Question 1

How do we get started?

Accepted Answer

The first step is to browse this site and the FAQs that follow to get your preliminary questions answered and to generally get a feel for how I practice. If you decide to move forward, we'll start with a free 15-minute initial consultation call. This call allows us to lay some foundation and get a better feel for our fit. To schedule this call, you can reach out through the contact form on the home page or email SetteTherapy@proton.me.

If we decide to move forward, our first session gives us a better opportunity to explore our fit and your goals for therapy. In that session, I'll review some foundational details about therapy, including administrative information, and my approach to the work. I'll ask a bit about your background as well as what's bringing you to therapy now and what hopes you have for this work. Of course, I will be happy to answer any questions you have for me.

No need to plan ahead for the session. Just bring what you're already carrying and a sense of curiosity, which is always a helpful adventure tool. We'll take it from there.

Question 2

How long and frequent will my appointments be?

Accepted Answer

Once scheduled, we'll meet at the same time each week for 50 minutes. The weekly frequency of therapy is found to be optimal. As it prevents the necessary momentum for the unconscious to come forward, I do not offer sessions at a lesser frequency.

Question 3

What are your session fees?

Accepted Answer

My current fee is $220 per weekly individual session.

As an out-of-network provider, I'm happy to supply you with a superbill each month which you can submit to your insurance company for possible reimbursement. Eligibility for these out-of-network benefits is determined by your specific coverage, and I cannot guarantee reimbursement at any time. Please contact your insurance provider for more information.

At this time, I do not have any available sliding scale spots.

I understand therapy can be costly, but money shouldn't be a barrier to getting the support you deserve. Private practice is only one way of getting therapy. Other options, including reduced-fee and sliding scale providers, are available depending on what you've budgeted for therapy.

Question 4

Do you offer in-person sessions?

Accepted Answer

Currently, I'm exclusively offering video telehealth sessions for residents of California.

For video sessions, we'll use a HIPAA-compliant web-based video program and you'll be emailed the link for our session prior to our meeting time. You won't need to download anything unless you're using a phone or tablet, but the app for those devices is simple. It's easy to log in and more convenient than commuting to an office.

With virtual sessions, it seems like where you are shouldn't matter. But due to state licensure limitations, I'm unable to serve anyone who lives outside of California and any California residents who are out of state for an extended period of time. Some states may allow temporary or long-term exemptions to this, so when you reach out to connect about therapy, let me know which state you're currently located in and if you're a resident there. Apologies for any inconvenience this may cause.

Question 5

Do you use AI in your practice?

Accepted Answer

The short answer is no.

The longer answer is this:
The term "AI" can refer to many different tools, but as we see it swiftly taking over the automation of things that were once slow and manual, it's important to stay in human conversation about which of these tools we're willing to integrate into our daily lives and why. One of the more popular ways AI has been recently integrating into the practice of therapy pertains to session note-taking. With services that will record sessions and then summarize their psychotherapeutic plotline into a clinical note, many therapists are automating what would otherwise be the dreaded manual administrative tasks of the job. And then, of course, there's the use of AI chatbots by potential clients for therapy services altogether.

While AI may have some beneficial uses, I personally don't find it to be a necessary addition to therapy, nor do I trust its current state when it comes to reliability, regulation, and confidentiality. We certainly don't understand it enough to be using it for things as vulnerable and intimate as therapy.

I also don't see it as a trusted resource to prioritize clinical needs and identify what we should be focusing on in session. AI may be helpful when it comes to organizing daily routines or developing a plan of action on your goals, but I do not see it as a therapeutic tool that should override the human relationship cultivated in therapy. For these reasons, I do not use AI functions, including note-taking programs, and I expect that a client who may choose to use such software in our sessions discusses it with me prior to use so that we can explore its pros and cons and both provide consent.

Question 6

How do you handle confidentiality and digital security with virtual sessions?

Accepted Answer

Technology is ever-evolving and the online privacy climate of 2026 has brought certain things into question. But this shouldn't prohibit you from engaging in telehealth. Given the confidential work we do in therapy, and the technology we use to do it, I'd like to break down what security measures I have taken to ensure as best I can that our virtual sessions are remaining private.

In addition to following standard HIPAA requirements, I:

Have added a layer of encryption to my email address, which is the primary way we would communicate about sessions.
Removed Google products from my practice, including Chrome as a web browser for our sessions.
Connect to sessions using a VPN (virtual private network) which adds another layer of encryption security. 
Never authorize any recording of our sessions for any purpose, including AI training on related software. 
Keep session notes simple and store them offline in a double-password-protected document on a device only I have access to. 
Do not keep any documentation of clients' legal issues, immigration status, religious affiliation, or political beliefs.

Before we begin working together, you'll review and sign something called Informed Consent. The idea behind this document is that I break down the general risks and rewards of the process of therapy, and with all the information possible, you consent to doing therapy. Pretty straightforward, but an important agreement between us that prioritizes your sovereignty in this process.

Your consent should match the issues of the times in which we're doing therapy, so I’ve recently updated my Informed Consent to include the themes addressed above and will continue to update it as technology continues to evolve.

Question 7

Do you work with couples?

Accepted Answer

At this time, I do not have any open couples spots.

Question 8

Why don't you accept insurance?

Accepted Answer

Affordable access to therapy is important. To support this, I often rotate sliding scale spots and pro-bono opportunities so that I'm able to provide services to a wide range of people.
 
Understandably, some of the most common questions I get about affordability are centered around insurance. There are a number of reasons many therapists, including myself, remain out-of-network with insurance companies. Those reasons include:

Diagnosis requirements: Not everyone who comes to therapy meets the criteria for a diagnosis in the DSM. Insurance companies determine reimbursement eligibility on preliminary diagnoses, putting the emphasis -- and the limitations -- of your care on a set of criteria that may not apply to you. This means therapists either need to turn away clients who don't fit those criteria or apply a diagnosis that may not serve the client in a clinically meaningful way. 
Determination of treatment: When working with insurance companies, they determine the framework and course of treatment based on diagnosis. This means that you and your therapist are not the ones collaborating on your treatment plan. If your insurance company decides you're only eligible for 10 sessions, your therapist won't be able to see you beyond that. This means that the context of any diagnosis (e.g. the impacts of undiagnosable trauma, how unexpected events may re-prioritize your therapy needs week-to-week, or what diagnoses you may actually have but won't be determined in our first few sessions) become irrelevant and unsupported. This makes it difficult for therapy to be a process of healing, taking a natural course rather than an arbitrarily rushed one. 
Access to records: When in-network with insurance companies, your confidential records go from being my-eyes-only to being accessible to many. While still kept confidential within the agency, insurance company providers, administrators, customer service representatives, and others within the organization will gain access to all or some portion of your records.
Resource limitations: Remaining out-of-network, I'm able to give my full attention and energy to my individual clients. When working in-network, time slots that would otherwise be open for client meetings instead become allocated to long phone calls, paperwork, and client advocacy with no guarantee of success. As you might imagine, the clinical standards of a financial institution and the clinical standards of a clinician are not informed by the same values and priorities.

I understand this complex process can be frustrating, but my hope is that transparency around this issue illuminates why I choose not to include these barriers to treatment in my work with clients.

Private practice therapy isn't the only option for care. There are quality clinics in California that provide mental health care on a sliding-scale basis, so if you find yourself saying "Vanessa, this all makes sense, but that still doesn't mean I can afford your fee," I hear you! Reach out and I'll be happy to help you with referrals to trusted low-fee therapists.

Question 9

What can I do to improve my telehealth experience?

Accepted Answer

While telehealth is convenient, there are details that can help make the experience as seamless as possible for you.

Ensure you have a private and safe space to talk on a personal and secured network; somewhere you feel comfortable and cannot be overheard or interrupted by others.

Avoid engaging in dangerous activities while signing on for our call. I won't meet with anyone driving a car during therapy.

Do engage in grounding activities, such as coloring, doodling, stretching, walking, or using a fidget toy during session, if you find them helpful, but avoid multitasking with distracting tasks, such as shopping, working, and texting. As stated above, this also includes driving and other risky activities that require your full attention.

At the time of our session, ensure the device you're using (laptop, tablet, phone) is as close to your WiFi router as possible. A site like speedtest.net will help you determine if your WiFi is strong enough to carry our video session. Upload speeds are recommended to be 10 Mbps or higher.

The fewer devices using WiFi at the same time will improve your experience as well, so if you're sharing your connection with someone using a lot of bandwidth in the next room (video games, streaming, etc.), your speed may become slow. This also means turning off the WiFi on your nearby phone if you’re meeting with me on your laptop or tablet.

If you're using a phone or tablet, you will need to download the Telehealth by SimplePractice app for iOS or Android. Information about this will be emailed to you prior to our first session.

If you're using your laptop or computer for sessions, you can use the web-based link sent via email and avoid downloading any programs. But please ensure you're opening the video link in your Chrome browser.

In lieu of a commute back home or change in environment, do something to ritualize the end of your session before integrating back into your space. This can include taking a walk, therapy journaling, drawing, dancing, meditating, etc.

Question 10

What's the best way to contact you?

Accepted Answer

You can reach out to me via my contact form and I'll reply via email.

Once we're in communication, email is typically the best way for us to stay in touch about appointments, cancellations, and any needed communication in between sessions.

You can also text for appointment changes or confirmation and by doing so, you consent to me returning your text. Please keep texts brief and related to administrative issues, which include setting up, confirming, or changing appointments, or contacting me in the event we experience technical issues during our virtual session. While I use a HIPAA-compliant texting app, in order to further protect your confidentiality, please avoid sharing any personal or clinical information via text as we will save longer, in-depth conversations for our session time.

Question 11

Can I book an urgent appointment with you?

Accepted Answer

I'm not available for crisis services. If you're experiencing an emergency, call 911, visit your local emergency room, or utilize these crisis resources.

Question 12

Good Faith Estimate Notice

Accepted Answer

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

Luckily, California law also says that therapy cannot begin if fees have not been discussed, so costs are always a transparent part of our work together.

Under federal law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

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