Finding Counseling

Update: At this time, Jennie is not accepting new clients. However, please review these resources and recommendations to find support. 

Looking for a Therapist?

If you're ready to try counseling, congrats -- that's a big step! For an approach similar to mine (Jennie), I recommend finding a counselor who specializes in anxiety or trauma-specific CBT therapies. Alternatively, an experienced EMDR counselor who has worked with trauma and PTSD can be helpful. 
Consider a therapist who is: 
*Trained in specific anxiety or PTSD approaches
*Mentions specific therapies, like CPT (cognitive processing therapy) or EMDR
*Targets specific conditions, rather than just a general "talk therapy" approach
*Has a few years + of experience with treating anxiety and/or PTSD (ask about their success with clients with your condition)
Meanwhile, you'll need a way to find a counselor who fits. Here are some options. 

Affordable Counseling

If you need to stay on a budget, use your insurance, or don't have insurance, consider these options. 
Non-Profit Agencies
Many communities have local therapy agencies with multiple offices and services. These larger organizations tend to have funding and resources to help with pay, and will accept nearly all insurance plans. The drawback of these is that there may be a wait, and you may not be able to get in as often. Counselors may also carry large caseloads and turnover tends to be higher. Visit here to look for such an agency. 
Personal Violence Centers
If your trauma relates to domestic violence (from a current or past partner) or sexual assault, you may qualify for free therapy through funded services. Quality of these services will vary from area to area. To learn more, visit here or call 1-800-799-7233. Let them know you're looking for therapy in your area. You may need to answer some questions to see if you qualify for their grant requirements. 

Open Path - Sliding Scale Therapists
Open Path is a place where private practice therapists (and others) can sign up to offer lower-cost self-pay services. They range from around $30 to $80, depending on your needs. You will need to look for a therapist within your state (as therapists are licensed in their own state or region, even if they're providing telehealth.) Visit here. 
Veterans and Military 
Vets are already familiar with the VA. You can look for local services here. Just like with other agencies, the quality of services will vary in your area. There are also various agencies that help with funding for counseling for veterans or those in the military. You can best find these by searching online. 

Private Therapy

These options will generally cost more, but may offer higher quality, specializations, and more availability. 

Local Group Practices and Private Practice
Often therapists tend to start out at agencies and then join a private practice group, or open their own office. Some may start out in a group practice. These therapists tend to charge more and carry smaller caseloads.
They may also be very experienced, with specialties in areas like anxiety, couples, or PTSD. The drawback is that they tend to be self-pay and not accept insurance. This is because it's incredibly complicated and time-consuming to accept insurance (and then companies don't always pay). Private therapists also have more overhead such as office space, software, insurance, etc., which ups the cost. 
Generally, the more experienced the therapist, the more it costs. This also allows these specialists to carry smaller caseloads, see individual clients more often, and provide a high level of support, quality and availability. It also decreases burnout rate which improves quality and consistency. 
Private practice therapists who charge out of pocket can range from $60 to upwards of $200 per session. This depends on their experience, overhead costs, and the local region. You can generally find these therapists by searching online in your area, or by looking through therapy listings such as Psychology Today, or Therapy Den
Online Therapy Apps - Pros and Cons
There are a lot of opinions about therapy apps (think Better Help or Talkspace) and how effective they are. In my opinion, these services can be helpful if you just need to talk out an issue occasionally with a therapist. However, this format may not work best for problems like chronic anxiety or PTSD, or if you need regular, ongoing support. 
Also, keep in mind that many counselors on these platforms carry very high caseloads and have limited session times (sometimes just 30 minutes per week). This may affect the quality of your therapy.
These apps also often advertise affordability, however the fee is generally $60 to $100 per week, and your therapist will only get a fraction of that (generally half or less). In many areas, you can find a private therapists with the same or lower fees, who will offer 50 minute sessions and be more available to you. 
Self-Help Resources
If you're on a waiting list for a therapist, haven't found the right one, or just aren't ready for that, you can start with self-help resources. I have written down all of the steps I use with my clients to treat anxiety and PTSD through various tools. These include my ebook, Finding Peace from PTSD, as well as CBT and self-care and development worksheets you can find here
I try to keep all of these materials affordable so they can fit within any budget. If you still can't afford these resources, I occasionally offer them for free. Contact me and I'll update you on free promotions. 

Counseling with Jennie
(Although she is not accepting new clients)
Although she is not accepting new clients at this time, here are archived answers to frequently asked questions about sessions with Jennie. 

Do you do telehealth (Zoom or phone) or in-person?
I am only providing telehealth appointments now. We can talk via video on Zoom (or a similar platform) or talk by phone. The limited research on this shows it works just as well as in-person therapy!

Do you offer a free consultation?
I am available to consult briefly via text or e-mail to discuss if I am a likely a good fit for your needs, and if an assessment is appropriate. 

Do you have a sliding scale? 
All sliding scale spots are full at this time. 

Do you take insurance? 
The short answer is no. I am not in any insurance networks, so you will pay for all appointments yourself. Some of my clients are able to get some portion of what they pay reimbursed through out-of-network benefits. If this interests you, I recommend you call the number on your insurance card and ask about "out of network mental health benefits." You should also verify that this is covered for telehealth appointments. 

What do sessions cost? 
Initial Consultation = $150
All Following Appointments = $125

What if I can't afford this/why don't you take insurance? 
I know healthcare can get expensive. Many individual therapists can't afford to accept insurance due to the difficulty of working with insurance companies (so much time fighting them, and then they still don't always pay), and a lack of any state or federal funding. Non-profit and larger agencies are better able to provide this. You can check with SAMSHA to look for these resources. 

What happens in the assessment? 
Initial assessments include symptoms screening, discussion of your mental health history, and my initial diagnostic impressions. If your symptoms appear to match the areas I currently treat (PTSD, general anxiety, or phobias), then I will recommend treatment options. This is most often CPT (cognitive processing therapy) or a related CBT approach.

These treatments are generally highly effective for clients who meet the matching symptoms and are motivated to get better quickly.

If your symptoms do not match these areas I treat, or either of us feel we aren't the best fit, I will refer you to another provider(s) for ongoing sessions following the initial assessment. 

How long will I be in therapy? 
Many of my clients with general anxiety or phobia issues begin to feel better within a couple of months. Those with PTSD are generally better within a few months. In my experience, those who come into therapy with me determined to be rid of their anxiety problems or PTSD once and for all, do so the quickest.  

This being said, many overlapping conditions can take longer to treat. For example, those with depression prior to PTSD, or those with other disorders like OCD or complex trauma may take longer to be free of symptoms. 

How often and how long will we meet? 
Appointments are generally 50 to 60 minutes, and this type of therapy works best if it's weekly for the first several weeks. Otherwise we will end up essentially starting over each session. 

How do I get started? 
If you've reviewed these questions and it sounds like a good fit, please e-mail me: jennie@thecounselingpalette.com  [Update: I am not accepting new clients at this time.]

Talk soon! 
-Jennie 

About Counseling in Columbia, Mo., and Online Counseling in Missouri

Jennie provides telehealth counseling (via phone and/or video chat) for mental health for those in Columbia, Mo., and throughout Missouri. She works mainly with issues of high anxiety, trauma and post-traumatic stress, or PTSD. (FYI, PTSD can affect anyone who’s had a trauma, not just Veterans.)

If you're interested in setting up an appointment with Jennie, read the info above for more details.

Jennie uses the most proven therapy techniques, combining mindfulness, acceptance of feelings, and challenging of negative self-thoughts. Through allowing feelings and healing thoughts, you can decrease and even eliminate daily symptoms like high anxiety, panic attacks, intrusive memories, disturbing dreams, sleep issues and flashbacks.

Trauma therapy and other types of focused therapies can often help people get better faster. To learn more, you can contact Jennie or keep reading to find what you need. You can also find quick relief techniques for anxiety symptoms while you continue to address underlying causes. 

PTSD Counseling 

PTSD, which stands for post-traumatic stress disorder, is a complication that some people get after experiencing a trauma. It is considered an anxiety disorder, and is basically getting "stuck" in the aftermath of a trauma. Immediately after a traumatic event, it's normal to have PTSD-like symptoms.

 

Some symptoms people often report in PTSD and trauma counseling are:

 

  • Feeling on high alert

  • Having flashbacks and bad memories

  • Disturbing dreams and nightmares

  • Nearly constant high anxiety and/or panic attacks

  • Depression symptoms, like feeling shame or guilt and blaming yourself

In most cases, these symptoms get better on their own within several weeks. Right after a trauma, our nervous system is confused and preparing for more danger. It takes a few weeks to adjust back to normal.

 

For some people, though, these symptoms persist even after a few weeks. This is often diagnosed as PTSD. This is a very miserable thing to go through, and can be very frightening and confusing. It can make it nearly impossible to work at times, difficult to get along with family, and hard to just leave the house sometimes.

Fortunately, there are really good, targeted trauma therapy treatments now that can help you get better within around 6 to 16 weeks! Even if you've suffered for years, targeted therapy can often help you heal and get back to a normal life, or even experience one for the first time. Keep reading to learn about the types of treatments Jennie offers for PTSD.

Types of Trauma Counseling for PTSD

There are a few types of therapy that are considered the standard for PTSD and related issues. Here’s an overview of three types of trauma therapy, all within the family of CBT.

Cognitive Processing Therapy (CPT)

This therapy is under the branch of CBT (cognitive behavioral therapy) treatments. CPT could be thought of as what you might do in traditional CBT therapy over a year or two, but targeted within two to three months.

 

Rather than simply flowing with the events of each week, which is what many therapies do, the client and counselor make a list of the most disturbing thoughts and beliefs that relate to the past trauma. They then go about challenging the most damaging thoughts, called “stuck points.”

 

Through beginning to break down thoughts that relate to shame, guilt and trust, the PTSD symptoms begin to weaken. Over several weeks of doing this, our pattern of thinking, especially around the trauma, begins to change, and we feel better. Symptoms like flashbacks and anxiety no longer have a place to take hold.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

This therapy, like it sounds, is much like CPT. However, it was created specifically for children, adolescents, and young adults. It includes the same core piece as CPT, which involves breaking down the negative beliefs about yourself and the world. I typically use this treatment when requested by young (or older) adults. 

However, it also includes more general education about managing emotions, and includes a trauma narrative, which allows someone to gradually work through struggles caused by their trauma

Prolonged Exposure (PE)

This therapy is similar at its core as the previous therapies described. However, it involves more directly telling the story of the trauma, repeatedly. Through this quick exposure, clients become desensitized to the trauma and are able to more easily process what happened.

 

While I have had clients who sing the praises of PE and I still offer it sometimes if it's asked for, I have found in recent years that this therapy has a high dropout rate compared to the other more gradual therapies, which work just as quickly. So I generally recommend CBT, TF-CBT, or some variation of these.

 

One element my clients and I do borrow form PE is called in-vivo exposure, which involves gradually facing everyday fears that are interfering with living a full and meaningful life. This part of the therapy is more gradual and gentler, and many clients choose to try it and love the quick benefits it offers.

Anxiety Treatment

Everyone feels anxious at times. This is normal before a special occasion, at particularly difficult times in your life (like a divorce or death of a loved one) or when you're trying something new, like public speaking. Sometimes anxiety can become more severe, causing problems in everyday life, even bringing anxiety attacks, sometimes called panic attacks. If the anxiety becomes very high or extreme, or occurs so frequently that it interrupts your life, it could be caused by a past trauma, anxiety disorder or other condition. Fortunately, most conditions that lead to high anxiety are very treatable. Jennie can typically help you figure out the cause of your anxiety and can help you learn ways to decrease, manage and heal it.

CBT for Anxiety

Jennie most often offers CBT for anxiety issues. This involves understanding the causes of anxiety and treating the root of what’s going on. If it turns out to be relating to trauma, she might recommend one of the PTSD treatments mentioned above. Otherwise, you might be dealing with situational anxiety, social phobia, or generalized anxiety disorder (GAD). CBT treatment takes a look at the thoughts, feelings and behaviors, and helps clients begin to examine if their thoughts are always accurate. Anxiety counseling often involves the following elements:

  • Mindfulness or grounding techniques to calm down the nervous system

  • Looking at the triggers and causes of the anxiety

  • Challenging the thoughts that are leading to the anxious response

  • Addressing the underlying fears and thoughts causing the anxiety symptoms

  • Reprogramming the body’s response to the anxiety trigger through specific homework

 

Most clients with specific anxiety issues begin to find relief within several weeks. Jennie helps you address the root cause rather than just the everyday symptoms.