How much does counseling in austin cost

How Much Does Counseling Cost in Austin?

Counseling prices vary a lot by the market, by the provider, number of years of experience, specialization, and by service. In Austin, counseling on average tends to cost between $100 – $200 per hour and the average being around $150. If you want to know more specifics on how much does counseling cost, check out some pointers below:

  • Some therapists take insurance however, there are a number of therapists moving away from insurance due to difficulties with insurers. This includes things like slow payment, poor reimbursement rates, no increase in payment amount despite years of experience and advanced training, poor case management on the part of the insurance company, some insurers are more focused on profit than quality care, and case reviews that require informing insurance companies about specific details of your treatment.
  • Younger therapists are often cheaper than more experienced therapists. They can range from $40- $80 per hour.
  • Couples counseling often tends to cost more than individual therapy. Sometimes this is due to the fact couples can require more work and therapists can’t see as many of them. This fee can range from $125 – $400 an hour. Many therapists will encourage clients to do 90-120 minute sessions to make sure whatever issues come up to have time to skillfully be resolved.
  • Niche specialties and that have extensive training tend to cost more. They often have extensive training and experience in this area that others don’t and supply often outstrips demand.
  • The number of years of experience a therapist has tends to increase their price. The more trained and experienced a therapist is, the more quickly they can help in correctly assessing an issue and providing a solution that they are well trained in implementing.
  • Psychologists tend to cost more since they go to school for a longer period of time and they have a Ph.D.
  • Psychiatrists also sometimes do therapy as well. They tend to be the most expensive on this list of options since they have an MD and can also do medication management. They tend to range from $300-$500 an hour.

If you are curious about our counseling prices or if you are looking for affordable counseling in Austin, check out the provided links.

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What are panic attacks?

What Are Panic Attacks?

By Daniel Hochman, MD and William Schroeder, LPC

Have you ever wondered what are panic attacks and why do people have them? Panic attack symptoms can be incredibly debilitating and embarrassing, and change the way people live. If they make you avoid grocery store and roads, it makes life pretty darn hard to navigate. You may have seen someone experience one, or even suffer from it yourself.

Let’s start with the basics. A panic attack is basically a sudden and unexpected feeling of terror that’s way out of proportion to the actual situation. About one in 20 U.S. adults has one at some point in their lives, with women being twice as likely to experience them.  Here are the common signs and symptoms:

  • Internal symptoms – Usually people sense a racing heart, sometimes with chest pain. It is not infrequent that we have a client come into therapy after they have had several emergency room visits because these symptoms can feel like a heart attack (in fact, most chest pain seen in the ER is due to anxiety and not heart attacks). As far as thoughts go, people feel a sense of doom, might even feel like they’re dying and feel totally out of control. To make it even more fun, people usually feel faint, woozy, tingly in their hands, and might sense a lump in their throat.
  • External symptoms – On the outside, breaths are more rapid. You will notice the person looking quite uncomfortable, at a loss for what to do, and have a hard time making eye contact. Their skin can get sweaty and pale.

What’s the difference between anxiety and panic attacks?

As far at the timing, the major difference is that panic attacks are more intense and usually peak at around 10 minutes, and last less than an hour. Anxiety, on the other hand, can last many hours, or even years. When you ask someone to describe a panic attack, there’s usually a focus on the panic itself, with a fear of having another panic attack. And whatever fear they can describe will usually sound quite unnecessary. If you ask someone with anxiety to describe what’s going on their head, they can usually describe one or several things clearly on their mind about what’s bothering them.

The horrible positive feedback loop

With panic attacks, usually, it starts with just one small fear. Like a fear that people at the mall will be judging you. When you feel scared, your body reacts as if there’s a physical threat. And when your body reacts, it convinces your mind that there’s actually a major threat out there, which only makes the mind more scared, which only makes your body even more hyped up… and so on. What’s more, you start to notice you get scared of the mall during your drive over. And then you start to get worked up about thinking about leaving the house with your car at all. And then you get scared you’re having a heart attack or going to pass out, etc. This is the vicious positive feedback loop where now there is an entire cycle of fear, and the fear feeds itself. No longer is it the initial fear of a crowd, but it’s the drive, the road, the keys to the car, a friend’s invitation to go out, and the symptoms. They all compound. This is the idea behind how panic attacks hit so fast and hard. When I can help my patients explore their primary fear, say a fear about a crowd judging them, it helps reign in the rest. They can begin to emotionally process the underlying issue, and there’s no more fire for the rest of the feedback loop to feed.

If we can be of help, you might also want to read more about anxiety counseling or you can contact us to make a counseling appointment. We also have more information on dealing with panic attacks. If this article was of interest to you, you can also read our post on why do we get nervous.

Daniel Hochman, MD is the founder of Self Recovery, a private online addiction recovery program. It is ideal for those in therapy or post-discharge from rehab and need ongoing programming. The program will help to continue developing prior skills and teach new ones to create a more complete approach.

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Taking Back Turkey Day

Taking Back Turkey Day!

by Adam Maurer, LMFT, LPC 

Thanksgiving is one of the most challenging holidays for some folx. Sandwiched in between two major month-long events, Halloween and Christmas, turkey day seems rather charming from afar. It’s the kickoff to the holiday season. A short twenty-four hours packed with football, parades, and pumpkin pie. The hardest part of the day for some people will be to hold their tongue while their distant relative prattles on about their political beliefs (also check out our Survival Tips for Holiday Homecomings). A small price to pay for an all you can eat turkey buffet. If you’re really fortunate then you get a four day weekend out of the celebration. So, what is there not to like? There are plenty of reasons people don’t like a conventional Thanksgiving celebration. Colonialism and sexism are often an undercurrent of the holiday. A Disneyesque retelling of what happened to Native Americans challenges some folx ability to joyfully engage in the festivities. Check out this article from the Smithsonian to better understand this concept.

Also, The holiday centers on an elaborate meal that takes a great deal of time, thought, and energy to prepare. This task might fall on the shoulders of women, women who may not particularly enjoy: fighting for a butterball at a crowded grocery store, getting up at 6:00 AM to make sure the turkey is ready for lunch, playing hostess to guests, or cleaning up after a feast. The social script for men on this holiday often allows for much more free time, to either enjoy the game or to hunt. Thanksgiving can also be particularly painful for people with strained family ties. On a day that celebrates homecomings and family relationships, many members of the LGBTQ+ community are not welcome home simply for expressing their authentic selves. So, what alternatives are there to all of this? That’s where I come in! There are so many ways to enjoy some time off together beyond the traditional celebration, so here are some new ideas to get you started on creating your own rituals.

Cooking Competition

Make your Friendsgiving the best with a cooking competition! It brings together your community while having the task of cooking a feast spread out to everyone. You can really spice it up by making your own trophy. To be honest, I tend to be ultra competitive and the idea of bringing home a coveted trophy only makes the event more spirited in my opinion. Another beautiful thing about this activity is that it allows for folks to create dishes they love and they get to share them with their community. You might just find a new favorite dish, or experience something that is truly meaningful for a guest to make.

Wine/Beer/Liquor Tasting

Another way to enjoy a day with your community is to do a tasting of your group’s favorite adult beverages. Last Thanksgiving I hosted a champagne tasting with guests, which was an absolute blast. You can rank the beverages by ballot or conversation, all so that the winning libation can emerge and be offered at future gatherings. You can even set up pairings with different courses of your meal.

Putt-Putt

Make your own putt-putt course at home. Community, competition, fun; and hot tip: if you have some restless kids let them design the course from items you already have. You can typically find some old putters at thrift stores or Amazon has one for under $25. What’s great about this activity is that it can be outdoors or indoors, depending on the weather. Here is an opportunity to make another trophy, I really love to win and take home the gold!

Camp Out

You can forgo all the turkey day hoopla and just enjoy time in nature. A few days away from it all can be relaxing before the gauntlet of holiday obligations begin in December. Also, you might just catch the last few warmish days of the year before it gets colder. What a great time to spend with your chosen family!

Thanksgiving, and any holiday really, are what we make of them. So why not choose to make holidays something that are wonderful for everyone involved? It can be time to reflect on what you want out of life, appreciate the love you have, or take a healthy risk and try something new. If the holidays are creating too much stress for you, therapy can be a wonderful place to find relief. Talking with a skilled clinician can provide a place to do the raw processing of your thoughts and feelings so that you’re better able to present them to loved ones in a way that might be easier to hear. Take care of yourself this turkey day, and every day.

If you feel that holiday stress puts a damper on your ability to enjoy this special time of year, you can contact us to make a counseling appointment. We have excellent clinicians and offer personal growth counseling for helping with stress and family and parenting counseling if you need assistance with family gatherings.

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When Love & Addiction Collide

When Love & Addiction Collide

Love is a funny thing; sometimes it makes a lot of sense and other times it’s quite bewildering. Similarly, addiction appears in the same fashion. What we’ll be exploring today is what happens when your love interest develops a substance abuse problem or an outright addiction and how you can help them (and yourself).

What you’ll find below is the result of a large collaboration between three Austin mental health professionals, William Schroeder and Julie Osofsky of Just Mind, and Dr. Daniel Hochman of SelfRecovery.org. Together, we understand the intricacies of addiction and the human mind, as we discuss it regularly amongst ourselves and within our patient sessions. We hear the same questions arise, so we’ve attempted to answer some of the most common concerns and questions below.

What are some character or behavior traits an addict might display?

Addiction affects individuals differently, but there are some commonly seen behavior changes that could be cause for alarm. Most of these are identified by a quick or dramatic change in areas of their life where they used to be very consistent and reliable. Examples of this can include, them not showing up to work or commitments on time, pulling back from mutually-enjoyable and healthy relationships and diving into toxic ones, becoming unreliable, being irritable or on the defensive, disappearing for hours on end, and getting short on once available money coffers. Many of these actions occur because the user is most likely feeling a wave of guilt and shame for their addiction and are trying their very best to keep it a secret. In general, rapid changes in money and/or appearance can be some of the first major indicators of when their controlled-habit is unraveling into full-blown addiction and they’ve saddled up for the ride.

If I become suspicious that a loved one is battling an addiction, what should I do?

There are several things you can do if you suspect your loved one is grappling with addiction, which are meant to help them and protect your own health and happiness. To begin, we suggest talking to them about it, but not in a combative or accusatory way. So many people (with great intentions) jump into this moment in the perfectly wrong way and say something like: “I think you’re an alcoholic and you need to stop.” That’s actually one of the quickest ways to make them defensive and shut down about it. One of the trickier things about addiction is the isolation a person experiences. Many people find themselves using a substance as a way to cope with some turmoil or uneasiness, so shaming them about it is counterproductive.

Many times, addiction is an indicator of something else that the patient is struggling with, so our suggestion is just to try to connect with them in a safe and loving way, while showing your concern. Address some specific changes you’ve noticed in their behavior or actions. Something similar to, “I’ve noticed you’ve been more upset with people recently and you’ve been drinking a lot more… I’m worried about you. What’s bothering you?” This is much easier and inviting for them to respond to or at least begin the conversation.

Lastly, you also need to seek help for yourself. Get your own support through some sort of group or therapist. Ultimately, you cannot control or change what your loved one does. Being able to accept that can be a difficult process, but it’s a needed one for both of you.

How can I best show support? What are some things I should avoid saying?

Like we’ve agreed upon before, we’d avoid judgment or shaming. This helps no one. You’ll likely need to set boundaries, but if done in a transparent and loving way, this is more effective than making them feel badly about their addiction. We’ve considered this next point a lot and we agree, once someone gets to this point, it is not enjoyable for them. Sure, the first drink or hit might provide them with a rush of euphoria, but we assure you that’s followed with anguish and torture.

Research indicates how important it is to have a supportive community for those who are struggling with addiction. This is partially behind the practice of sober houses and the decriminalization of drug crimes in most European cities. Community support and alternative thinking is how Iceland got kids to say no to drugs and essentially wiped out a massive “epidemic” they were experiencing. It’s also quite helpful to distinguish the difference between the person and their addiction; treat the addiction as its own being. You might say, “I love you, but I’m becoming anxious the addiction might come back.” Instead of, “What is wrong with you? Why don’t you just stop?” This depersonalizes the addiction, which can help the person to be less defensive, as it’s a separate entity.

Remember, your goal is to convey that you care and emphasize your willingness to be leaned on as support, while they navigate their options for help. When different approaches are compared, the best ones outcomes come from those that that treat a person suffering in addiction no differently than another illness, such as cancer. Nobody wants a life of addiction (or cancer). Both are absolutely horrible, and we have to understand that.

If my loved one already has a therapist or psychiatrist, should I call them? Can the therapist or doctor speak with me or is that a confidentiality issue?

This is something that has come up in the past, so we thought we should answer this definitively. We have received voicemails or emails from a friend or family member who is expressing concern regarding the patient. This is usually triggered by a recent event, such as suspecting a relapse or displaying troubling behavior like we highlighted above. Other times, it’s overt displays of struggle, like being hospitalized with a high blood alcohol level or overdosing. No matter how much we would love to comfort you in this time of uncertainty, unless we have a signed agreement allowing us to talk with others about the patient (signed by the patient), we can’t reply due to confidentiality. That being said, if you think you have valuable information that could assist in their recovery, a good provider will appreciate your disclosure and will make use of it, albeit discreetly and without acknowledgment, we received your correspondence.

Another approach you could present to the patient is to join them in one of their sessions. This not only strengthens your commitment and resolve, but it also will give you the opportunity to potentially have a voice with them and their counselor. So long as the patient is fine with your joining, most providers won’t have an issue with your addition.  

I’ve had it! Can I have someone committed into rehab involuntarily?

Not really, and for good reason, as it is difficult to legally force a free person into any kind of treatment (yes, even while intoxicated). It is feasible to involuntarily commit someone for a detox program and most states have a system in place for that. This involves proving (with documentation) that the likelihood of imminent physical harm (beyond intoxication) or a fundamental lack of capacity to provide for their own basic needs. However, this is exceedingly rare in practice, considering the amount of people harming themselves with their addiction every day. It can also be impractical to force detoxification without the patient being completely on-board, as they might not be ready for it. So the answer to the question relies on which situation and state you’re in.

Anything else I should know?

With certain substances, it is best not to stop cold-turkey without the guidance of a medical doctor, as some addictions can prove fatal if stopped suddenly. This should not deter any addict from seeking recovery, it just means that should be honest with their desires to stop. Alcohol, benzodiazepines (also called benzos), and opioids are of the gravest concern. To provide the patient with their best foot forward, medically-supervised detoxification should be considered as an option or at the very least, get your doctor’s approval to wean off at home.   

Secondly, addiction recovery can take many forms. The evidence shows that most people can improve greatly at a traditional outpatient clinic that’s well-versed in how to address underlying mood issues that drive addiction. When it comes to recovery, many people often incorrectly believe the best (or only) solution is to arrange for a 30-day on-site rehab. The evidence is quite clear that it’s typically not needed, on top of being only 5-10% effective. Why is the effective rate so low in rehab facilities if I see my favorite celebrities going to them all the time? Well, there are many reasons for this, including very few regulations on the standards of care and the lack of utilizing evidence-based treatments. Additionally, there’s a type of fallacy when you’re part of an in-patient rehab program, as it’s “easier” to get well in this removed and idyllic setting. However, many patients that show promise while in rehab have been known to struggle when they return to their “real life” and all the toxic opportunities, situations, and/or people present themselves. This was the idea behind SelfRecovery.org: to make evidence-based strategies available to everyday people in their everyday environments. One thing we can all do to help is to destigmatize addiction so more people reach out for the help they need and get there earlier.

Finally, a common misunderstanding is around the topic of relapses, which are unfortunately an expected part of the journey. We typically educate clients to not think of a relapse as the worst thing that can occur, but a possible hurdle they might experience. We want to be clear here, we don’t recommend relapses, so don’t strive for them or allow yourself a weekly “cheat day”, as that won’t get you into the clear, but it could happen. The truth of the matter is that if a relapse occurs, the goal is to make them less frequent, less intense, and to decrease the duration. It’s not so much what happens when you get bucked off the horse; it’s what happens when you’re on the ground. If you or a loved one need any assistance in this process, you can contact us to make a counseling appointment. You can also find more information about adult counseling on our service page.

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