Frequently Asked Questions About Couples Counseling

My fee is $175 for a 45 minute session. I offer both longer and shorter sessions as well, so we can customize the length of a session to meet your needs and budget. Nearly everyone I see comes for a 45 minute session, but some new clients desire a longer session to jump-start their treatment, whereas others want a shorter session for a quick tune-up.

2. How long will we need couples counseling for?

This is a difficult question to answer without knowing more about your situation. My goal is always to help you and your partner feel better as quickly as possible. Most of the couples I see spend between 12-25 sessions working with me on a weekly basis. Some take a little longer, and some take a little less time. Your individual needs will vary.

Keep in mind is that lasting change happens slowly. For most couples who are having serious challenges, it seems to take about 9 months to see a significant change. This is probably longer than you'd like, but my experience and over 30 years of research shows this to be the case. The good news is that you will start to see change right away, particularly if you are both willing to work at it. You should start to notice improvement in your relationship after just a few sessions, whereas things should be much better after about 10 sessions, and things should be great by about 20 sessions.

3. Why do some couples counselors charge more than others? Why can't we see a therapist for $50 per hour?

What a great question! Having been in therapy for many years, I understand that it is expensive. Instead of focusing only on the cost, I invite you to look at couples counseling as an investment. If your marriage is in need of help, an investment in couples counseling could be less costly than a divorce. The average divorce in California costs upwards of $20,000, with most litigated divorces cost much more. If you do the math, you can see that is well over 100 therapy sessions, and you get to keep your house.

As far what you should pay for a good couples counseling, good therapists and counselors can be found in almost every price range, but the best therapists tend to charge more for their services. Highly skilled couples counselors have years of graduate training, research backgrounds, professional expertise, publications, and experience that takes a great deal of time to acquire. Just as with other professionals, such as attorneys, surgeons, and anyone else in a specialty field, the better you are at what you do, the more you can charge for your services. While there are exceptions, the more specialized and experienced the practitioner, the more they typically charge.

Of course, you could always go to a therapist who charges $50 per hour and you may even have a positive experience; However, I would be concerned about a couple of things if I was thinking about seeing to a low-cost therapist: 1) How skilled is the therapist? and 2) How motivated is he or she to help me to get better fast?

In respect to how skilled the therapist is, I would want to know the following; 1) their educational background (i.e. PhD, LMFT, LCSW), 2) years of experience, 3) level of licensure (trainee, intern, or fully licensed), 3) their specialty. and 4) has their work been published and have they written any books. These things demonstrate a level of passion and commitment.

4. Do you take insurance?

I do not take insurance. However, many PPOs and HMOs will cover all or a portion of my fee. If you would like to use your insurance, please contact your insurance company and ask what coverage you have to see an "out-of-network provider." They will tell you what your coverage is; if possible, ask them to fax you or email you a copy of your coverage so that you can use this when you submit any documents to them in the future. I will then start to provide care to you, you will pay for the sessions as we go, and once a month I will prepare a superbill for you that you can submit to your insurance company for reimbursement.

5. Why don't you take insurance?

Thank you for asking this. I decided not to work directly with insurance companies for several reasons. The first is that they require me to give you a mental disorder diagnosis. Many people that I work with want to learn new skills and different strategies to try at home or work and do not necessarily have a diagnosis. Secondly, many insurance companies put severe restrictions on what types of services they will cover. For example, many insurance companies do not cover marriage or family counseling. Another reason is that I want you to be actively involved in determining what type of care you are receiving. With insurance companies, many of your choices and my treatment options are limited. The most important reason for my not taking insurance is that it jeopardizes your confidentiality. If I submit a bill to an insurance company on your behalf, your confidential information is processed by the insurance company and then stored in a national database. Anyone who is involved in the processing or handling of your claim has access to your records and anyone who has a legitimate reason to access the medical database, such as insurance companies and future employers, can view your confidential records. Theoretically, a potential employer or other company could discriminate against you based on this information. For all of these reasons, I have decided not to accept health insurance directly.

6. What kind of therapy do you do?

In couples counseling and premarital counseling, I use a blend of therapies, including the following:

• Psychoanalytic, object relations, transgenerational, pluralistic
• Cognitive behavioral, behavioral, integrative behavioral
• Emotionally focused
• Solution focused
• structural therapies
• Bowen family systems
• The Gottman approach

7. What do you specialize in? What is your style like?

I specialize in couples counseling, family counseling, and individual therapy. I limit my practice to 20 clients per week because I want to be able to spend ample time with each client, read, write, and conduct research. This scenario is drastically different from most therapists who work with insurance companies. Many of them see upwards of 35 clients each week which translates into a caseload of 100 clients or more. I don't believe that a therapist with this type of caseload can be available to their clients.

I also specialize in complementary and alternative medicine therapies, because I have a Doctorate in Naturopathy and numerous other certifications in natural medicine therapies. I have found this to be quite useful in couples counseling as I often find an alternative means to help someone solve a personal problem that has been creating difficulties in the relationship.

Something else that is different about me is the fact that I am classically trained in communication theory. My undergraduate major at Santa Clara University was Communications where I conducted a landmark study on communication, families, and alcoholism. With my strong reseach background, I have blended my love of science with the practice of psychology. I believe that all therapy should be rooted in strong scientific evidence and research, so I only use methods that have been proven to work. This can be very different from therapists who work primarily off their intuition. While I believe strongly in the importance of inner knowing, I think it is important to use proven methods when a marriage or significant relationship is on the line.

Of the 20 patient hours I have per week, about 50% are couples, 10% are families, 40% are individuals. My success rate in helping people is very good, although I cannot promise or guarantee any result, I would invite you look at my testimonials page.

As far as my style goes, I try to be as sensitive and compassionate as, I can be. I am committed to being direct, honest, sensitive, caring, and attentive, and to working very hard to help you.

8. What happens in the first couples counseling session?

During my first meeting with a new couple, I begin with a quick history of how long you’ve been together, how you met, whether you are dating/married/engaged, and how your life together has been. In order to get an overview of your current relationship problems, we spend some time talking about your reason for coming in and what you have already tried to make things different.

Next, I ask the Miracle Question: If we are successful in our work, how will we know it and what will is look like? This helps us to determine what goals you may have,

If you and your partner are having communication problems, we may do an activity that teaches both members of the couple how to listen to each other and respond in a different way.

At some point during the first session, I provide you with an overview of how relationships get better and how they get worse. I then talk about what stage I believe the couple is in and what I think we need to do to make improvements.

In our first session, we'll start to address the issues that are causing the most conflict. Sometimes we will develop strategies in the first session, but it is more common that these are gradually introduced in subsequent sessions as you get more comfortable with dialogue during couples counseling.

Last but not least, I usually assign some communication homework so that therapy can continue while at home.

9. What are your office hours?

I see clients Monday through Thursday (my first appointment starts at 10am and my last appointment starts at 6pm). On Saturdays I see clients who cannot come in during the week (my first appointment starts at 9am and my last appointment starts at 2pm). On Mondays, I teach and work with my corporate clients. Other times may be available by special arrangement. If you have a difficult schedule, give me a call and we can work something out. If you feel ready to make an appointment now, please call or click on the schedule now button below:

To read more about my office policies and practices, please click on the following link: Office Policies and Informed Consent Page

11. How can I learn more about your background and training?

If you would like to know more about me, please click this link:
About Dr. Randi Fredricks.

You can verify my licensure with the California Board of Behavioral Science by clicking here: Verify Dr. Randi Fredricks' License.

11. Where do most of the couples you counsel live?