FAQ

People have many different motivations for coming to psychotherapy.  Often, people start seeing a therapist during a time of crisis; after the loss of a loved one, a break up, the loss of a job, or when you might be thinking about harming yourself in some way. 

Others come during non-crisis times for ongoing issues of focusing difficulties, problems with procrastination, relationship issues, anxiety, or non-life-threatening depression.

Others yet, will come to therapy just to gain better insight and awareness about themselves; to get in touch with deeper issues, to have someone to explore life choices with.  There is no "wrong person" for therapy and whether you are looking for a one time appointment, therapy for a few months while you get back to your old self, or long-term therapy that may continue for years; we have a place for you!


Because each person has different issues and goals for therapy, treatment will be different depending on the individual. In general, you can expect your intake session to be a time for your therapist to get to know you; questions will be asked to help understand your biological, psychological, and sociological makeup.  Tacoma and Associates pride ourselves on making this process as stress-free and as comfortable as possible.  You disclose as much or as little as you are ready to.  During this session you will also be filling out the initial paperwork and may be asked to fill out a questionnaire pertaining to your mood or symptoms.  Subsequent session will typically be weekly; between 45 and 60 minutes (dependent on your needs) where you and your therapist will discuss the current events happening in your life, explore your personal history relevant to your issues, and gain a deeper insight and awareness about your patterns of behavior and relating.  Therapy does not have a time-limit, and you should not feel pressured to "fix your problems" by a certain deadline. Every person is different .  

It is important to understand that you will get more results from therapy if you actively participate in the process.  The ultimate purpose of therapy is to help you bring what you learn in session back into your life.  Therefore, it is not unusual for your therapist to suggest things to work on, reflect on, or try in between session.  People seeking psychotherapy should be ready to make positive changes in their lives, and be open to new perspectives and techniques.


Like therapy with adults, therapy with children is a process; it's not a quick fix.  The therapists at Tacoma and Associates, PC often use a form of child psychology called Play Therapy.  For children, toys are their words and play is their language. Imagine if you were feeling really angry, but you couldn't use the word "anger" to describe how you are feeling.  This is often the position children are in and Play Therapy allows the child to express and work through these emotions even if they can't find the words to express how they feel yet.  

Many perspective clients share with me their concern about medication.  It has been well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication.  At the same time, there are people and situations where therapy alone is not enough.  I always explain to clients that I like to work with you or you child first, to see what exactly is going on and if therapy alone will be enough.  Medication may treat the symptoms, but it will not treat or change the underlying cause of the distress or the behavioral patterns in your life that are affecting you negatively.   Together, you and I will work with your primary care doctor or your psychiatrist to educate you on your options and to ensure we are taking the right course of action in your mental health. 


Dr. Tacoma does take most Blue Cross/Blue Shield plans, however to determine if you have mental health coverage through your insurance carrier, the first thing you should do is call them. Check your coverage carefully and make sure you understand their answers.  Some helpful questions you can ask them:

·       What are my mental health benefits?

·       Is Dr. Nicole Tacoma IN my network?

·       How many therapy sessions does my plan cover?

·       Do I have an unmet deductible?

·       Do I have a copay?

Also noteworthy: If you are seeing an associate of the practice, the billing for your services will still be under Dr. Tacoma's name so please ask the above questions no matter which therapist you may be seeing.  


Confidentiality is one of the most important components between a client and therapist. Confidentiality (and the limits of confidentiality) will be discussed during your first session.  You will be asked to sign a consent form and a standard HIPAA form that will both discuss confidentiality.  

As psychologists/psychotherapist, we are mandated reporters and we are required to report suspected  abuse or neglect of children, adults, and elders to the authorities based on information provided by the client or collateral sources.

If the therapist has reason to suspect the client is seriously in danger of harming him/herself or has threatened to harm another person, this will also need to be reported.

At Tacoma and Associates we take your life and the lives of others very seriously, and we will always try to be upfront with you when there is something that needs to be reported. 




If you feel like you or someone you know is in immediate danger of harming yourself or others, please call 911 or go to your nearest emergency room.

If you are not in immediate danger but feel like you need to talk to someone and your therapist is not available, you can text NAMI to 741-741 to connect with a trained crisis counselor to receive free 24/7 crisis support via text message.  

If you or someone you know is in a crisis-whether they are considering suicide or not-please call the toll-free Lifeline at 800-273-TALK (8255) to speak with a trained crisis counselor 24/7.  Your call will be confidential and free.

*Please talk to your therapist about how you are feeling.  Together you will come up with a plan of support if you are ever in need*

You must be in the state of Michigan to schedule/receive the evaluation
Yes, but only during the assessment. Many people find these assessment sessions beneficial and wish to continue with individual therapy beyond the ESA evaluation. We are happy to discuss setting up an appointment for you with your evaluator or with another therapist in the practice if you'd like to continue on your mental wellness journey.  
No. We ask that you do not bring your animal to the clinical interview. We do not assess the animal and do not take any responsibility for the behaviors or health of your animal. Instead, we evaluate the individual for the need for an ESA. If you bring your animal, we will need to reschedule your appointment.
Tacoma and Associates, P.C. is in-network with many BCBS PPO plans. In most cases your sessions will be covered by your mental health plan and will be billed as a standard intake and therapy sessions.  If your insurance does not cover your sessions, you will be responsible for payment in full.  Insurance does not cover the cost of the letter which will be billed at $50. 

If you do not have insurance, or you are out of network, fees for the process are the same as standard therapy appointment rates and If indicated, a report/letter fee will also be charged for the ESA letter.