FAQ
Therapy is an endeavor of growth. Anytime we try something new, it is natural to feel nervousness or trepidation. That’s one way our hearts and minds inform us that we are genuinely turning towards change. It’s also natural to feel nervous to let a stranger so close to our fears, insecurities, fantasies, and emotions. The therapy relationship is unlike any other relationship in modern society. We sometimes let therapists closer to our inner emotions than we let our partners, spouses, parents and our friends! Once we decide to begin this endeavor it is imperative that we find a therapist who genuinely can meet us where we are. Someone that can actually hear us, can give us reflections, and can engage with us honestly - while also having our best interests in mind.
What does therapy cost?
Current fees and payment details are on my Fees page.
Do you take insurance?
I am currently in-network with Blue Shield of California. For other insurances, I can provide a superbill you can submit to your insurance for possible out-of-network reimbursement. It’s worth checking with your plan about your out-of-network benefits.
Do you offer online sessions?
Yes, I offer sessions online throughout california and in-person at my office in Petaluma.
How long are sessions, and how often do we meet?
Sessions are typically 50-55 minutes.
What happens in the free consultation?
It’s a 15-20 minute phone or video call where you can tell me a little about what’s bringing you to therapy, ask any questions you have, and get a sense of what it’s like to talk with me. There’s no pressure to decide anything on the call.
What are the first few sessions like?
Mostly, we get to know each other. I’ll ask about what’s happening in your life now, what you’d like to be different, and some of your history. Just as importantly, you’ll be getting a feel for whether working together feels right.
How long does therapy take?
It depends on what you’re working on and what you want from therapy. Some people come for a few months to work through something specific. Others stay longer because the work keeps opening up. We’ll check in along the way about how it’s going and whether it’s still useful.
What is your cancellation policy?
I ask for 48 business hours’ notice to cancel or reschedule. Sessions canceled with less notice are charged a cancellation fee.
How do I choose a therapist?
Everyone is different. Many folks who have similar ‘symptoms’ have different personalities. Clients mostly want a therapist that they feel confident can help them feel better. Clinically speaking, the ground of progress in any therapy is the strength of the relationship. If a client isn’t open to what their therapist has to say because there is no relationship trust, the therapist could be the most skillful and insightful therapist and it wouldn’t matter.
So first and foremost:
Do you feel a sense of ease when you speak with the therapist?
Do they feel present with you?
Do you feel subtly more in contact with yourself during or after the conversation?
Do you experience warmth from the therapist?
Different approaches and techniques can be useful. But if your patterns formed in relationship, then the relationship itself becomes part of the work, not just what’s being talked about or the tools being used. This is why if it were me, I would focus on trusting how I feel inside when I talk to a potential therapist. If the above questions aren’t met with a “yes” I would feel less confident to make this person my therapist.
What do you mean by overthinking?
For many people, overthinking is a response to perceived threat. It can be a way of staying safe, anticipating what others need, or trying to avoid conflict or disconnection. Often, it has roots in earlier relational environments where being attuned, careful, or self-monitoring was important. In the present, over-thinking is often a result of constricted affect or emotion that gets expressed through a cognitive stream of consciousness. The experience of ‘threatened’ is already happening inside of me, and so I try to find a way out. Understandable, but this is where we do want to develop the capacity to focus on other streams of consciousness so that we don’t have to get stuck in a rut. Therapy is one way to do that.
How does this connect to attachment or early experiences?
The ways we learned to relate to ourselves and others from a young age persist throughout our lifetime. They tend to show up in adulthood as patterns in relationships, decision-making, and how we handle stress or uncertainty.
Overthinking, anxiety, avoidance, or self-doubt can be part of those patterns. In our work, we look at how these developed, not to analyze the past endlessly, but to understand what your system learned and how it’s still operating now. We try to give language to an experience that previously may have lived in the background. Dan Siegel calls this approach “name it to tame it,” meaning that when we make our implicit experience explicit it helps us to practice mood regulation, and develop new pathways of relating to our material.
Do I need to have experienced major trauma for this to be relevant?
No. Many people wouldn’t describe their background as “traumatic,” but still grew up in environments where emotions weren’t fully supported, where there was unpredictability, or where they had to adapt in subtle ways.
Those adaptations can show up later as chronic tension, over-responsibility, difficulty trusting yourself, or feeling stuck in certain relational dynamics.
What kinds of patterns do you help with?
This work often resonates if you notice things like:
Getting stuck in your head, second-guessing yourself
Feeling responsible for others’ emotions
Repeating relationship dynamics that don’t fully work
Difficulty slowing down or feeling at ease
Excessive self-criticism
A persistent sense of “something’s off,” even if things look fine on the outside
How is this different from just talking things through?
Understanding something intellectually really is only part of the equation. These responses are often held at the level of the nervous system and the body. In addition to talking, we pay attention to what’s happening in real time, sensations, reactions, impulses, so change can happen at the level where the pattern actually lives.
Is this focused on the past?
The past is absolutely relevant, especially in understanding how patterns formed. What is happening in the present moment is often a mixture of past, present, and future. We each have our individual ‘nature,' or personal expression that is shaped by our culture, our family’s beliefs about life, emotions, children, relationships, and more… these are intergenerational patterns that we incorporate into how we relate to ourselves and others. Many of these are automatic or unconscious. In therapy we try to become more conscious of these patterns, because that gives us more ability to choose how we want to enter into relationship to ourselves and to others. The goal isn’t to blame, but to name our experience in service of self-empowerment and developing loving relationships.
How do I get started?
You can reach out here to schedule a consultation. It’s a chance to see if this way of working feels like a good fit for you.
I'm here to talk during a free phone consultation where you can share what’s going on for you and I can share my ideas around how I can help you.
Email me today to get your free phone consultation at scott@scottmenasco.com.
or sign up through the calendar below!
Citations
Miller, S. et al. (2020).Better results: Using deliberate practice to improve therapeutic effectiveness. Washington, DC: American Psychological Association.
— Used to support the point that despite more therapy modalities existing, overall psychotherapy effectiveness hasn't meaningfully increased in ~40 years.
Prusiński, T. (2022). The Strength of Alliance in Individual Psychotherapy and Patient's Wellbeing: The Relationships of the Therapeutic Alliance to Psychological Wellbeing, Satisfaction With Life, and Flourishing in Adult Patients Attending Individual Psychotherapy. Frontiers in Psychiatry, 13:827321. doi: 10.3389/fpsyt.2022.827321. PMID: 35173642; PMCID: PMC8842997.