If we already have an established relationship, click here to book your next appointment.
If you are curious about starting services, or would like to know more about what services I offer, you’ve come to the right page. This page should answer all of your questions, but please don’t hesitate to reach out to me if you have more questions. You can call me at 757-606-0145 for more information, or book a call with me. Typically, it’s much more effective to book a call since I am often in session and unable to answer the phone.
Individual counseling is available for anyone seeking services where the spouse will not be involved. People may choose individual sessions because their spouse in unable to make it to sessions. Typically, people are coming in to work through issues that are affecting their marital relationship. These issues may have to do with sexual concerns (such as pain with sex, difficulties with orgasm, compulsive sexual behaviors, or lack of desire just to name a few), or because of mental health conditions such as depression or anxiety.
The SYMBIS Assessment (Saving Your Marriage Before It Starts) was created by husband and wife team, Dr. Les and Dr. Leslie Parrott. This assessment is taken by engaged couples or married couples within their first five years of marriage. This assessment allows a couple to see basic personality traits, areas of strength, possible areas of growth, communication and conflict resolution patterns and more. This assessment can be a helpful place for starting the process of counseling prior to marriage.
This assessment is not intended to tell you if you “should or should not” get married, but instead helps you understand areas that you might struggle with as a couple. This allows you to work on those difficulties prior to having them come up. In other words, it gives you the insight you’ll need to tackle some of the difficult situations that may arise after marriage.
You can learn more about the assessment here.
There are times when it can feel that we are just getting started when the session comes to a close. This can be especially true for couples who have been dealing with truly difficult struggles for an extended period of time or for couples who have a hard time communicating well with one another. Sometimes these couples will elect to come in less frequently, but to spend a greater amount of time in session. This can also be helpful for couples who have limited flexibility in their schedules and who need to have longer sessions less frequently.
Couples can choose to have 50-minute sessions (the typical session time), or have sessions of 90 minutes or 120 minutes. For couples who live outside of the Hampton Roads area, but still within driving distance, intensive four-hour sessions are available on occasion. These sessions typically occur on Fridays with a lunch break in-between two 2-hour sessions. These have to be planned in advance and approved by Dr. McCleese as the availability for these sessions is quite limited.
Sex therapy is a service that is offered to both individuals and couples. This service focuses primarily on the actual sexual relationship or sexual concern. People seek sex therapy for a variety or reasons such as: recovering from an affair, sexual desire differences in the marriage, erectile dysfunction, orgasm difficulties, pornography use, past sexual trauma, and issues with infertility, as well as other issues related to body image and self-esteem. While sex therapy is unique in it’s focus on sexuality, we spend a great deal of time focused on your relationship as well.
The process of sex therapy can be difficult for many people because most people have at least a little discomfort with the topic of sex. I do what I can to make our conversations as comfortable as possible. One way I do that is by treating your story with respect and reminding us both of how difficult these topics can be. Please note that sex therapy is similar to marriage counseling in the sense that this is “talk therapy.” Click here to learn more specifics about the process of sex therapy.
About 80% of my practice is focused on marriage counseling and sex therapy. There are a few differences between these services, but there is also quite a bit of overlap. In couple’s sessions, the husband and wife (or engaged couple or boyfriend/girlfriend) come to sessions together. It is not possible to have couple’s sessions without both partners present. Couple’s sessions, by it’s very definition, requires that the three of us work together.
Occasionally, as part of the process of couple’s counseling, I will elect to have a session or two with each of you individually. This happens when I need to gather a large amount of info from each of you and find that we are limited in doing so in the couple’s sessions. I may also ask for this time if a couple has a difficult time communicating without arguing heavily. These individual sessions can occur to get you each to a place where you can gain the skills necessary to begin couple’s sessions again. This is a rare situation since couple’s sessions should include both people, but occasionally it is the best way for us to move forward.
In couple’s sessions, I will gain information from you regarding the history of the relationship, areas of strength that you want to maintain, and areas that are more difficult for you. We’ll assess your goals and determine what is needed to move toward those goals. Click here to learn more about the process of marriage counseling.
Cancellation is required 24 hours in advance. If you do not cancel your appointment within 24-hours, you will be charged for the missed session and the charge will be equal to the cost of your session.
Once a year you will be given “grace” for a miss and will not be charged if you had a valid reason for missing. In other words, if an unavoidable emergency situation prevents you from coming in, you will not be charged for that session.
Free 20-minute initial consultation (required before we begin services)
50-minute session for $150
90-minute session for $225
120-minute session for $250
60 minute session with my intern for $60
-Interested in learning about my intern? You can see her profile here.
SYMBIS – Click here for information regarding SYMBIS
Assessment plus one session for results – $150
Assessment plus 3-8 sessions – $35 paid to SYMBIS for assessment plus $110 per session
People sometimes wonder what we will talk about during that 20-minute call and why we need to do that first. There are a couple of reasons why I do this. First of all, I want to make sure that I am the best choice for you based on your need. On that call, I’ll ask for a brief description of what your reason is for seeking counseling. This is not an interview, so I will not be asking you why you want to work with me. I will simply get a 2-3 minute explanation of your concerns. I will then tell you if I work with similar concerns and how I would move forward with treatment. You then have several minutes to ask me any questions you have that have not already been answered. You are under no obligation to commit to services after that call and if I feel that someone else may be a better fit for you, I will offer a referral for that therapist.
The other reason that I require the 20-minute phone call is because I know from research that one of the most powerful factors involved in helping you meet your goals has to do with if our personalities mesh well or not. If you feel a connection to me and feel like I’m a good fit for you, you are much more likely to meet your goals. On the other hand, if you do not like my approach or if you feel I can’t relate to you, you are much less likely to get what you need from counseling. If you can’t get what you need, you end up wasting time, money, and energy. I want this to be a positive experience for you. From my work with people, I’ve seen that we are able to determine if this is a good fit within that initial phone consultation. If you’re ready, you can schedule that initial call here.
Many people prefer to use their insurance to seek counseling services and when they choose to do so they are limited to the providers that accept their insurance. This means that they are likely to work with someone who has some experience in a large array of situations instead of someone who specializes in a specific area of concern. This is one reason that many people choose to seed services outside of their insurance benefits. In doing this, they are allowed to choose their provider based on areas of specialty for the provider and a personality match between the provider and person seeking services.
Additionally, with the changes in managed care, many people are finding that their deductibles are so high that they cannot actually meet them in the span of one year or they find that counseling services are not reimbursable through their insurance. This is particularly true of people seeking marriage counseling or sex therapy as these services are not always deemed “medically necessary” by insurance companies.
People who chooses to see providers in private practice also often appreciate the higher level of privacy afforded by those not on insurance panels. Since I am not on panels, my notes will not be audited. This means that you will not have to worry about insurance coming in looking at the notes I keep regarding your care. Your information (including diagnosis and treatment) stays 100% private. Since I’m not on insurance panels, I also keep paper notes instead of notes on the computer meaning that you never have to worry about your information being found by hackers. My treatment notes are only accessible to me (and you if you request them). Even when I have students working under me, my notes are secured in locked file cabinets that they have no access to.
Counseling is certainly a difficult process. It requires a commitment to meeting with your therapist, time outside of the session to practice the new skills you are learning, a good amount of energy to practice making changes, and a fee every time you come to session. Though the cost can be high and seen immediately, the cost for not seeking services is typically much greater and felt for a longer amount of time. Not seeking services could mean the loss of a marriage or loss of important friendships. For some, there can even be a loss of job if personal concerns are starting to affect them outside of the session. In deciding if you are ready to commit to the process of counseling, it can be helpful to assess the cost of not going along with the cost of engaging in services.
It absolutely does. In fact, we have 50 years of research that shows the effectiveness of therapy. Therapy can people communicate more effectively, resolve their conflict, and better connect with the people that are most important to them. At the core, counseling services help people see their situation from a new perspective and learn some problem-solving skills and strategies to meet the goals they set. If you’d like to know a little bit more about making the process of counseling as effective as possible, I encourage you to read this article.
Yes, I do offer online sessions. These sessions are conducted through a free cloud-based HIPPA compliant system. The cloud-based system means that you will not have to download any extra software to meet for our sessions. Using HIPPA compliant software means that your data is protected, however, you still bear the responsibility of having your session in a private area. For instance, going to your local coffee shop will not provide the protection or privacy that you would have in your own home.
Online sessions are sometimes used by people local to this area, but unable to get to the session for a variety of reasons. However, this is usually the format for those that live too far away to get to the office. Consultation services often utilize this format. Additionally, clients that live in-state and come periodically for intensive sessions find that online sessions in-between in-office sessions can be quite beneficial.
With counseling services, you will receive a diagnosis based on the symptoms that you present with. This diagnosis will be discussed with you as well as the treatment that works best for the diagnosis that you have received. If you are seeking insurance reimbursement, you can request an invoice with the diagnostic code on it to send to your insurance company.
With counseling services, your invoice will also include a CPT code which tells the insurance company exactly what we are doing together. For instance, 90791 means that we have had our initial intake, 90834 is an individual session, and 90847 is used for couple’s sessions. The CPT code and the diagnostic code for sessions must both be reimbursable services with an “out of network provider” for you to be reimbursed.
Counseling services can only be performed by a person licensed in the state that you live. In other words, since I am only licensed in Virginia, I can only provide psychological services to people who live in Virginia.
Consultation services, on the other hand, can be received by anyone who speaks English (since this is the only language I speak). You do not have to live in the state of Virginia to receive these services. While I can’t help but rely on my training as a psychologist to provide treatment, what I will do with you will not be called psychological services. This means that I cannot provide you with a psychological diagnosis or a CPT code since one does not exist for consultation. Since you cannot receive a diagnosis or a CPT code, you also cannot seek reimbursement through your insurance. Some people may choose to engage in consultation services when they live out of state but feel that I am the best match for them. If this is the case, I still require the initial 20-minute phone call required of counseling clients to make sure that we are a good fit. I also require initial paperwork and a contract that shows that you understand that we are engaged in consultation services and not counseling services.
*Please note that I am legally and ethically unable to provide psychological advice, diagnosis, or treatments via email to people who are not my clients. If you are in need of immediate assistance, call 911 or your medical doctor for an immediate referral for care.*