Category Archives: News

Good Faith Estimate

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Good Faith Estimate

Effective January 1, 2022, a ruling went into effect called the “No Surprises Act” which requires practitioners to provider a “Good Faith Estimate” to individuals who are uninsured or utilize self-pay. The Good Faith Estimate (referred to throughout this document as “GFE”) works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for mental health services. The estimate is based on information known at the time the estimate was created. The GFE does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur and will be provided a new GFE should this occur. If this happens, federal law allows you to dispute (appeal) the bill if you and your provider have not previously talked about the change and you have not been given an updated GFE.

Under Section 2799B-6 of the Public Health Service Act (PHSA), health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request, or at the time of scheduling health care items and services to receive a GFE of expected charges.

Note: The PHSA and GFE do not currently apply to any individuals who are using insurance benefits, including “out of network benefits” (i.e.., submitting superbills to insurance for reimbursement). 

Timeline requirements: Providers are required to provide a GFE of expected charges for a scheduled or requested service, including items or services that are reasonably expected to be provided in conjunction with such scheduled or requested item or service. That estimate must be provided within specified timeframes:

  • If the service is scheduled at least 3 business days before the appointment date: no later than 1 business day after the date of scheduling;
  • If the service is scheduled at least 10 business days before the appointment date: no later than 3 business days after the date of scheduling; or
  • If the uninsured or self-pay individual requests a GFE (without scheduling the service): no later than 3 business days after the date of the request. A new GFE must be provided, within the specified timeframes if the individual reschedules the requested item or service.
Samaritan Center of Puget Sound recognizes every individual’s mental health treatment journey is unique and personalized. How long you need to engage in mental health services and how often you attend sessions will be influenced by many factors, including, but not limited to:
  • Your schedule and life circumstances
  • Your provider’s availability
  • Ongoing life challenges
  • The nature of your specific challenges and how you address them
  • Personal finances

You and your provider will continually assess the appropriate frequency of services and will work together to determine when you have met your goals and are ready for discharge and/or a new “Good Faith Estimate” will be issued should your frequency or needs change.

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

Re-entry from Covid

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And Now… How Do We Think About Re-entry?

It’s spring. We can feel the changing, evolving season. Light that lasts longer. New growth appearing. A taste of warmer days to come. People venturing out of hibernation.

It’s been a long winter, a long year, and we’ve become accustomed to the many ways in which we’ve been separated from one another. Many of us are wondering what this season of re-entry–the emerging from separation–will look like. There’s a feeling of uncertainty, a forgetting of how everyday relationship with the outside world is done. Used to be done. Should be done. Can be done.

Some of us feel the questions more intensely than others. Instead of embracing the new freedom, we look at it with a raised eyebrow. Our habits of caution outweigh our impulse to engage. That can lead us to wonder in a self-critical way–about ourselves, our resilience, our ability to adapt.

We know that distressing situations can trigger our feelings of anxiety and depression. When this happens, we do well to remind ourselves of strategies that can help manage these feelings. We may have learned some of them through Cognitive Behavioral Therapy and the practice of Mindfulness. While they’re simple skills, they’re not easy to maintain when we’re feeling stressed. Our efforts, however, can be rewarding.
Here is a reminder of some of those useful strategies:

  • Stay in the present–don’t ruminate about the past or try to predict the future
  • Focus on what you can control and set aside what you cannot
  • Appreciate those things that are going well
    Maintain healthy habits of eating, sleeping and exercising
  • Seek out pleasurable activities and meaningful connection with others
  • Extend an attitude of generosity, both to yourself and to others

It seems fortuitous that our emerging from this highly restrictive year of the pandemic coincides with our calendar’s emergence from winter into spring. Access to vaccines and lower numbers of serious illness and death from the virus are allowing us to move about more freely. Sunny days are inviting us to come outdoors, shedding our raincoats and boots and woolen scarves.

So, is there a way to step into this re-entry, this emerging from separation into reconnection, with lightness, the spirit of spring? Can we bring what we’ve learned in this past year, about ourselves and others and reality itself, to a clearer and more compassionate understanding of what life is about? Will our inner conversations and our relationships with others thrive in this warmer climate? Will our sense of gratitude and hope speak to our experiences of loss and grief? Will we agree to move forward with a smile – one that may still at times be hidden by the masks we agree to wear but will surely be visible in our eyes.

GiveBIG: Washington Gives 2021

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Keeping Our Commitments: With Your Help

On May 4 and 5, Samaritan Center of Puget Sound is once again participating in the annual GiveBIG campaign. We know that many of you have taken this opportunity in the past to extend our ability to provide counseling for those who are unable to afford the cost of the care they need. Thank you.
In this year of so much uncertainty and pain, the need for psychotherapy has grown exponentially. Samaritan Center continues to provide high quality, relationally based, spiritually integrative psychotherapy that is affordable and accessible to all.
Your gift directly helps us provide essential mental health services to those in most need. By adopting a telehealth platform in the face of the coronavirus pandemic, we maintained the accessibility of our services, and as an unexpected consequence, we extended the availability of those services throughout the state.
We are immensely grateful for your partnership in making equitable access to mental health care a reality.
Thank you for considering participating in this year’s GiveBIG campaign.
With gratitude,
Beverley Shrumm, President
Samaritan Center of Puget Sound

I Will Not Give Up

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It was above the timber line. The steady march of the forest had stopped as if some invisible barrier had been erected beyond which no trees dared move even in a single file. Beyond was barrenness, sheer rocks, snow patches and strong untrammeled winds. Here and there were short tufts of evergreen bushes that had somehow managed to survive despite the severe pressures under which they had to live. They were not lush, they lacked the kind of grace of the vegetation below the timer line, but they were alive and hardy.

Upon close investigation, however, it was found that these were not ordinary shrubs. The formation of needles, etc., was identical with that of the trees farther down; as a matter of fact, they looked like branches of the other trees. When one actually examined them, the astounding revelation was that they were branches. For, hugging the ground, following the shape of the terrain, were trees that could not grow upright, following the pattern of their kind. Instead, they were growing as vines grow along the ground, and what seemed to be patches of stunted shrubs were rows of branches of growing, developing trees. What must have been the tortuous frustration and stubborn battle that had finally resulted in this strange phenomenon!

It was as if the tree had said, “I am destined to reach for the skies and embrace in my arms the wind, the rain, the snow and the sun, singing my song of joy to all the heavens. But this I cannot do. I have taken root beyond the timber line, and yet I do not want to die; I must not die. I shall make a careful survey of the situation and work out a method, a way of life, that will yield growth and development for me despite the contradictions under which I must eke out my days.

In the end I may not look like the other trees, I may not be what within me cries out to be. But I will not give up. I will use to the full every resource in me and about me to answer life with life. In so doing, I shall affirm that this is the kind of universe that sustains, upon demand, the life that is in it.” I wonder if I dare to act even as the tree acts. I wonder! I wonder! Do you?

       This meditation was called to our attention by Samaritan therapist John Baumann, MDiv, LMHC, who sees clients in Seattle, Renton and Federal Way. John says: “I was introduced to Howard Thurman in 1995, some 14 years after his funeral.  Reading his biography brought a sense of wonder at the grace-filled and graceful manner in which he lived.  He spoke of offering a meditation a half hour before each Sunday service and discovering that calls for counseling began dropping.  I quickly ordered his book, Meditations of the Heart.  I find myself returning to it from time to time and each time I find a new jewel.  As always, the jewel seems to shine ever brighter as I read and reflect again and again.”

 

 

“Lockdown,” a Poem by Franciscan Richard Hendrick

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Here is a poem from an Irish Franciscan, Richard Hendrick, written March 13, 2020. Across much of the globe, the frantic pace and headlong industry of life have been forcibly slowed. Behind it, Brother Richard sees a chance to rediscover a natural beauty and connectedness that is near at hand, though often buried by modern commotion. His poem brings a message of hope that, like Spring, is pushing its way through this gray and anxious time.

 

Lockdown
by Richard Hendrick

Yes there is fear.
Yes there is isolation.
Yes there is panic buying.
Yes there is sickness.
Yes there is even death.
But,
They say that in Wuhan after so many years of noise
You can hear the birds again.
They say that after just a few weeks of quiet
The sky is no longer thick with fumes
But blue and grey and clear.
They say that in the streets of Assisi
People are singing to each other
across the empty squares,
keeping their windows open
so that those who are alone
may hear the sounds of family around them.
They say that a hotel in the West of Ireland
Is offering free meals and delivery to the housebound.
Today a young woman I know
is busy spreading fliers with her number
through the neighborhood
So that the elders may have someone to call on.
Today Churches, Synagogues, Mosques and Temples
are preparing to welcome
and shelter the homeless, the sick, the weary
All over the world people are slowing down and reflecting
All over the world people are looking at their neighbors in a new way
All over the world people are waking up to a new reality
To how big we really are.
To how little control we really have.
To what really matters.
To Love.
So we pray and we remember that
Yes there is fear.
But there does not have to be hate.
Yes there is isolation.
But there does not have to be loneliness.
Yes there is panic buying.
But there does not have to be meanness.
Yes there is sickness.
But there does not have to be disease of the soul
Yes there is even death.
But there can always be a rebirth of love.
Wake to the choices you make as to how to live now.
Today, breathe.
Listen, behind the factory noises of your panic
The birds are singing again
The sky is clearing,
Spring is coming,
And we are always encompassed by Love.
Open the windows of your soul
And though you may not be able
to touch across the empty square,
Sing.

Ongoing Care Available with Teletherapy

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Now more than ever, there is a need for ongoing support in our communities. With physical distancing in practice to help us all minimize the risk of spreading COVID-19, we still need to connect with each other. Our therapists are equipped to offer virtual counseling, or teletherapy, moving forward.

Teletherapy is a valuable solution, enabling us to continue serving clients both new and already established. Below are commonly asked questions clients might consider before starting or switching to teletherapy:

 

How is a teletherapy session different than an in-person session? 

Teletherapy sessions and in-person sessions have more similarities than differences. They are both private, secure, one-on-one conversations in the context of a therapy relationship. Most of the boundaries remain consistent between both: the scheduling of times, the length, and the content of the sessions. The major and obvious difference is that you and your therapist are using video technology to communicate instead of being in the same room. With that difference, it can for some seem very similar to in-person therapy; for others it can require more adjustment.

 

Will my insurance cover teletherapy?

In most cases, yes. Fortunately, Medicare covers teletherapy sessions and insurers (including employee health plans) must reimburse a provider for services delivered through telemedicine or store-and-forward when the service is “medically necessary” (a standard that also applies to in-person therapy services). Note that only video conferencing (and not phone calls) will be covered by insurance. To ensure coverage, please enquire directly with your insurance provider about your plan’s teletherapy (tele-mental health) benefits.

 

What will I need in order to get started with teletherapy?

You will need a computer or device with a camera and a microphone. In addition, internet access is required and we ask that, if you are using wifi, you use a secure signal. Once you have consulted with your therapist about the prospect of using teletherapy, you will be given forms to read, fill out, and sign. Then, you will meet with your therapist for an intake evaluation.

 

What measures are my therapist putting in place to protect my privacy? 

At Samaritan Center, we only use teletherapy that is secure and HIPAA compliant. All privacy laws are strictly enforced while using teletherapy, as they are when meeting face-to-face. No sessions are recorded, and we will verify with you at each session that no one else is in the room on either end. Your therapist will ensure that their workspace is free of intrusion, distraction, or interruption, and file charts will be maintained in a safe, secure manner.

 

How long are teletherapy sessions? 

Like in-person therapy, teletherapy sessions can vary in length, depending on your needs and your insurance coverage if applicable. Typically, sessions are either 45 minutes or an hour.

 

How much does teletherapy cost if I am paying out of pocket? 

When using private pay for teletherapy, the same standard fees as in-person therapy apply. Your therapist will discuss fees with you prior to starting.

 

Is a sliding scale fee available for teletherapy? 

Yes! When using private pay, you may talk with your therapist about our Adjusted Fee Schedule, which can be a useful tool in adjusting standard fees based on family income and other considerations. We want to work with you to arrive at a fee that works for you.

 

Can we do couples or family counseling over teletherapy? 

Yes. Our current setup requires all persons on your end of the video to be in the same space, using the same camera. Practical issues, such as how to capture all parties on screen, can arise when working remotely in this way, though we do not consider these to be limiting in themselves. Your therapist can help determine if your particular couple or family “setup” is right for teletherapy.

 

If I am new to therapy, can I begin with teletherapy? Or do I need to have met my therapist in person first? 

The best practice at Samaritan Center is that teletherapy relationships begin with an in-person assessment. We believe that this assessment, which can last 1-3 sessions as needed, is important for the establishment of rapport, trust, and safety. Your therapist can discuss this expectation with you prior to beginning treatment.

The initial phase of therapy is critical for you and your therapist to be evaluating your “fit” with each other, and to establish “medical necessity,” while also determining if teletherapy can be helpful in your specific situation. Additionally, it is our practice that therapists meet face-to-face with their clients periodically in order to maintain and attend to important aspects of the personal relationship.

 

How do I find a therapist? 

To find a Samaritan Center therapist who is currently offering services using teletherapy, please contact our front desk at (206) 527-2266 or visit our Find a Therapist search page. We look forward to meeting you!

 

Samaritan Center COVID-19 Response

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Please note: This policy may be updated as new information becomes available from the Center for Disease Control (CDC) and Seattle & King County’s Public Health Department.

Here at Samaritan, we are dedicated to providing ongoing support to our clients. In this spirit, we are choosing to remain open at this time and to continue serving our clients—balancing this commitment with the prevailing risks by taking aggressive steps to protect clients and staff.

As we take protective measures internally, we ask that any clients please stay home if they are showing symptoms or suspecting possible exposure to persons with COVID-19.

Should you need to cancel an appointment, you can reach out to your therapist directly to reschedule (find your therapist’s contact information here). Note that teletherapy (over video chat) or a phone session might be options to discuss with your therapist.

We care deeply about continuing to offer a safe and healthy environment to all who walk through our doors. We will continue to monitor the situation as it evolves and post updates here.

If you believe you were exposed to a confirmed case of COVID-19, contact the Seattle-King County Public Health novel coronavirus call center: 206-477-3977. For general questions and concerns about COVID-19, you may call the Washington State Novel Coronavirus Call Center: 800-525-0127. For tips on how to reduce the risk of spread, read King County’s official recommendations.

 

If you are in need of additional emotional support at this time, below are resources you can safely access from home: 

Crisis Connections (24 hours): 866-427-4747

Online 12-Step Recovery meetings: InTheRooms.org

National Domestic Violence Hotline: 1−800−799−7233

National Suicide Prevention Lifeline – For youth and adults: (800) 273-TALK (8255)

National Eating Disorders Association Helpline: (800) 931-2237

The King County Warm Line: 206-933-7001

Love and Imperfection

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One long-ago Christmas, a few weeks after my husband’s death, my children and I sat in the family room of new friends in California.

There were two pianos in the room and we sat, on that dark winter afternoon, listening as our host and his 10-year-old son, Karl, played a duet.  Midway through the piece, Karl stumbled and began to fall behind a bit.  Without pausing, his father called cheerfully over his shoulder, “Karl, keep going! It’s not whether you hit every note right.  It’s whether you can recover.”

We saw Karl lean forward as he concentrated on the music, and he did catch up.  He and his father finished the piece together, smiles on their faces, laughing and accepting the enthusiastic applause of their small audience.

“It’s not whether you hit every note right. It’s whether you can recover.”  Words delivered from a young father to his young son, not carelessly or dismissively but in a spirit of generosity.  Of respect and friendship.  And the words worked.  For the 10-year-old in the moment.  And for me in the months to follow as I struggled with the broken pieces of an imperfect life.

Many years later, when my children were grown and I was learning to be a family therapist, I discovered the books and, later in a training workshop, the gentle and wise person of Ivan Boszormenyi-Nagy*, the creator of the theory of Contextual Therapy.

What I appreciated most about Nagy’s vision of individual and family therapy was his understanding of the deep need we all have for fairness and justice in our relationships and, equally important, our need for ways to understand and cope with the injustice and perceived unfairness that is inevitable in family relationships.

I was comforted by his putting greater weight on a person’s good intentions and honorable motives than on the “right” outcome or the expected, hoped-for results.  That seemed to me both generous and practical, given that we are human beings.

And so I carry with me both in my work and my life – which I find often look like the same thing—the words of the young father and the old teacher.

It’s not whether we hit every note right.  It’s more about what we do after we haven’t hit the note right.  It’s not about being perfect or trying to be.  It’s about why we do what we do.  It’s about what we do when we realize we’re not perfect and they’re not and nothing is.  It’s about love and imperfection.

*Ivan Boszormenyi-Nagy was a Hungarian-American psychiatrist and one of the founders of the field of family therapy. Contextual Therapy is based on the ideas of a person’s indebtedness to his or her family of origin, the influence of one’s biological relations, and concepts such as the consequences of ethical and unethical relating. You can read more about his theory of Contextual Therapy in his books, including Invisible Loyalties and Between Give and Take.

Meet Heather Macdonald

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Profile for HeatherDr. Heather Macdonald joins our clinical staff this spring, bringing with her a wealth of experience and depth of training. We are particularly excited to welcome her to our psychological testing and assessment program. Heather’s professional background includes working with young children, adolescents and adults in a variety of settings with a wide range of identified concerns. A licensed clinical psychologist since 2010, she has experience working with neurodevelopmental challenges, specific learning differences, complex developmental trauma, ADHD (in adults and children), and mood issues.

Working with Clergy. Heather also has a great deal of experience working with clergy around issues of leadership, mid-career questions, as well as pre-ordination evaluations. In her work with clergy she is careful to include perspectives on adult development and how this can impact behavior and functioning. In such work with spiritual leaders, she uses standardized and objective test batteries but focuses largely on the complicated intersections of personality structure, leadership style, spiritual calling, and social and psychological functioning.

Passionate about Assessment. Heather is committed to making the process of psychological evaluation deeply collaborative and therapeutic so that a person’s lived experience resonates with the results written in the final report. When viewed as a therapeutic intervention, assessment yields much more insightful results. The collaborative space of the assessment process necessarily includes multi-dimensional perspectives on identity and intersectionality.

She often asks, “Can psychological testing be a site of invitation, provocation, revelation, or promise? Can it be a space of apology, mourning, and forgiveness since the true suffering of the Other refuses to be put into language to begin with?”

Trained on Both Coasts. Prior to working at the Samaritan Center, Heather worked at the Danielsen Institute at Boston University and taught psychology at Lesley University in Cambridge, MA. She completed her MA degree in psychology at Seattle University and her doctorate at Pacific University in Forest Grove, Oregon. She sees clients at the Bellevue office and at the Samaritan main office in Seattle.

Alcohol Use Disorders: A Closer Look

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What would it be like for you to go 72 hours without alcohol? As part of Alcohol Awareness Month, the National Council on Addiction and Drug Dependence (NCADD) has invited all Americans to abstain from alcohol the first weekend in April (5th-7th). Taking a break from alcohol can be a great way to explore what role it plays in your life, even if you would not identify as someone who struggles with alcohol use.

As you probably know, drinking too much can harm your health. According to the World Health Organization, the harmful use of alcohol contributes to more than 200 diseases and injury conditions, most notably alcohol use disorders, liver cirrhosis, and cancers.1 An estimated 88,000 people (62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the 3rd leading cause of preventable death in the United States.2

So what does responsible alcohol use look like? It may surprise you. Both the USDA and National Institute on Alcohol Abuse and Alcoholism (NIAAA) have developed recommendations to limit the risk of alcohol-related harm, suggesting that women should consume no more than 7 standard drinks per week and men should have no more than 14.3, 4

It is important to note that these recommendations define a standard drink as: 1.5 oz of hard liquor (40% alcohol), a 5 oz. glass of wine (12% alcohol), or a 12 oz. beer (5% alcohol).5 Step foot into one of the many breweries located in Seattle, and you will notice that it is difficult to find a beer whose alcohol content is 5% or less; similarly, most cocktails contain multiple shots of hard alcohol and the alcohol content of wine can vary drastically.  All of this to say, you may be having more than “one standard drink” with every drink you consume.

In addition to the weekly guidelines highlighted above, the NIAAA recommends that daily consumption of alcohol is limited, no more than 3 drinks for women and no more than 4 for men, in order to reduce the risk of developing an alcohol use disorder.

What exactly is an alcohol use disorder? It is a clinical term describing a collection of symptoms related to alcohol use that cause significant distress and or impairment during the same 12-month period; these symptoms fall into four major categories including impaired control, social impairment, hazardous use, and pharmacological criteria (i.e. tolerance and withdrawal).  An estimated 16 million people in the United States have been diagnosed with an alcohol use disorder.6

The good news is that there is hope for recovery from an alcohol use disorder. In fact, it is estimated that between 42%-66% of people with substance use disorders achieve full remission7,8  and as many as 20 million individuals and family members are living lives in recovery from alcohol.9 Recovery is not a one-size fits all concept and it may include the use of self-help groups (i.e. AA, SMART Recovery, LifeRing, etc.) and/or formal treatment (i.e. medications, therapy); no single option is right for everyone, and treatment should reflect an individual’s unique history and hopes for their recovery.

Are you wondering if your relationship with alcohol may be problematic? Next steps might include speaking with your family, friends, or pastor; attending a self-help group; or speaking with a treatment professional in your area.