Frequently Asked Questions
Q: Do you accept insurance?
A: We do not accept insurance directly, but we provide a superbill that many of our clients use for out-of-network reimbursement. Because we offer highly specialized care, we are also happy to assist you as you navigate single case agreements or exceptions with your insurance.
Q: How much does therapy cost, what are your rates?
A: Therapy session rates range from $150 to $200 for a 60-minute session, depending on the therapist. Initial intake sessions range from $200 to $250 and may include additional fees for assessments.
Q: Do you offer therapy in person, online, or both?
A: We primarily meet with clients online, but we typically see couples in person and hold trauma intensives and disclosures in person as well.
Q: I just found out that my spouse/partner cheated on me – do we need couples counseling, or individual counseling? Where do we start?
A: Because couples counseling can cause damage and is contraindicated when affairs, addiction, or abuse are present, we use a phased approach prioritizing emotional safety for both partners while laying a foundation for deeper healing later on.
To repair safety and trust, we work with clients individually at first and focus on:
- Stopping the dishonest and acting out behaviors
- Identifying and disclosing the behaviors and deceptions to the partner
- Helping the betrayed partner to stabilize, find support and begin healing from the PTSD-like trauma symptoms.
We begin couples work after disclosure and when safety has been established, or as needed to address specific concerns with both individual therapists present – without bypassing the disclosure and trauma work that needs to occur first.
Our resources page contains helpful links to online courses, conferences, podcasts etc. for clients throughout this process.
Q: What is a CSAT therapist, and how can they help?
A: A CSAT therapist (Certified Sex Addiction Therapist) is certified through IITAP (International Institute of Trauma and Addiction Professionals) and is specifically trained to help individuals who are struggling with compulsive sexual behavior, unwanted sexual acting out behaviors, pornography addiction, as well as their partners impacted by their betrayal and acting out behaviors. CSATs follow a structured, evidence-based model that includes the formal therapeutic disclosure process, relapse prevention, trauma work, and relational healing. They are uniquely qualified to support clients through the complex challenges of addiction and relationship repair using trauma-informed care and specialized tools.
It takes approximately 24 months with a month of training and 30 hours of supervision for a licensed therapist (with 5 years of clinical practice) to become CSAT certified. MaryAnn is one of 3 CSATs in Eastern Washington, one of 4 CSATs in Hawaii, one of 19 CSATs in Oregon, one of 22 CSATs in Idaho, and one of 49 CSATs in Utah. Jeff is one of 2 Associate CSATs (ASAT) in Eastern Washington – he has completed the training and supervision hours and is still completing the five years of clinical practice requirement.
Q: What is a CPTT therapist, and how are they different from a CSAT?
A: A CPTT (Certified Partner Trauma Therapist) is also certified through IITAP but focuses on supporting the partner of someone who has engaged in compulsive sexual or acting out behaviors. CPTTs specialize in betrayal trauma – helping partners who have discovered betrayal in their relationships to heal from the PTSD like trauma responses. CPTTs are trained in the formal therapeutic disclosure process (see below) and use a partner-sensitive, trauma-informed model for healing. While CSATs primarily work with the person struggling with the behavior, CPTTs work with the betrayed partner to restore emotional safety, personal empowerment, and relational trust. MaryAnn and Jeff have both been trained as CSATs and CPTTs.
It takes approximately twelve months to become a CPTT with two weeks of training and 10 hours of supervision. MaryAnn is the only CPTT in Eastern Washington, (one of 16 in the state), is one of 2 in Oregon, is one of 3 in Hawaii, one of 6 in Idaho, and one of 8 in Utah. Jeff is an Associate CPTT (APTT)- he has completed the training and supervision and is still completing the five years of clinical practice requirement.
Q: What is the difference between a regular therapist and a CSAT or CPTT?
A: A regular therapist may have general training in mental health but may not have specific expertise in treating sex addiction or betrayal trauma. In contrast, CSAT and CPTT therapists have completed intensive training focused on compulsive sexual behavior, partner trauma, and the full therapeutic disclosure process. They use a specialized protocol designed to promote long-term recovery for individuals and healing for relationships impacted by secrecy and sexual acting out behaviors.
Q: What is a Formal Therapeutic Disclosure?
A: CSATs and CPTTs are specifically trained in the Formal Therapeutic Disclosure process. Research indicates that 96% of addicts and 93% of partners felt it [formal therapeutic disclosure] had been the right thing to do, and both groups reported significant positive aspects of disclosure, including: clarity, honesty, validation, having valid information about the relationship, a new start, and hope for the relationship.
The Formal Therapeutic Disclosure is highly structured and supported process including the following 3 parts:
1. Disclosure Letter – the partner who engaged in betrayal or compulsive sexual behavior shares the full truth with their betrayed partner in a safe, supportive environment. In this step, the betraying partner shares their sexual history timeline, acting out and dishonest behaviors, and answers and clarifies the betrayed partner’s specific questions. Sometimes this includes a lie detector test.
2. Impact Letter – after receiving the disclosure, the betrayed partner shares an impact letter in which they paint the picture of all of the different aspects of their life which were impacted by the betrayal. The impact letter focuses on verbalizing and honoring the betrayed partner’s experience and emotions rather than shaming and blaming the betraying partner.
3. Emotional Restitution – after receiving the impact letter, the betraying partner shares an Emotional Restitution letter in which they acknowledge and validate the betrayed partner’s experience, address the lies, deceit, manipulation and gaslighting, and take responsibility for all of the repercussions and impacts of their behaviors, including sharing restitution plans.