Frequently Asked Questions
Transitions Counseling does not provide 24-hour crisis hotline services. Should you have a mental health emergency please visit your nearest hospital emergency room or call 911.
Community Emergency Resources
The below agencies are completely separate from Transitions and are provided to give you additional options in a mental health emergency.
- If you are considering harming yourself please either pursue one of the above options or call the National Suicide Prevention Lifeline at 800-273-TALK (8255).
- If you have been sexually assaulted The Collins Center (located in Harrisonburg) has a 24-hour Sexual Assault Crisis Hotline: 540-434-2272.
- First Step (located in Harrisonburg) 24-hour Domestic Violence Hotline: 540-434-0295.
- Sentara RMH Behavioral Health 24-Hour Crisis Care: Call 540-689-1000 and ask them to page the Psychiatric Emergency Team (PET).
- Harrisonburg-Rockingham Community Services Board, Emergency Services: 540-434-1766.
- Valley Community Services Board, Emergency Services (serving Staunton, Waynesboro, and Augusta and Highland counties): 540-885-0866, 540-943-1590 or 866-274-7475.
- AVA Care of Harrisonburg (support for women and men facing unintended pregnancy): 540-434-7528.
I aim to respond to phone calls and emails within 2 business days, and I prioritize clients and potential clients over other correspondence (e.g., I usually take longer to respond to questions regarding internships, etc.). Phone calls or emails offering unsolicited products or services (i.e., potential spam) usually do not receive a response from me at all (though I am more likely to reply if it is a local business).
Email is the quickest way to reach me. However, if you would like to connect with me via phone prior to your first session I would be happy to do that.
I normally return phone calls Monday-Friday, primarily during daytime hours. I reply to emails primarily Monday-Friday and occasionally on weekends.
My fee is a sliding-scale of $120 to $80 a session (based on income), and I offer potential clients a trial session at half-price (e.g., $60). The fee is per-session, not per-person, for up to three people present in a session. If your Annual Household Gross Income is less than $100,000/year please consult the Fee Sliding-Scale for your discounted session fee.
I accept Cash, Check or Online Payment (via Dwolla). I do not accept credit cards. Checks should be made out to Transitions Counseling, and payment is due at the beginning of each session. If possible please make your check out prior to your visit in order to save time during your session.
I do not accept health insurance, but I can provide monthly statements that you can use to seek reimbursement from your insurance carrier. Do note, however, that health insurance companies require you to be assigned a mental health diagnosis code which then becomes a permanent part of your medical record. If you are not comfortable receiving a mental health diagnosis (or you do not meet the diagnostic criteria for a diagnosis) you may wish to consider alternatives to health insurance reimbursement as a way of helping you cover the cost of your counseling sessions.
I provide sliding-scale discounts based on the Annual Household Gross Income of whomever is paying for counseling (i.e., who is writing the check or sending funds digitally).
Who Is Paying for Counseling: If you (or your spouse/partner) are the one paying for your counseling sessions, you can skip ahead to the instructions on calculating your Annual Household Gross Income.
In some instances the person paying for counseling may not be the same as the person attending. Common examples are college students (where parents are paying) and those in financial need (where a church, friend or family member is paying). It is the payer’s Annual Household Gross Income (which in this case is the helping party’s, and which may be different from the client’s) that determines the sliding-scale fee to be paid. However, it is my belief that clients get more out of counseling the more connected they are to the cost of counseling. So in instances where another party is offering to pay for a client’s counseling I strongly encourage the client and the person assisting them to arrange things such that the client pays me directly for each session and is reimbursed (before or after the session) by the one helping them financially. Psychologically this helps the client to stay connected to the cost of their counseling, which in turn can help them to better emotionally invest in, and take ownership of, their growth and healing.
Estimating Annual Household Gross Income: Note that these instructions are for when an individual is paying for counseling. The Fee for Organizations/Businesses is different (i.e., when an entity is paying directly for counseling or consulting).
- On your pay stub, find the amount listed as Gross Pay or Total Earnings. Do not use the amount listed as Net Pay.
- Determine how often you receive payment—monthly, twice a month, every two weeks or weekly.
- Take your Gross Pay, and multiply it by the frequency you are paid in order to calculate your Annual Gross Pay: If you are paid once per month, multiply by 12. If you are paid twice per month, multiple by 24. If you are paid every two weeks, multiply by 26. If you are paid every week, multiply by 52.
- If you have a partner/spouse in your household, complete the above for them as well, and then combine the two numbers to calculate your Estimated Annual Household Gross Income. Use this number to find the appropriate corresponding fee in the chart below.
|Annual Household Gross Income||Fee Per Session
(after any discount)
|$100,000/year (or greater)||$120 (1st session $60)|
|$80,000 to $99,999/year||$100 (1st session $50)|
|Less than $80,000/year||$80 (1st session $40)|
Fee for Churches, Organizations and Businesses: When an organization or business is paying for counseling or consulting services the fee is $120 (per 50 minutes), and the first session is half-price (i.e., $60). However, in order to better accommodate the wide range of business and organization sizes, the following are some guidelines/exceptions wherein a discounted fee is offered:
- Small Business, No Employees (comprised of just yourself and/or yourself and your spouse): You may use the above instructions for calculating Annual Household Gross Income.
- Small Businesses, with Employees (less than 10 employees, including owners): $100.
- Churches, Small/Medium (congregation size of regular attenders, 500 or less): $80.
- Churches, Large (congregation size of regular attenders, greater than 500): $100.
- National & International Ministries and Other Charities (e.g., campus ministries, missions agencies): $100.
Note: There are more variables regarding business and organization sizes than the above can account for. If your organization/business wishes to pay for counseling or consulting services and you feel it does not fit well within the above categories, please feel free to contact me to discuss things further.
I handle health insurance in the following manner:
- Clients pay the full fee (based on the sliding-scale) at the beginning of each session.
- Upon request I can provide a printed monthly statement to clients wishing to pursue health insurance reimbursement. Please note that health insurance companies require that this statement include a mental health diagnosis code which, if filed with your insurance company for reimbursement, will then become a permanent part of your medical record. If you are not comfortable receiving a mental health diagnosis (or you do not meet the diagnostic criteria for a diagnosis) you may wish to consider alternatives to health insurance reimbursement as a way of helping you cover the cost of your counseling sessions.
- Clients submit this statement to their insurance company for reimbursement. The amount of reimbursement is subject to the terms of the client’s insurance coverage (e.g., an insurance policy may cover some mental health diagnoses less or more than other diagnoses).
- I do not accept Medicare or Medicaid.
All insurance claims are filed under “Sean Slevin, LMFT, LPC”. I am an out-of-network provider of counseling services, which may affect how much you are reimbursed by your insurance carrier. If getting reimbursement from your insurance provider is important to you I recommend that you call them in advance to check your coverage. You may also need to clarify to the insurance company that I do not handle filing reimbursement claims, but rather that is handled by you (the client), as described above. Additional codes and information which are required to file for actual reimbursement are all included on monthly statements, as indicated above.
Using health insurance (directly or indirectly) is one way of reducing the cost of counseling. However, there are a number of reasons you might be exploring other options, such as:
- You do not have health insurance, your health coverage does not cover counseling, or you have a high deductible (and do not expect to meet your deductible).
- You do not want to have a mental health diagnosis assigned to you (which would then become a permanent part of your medical record).
- You do not want your counseling to be in any way limited, or dictated, by your health insurance company (e.g., you want to see an out-of-network counselor, you do not want your counseling to be dependent on whether the insurance company considers your diagnosis “reimbursable,” etc.).
Fortunately, there are a few ways (in addition to my sliding-scale) in which you may be able to reduce the cost of your counseling. In the event that monthly statements are needed for any of the below options I recommend that you elect to have your statements omit the diagnosis code, so as to protect your privacy.
You might have friends, family or organizations (e.g., church, civic group, employer) you are closely connected to whom would be willing to assist you in your pursuit of growth and healing through counseling. There is definitely a degree of vulnerability with this option, but it has the potential to be the most impactful of the options listed, in part because you would be inviting someone into your life in a new way (which can deepen relationship connections and help you to feel more supported in your journey). Here are some suggestions and things to consider as you explore who you might approach, and how to approach them (and if you have already begun counseling with me I would be happy to talk further with you in-session about your particular situation):
- Approach Those Supportive of Counseling: Have any of your friends or family members ever spoken positively of their own counseling experiences and/or have any of them encouraged you to consider counseling? Similarly, has your church (or other religious organization) ever indicated a positive stance towards counseling (e.g., many churches will periodically be involved in marriage retreats for couples)? Even employers are increasingly recognizing that when employees are addressing their emotional wellbeing they are able to be more productive. Has your employer ever offered workshops on communication, personality types or even general productivity tips? Any of these categories of people can be a great place to start because of the likelihood that they already have some concept of counseling and how it can be very worthwhile. But if you do not have any relationships like the above, your next best option is to explore any relationships that feel relationally close and/or supportive (i.e., people whom you believe would generally want to help you if they can).
- Consider What You Are Comfortable Sharing: Before approaching someone, spend some time thinking about how much you are comfortable sharing with them. Inviting them to partner with you in this way does not mean you have to share every detail of your life. It is helpful to be able to give them some kind of succinct explanation of why counseling is important to you at this time, but it is okay for that to be somewhat broad (e.g., “I am struggling with some things / anxiety / depression / _________, and I think counseling could really help me to get unstuck and move forward.”). And it is okay to tell them upfront that you would like their help, but you are not sure how many specifics you will feel comfortable sharing with them (ideally they should be willing to respect this boundary). If you are approaching an organization (e.g., church, business, etc.) they may have their own protocol for this type of conversation. In some cases it may be sufficient simply to indicate you would like to work with a counselor and that you need some financial assistance with that.
- Emphasize That You Are Asking Them to Partner with You: I highly recommend that you plan on paying for as much of your counseling out of your own pocket as you are able. As I touch on above (regarding the sliding-scale), I believe that there is significant psychological benefit to you staying connected to the cost of counseling, and how doing so foster’s a healthy sense of personal investment in, and ownership of, your counseling journey. If you have not yet begun counseling you may feel very unsure of how much of your counseling cost you can cover yourself, because you are unsure of how long you may wish to attend counseling. If that is the case, just be honest with your potential sponsor about that—tell them the portion of each session you currently think you can cover yourself (e.g., 50%) and ask if they would be able and willing to cover the remainder. Again, approach this with the intention of always paying a portion of each session out of your own pocket (if that is at all possible for you). Even if you can only pay a few dollars yourself (and your sponsor is covering the rest), still pay whatever you can pay yourself—your sacrifice will net you great gains in your long-term growth.
- Discuss Accountability: This is particularly pertinent in organizational settings, as they often have their own record-keeping requirements they have to follow, but in some cases a friend or family member may want some way of verifying the number of times you have attended counseling during a given period of time. Ask your potential sponsor what they would be comfortable with. For example, do they want to give you funds before or after your session? Would they prefer that you pay for several sessions and then bring them a monthly statement which they would then reimburse you for the agreed upon portion per session? There are many ways to handle all of this—work to come to an agreement that works for everyone involved. As I indicated above, if a monthly statement is needed, typically a diagnosis code on the statement is unnecessary.
Reaching out for help, whether in the form of approaching a counselor, or in the form of approaching someone to help you pay for counseling, can feel very vulnerable. Most of us have grown up in a culture that suggests it is shameful to need or ask for help. But the reality is, we all need help (counselors included!), and seeking help is a courageous, healthy step towards greater growth and healing.
Health Savings Accounts (HSA), which are typically available to individuals and families with certain high-deductible health insurance plans, are a special type of bank account which is usually exempt from taxes. The intent is that you set aside money in this special bank account in order to cover any medical expenses that may arise prior to reaching your health insurance deductible. Normally you can only use the funds in a HSA for health-related expenses. Flexible Spending Accounts (FSA) and Health Reimbursement Arrangements (HRA) are similar to HSA’s, and are both typically offered through an employer. You might be able to use funds from the above types of accounts to help pay for your counseling sessions (or to receive partial/full reimbursement afterwards). However, I am not permitted to give specific tax-related advice, so you must do your own research (e.g., consult with an accountant, speak to the human resources department at your employer, etc.) to determine if any of these are appropriate options for you.
The federal government usually allows some health-related expenses to be deducted on one’s tax return. Typically this is only beneficial if you normally itemize your deductions (as opposed to taking the “standard deduction”), or you anticipate that you will be itemizing your deductions on your upcoming tax return. I am not permitted to give specific tax-related advice, so please speak with an accountant to determine if your counseling sessions at Transitions Counseling can be deducted on your tax return.
Sessions are 50 minutes long. Please make every effort to be on time for your session. Since sessions are normally scheduled back to back with other clients it is not usually possible to run sessions over the scheduled time. Longer session lengths are available upon request (dependent on my Availability ). Note that the fee is based on 50-minute blocks, so if you schedule 2 sessions back-to-back that equals 100 minutes (i.e., 50 + 50).
The frequency of sessions (i.e., how often you would meet with me) is very flexible, and something that I seek to tailor to each client. I have found that clients get more out of therapy when the frequency is in sync with what they are needing and wanting in each phase of their counseling. Therefore I recommend letting the frequency ebb and flow based on what feels congruent to you over time.
For example, some clients find it more fruitful to meet less frequently (e.g., every other week) to allow them more time between sessions to process and practice what they are working on in counseling. For other clients meeting weekly or even more than once a week feels like a better fit. Some clients will start out weekly and then drop back to every other week and eventually once every four weeks. Others will go to every other week early on (perhaps from the very beginning) and then go to weekly later when the things they are working through warrant that.
With all of my clients I usually recommend doing the first few sessions closer to each other, especially for marriage counseling. This initial frequency facilitates my getting to know you more quickly and you getting to know me, and in the case of marriage counseling it helps us to cover more ground more quickly. However, this is just a recommendation (not a requirement) and I recognize that this may not make sense for everyone (e.g., in some cases the client’s finances may be a limiting factor). I usually explore with each client during the 1st session what frequency feels right to them.
If you have previously concluded, or paused, your therapy you are still welcome to schedule sessions as-needed. There is no requirement or expectation for you to resume regular (i.e., recurring) sessions in order to resume therapy—I am happy for you to just schedule a single session if that is all you are needing at the moment. This is true regardless of how long it has been since your last session.
Please plan to arrive about 5 minutes early for your first session to allow for any unexpected delays in your arriving at my office.
My preference is to have new clients complete the required paperwork in advance of their first session (I use a secure online service which I will send you more information about once you have scheduled your first session). If for some reason you are not completing the paperwork online please plan to arrive about 15 minutes early for your first session so that you have adequate time to read and sign the paperwork.
You do not need to bring anything to your 1st session other than yourself (and, of course, payment). If there is anything you wish to bring or are wondering if you should bring please contact me to discuss those questions and I will give you my recommendations.
Please give a minimum of 24 hours notice if you need to cancel a session or you will be billed the full fee. Sometimes it is not possible to give 24 hours notice. In such cases please notify me as soon as you are able and I will take your circumstances into consideration. If you still wish to have your counseling session but are logistically prevented from keeping your appointment I recommend you consider the Distance Counseling option.
Your physical safety is important to me. If you do not feel safe traveling to my office due to inclement weather conditions please refrain from traveling. Your safety takes precedence over the Cancellation Policy (i.e., you will not be billed the session fee for canceling due to inclement weather). I do still ask that you notify me as soon as you are able. In situations where you are unable to come to your session due to inclement weather I invite you to consider Distance Counseling in order that you not have to miss your session.
For clients who cannot physically come to my office (e.g., due to living outside the area, scheduling limitations, etc.) I utilize a secure, web based technology (similar to Skype, but easier to use) in conjunction with webcams to provide two-way, interactive video counseling sessions. If this option interests you I invite you to read more about Distance Counseling and the logistical requirements involved.
I receive many requests regarding employment, internship and volunteer opportunities at Transitions Counseling. Unfortunately, I do not have any openings (either paid or volunteer). If that changes at any point I will update this page.
The one thing I can offer is that I would be happy to work with you as a client (and perhaps with myself in more of a mentoring/coaching role in this instance) if there are things you would like to process periodically regarding your pursuit of a counseling vocation. I would still need to charge for any sessions the same as for other counseling clients (though I do offer the first session at half-price, as noted above).
Whether it is with me or with another counselor I would strongly encourage you to pursue counseling for yourself as part of your vocational development. There is much that you can learn from working on yourself that can then be applied to you helping others work on themselves (and this kind of learning is usually not possible in the classroom). I share all of this from my own experience—some of the more powerful, experiential learning I have done (that has directly improved the quality of my counseling) has been in the context of my own therapy, where I am the client.