Frequently Asked Questions

Who will answer my phone call or email message?

Dr. Rishikof will personally respond to your message as soon as possible (unless the outgoing message says they are out of town).

What will my first appointment consist of?

You and Dr. Rishikof will discuss the problem that led you to call, as well as going over a brief history.

What is the length of a typical session?

Typical sessions last 45 minutes.

How long will I need to be in therapy?

The length of your treatment depends on the issues that you need to address. It is worth noting that some patients report feeling better after a few sessions. As you make progress you and I can discuss the option of maintenance sessions.

What is the typical waiting period for a new client?

It is our policy to make every effort to make room for a client who is a good match, and to never take on a client who is not a good match.

What are the areas of specialty that are out of your expertise?

We do not specialize or see clients who are actively suicidal, at risk for self-harm, clients with Eating Disorders, clients who are being sexually abused, clients in a situation of active domestic violence, clients who are actively violent, clients who are abusing a substance, or clients with active psychosis.

What services do you NOT provide?

We DO NOT provide emergency crisis services, as I am not reachable outside office hours. In such an emergency, please contact your local E.R.

We also DO NOT provide substance abuse counseling.

What insurances do you take?

We do not bill any insurance companies directly. We do provide itemized receipts that can be submitted as claims to your insurance company. Regardless of your insurance plan, you should always ask your insurance company what mental health benefits your plan allows for.

Why do you not bill insurance companies directly?

There are several reasons for this choice

• Insurance companies can, and often do, make drastic changes to the payment policies of their plans and to the process for reimbursement. It is our opinion that these changes are designed in the best interests of the insurance companies, and not in the clients/members’ clinical best interests.

• Insurance companies want a psychiatric diagnosis and will then determine based on the diagnosis given how many sessions they will cover. This information often becomes a permanent part of your medical file and might increase the cost of your future health insurance premiums.

• Not all the reasons for coming to see a psychologist require you to be labeled with a psychiatric diagnosis. There may be situational issues that a family is facing, developmental phases that a child is going through, or personal growth challenges that a woman needs to confront. We believe that many of these issues may not require labeling with a psychiatric diagnosis.

We sincerely regret being the ones to convey the above facts to you, and the inconvenience and hardship caused to you by our policies. But we have arrived at our policy after many years of experience. We believe we are being ethical, and creating the conditions within which we can deliver the best results. We are an intentionally small practice that provides deeply personal, thoughtful care.

While we will always work with you to facilitate reimbursement, we want you to retain the choice.

What is your policy regarding confidentiality?

Confidentiality is a strict guideline in the practice of psychology protected by state law and by the rules of my profession. All information concerning patients is held confidential and is released only through procedures consistent with the law and professional ethics. We cannot even acknowledge that a person is our client outside of certain specific situations:
•    The client has signed a written release to speak with a specific person
•    An emergency that requires breaking confidentiality
•    There is an incident of child abuse
•    The client is a danger to themselves
•    The client is a danger to someone else
Outside these exceptions, we uphold a client’s confidentiality.

What is your policy regarding confidentiality specifically between parents and children who are clients?

Confidentiality is more complicated when a client is a minor. While there is a professional relationship with the parents, as their consent is required, the child is the client.

In my experience, this is less of an issue with younger children, as their parents are more actively involved in the treatment, and they have less of an expectation of privacy.

For older children and teenagers, confidentiality is more complicated, and must be handled with finesse. Factors such as the client’s safety, their need for privacy, their trust and investment in the treatment, and the parents’ desire to be involved must all be carefully weighed. Each case results in a personal boundary that the client, the parents, and I agree will best serve the treatment and the client.