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Frequently Asked Questions

Informed Consent is a big part of my job!

Check out the dropdown menus below for lots of information about therapy in general and some technical specifics about the details of therapy with me.

If you are looking for more information specifically about me and my practice, check the About section.


About Therapy / Counseling / Psychotherapy

+ What is therapy?

  • In general, therapy is place where you can talk about anything you are struggling with. A therapist is someone who has expertise in the human mind, relationships, and related skills and they use that knowledge to help their clients.
  • Therapy is a priviledged relationship, much like doctor/patient or attorney/client relationships. I am required by law to keep our conversations totally private (confidential) unless there are safety concerns. We will talk about the limits to confidentiality in your first session.
  • Forget every therapist/psychologist/psychiatrist you have ever seen on TV and movies. I haven't seen an accurate portrayal yet.
  • Therapy is a place where you can
    • Explore ideas/expectations/wants/dreams/decisions without judgement
    • Process painful (and even positive) experiences so you can understand them and make meaning from them.
    • Discover and change patterns that aren’t working for you (By discover, I mean I’m going to call them out if you don’t discuss them first)
    • Build skills/understanding to help you move through life in a way that is aligned with who you are as well as skills to create/maintain an awesome support network to help you along the way
  • You’re in charge of what we talk about/work on. My role is supportive. I may give suggestions or feedback, but it’s your life and your choices are always yours to make.

  • If you want to read more, the folks over at Good Therapy wrote a great general definition as well as some excellent follow up questions. Their article is HERE.

  • Fill out the form on my Get Started page and we can schedule a FREE 30 minute consultation.

+ What is the difference between a psychologist, therapist, counselor, and psychiatrist?

  • I am a psychologist (I have a PhD). All psychologists can also use terms like counselor, therapist, or psychotherapist. However, “psychologist” is a protected term in some countries (not all) that requires a PhD or PsyD degree. Psychiatrists have medical degrees (MDs), went to medical school and can prescribe medication. Some therapists can prescribe medication in some places with an additional certificate. I do not have this certification.
  • Some people might argue with me, but I think it’s okay to use the terms counselor, therapist, and psychotherapist interchangeably. I’m not offended if people call me any of these terms. I answer to just about anything. Including the occasional “hey you”.

+ What does a therapist/counselor/psychologist do?

  • As usual, the answer with therapists is “It Depends”, but let me tell what I do.

Things I do

  • Help people to
    • Explore/define their values/goals
    • Work through difficult problems/decisions
    • Process difficult emotions/events
    • Better understand themselves/their behaviors/their emotions/ those around them/systemic influences
    • Set goals and plans to reach those goals
  • Teach skills around
    • Reflection
    • Self-regulation
    • Communication
    • Advocacy (self & community)
    • Conflict
  • Fill out the form on my Get Started page and we can schedule a FREE 30 min fit consultation.

+ Can we meet while I'm located in....

  • The vast majority of my clients are FSOs/EFMs at Post. If you meet with me on Embassy/Consulate grounds or in your Embassy/Consulate provided housing, then YES! I can meet with you.
  • I can also meet with anyone willing to come to my office in DC.
  • I can ALSO meet with individuals online who are physically located in any of the 40+ states listed HERE, thanks to an interjurisdictional compact called PSYPACT.This list does include Virginia and Maryland.

+ Will therapy impact my secuirty/medical clearance?

  • This one is for U.S. Foreign Service Officers and their family members.

Here is some excellent guidance passed on to me in January 2022 by an incredibly helpful Department of State Regional Psychiatrist (RMO/P), Dr. Thomas Mak.

  • The State Department is clear that, “The act of seeking help from a counselor, psychotherapist, or other mental health professional to address stress, depression, grief, anxiety, family or marital issues, or other concerns is not derogatory in a (DoS) security clearance determination.”
  • RMO/Ps assigned overseas are medical providers and not involved in the medical clearance or security clearance adjudication process
  • The State Department security clearance is a completely separate process from a State Department medical clearance process and is administered through Diplomatic Security.
  • If you are not a State Department employee, please check with your agency’s Human Resources Office for guidance. The RMO/P office is here to assist you.

Medical Clearances:

  • Employees and family members eligible for a State Department clearance will still be asked to report counseling on the DS-3057 Medical Clearance Update form and may be asked to provide supplemental information. However, due to recent changes from The Department of State’s Bureau of Medical Services (MED), counseling for grief, bereavement, marital difficulties, family therapy, parenting issues, situational stress, pandemic stress, phase of life transitions, adjustment problems, coaching for attention deficit disorder, pastoral or spiritual needs, and other supportive services will no longer require any further review by the State Department Mental Health Clearance team.
  • Additionally, the expansion of MED’s free Employee Consultation Services (ECS) to be available 24/7 means employees always have support available. ECS services and USAID’s Staff Care are Employee Assistance Programs and strictly excluded from clearance review and should not be reported on the DS-3057 Medical Clearance Update form.

Security Clearances:

  • Key Points for DoS employees from ALDAC DTG: 310146Z JUL 19 Subject: Mental Health and Security Clearances
  • If employees need mental health care, they should get it. They should not neglect their mental health for fear that seeking treatment will negatively affect their security clearances
  • The act of seeking help from a counselor, psychotherapist, or other mental health professional to address stress, depression, grief, anxiety, family or marital issues, or other concerns is not derogatory in a security clearance determination.
  • From 2016-present, only approximately .001% of security clearance suspensions and revocations were based on significant concerns about an employee’s judgment, reliability, or stability stemming from mental health issues such as irresponsible, violent, paranoid, manipulative, impulsive, chronic lying, deceitful, exploitative, or bizarre behaviors.

+ How do I get started?

  • I highly recommend you review the sections that interest you in my About Me section to see if you think I might be a good fit for you.
  • If you decide you would like to schedule a consultation with me, you can do so by filling out the form on this page. If it’s possible to meet, I’ll give you access to my calendar and you can schedule a consultation appointment.
  • If we decide we want to continue working together, I will send you some online paperwork to review and e-sign and boom. We’re working together.
  • Fill out the form on my Get Started page and we can schedule a FREE 30 minute consultation.

Fees & Insurance

+ Cost

  • I provide free 30 minute consultations for us to talk and decide if we are a good fit and will work well together.

  • My rate is $230 per 50 min session.

  • Payments must be made through my Electronic Medical Record System (Simple Practice) in USD, so you must have a card that can be charged in USD. This method best protects your data.

+ Sliding Scale / Reduced Fee

  • I do not provide sliding scale or reduced fee services. I give back through consultations and practical on the ground services in my community.

  • If my services are not affordable to you, I encourage you to check out my Fae's Friends page for other options.

+ Insurance

  • Check out my full guide "How to Access Mental Health Counseling/Therapy Abroad: A Resource Guide for US Foreign Service Officers and Their Families". I go into great detail about options concerning insurance and reimbursement.

  • Most U.S. FSOs/EFMs have been able to be reimbursed for 70-90% of my fee through their insurance providers as I am able to provide a "super bill" that has my American creditials listed.

  • I do not bill insurance directly. If you choose to file for reimbursement with your insurance, it is important for you to understand what data your insurance company may want about you. I encourage you to talk to them directly and in advance so you are well informed.

  • Some questions you might ask may include:

    • Does my insurance plan cover talk therapy (mental health)?
    • Who qualifies as an in network vs. out of network provider?
    • Is there a limit to the coverage (number of sessions; cost; does it depend on the diagnosis?)
    • If all of the qualifications are met, would you reimburse the full amount of the session or a percentage? Is there a deductible that must be met first?

+ "No Surprises Act" Required Disclosure

  • As of January 1, 2022, all healthcare providers are required to inform you of the following information. The cost of my services are clearly listed above and in all intake paperwork already, but I will provide a "Good Faith Estimate" to any client who does not have insurance, is not using insurance, and/or requests an estimate.

    • You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

    • Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

    • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

    • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

    • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

    • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises


Technical Information about Online Therapy

+ Platforms

I use Simple Practice and ProtonMail for my practice. I also sometimes use Doxy.me as a video service. Each of these platforms were designed for healthcare providers and comply with HIPAA and GDPR. for client privacy. I have Business Associate Agreements with each of these companies.

+ Tech requirements to meet with me

  • My client platform is Simple Practice and it can be run on most browsers, tablets, and phones.
  • You will need a camera and microphone to be able to meet with me.
  • If your internet is too slow/unreliable, it may not be possible for us to work together. Meeting online already loses some of the data I would be able to see in a physical room, so we need a strong internet connection to help our therapy connection be all it can be.

+ How is online therapy different from in person therapy?

  • As I mentioned above, there is a possibility that technical issues can get in our way, so it’s important to minimize those where we can.
  • You will need to have a quiet/private space where we can meet.
  • You will need to state your location before each meeting in case I need to notify emergency services/contacts for any reason during our call.
  • In general, we try to bring in all aspects of an in-person therapy session that we can, so I ask that my clients silence their phones and notifications during our call. I also ask that you stay in one place and do this one thing (therapy) with me. Please do not walk around, do errands, etc.

+ Online privacy

  • I take online privacy as seriously as I take confidentiality (which is very serious to me, basically the lynchpin of my profession). I do everything in my power to protect your data by securing my computer and by using platforms that meet American and UK health data privacy requirements (the strictest in the world).
  • What information am I collecting about you

    • Website Visitors

      When an individual visits therapyvietnam.com, Frances uses Google analytics, who are considered a third party service, to collect information about what visitors do when they click on her website, e.g. which page they visit the most. Google analytics only collect non-identifiable data which means she or they cannot identify who is visiting. Google analytics privacy notice can be found here: https://policies.google.com/privacy

      Squarespace is a third-party service that hosts my website. When an individual visits therapyvietnam.com, I use Squarespace analytics to collect non-identifiable data about what visitors do when they click on her website. Squarespace also hosts the initial contact form, which is emailed to my secure email account. No personal data is stored on Squarespace. Squarespace’s privacy policy can be found here: https://www.squarespace.com/privacy.

    • Electronic Medical Record (EMR)
      I use Simple Practice as my EMR. This is a HIPAA compliant medical record system built for therapists and related professions. I chose this secure platform so that your data (forms, video meetings, notes) can be securely stored in one place. You can read their full privacy policy here. https://www.simplepractice.com/privacy/

    • Social Media

      I keep a Facebook, Instagram, and LinkedIn account for my professional practice. I use these websites' built in analytic systems to collect data about interactions with my Pages & Posts. Facebook’s privacy policy can be found here: https://www.facebook.com/about/privacy/update?ref=old_policy.
      Instagram's privacy policy can be found here. https://about.instagram.com/blog/announcements/instagram-community-data-policy
      LinkedIn's privacy policy canbe found here. https://www.linkedin.com/legal/privacy-policy

I will always be transparent when it comes to collecting personal data and will be clear about how that data is processed. My full social media policy will be given to client's at intake and on request.

  • How do I use your information
    • I only use it for your care as contracted with you and as it is necessary to document your care within the secure platforms I use. I will never sell your data. With the internet, there is always a risk of data breach, regardless of the level of security of the platform and other components. I have carefully chosen platforms to reduce this risk, but should it happen they or I will contact you to make you aware.

+ Am I licensed to work abroad?

  • I am an independently licensed psychologist in the District of Columbia. This license is restricted to the jurisdiction in which it was issued, and does not represent an international practice license. As far as I am aware, no such license exists. Many countries have their own regulations for the practice of psychology and counseling, and some have none. As a result, I am limited on what I am allowed to call myself abroad and where I am allowed to practice, because I am not and cannot be licensed in every country around the world.
  • Many countries allow therapists the ability to practice, as long as we do not claim restricted titles. Because of this, I need to state that I am not a licensed provider (mental health counselor, psychologist, etc) in any country outside of the US. We will talk about what this means for you in your location in your consultation session and you will have the opportunity to refuse services if you choose.