Frequently Asked Questions

What happens during the Free 15-minute phone consultation?

The initial Free 15-minute phone calls gives you an opportunity to ask questions and decide if you would like to be seen in person with Dr. Freshwater or meet in person via Online video/audio platform. You also can decide at any future time to receive treatment services via either modalities, which ever one is more convenient for you.

The Free 15-minute phone call also helps us get a sense of what you are looking for help with in therapy. You are encouraged to share a brief summary of why you are seeking therapy. If we are a “good fit”, then we will schedule your 1st session: the BioPsychoSocial Assessment. You will need to complete all Client Forms prior to our 1st session so that time is not wasted on routine paperwork when we meet. Thank you.

Who Can Benefit From Therapy?

The brief answer is that we all can benefit from therapy. We all go through life’s journey of challenges, losses, and stressful situations. We all acquire along the journey some psychological and emotional bruises and mind conditioned patterns of responding that are often maladaptive and unhealthy for our well-BEING.

We all develop defenses and conditioned responses against unpleasant emotions and experiences. We all experience periods of fear, anxieties, depressed mood, and stress. We all struggle to fit in, form intimate relationship bonds, and develop meaning in our lives. We all wish for holistic health. Overall, the most important factors for the ability to benefit from therapy are the motivation to explore our self, our habitual reactions of suffering, and a desire to change or heal some aspect of it.

Do I Need a Referral?

No, you do not need a referral. Just contact me to set up consultation.

I Never Had Therapy, What Is Therapy Like?

The first couple of sessions will focus on exploration and investigation of the most pressing issues, or your most immediate problems, symptoms and signs of distress, and salient challenges in your life.

I will ask general questions and other times very specific questions about different aspects of your life. I will share with you some initial impressions. Later, some sessions will be less structured (e.g. sharing your unedited thoughts) and other sessions more structured where I help you to go deeper into your thought patterns and their meaning and connections to emotions, relationships, physical sensations, and your spirit.

I will help create the spaciousness so that you can go deeper and help you uncover the root causes of your issues, symptoms/signs, and challenges, so that you can awake, evolve, transform into your true centered and balanced Authentic Being.

How Long Will I Need Therapy?

There is no specific and exact answer to this question. Clinical research demonstrates that benefits can be immediate even after the first visit. Overall, research demonstrates the more sessions that you attend are positively correlated with the benefits that you receive.

The majority of people who enter therapy choose to extend their visits over months, and some over years, because they find that the benefits in their life is worth the effort. Keep in mind that therapy is a process that needs time to unfold. It is discovery of where you are at this very moment, where you want to go, and what you want to heal. Therapy is not about getting to the end that is known in advance.

Most people have ways of habitual responding that are deeply engrained, mind conditioned unconscious patterns, conditioned behaviors, suppressed and repressed emotions, and energy blockages that may need to be released, removed, and unlearned.

The goal of healing —the goal of psychotherapy is to help us undergo a journey of discovery where the journey itself is in and of itself the goal. It is possible to accomplish some very meaningful progress in as little as 5 to 10 sessions.

I recommend committing to at least 5 sessions and assessing the benefits. Most people who walk in the door with a very specific symptom later realize that specific symptom was only the “tip of the iceberg” of a deeper issue.

They are some of the very fortunate who present for treatment in the earliest presentation of a symptoms. They recognize immediately that the symptom is an alert signal that something is wrong or not in balance in their life or how they approach life. Life is a Journey.

Life is a Dance.

What Can I Expect As A Result From Therapy?

There are multiple and various benefits from therapy. Psychotherapy has been empirically validated to have many benefits and in most cases significantly greater clinical benefit than any medication. The majority of individuals who obtain therapy benefit from the process and practice.

Benefits may include relief of emotional distress. That is a form of suffering (e.g., symptoms of anxiety, depression, stress, fears), physical symptoms (e.g. headaches, GI problems), improved inter-personal relationships, greater self-confidence, easier decision-making, improvement in the specific concerns that led you to seek therapy, and overall resulting in healthier physical and psychological well-being.

Success may vary depending on the particular problems being addressed as well as your consistency, motivation, and dedication to improving yourself. I emphasize again that your journey of transformation and healing involves active participation, self-exploration, gaining new insights about yourself and others, finding ways of dealing with problems, learning new skills, and diligent practice.

Are You Licensed? What Are Your Qualifications?
  •  am licensed professional counselor.
  • I have been licensed since 2012.
  • I earned multiple diplomas: Bachelors of Arts in Psychology, Masters of Science in Professional Counseling, Doctor of Philosophy (PhD) in Counselor Education and Supervision
  • I am highly trained in various psychological theories and paradigms and utilizing a integrated and specialist approach.
  • I am educated, trained, and experienced with Child/Pediatrics, Adolescents, Adult, and Geriatric assessments and clinical psychotherapy.
  • I am currently only accepting new therapy clients via Telemental Health (online) or VIP/Concierge..

If you have more interest please visit my about me page


What Do You Charge For Therapy?

Fees vary depending upon type of service, type of session, and length of session.

Please see my fees page.


Do You Accept Insurance?

If you plan on using your mental health insurance for reimbursement, please note that I am considered an “out of network” provider. If you are not sure what your insurance will cover, please call them directly for the specifics of your plan’s coverage.“Out of Network”.  If you choose to utilize your mental health insurance, per your written request, I will supply you with a SuperBill.  A SuperBill is a medical documentation receipt.  Keep in mind your insurance carrier will require a diagnosis. 

I am committed to my patients privacy and their health. An insurance carrier is not committed to your health nor your confidential personal information. I choose not to be contracted with insurance carriers for those reasons.

If you want to utilize your Insurance carrier mental health coverage, then insurance carriers require a psychiatric diagnostic disorder to be submitted and also they can request your confidential and private/personal information about you and your visit. Insurance carriers also will deem whether your visit is deemed “medically necessity” per their terms, not yours.

I am not affiliated nor contracted with health insurance plans. PPO health insurance plans will allow you to see me as “out of network provider” and I will with your written consent and supply to you documentation that you can submit to your insurance carrier who will reimburse you directly if you have coverage in your insurance policy.

I do not collect from insurance carriers.   Payment for professional services are due at time of session.

What are the Benefits of Not Using Insurance to Pay for Therapy?

When you pay for therapy without involving your insurance carrier, your therapy, treatment is private/confidential. No one besides you will know that you are seeing a clinical therapist and for how many visits. You also will not need to be diagnosed with a “psychiatric disorder” and your medical record can remain diagnosis clear. More over, your insurance carrier will not be able to dictate how many sessions, how often your sessions, the length/ time of your session, how long you can attend therapy, or the kind of therapy that you receive. This gives you and your therapist greater collaborative freedom to tailor and customize the therapy to your individual needs.

Most people do not to use their insurance coverage because of privacy concerns and the significant insurance policy limitations and caps to mental health services, insurance policy limitations on number and length of sessions, lengthy processing of reimbursement benefits, your time invested in insurance negotiations for mental health disputes of coverage.



What Are Some Highlights and Caveats to Insurance for Mental Health?

When you utilize your insurance benefits, the insurance company has a right to request your records as well as speak with your therapist regarding your treatment. Often, the insurance companies require their staff to review your case and determine if you are progressing far enough in your treatment and whether they should continue to pay for therapy. Due to patients not wanting their personal confidential information to be told to insurance companies who keep databases on their treatment, patients often feel that they would rather pay for services out of pocket rather than expose themselves to unnecessary privacy concerns as well as having their treatment dictated by a staff rather than by their therapist.

Whether or not you use your insurance is a personal decision that should be made after careful thought. I am not contracted with insurance plans. However, if you plan to use your insurance to reimburse you then you should carefully check your insurance contract policy by determining the following:

  • Do I have mental health benefits?
  • What is my mental health deductible ? and has it been during this insurance policy contract?
  • How many sessions does my plan allow for the policy period?
  • How many minutes per therapy session does my policy allow?
  • How much does my insurance plan cover of the Doctors professional fees for services provided?
  • What is the insurance coverage amount per therapy session?
  • Do I need approval and prescription from my primary care doctor?

Please be aware that it is ultimately your responsibility to know the terms and facts of your insurance plan. Your insurance plan is a contract that you signed with your insurance company. Your insurance card should have a phone number on the back side so you can call them with any questions regarding your policy.

Any disputes you have with the benefits quoted must be dealt with directly with your insurance company. Please understand that I am in the profession of healing, not in the profession of insurance policies nor insurance contracts.


Does Anyone Else See the Notes that You Write?

I keep notes locked. Notes and diagnostic testing records are kept for 7-years per Virginia Law and then destroyed. All sessions are confidential and all psychotherapy records and diagnostic protocols are confidential. Note: if you choose to use your insurance plan, then information that is normally confidential will be released per your insurance carrier. It is your personal decision whether you decide to use your insurance.

Federal and State law exceptions. Please read below.

Confidentiality and Exceptions

The law protects the privacy of all communications between a client and a therapist. In most situations, I can only release information about your treatment to others if you sign a written Authorization Form that meets certain legal requirements imposed by HIPAA. There are other situations that require only that provide written, advanced consent. There are some situations where I am permitted or required to disclose information without either your consent or your authorization.

Duty to Warn and Protect

When a client discloses intentions or a plan to harm another person, the mental health professional is required to warn the intended victim and report this information to legal authorities. In situations in which the client discloses or implies suicide, the health care professional is required to notify legal authorities and make reasonable attempts to notify the client’s family.

Abuse of Children and Vulnerable Adults

If a client states or suggests that he/she is abusing a child (or vulnerable adult) or has recently abused a child (or vulnerable adult), or there is danger of imminent abuse, then the mental health professional is required to report this information to appropriate legal authorities and social services.

Prenatal Exposure to Potentially Harmful Substances

Mental health care professionals are required to report admitted prenatal exposure to controlled substances that are potentially harmful.


Parents or legal guardians of non-emancipated minors clients have the right to access client records.

Insurance Providers (when applicable)

Insurance Providers and other 3rd-Party payers are given information that they required regarding services to patients. Information that may be requested includes type of service, date/times of services, diagnoses, treatment plan, and description of impairment, progress of therapy, case notes, and summaries.


  1. If you are involved in court proceedings and a request is made for information concerning your diagnosis and treatment, such information is protected by the therapist-client privilege law. I cannot provide any information without your (or legal representative’s) written permission/authorization, or a court order, or if I receive a subpoena of which you have been properly notified and you have failed to inform me that you oppose the subpoena. If you are involved or contemplating litigation, you should consult with your attorney whether a court would be likely to order to me to disclose information.
  1. If a government agency is requesting the information for health oversight activities, within its appropriate legal authority, I may be required to provide it to them.
  1. If a client files a complaint or a lawsuit against me I may disclose relevant information regarding that patient in order to defend myself and defend the practice.
  1. If a client files a worker compensation claim, and I am providing necessary treatment related to that claim. I must, upon request, submit treatment reports to the appropriate parties, including the client’s employer, the insurance carrier or an authorized qualified rehabilitation provider.



What is Your Cancellation Policy ?

Once an appointment session is scheduled, you will be expected to pay for it unless you provide 48-hours advanced notice of cancellation (week-ends do not apply). This policy is representative of the industry standard for doctors within the counseling and psychotherapy professions.

You will find that treatment progresses best and produces long lasting change when appointments are regular and consistent. So, as an example, if you have a Monday  morning appointment time, then you would need to cancel that appointment by Thursday morning the preceding week.

PLEASE NOTE:  If we are working together in intensive therapy or psychodynamic therapy, a schedule of 2 to 4 sessions per week a set time is protocol. If you are not able to keep your appointment(s), you will be charged for the missed or cancelled session(s) as these days and times are reserved specifically and only for you.

If we are doing deep work together, that is,  intensive psychotherapy or psychodynamic, and if you plan to be on vacation or plan to be away from psychotherapy treatment for extended time frame, then please provide at least a 2-week advance notice to Dr. Tiffinee Yancey. This is policy representative of industry standards for doctors utilizing depth psychology, intensive, or psychodynamic modalities of treatment.

Please see Helpful Forms

Cancellation Policy Form

Credit Card Authorization Form


How Do I Schedule My Appointments?

We will schedule sessions to occur on same day and time each week. Over the course of the initials sessions or course of treatment, it may be decided that more than one session per week is needed. Standing weekly appointments at the same time every session helps builds consistency and helps our work together.  The standing sessions and time are reserved specially for you.

How Do I Pay for Services?

All therapy services can be paid with all major credit cards issued by USA institutions and PayPal.  

Package plans are offered to Concierge/VIP clients. Please inquire if a package plan best suits your needs.  


What Will Make Therapy Successful for Me?

The harder you work in therapy the better your outcome will be.  This means coming to sessions regularly and on time; writing down your questions, comments, observations, concerns, and even your dreams between sessions, so that we can work on them together.  It also helps to get clear on your goals for your life; and by all means doing assignments that we develop together in session and practicing them outside of session.

I only have a small amount of time with you each week, so it’s important that we use our time wisely, effectively, and therapeutically.

The more prepared you are for our sessions, the more quickly the therapy will proceed and the more you will get out of it.

Think about our sessions during the week. I encourage you to keep a therapy journal-to take notes after session about key points or things that you may want to try differently, and before your next session document your agenda.

Be patient with yourself and the therapeutic process.  Therapy is hard work and often brings up a lot of buried unpleasant emotions that you have not been dealing with for years.  However, to go through life carrying all that heavy weighted unnecessary emotional baggage is self-sabatog.

There will be times when you leave a session that you feel worse than when you walked in. However, that means we are talking about and you are processing the right things.

You are not coming to get a massage, so you have to expect some times that you are not going to feel immediate relief, but that will arrive if you stay with the process. You are much stronger than you believe.

Hopefully, over the course of treatment as a whole, you will walk out of my presence for the very last time feeling light, free, and empowered then when you entered for the very first time.

It will be my honor to co-create with you the life you want….and it will be my honor to have worked with you.

Peace, Dr. Yancey

What is Evidence-Based Treatment?

Doctors who are  Clinical Psychologists utilize Evidence Based Treatment ~ Evidence Based Therapies. We are extensively trained and skilled with decades of expertise.  The American Psychological Association (APA) defined Evidence Based Treatments as “the integration of the best available research with clinical expertise in the context patient characteristics, culture, and preferences.”  This does not mean you get a “cookie-cutter” approach. Rather, it means I use clinical judgement and expertise to formulate a specific treatment plan that considers all factors and symptoms unique to you.

If you have questions, then please ask.

Dr. Yancey

Does Going to Therapy Mean I'm Crazy or Weak?

Absolutely not. I can assure you that there is no such diagnosis as “Crazy” nor “weak”.   It takes an incredible amount of strength to reach out for support.  Once, you engage in therapy, you may be surprised to learn that many of your symptoms actually have a name and are more common than you think.

How Do I Know If I need Therapy?

If I am honest, I think we all could benefit from therapy at some point in our lives, but of course, I would say that as a therapist because I know how important our mental and emotional state influences our physical health and our relationships.

However, without knowing the specifics of your situation, I can not say for sure. We have yet to meet.   I encourage you to consider the following questions:  Do you keep running into the same conflict in your relationships?  Do you keep getting the same feedback from others?  Do you have emotional distress that does not seem to get better ? or presents over time?  Ever feel like you are putting strain on your relationships because you need so much advice?  Do you just feel that something is not quite right about how you are feeling or thinking or acting ? or just feel lost and not enough?


Coaching vs. Psychotherapy

The fundamentals of life coaching are what distinguishes it from therapy. Life coaches do not diagnose the people they work with, while therapists determine illnesses and pathologies so their clients can be clinically treated. Therapists analyze their client’s past as a tool for understanding present behaviors, whereas life coaches simply identify and describe current problematic behaviors so the client can work to modify them. In other words, therapists focus on “why” certain behavioral patterns occur, and coaches work on “how” to work toward a goal.

When you look at a life coach vs. a therapist’s practice, it’s important to recognize that therapists help clients explore and understand their subconscious and unconscious mind. Their goal in this exploration is a deep understanding of behaviors and patterns. Life coaches focus on an individual’s actions and results. Life coaches measure their client’s success with key performance indicators and specific behavioral outcomes and goals.

Therapy and life coaching do share certain traits and aims. However, whether you choose to work with a life coach or therapist, both work to enable clients to make positive changes in their lives and become more productive. While therapists diagnose and treat from a healthcare perspective, not all therapy clients are ill; many healthy people seek the services of both therapists and life coaches. Therapists may at times work with specific results in mind, such as the cessation of a particular problematic behavior.

Despite occasional areas of overlap, the work and processes of therapists and life coaches are distinct.

1 Step 1
Select Service