapist. We'd love to hear your experience and help you figure out if it's worth trying again in a different way.
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Do all of us have to come to every family session?
Not necessarily. Sometimes we meet with the whole family, sometimes just parents, sometimes individual kids. It depends on what's needed. Your therapist will help you figure out what makes sense for your situation.
What if my partner doesn't think we need family therapy?
That's common. Sometimes one parent is ready before the other. You can start with an individual session to talk through what's happening, and we can help you figure out how to bring your partner on board if needed. Many reluctant partners come around once they understand what therapy actually involves.
How old do kids need to be for family therapy?
If we are working with the children, typically 6 years and older is normal. We work with families with very young kids all the way through teenagers. The approach adapts based on developmental stage. For families with very young children under the age of 6, much of the work happens with the parents learning new strategies.
Will you tell us we're bad parents?
No. Parenting is hard, and every parent is doing their best with what they know. We're not here to judge or shame. We're here to help you understand what's happening and teach you tools that work better. This is a judgment-free space.
How long does family therapy usually take?
It varies. Some families see significant improvement in 8 to 12 sessions, especially if they're working on specific skills. Others need longer support to address deeper patterns. We check in regularly to assess progress and adjust the plan.
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How do I know if my insurance will cover sessions?
The best way is to call the member services number on the back of your insurance card and ask about your outpatient mental health benefits. For Aetna, Premera Blue Cross Blue Shield and Cigna members, we're in-network and can verify your benefits before your first session. For other plans, we can provide superbills for out-of-network reimbursement.
What is a superbill and how do I use it?
A superbill is a detailed receipt we provide after your sessions. It includes all the codes your insurance needs to process a reimbursement claim. You submit it directly to your insurer, and they'll reimburse you based on your out-of-network benefits. Many clients recoup a meaningful portion of their costs this way.
Can I use my HSA or FSA card?
Yes. Therapy is an eligible expense under most HSA and FSA plans. Your card works just like a regular credit card at time of payment. If you need itemized receipts for your plan administrator, we provide those automatically.
Why might someone choose private pay over using insurance?
Private pay gives you and your therapist full control over your treatment, including session frequency, length, and approach, without restrictions from your insurance company about what they'll cover or for how long. It also keeps your mental health records more private. Some people find this worth it; others prefer the cost support of insurance. We'll talk through what makes sense for you.
How often will I need to come in?
Most clients start with weekly sessions, which tends to build the most momentum early on. As things stabilize, many shift to every other week. We'll talk through what makes sense for your goals and your schedule in your first session.
Premarital Counseling
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How many sessions does premarital counseling take?
Most couples complete premarital counseling in 6 to 10 sessions, though we tailor the process to you. Some couples come in with specific topics they want to address and wrap up in fewer sessions. Others find they want to go deeper. We'll talk with you about what makes sense given your timeline, your goals, and where you're starting from.
We don't have major problems. Do we really need this?
That's actually the best time to come. Premarital counseling isn't for couples in crisis, it's for couples who want to be intentional. The conversations you have before you're in the middle of a hard season are much easier to have than after. Think of it like strength training before a race. You build capacity before you need it, not after you've already hit the wall.
Does insurance cover premarital counseling?
Premarital counseling is typically not covered by insurance since it isn't classified as treatment for a mental health diagnosis. We keep our rates accessible and transparent. If you have questions about cost or want to explore options, reach out and we'll talk it through with you.
What if one of us is nervous or unsure about counseling?
That's more common than you'd think, and completely okay. We don't put anyone on the spot or push for more than you're ready to share. Our job is to make the room feel safe enough that the conversations you need to have can actually happen. You don't have to have it all together to show up.
Can we do premarital counseling online?
Yes. We offer both in-person sessions at our Spokane Valley office and telehealth appointments for couples who prefer the flexibility. Many engaged couples are busy, planning a wedding while managing work and life, so we want to make it as easy as possible to actually show up and do this.
Will the therapist tell us whether we should get married?
No. That's not our role, and it's not our call to make. What we will do is help you both see yourselves and each other more clearly, so you can make that decision with full information and genuine honesty. If there are concerns worth naming, we'll name them. But we're not here to judge your relationship. We're here to support it.
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Is sexual addiction a real thing, or just an excuse?
Compulsive sexual behavior is clinically recognized and well-documented. It often involves real neurological patterns similar to other process addictions, frequently rooted in trauma, shame, and attachment wounds. That doesn't remove personal responsibility, but it does mean there's a genuine clinical picture to understand and address. It is not an excuse. It is an explanation that opens the door to real change.
My partner just told me about their addiction. Where do I start?
Start with yourself. You've experienced a significant betrayal, and your own healing matters whether or not your relationship survives. Individual therapy for the betrayed partner is often the most important first step. We have therapists who specialize in this, and we'll help you find the right fit quickly.
Will you tell my spouse or pastor what I share in therapy?
No. What you share in therapy is confidential. There are narrow legal exceptions (risk of harm, child abuse, a court order) but your private disclosures stay between you and your therapist. You won't be exposed without your knowledge and consent. We take that seriously.
Can a marriage really survive sexual addiction?
Yes, some marriages do survive and even become significantly stronger. It requires genuine commitment from both partners, real honesty, and consistent work over time. It's not quick, and it's not guaranteed. We'll be honest with you about what we observe in your situation, and we'll support both of you in making the decisions that are right for your lives.
I'm a pastor and I'm scared someone will find out. Is this really confidential?
Yes, fully. We adhere to HIPAA laws and take your privacy with complete seriousness. We understand the particular fear that comes with ministry leadership, the reputational stakes, the community, the role. We are not here to expose you. We're here to help you. Many ministry leaders have found genuine healing in our office. You can too.
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What if my teen doesn't want to go to therapy?
That's really common. Most teens are hesitant at first. We recommend framing it as trying it out, not committing forever. Often once they meet the therapist and realize it's not what they expected, resistance drops. We're good at meeting skeptical teens where they are.
Will you tell me everything my teen says in therapy?
No. Confidentiality is crucial for building trust with teens. Your teen's therapist will keep what's shared private unless there's a safety concern like risk of harm, abuse, or a court order. We'll check in with you about progress and give guidance, but specific session content stays between your teen and their therapist.
How do I know if my teen needs therapy or if this is just normal teenage stuff?
It's normal for teens to be moody, push boundaries, or pull away sometimes. But if you're seeing persistent changes in mood, sleep, appetite, relationships, or school performance, or if they're expressing hopelessness or self-harm, those are signs to take seriously. When in doubt, it's better to reach out. A consultation can help clarify whether therapy would help.
Do you offer telehealth for teens?
Yes. Some teens prefer the convenience and privacy of telehealth, especially if they have busy schedules or transportation challenges. We offer both in-person and telehealth options. We'll help you figure out what works best for your teen.
How long does teen therapy usually take?
It varies. Some teens benefit from short-term therapy focused on a specific issue, while others need longer support to work through deeper patterns. We check in regularly to assess progress and adjust the plan as needed. The goal is always to equip your teen with tools, not create dependency.