Who are your clients?

I work with adults, including individuals and couples, who present with a range of concerns, people of diverse cultural backgrounds, religions, origins, lifestyles, interests and occupations. Although I find that there is much to learn about each person I meet and treat, I can say that common concerns among many people who call me are anxiety and depression, relationship, work and life transition concerns. I welcome people who are confronting specific issues as well as people who are questioning identity, life purpose, self development.

Are you available during evenings?

Yes. I hold appointments as early as 8:00 AM and offer some evening appointments. My office is closed on Saturdays and Sundays and major holidays.

How often should I come to therapy?

Weekly appointments are necessary at the start of therapy. As you benefit from your therapy we can discuss a plan to modify the frequency of appointments to biweekly visits and then eventually taper off.

Do you believe that medication is helpful?

Some people benefit from medication intervention, some do not. There are many possibilities to consider. I am happy to talk with you and your prescribing doctor or psychiatrist (M.D.) about combining therapy with medication intervention. I can also recommend a few excellent doctors who are happy to work as a team and share information if you wish.

Will mindfulness-based, existential psychotherapy conflict with my religious beliefs and practices?

The mindfulness-based therapy that I offer is psychotherapy. It is not spirituality or religion. However, you are free to discuss your religious or spiritual beliefs and practices in therapy, but only if you wish to, and I do not require you to do so, and I do not need to become involved in your religious beliefs or practices to help you. I respect your beliefs.

Mindfulness-based therapy is a clinically valid and scientifically verified method of treatment for depression and anxiety, not a religious practice or “spiritual therapy”. Mindfulness-based therapy and existential approaches can be used in harmony with whatever tradition or beliefs you hold, observe or practice.

Psychotherapist or spiritual teacher?

Please know that I am a mindfulness-based psychotherapist and I meditate, but I am not a spiritual teacher, medium, monk or Zen master or Buddhism teacher. I offer meditative and mindfulness practices in psychotherapy that include some philosophic principles from Zen practices and the Madhyamika-Prasangika Tibetan Buddhist philosophy, and if you know something about these areas of philosophy and practice, I might be able to help you integrate some of it with psychotherapy in ways that you find helpful. These approaches are certainly well regarded by the mental health community and referenced in the mental health literature (see Marsha Linehan, Dan Siegel, Jack Kornfield, John Kabat-Zinn and Mark Epstein). I practice psychotherapy as permitted by in California by my license as an LMFT or marriage/family therapist (MFC # 38351). I incorporate mindfulness practices into psychotherapy to help people achieve more satisfying interpersonal adjustments.

What is your background?

I have graduate education in psychology and sociology and twenty years of clinical experience gained in private practice, outpatient community clinic, acute care and psychiatric hospital and residential treatment settings. My specializations are in the areas of mood and anxiety disorders, experiences of borderline and narcissistic personalities, relationship and stage-of-life adjustment difficulties. I practice mindfulness-based, existential psychotherapy with  multi-cultural sensitivity. I am also gay/lesbian friendly and have alternate lifestyle awareness. I have also been a clinical supervisor of psychotherapists in residential outpatient, private practice and community clinic settings.

Is therapy confidential?

With a few important exceptions provided by law, therapy is strictly confidential. The mere fact of seeing a psychotherapist, and all of the spoken and written content generated in and around that contact, everything you say in therapy and any notes the therapist takes on those sessions, are confidential unless you provide the therapist with written permission to disclose this information to someone else. Exceptions to confidentiality exist, however in the following circumstances and events: certain legal proceedings where there is a court order for records, cases of suspected or actual child, elder or dependent adult abuse, or when there are threats a client makes to harm him- or herself or certain persons or property, or when the therapist learns of a threat from the client’s family members.

How much does psychotherapy cost?

I like to keep my standard fee relatively reasonable at $140.00 per sixty-minute session. Sometimes the question arises, “do you offer a sliding scale”?  The answer is no. Why? Because I find that it’s best to value the therapy as much as possible.  When the client and therapist dedicate themselves completely to the therapy through effort, work, consistency, valuing the time, the rewards of being “all in” are very good!

Do you accept insurance?

I do accept CIGNA, AETNA, MAGELLAN insurance. If you have insurance and you want to use it, tell me that you have it and we discuss your options. If you have an insurance other than the three above and it is a PPO policy you can receive psychotherapy from me but you must pay for it in full and take responsibility for your reimbursement. In such cases I will not bill your insurance company. That is up to you. But I will gladly provide you with properly coded “paid” invoices reflecting what you have paid for therapy—check or cash—and then you can choose to submit them to your insurance company directly, yourself, and find out whether your insurance will reimburse you. Please know that there are no guarantees.

Insurance coverage for psychotherapy is determined by your insurance company almost completely on the severity of your medical symptoms and how impaired or disabled you are in your daily work and home and self-care routines, and/or how likely you might be to harm yourself or other people. This may sound quite surprising to some people, but please know that insurance companies mostly view psychotherapy as a medically driven service, and that dysfunction and impairment, or the lack of these, are what you and your therapist need to address,  not your sense of happiness, adjustment at home or work, or support or personal growth per-se. This means that your insurance will pay for your therapy only as long as strict medical necessity criteria are met. For example, again, if the symptoms of your anxiety and/or depression are evident and making it difficult for you to function at home, work or in school, then you might receive coverage for therapy; likewise, if your symptoms are mild and you are able to work and function at home and school and in other important areas in your life, and you are in no danger of harming yourself or others, your psychotherapy, according to your insurance company’s case manager/evaluator, may no longer be justified; in other words, not fundable.  And while this medical, impairment-based model of decision making has some validity, it can in some cases shorten therapy to just a few sessions even when you might want to continue and it’s no about impairment. Finally, please know that to use your insurance company for psychotherapy services means receiving a diagnosis. Mental health diagnoses are a part of your medical record.

If you have one of the insurances above that I accept (call me and discuss this, please), one that allows me to bill your insurance company for your appointment, then here’s what to do: before your first appointment with me, please call your insurance company to verify coverage for outpatient psychotherapy and ask the following questions:

• Must I obtain treatment authorization before my first psychotherapy session  with Niles D. Willits-Spolin LMFT?

• Do I have a deductible?

• What is the amount of my deductible?

• Has my deductible been met this year?

• How many sessions of psychotherapy are permitted per year?

• What is the amount of my per-session co-pay (usually $15.00 to $60.00)?

Unlike medical providers who widely accept a variety of insurance and maintain a staff of billing clerks to handle all aspects of claims, most of my work is private pay and not insurance based, therefore, unlike a busy, high-volume medical office, my individual practice and involvement with your insurance is quite limited. Your insurance policy is an agreement between you and your insurance company. And the consent agreement that you create with me at your first appointment is a separate agreement between the two of us for psychotherapy services. These are separate. Therefore, when you agree to receive psychotherapy, it will remain your responsibility to make sure that your psychotherapy is paid for, whether or not you use your insurance, and whether your insurance pays for therapy or we find out, after submitting claims, that it does not–for whatever reason that is beyond your/my control or, after reasonable efforts, three attempts, does not resolve itself. Thank you in advance for your understanding and cooperation.