The questions people ask before they book.

How do I know whether I need counseling or occupational therapy?

Both professions serve a much wider range of people than I do. In my practice, I've chosen to focus each one. Counseling here is for adults working on how they feel and what keeps repeating. Occupational therapy here is for children who are struggling with the everyday work of childhood, such as sensory regulation, handwriting, routines, and self care.

If you're not sure, that's what the consultation call is for. I'll tell you honestly which one fits, or whether someone else would serve you better.

What happens on the consultation call?

It's about fifteen minutes, by phone or video, at no cost. You describe what's going on, I ask a few questions, and we decide together whether to move forward. There's no pressure and no obligation.

How soon can we start?

It depends on current availability. Reach out and I'll tell you where things stand, including whether there's a wait.

What languages do you work in?

English and Portuguese.

Are counseling sessions online or in person?

Online only, available in Massachusetts, Texas, Florida, and Washington.

Do I need a referral or a diagnosis?

No. You can reach out directly.

How long is a session, and how often will we meet?

The initial evaluation runs 60 to 90 minutes. Ongoing sessions run 50 to 55 minutes. Most people begin weekly, and we adjust the pace together as things change.

How long will I be in therapy?

It's genuinely case by case, and it depends on what you're working on and what you want to be different. What I can tell you is how I work: we set goals early, revisit them regularly, and you'll always know what we're working toward and whether it's helping. My aim is to help you build tools you can carry on your own, not to keep you here longer than you need.

Do you see couples, families, or children for counseling?

No. My counseling practice is individual work with adults. I see children for occupational therapy only.

Do you prescribe medication?

No. I'm not a prescriber. If medication seems worth exploring, I can coordinate with your primary care physician or a psychiatric provider.

Where do sessions take place?

By telehealth in Massachusetts, Texas, and Florida. In-home sessions are also available in Massachusetts, since that's where I'm based.

What's the advantage of an in-home session?

When it's an option, there's a real benefit to working where the difficulty actually happens. Seeing the real kitchen table, the real morning routine, and the real bedroom tells me things a clinic room can't, and the strategies we build fit your actual home. That said, plenty of good work happens over telehealth, and many families prefer it for the flexibility.

Does my child need a referral?

Yes. A referral from your child's pediatrician is required before we can begin. If you don't have one, tell me on the consultation call and I'll help you request it, including what to ask the pediatrician for.

How long is a session, and how often will we meet?

The evaluation runs 60 to 90 minutes. Treatment sessions run 50 to 55 minutes. Frequency depends on your child's goals, and we decide it together after the evaluation.

How involved will I be as a parent?

Closely. You're with your child all week and I'm not, so much of the work is giving you strategies, language, and small changes that hold up at home between sessions.

Can you do my school district's evaluation?

My evaluation is a private clinical assessment and can often support a school conversation, but a district's own special education evaluation is a separate process with its own requirements. Tell me what you need and I'll be straight with you about what my report can and can't do.

Do you take insurance?

For counseling, I'm in network with Blue Cross Blue Shield in Massachusetts and Texas, and with Aetna in Massachusetts, Texas, Florida, and Washington. Pediatric occupational therapy is private pay only.

For any plan I'm not in network with, I can provide a superbill you may submit for possible out of network reimbursement.

What is a superbill?

It's a detailed receipt with the diagnosis and service codes your insurer needs. You pay me directly, submit the superbill, and your insurer reimburses you according to your out of network benefits. Reimbursement isn't guaranteed, so it's worth calling your plan first to ask what those benefits are.

What is your cancellation policy?

Appointments canceled with less than 24 hours notice, and missed appointments, may be charged the full session fee.

Can you complete disability, leave, or accommodation paperwork?

For established clients, yes, when it's clinically appropriate. This work happens outside of scheduled sessions and is billed separately. Requests requiring clinical certification can be completed only after enough sessions to support the opinion. I don't accept documentation requests from people who aren't in ongoing care.

Is what I say confidential?

Yes, with the limits every licensed clinician has: risk of serious harm to yourself or someone else, suspected abuse or neglect of a child or vulnerable adult, and court orders. I'll go over this in detail before we begin, and you're welcome to ask questions about it at any point.

What if I live outside the states you're licensed in?

I'm not able to work with you. Licensure follows where you are located at the time of the session, not where I am. If you're planning to move, tell me early so we can plan.

What if I need help between sessions?

You're welcome to reach out between appointments with a question or an update, and I'll respond as soon as I'm able. We'll also talk early on about what to do when a hard moment comes up between sessions, so you have a plan before you need one.

What I can't be is an emergency service. I don't monitor messages around the clock, so there will be times I can't respond quickly. If you're in immediate danger or having a medical emergency, call 911. For mental health crisis support, call or text 988, which is available 24 hours a day.