Counseling and Therapy Services
By Susan Kraus, M.S.W., L.S.C.S.W., L.M.F.T.

Introduction
What sort of committment is involved?
What kinds of therapy do you do?
Can you work as my therapist and also do my mediation?
How long are appointments?
What is the cost? Does insurance cover therapy services?
How confidential are these sessions?
What is your education, training and experience?

Introduction:
For many people, making the decision to pursue therapy requires courage (or desperation.) The feelings of individuals and couples may range from ambivalent and suspicious to excessively optimistic about either the process or potential results.

Some people are in crisis, struggling with a significant loss (whether a death, divorce, job, relationship, etc.). Others want to change behaviors, beliefs, or relationships that are no longer satisfying. Some are overextended in taking care of others, and inexperienced in taking adequate care of self. Still others seek clarity, a different perspective, or the opportunity to explore the multigenerational patterns that unconsciously influence choices.

Couples seek counseling to regain feelings of trust and love that they once had, to negotiate tough transition periods, to improve communication, to salvage a marriage that has been distant or unhappy for a long time. Some couples have one clearly defined concern or problem, but most struggle with a variety of issues.

Therapy (or whatever you choose to call it) cannot ‘fix’ your life or relationship. It can, however, be part of a process of initiating and implementing change, of resolving past or current conflicts, of moving towards increased personal and professional satisfaction. This process is often a catalyst for other changes, for experimentation, for growth. It will not work, however, without your participation.


What sort of commitment is involved?
To start, there is no commitment. I believe that clients should meet with a potential therapist to “check them out” and see if the client feels like it would be a good match. Part of the therapeutic process is the relationship between therapist and client, the trust that develops. After all, to be willing to risk making changes or trying new behaviors, you have to trust the person making the suggestions. If, after meeting with me, and thinking about it, you decide that you want to work with me, then we can discuss the “sort of commitment” involved. This will be a shared process.

In general, however, I don’t have an indefinite… “lets just talk and see what happens” … style. I prefer to define a few particular goals, decide on a number of appointments, and then see how much we can accomplish within that time period. We can then reevaluate the process, and progress, and decide whether to continue. I often begin with 2 to 5 once-a-week appointments, and then increase the time between appointments. Were you to decide that you only wished six appointments, however, I might prefer to space them monthly rather than weekly to increase the time for ‘practice’ and reading assignments between appointments. You may choose at any point and for any reason to terminate. I do request notice, and one final session, so that we can sum up what we have covered and discuss a plan for the future.
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In working with clients during a high-stress period in their lives (divorce, grief, a critical decision that needs to be made, recovery from addiction, family crisis, etc.), we move into survival mode. It can be hard to even see what the goals will look like until the intensity lowers and life feels more ‘normal.’ In such cases, we work together, as often as necessary, doing whatever it takes to cope with the presenting challenge.

There is, in my experience, a correlation between how much clients feel they have accomplished, how satisfied they are with their changes, and how willing they are to follow through with tasks assigned between appointments. All in all, much of what is accomplished in a therapeutic process will occur outside of the appointment.

I do request that clients have a physical exam, in particular when there are symptoms, whether depression, anxiety, insomnia, etc., that could have a physical cause. All clinical social workers are required to “consult with the client primary care physician to determine if there may be a medical condition or medication that may be causing or contributing to the client’s symptoms of mental disorder.” (KSA 65-6306). I will request a release to consult with your physician. You may approve or deny this request.

What kinds of therapy do you do?
I work with individuals, couples and families. Sometimes I will start out with an individual, then include a spouse, then have a few family sessions (if the issues involve the kids.) I do pre-marital work with engaged couples, adjustment issues with blended families, “can-we-make-it” with couples on the brink of divorce. I do a lot of work with people who are trying to make life-changing decisions… “Should I stay in this marriage?” “ Can I survive on my own?” “Can I leave this job?” “What will happen if I ________?”

I work with men and women coping with health issues (cancer, diabetes, mental health concerns), grief and loss issues (death, divorce, betrayal, abandonment), relationship issues (spouses, parents, adult children, friends.) I work with parents struggling with their kids and kids struggling with life, growing up and worried parents.

I try to help people make the best choices that they can with the information they have at a given time. I work with people on how to communicate more clearly, how to express the emotions they want to express and control the ones that need to be controlled, how to resolve inner conflicts so that they don’t sabotage their relationships.

I do not adhere to a particular mode or theory of therapy. In the end, the “kinds of therapy” I do comes down to working as honestly as I can, using all the skills and resources I have available, to help people make the changes they want to be more at peace and happier in their lives.
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Can you work as my therapist and also do my mediation?
No. Once I work as your therapist, I cannot also be your mediator, nor your case manager. They are separate and distinct roles.

How long are appointments?
Appointments are scheduled in advance, varying from weekly to monthly intervals. Each appointment is for 50-60 minutes, sometimes more. The fee is per appointment, although appointments that extend from 1 1/2 to 2 hours will be billed accordingly. If I start an appointment late, we will go for the full time. If you arrive late, however, I may have to stop at the scheduled time, particularly if someone else is waiting.

What is the cost? Does insurance cover therapy services?
The fee is $100.00 per session. The fee is the same for individuals, couples or families, regardless of how many family members participate.

There is no charge for canceled appointments when there is a good reason (we all get sick without warning, and our children get sick when it is least convenient), but request at least 24 hours notice if possible. Clients are responsible for 1/2 of the fee for missed (“no-show”) appointments as I have marked off that hour specifically for their appointment

I am an approved insurance provider for Blue Select, Blue Choice, and a variety of other medical insurance companies. I am not, however, on the provider panels for certain HMOs and PPOs. While I have a billing service that will submit statements to your insurance company for reimbursement, I do not verify for you whether or not your insurance will cover this service. It is your responsibility to determine whether your insurance company will reimburse for clinical services (and if ‘in network’ or “out-of-network’).

All clients are responsible for their fees. If insurance pay partial reimbursement, clients are then responsible for any balance.

If your insurance company requires a referral from your primary care physician, you are responsible for getting that referral. You are also responsible for noting when it expires and requesting another referral. I do not have a support staff to keep track of referral restrictions and deadlines.

If you will not be using your health / medical insurance for my clinical services, payment is due at time of service. If there is a problem with payment, please discuss this will me. If you know your co-pay, I would also appreciate that at time of service.
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Insurance reimbursement does require a diagnosis, the implications of which I will be happy to discuss prior to billing. Some clients prefer to pay out-of-pocket rather than have a mental health diagnosis on a medical record. If you intend to run for public office, or anticipate seeking high security clearances in the future, consider this option.

How confidential are these sessions?
Whatever you share with me stays with me, unless you sign a release authorizing me to share particular information (i.e. with insurance companies, physicians, attorneys, etc.) With certain insurance companies, releasing data is required for reimbursement. Overall, my notes are for my personal use only and I only send insurance companies a diagnosis and/or summary statement. I have declined to participate with HMOs and PPOs that require a provider to share intimate details of treatment as so doing violates my own sense of ethical treatment.

I may request that you sign a release for my clinical supervision group. While I have been in practice for 25 years, I think that consultation and supervision are essential for ethical practice. If I ever were to discuss your case within the group, I would not use any identifying information.

There are some exceptions to confidentiality: should I be subpoenaed; should you indicate that you seriously intend to harm yourself or another; should I suspect child abuse. In any of these instances, I would try to discuss with you first any action I intend to take unless there is an imminent threat or danger to self or another person.

What is your education, training and experience?
I am a Licensed Specialist Clinical Social Worker (LSCSW) and a licensed Marriage & Family Therapist (LMFT). I have maintained a private clinical practice for over 25 years.

I received my M.S.W. in 1978 from the University of Texas, Austin, where I previously taught English. I was with the Washburn University Counseling Center for 8 years (‘78-’86), working with individuals, couples, families and groups. In ‘84, I co-founded a small agency, The Family Center, and was actively involved until ‘94 developing community education programs and support groups for women, couples and families. I taught graduate level clinical skills and supervised graduate interns part-time at the K.U. School of Social Welfare from ‘86 to ‘99.

In terms of post-graduate education, I completed a two-year marriage and family therapy training program at the Menninger Clinic in ‘81. Over the years, I’ve continued my professional education through seminars and workshops. I’ve participated in a peer supervision group with other clinicians for over a decade.

I moved my practice from downtown Lawrence into my home in 1991 to provide flexibility in scheduling appointments, and to better balance work with the needs of my family. I’m married and have two children, now ages 19 and 24.

I am not listed in the Yellow Pages, do no advertising and work only by referral. Almost every client I work with has been personally referred to me by a former client, their physician, attorney or a friend-of-a-friend.

Feel free to ask any additional questions. E-mail me directly at skraus@sunflower.com or call 785-843-8321 Ext. #1.
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