Diane Spear

Counseling is short-term treatment that is a practical approach to achieving personal and professional goals. Therapy is longer-term, deeper treatment that gets to the underlying issues that create problems and interfere with satisfaction.

I offer individual counseling and individual psychotherapy for adults and older adolescents. The issues covered in individual treatment include anxiety treatment, depression treatment, job and career support, substance use disorder counseling. For couples and parents, I offer marriage and couples counseling, and parenting counseling (which can be for an individual parent, or for the parents together).

My approach to therapy is interactive: I talk as well as listen closely. It’s a warm, collaborative exploration. The therapy I practice is based in reality. I’ve heard professionals promise they’ll make your dreams come true. Okay, but what if my dream is to win “American Idol”? Could be a problem: I’m over 30 and I can’t sing. I help people look at whether their ideas of themselves, other people, and goals are realistic. If so, we work on steps to get there and deal with the things that get in the way. If not, we deal with the problematic thoughts involved, so we can then set realistic goals and plan how to get there. One of my favorite quotes that deals with dreams and reality is from Paul Valéry: “The best way to make your dreams come true is to wake up.” In therapy, I also work with the idea that history repeats itself un

Yes. Because I have opted out of participation with managed health-care organizations, I can protect your confidentiality. This helps you develop the trust necessary for successful treatment. There are extremely rare situations in which therapists are legally required to divulge certain information. However, in all my years of treating people, I’ve been in that situation only twice.

The short answer? It depends. I provide treatment on an out-of-network basis, which is often partially reimbursed by insurance companies. Call your insurance company and ask if you have coverage for “out-of-network outpatient mental health treatment”—that’s the phrase they use. If you have it, ask what percentage of how many sessions per year the insurance company will cover and what the annual deductible is. These figures vary greatly from policy to policy. I’ll be happy to give you a monthly receipt of your payments that you can submit with your claims. Another option for reimbursement is a flexible spending account or health savings account through your employer. These options allow you to pay for your treatment with pretax dollars. Check with your accountant to see if this works for you. Alternatively, you may be able to use your treatment and transportation costs to and from sessions as tax deductions. Your accountant or the IRS can advise you.

I don’t prescribe medication. Not everyone wants to be on medication or needs to be on it. If I think it may be helpful, I’ll refer you to a psychiatrist I collaborate with to be evaluated for possible medication. The psychiatrist and I will work closely as a team. The psychiatrist monitors medication and I do the “talk therapy.” Some people are on medication when they come to me and want to get off of it, and their psychiatrist and I work together to accomplish that. It really is an individual process.

Yes, I offer remote and virtual sessions in addition to in-person sessions in my office.