Katy Clark, LMSW

My standard fee is $165/55 minute session. Longer sessions are available for relationship therapy clients at a prorated rate. I accept several kinds of insurance for individual therapy, but do not bill insurance for relationship therapy. Depending on your insurance plan, your benefits may cover all or most of the cost of therapy right away or after meeting a deductible. Some plans even cover out-of-network providers. Sometimes, deductibles can be very high and make using insurance to pay for therapy impractical. I encourage you to check your benefits.

In order to ensure that established clients are able to stay in therapy even if they experience a financial disruption or change of insurance, I typically restrict opportunities for sliding scale to current clients facing unanticipated hardship. If you would like to begin therapy and cannot afford the full cost, I recommend seeking a therapist through Open Path Collective or The Women’s Center of Southeastern Michigan.

In short, insurance companies do not agree that it is a covered, medically necessary service. Insurance is meant to be billed for services rendered to the covered individual to treat that individual’s medical problems. In true relationship therapy, the relationship itself is the client, rather than any individual who is part of the relationship. There is no corresponding billable procedure code and it is not treatment for an individual psychiatric diagnosis. Billing relationship therapy to insurance therefore involves a substantial amount of theater, risk, and ethical and liability hazards for the therapist. Furthermore, the payout provided by insurers for this highly specialized service is paltry in comparison to what they pay for individual therapy, and pales against the advanced training needed to become a competent relationship therapist and the skill required to navigate the increased complexity of multi-person sessions. It’s risky and, financially, not worth the risk. Therapists, like everyone else, vary in their risk tolerance and financial flexibility, so you may be able to find a relationship therapist willing to bill your insurance if that is essential to you in your search. If you’d like to see me for this service, sessions will be self-pay.

At the moment, I offer virtual therapy only to clients throughout Michigan using a HIPAA compliant telehealth platform. Due to licensure and practice laws, all clients must be located within the state of Michigan at the time of our meetings, so I cannot see you if you live out of state or if you will be attending relationship therapy with someone who lives out of state. Virtual therapy is as effective as in-person therapy for most clients and offers the convenience of attending from your preferred location without a commute to an office. I enjoy meeting with clients in-person, but have found that in today’s busy world, virtual appointments tend to be easier for clients to attend and beneficial for accommodating cancellations and rescheduling. If you would like to meet in-person if the option becomes available, please fill out this interest form to let me know!

I will most often attend our virtual appointments from my home office. Wherever I am, I value providing a private and as distraction-free as possible setting for clients. To that end, I will ensure that my working location is one where no one else can see or hear us during our sessions, although you may occasionally hear ambient neighborhood noise or my cat sorting through his own feelings. I close the office to my cat by default during session time; if you would benefit from some virtual cat therapy and would like me to let him in for our sessions instead, you can let me know.

For clients attending relationship therapy, I do recommend that all parties attend from the same geographic location on one device so that you are physically with each other. However, when this isn’t possible, we may hold therapy with all attending from different locations/devices.

The fit between client and therapist is incredibly important in order for therapy to be effective. It can be useful to think about practicalities (insurance, fee, location, etc), approach (theoretical orientation, modalities used, style), training/experience, and affinity (identity, culture, and/or shared lived experiences) when choosing a therapist. You can learn more about me and the services I offer on this website. I also offer a free, 15-minute phone or video consultation call to explore the idea of working together.

I specialize in working with healthcare and helping professionals and first responders who are disconnected from themselves and others, in both individual and relationship therapy. My practice is LGBTQ+ and non-monogamy affirming and I welcome current therapists as clients. I also work with young people ages 18-28 to navigate school, careers, finances, and self-care to effectively make the transition into independent adulthood.

I am not able to provide on-call crisis response and therefore generally do not work with clients with high-acuity problems that require medical treatment or routinely result in emergency room visits or hospital stays. This can include active psychosis, active addiction/substance use, severe eating disorders, or acute suicidality. I also do not work with minors or with adults who have a guardian. I only work with mandated clients who want to be in therapy of their own accord, regardless of court-involvement. If you aren’t sure if this applies to you, reach out and we’ll talk it through!

In general, you will feel better faster the longer and more frequently we meet. For most clients, weekly sessions are appropriate and recommended, especially when we are first getting started.

For individual clients, I recommend standard-length sessions of 53-55 minutes beginning with weekly appointments. Insurance generally does not cover extended sessions, so if we need extra time I will recommend multiple sessions within one week. Depending on your circumstances, it may be an option to attend shorter sessions (30 or 45 minutes) or come less often (every other week).

Relationship therapy (couples, family, etc) is available in 55, 85, and 115 minute intervals. With multiple people in the room, it can be extremely helpful to have the extra time that extended sessions allow. When schedules and finances permit, I recommend weekly 55 or 85 minute sessions, or biweekly 85 or 115 minute sessions, as a good starting point for most relationship work.

You can stay in therapy for as long as you’d like. Research has shown there is no one-size-fits-all length of treatment and that clients tend to self-initiate ending therapy when their symptoms are back within, or close to, normal range. How much therapy will be right for you depends largely on what’s bringing you in and how you uniquely go about changing; we can talk about your goals and our expected timeline during the first few sessions. Many clients derive benefit from a “short” course of therapy of 12-20 sessions, and many clients, especially those with persistent relationship problems, self esteem difficulties, family-of-origin issues, and trauma histories, benefit from depth-work (long term therapy of more than a year).

As we work, I’ll be checking in with you periodically about how our work is going so that we can continually ensure our time together is effective for you. As we make progress and achieve your goals, it can make sense to decrease the frequency of therapy (e.g. move from weekly to every other week). At some point, you may like to come even less often (e.g. monthly) for maintenance instead of active work, or try going without therapy for a while to see how that feels. If you need support again or develop new goals, you can always come back.

First appointments include time for us to talk about what brings you into therapy and your goals for our work. I’ll also ask you some questions about your life context and personal history. We’ll have plenty of time throughout our work together to continue to discuss these topics, so you can share as much or as little as you feel comfortable to during our first meeting.

Once I know more about what brings you in, we’ll talk about how we’ll approach your goals and develop a plan for our work. I’ll check in with you to see how it feels to be meeting and if you have any questions for me. If it feels like a good fit and we’d like to keep meeting, I’ll save us a bit of time at the end to go over some policies so that we can be on the same page about appointments, confidentiality, privacy, etc.

For relationship work, we’ll take the first several sessions for intake and assessment so that I can meet with you together and then each of you individually before resuming as a group. Meeting with relationship therapy clients one-on-one at the beginning helps me learn a bit more about how you as individuals view the relationship and the problem, get some individual history that may be relevant to our work, and hear any concerns you have that may be difficult to discuss as a group.

Sometimes during first appointments, we figure out together that we aren’t a good fit. If that happens, I’ll give you some names or organizations where you might be better able to find what you’re looking for.

What our sessions look like will depend on whether we are meeting for individual or relationship therapy; your goals; if we are working from any particular model; and, importantly, what works for you. Sessions may involve talking about current or past events, exploring internal or interpersonal conflicts, identifying and experiencing emotions, paying attention to the body, guided practices such as grounding or relaxation, learning and practicing communication or regulation skills, reflecting on values and actions, and active inquiry into your worldview, beliefs, and history. We’ll check in with each other from time to time to make sure the way we are spending our time together is meeting your needs.

Using your insurance to pay for therapy requires that I document a diagnosis to justify medical necessity of services. These diagnoses come out of the Diagnostic and Statistical Manual (DSM). There exist a wide range of diagnoses, many of which describe overlapping sets of symptoms and experiences. Some people, but not everyone, resonate with one or more diagnoses and find this framework to be a helpful way of understanding their experiences. Whether because we are using your insurance or simply because it interests you, if you’re curious about it we can discuss which diagnosis/es might apply to you. When insurance is not involved, documentation of a diagnosis is not required but we may still discuss it if you’d like. Diagnosis is one of many frameworks I draw on to make sense of clients’ lives, and low in its significance to my case conceptualization.

As for privacy, your treatment and records are confidential with a few legal exceptions such as when there is imminent risk of harm to others, ongoing child or elder abuse, a court-issued subpoena, or an audit or records request from your insurance company. I keep my notes as vague as possible within professional standards for documentation in order to best protect clients. Paying for therapy out of pocket can provide an added layer of privacy by limiting third-party payor access to your records and eliminating the need to justify medical necessity of services.

Your confidence in your records and in our work is important to me. If you have concerns about being assigned a diagnosis or about privacy and documentation, please discuss them with me.

My role in relationship therapy is not to take sides or referee who is right or wrong or good or bad. Instead I will be looking to understand how everyone’s actions make sense given the context but also how you are interactively co-creating a dynamic that isn’t working for you. It’s important that everyone feel seen, heard, understood, and respected.

I accept inquiries throughout the year from interested prospective clients. In the event that I do not have any immediate openings that work for you, waitlist times vary based on the service you are seeking as well as your scheduling needs. Typical wait times range from several weeks to three months for daytime appointments. Please note that wait times for evening appointments may exceed this as there are fewer of them and they are in high demand. We can consider getting started immediately with cancellation-associated openings while we wait for something more predictable to become available.

Appointments are available Tues-Thurs with morning, afternoon, and limited evening times offered, as well as on some Fridays. Reach out by phone (734-210-0116), email or this form to get started.