Question 1

Why did Dr. Gould choose the name Balanced Psychiatric Solutions for her practice?

Accepted Answer

I believe that many difficulties arise when emotions, thoughts, or behaviors are out of balance.  For example, we all experience sadness and anxiety.  However, when these emotions are too strong or too persistent, our ability to function can become seriously compromised.  Significant problems can also occur when emotions, thoughts, and behaviors are either over-controlled or under-controlled.  Sometimes these issues are primarily related to underlying biology or genetics.  Other times, past life experiences, traumas, current life stress, and/or physical health issues play a major role.  I feel it is essential to look at each of these factors and explore treatment options that can help restore a more natural balance.

Question 2

Why don’t you take insurance?

Accepted Answer

The decision not to contract with insurance companies was a difficult one as I, like most people, depend upon insurance for my personal healthcare.  Insurance plans, however, often have restrictions on mental health and psychiatric benefits that can significantly limit care and treatment options. It is extremely important to me that the treatment I recommend for you/your family member is based upon what is clinically indicated and not ‘driven’ by insurance companies. 
 
Insurance reimbursement to mental health providers also does not typically support the in-depth level of assessment and follow up care that I provide.  To compensate for lower reimbursement rates and higher overhead associated with billing and collections, psychiatrists who accept insurance may be forced to ‘double book’ appointments or see patients for less time than is indicated.  I meet with new patients for at least 60 minutes (90 minutes for combined youth & family assessments) and see established patients for at least 30 minutes.  This allows me time to more fully understand your situation and needs before I make treatment recommendations.  Longer appointments also allow more time for you to ask questions about your care.

Question 3

Are there ways I may be able to use my insurance to help with costs of psychiatric care through Balanced Psychiatric Solutions (BPS)?

Accepted Answer

Yes.  While BPS does not file for insurance on your behalf, we will provide you with documentation (often called a ‘superbill’) you can submit to your insurance provider for reimbursement of any benefit your plan qualifies you for.  This typically requires that your insurance plan includes ‘out of network’ benefits.

Question 4

Are there privacy issues associated with filing for insurance reimbursement?

Accepted Answer

Yes.  Insurance companies typically require the ‘superbill’ include information regarding your diagnosis and services received.  While not routine, insurance companies may also request your records to verify services provided.

Question 5

Dr. Gould’s profile says she is trained in DBT.  What is DBT?

Accepted Answer

DBT stands for Dialectical Behavior Therapy.  DBT is an evidenced based therapy developed by Marsha Linehan, Ph.D. that incorporates cognitive (behavioral) therapy, mindfulness principles, and dialectical strategies.  Numerous studies have shown DBT to be an effective treatment for persons suffering from problems with emotional regulation and related difficulties including depression, eating issues, behavior control problems, anxiety & trauma, self-injury, and suicidal thoughts or behaviors.

Question 6

What are the components of comprehensive DBT?

Accepted Answer

Standard or comprehensive DBT includes four modes of therapy:
 
1. Individual Therapy with a DBT trained therapist.
2. DBT Skills Training – typically done in a group setting; groups should meet weekly and generally last 90 or 120 minutes.
3. Phone Coaching – your DBT therapist should be available to you for between session DBT coaching calls.  These calls are essential to help you use skills you have learned ‘in the moment’ BEFORE you engage in problematic behaviors.
4. DBT Consultation Team – your DBT therapist (not you) is required to participate on a DBT consultation team to improve their clinical skills. Therapists who are not participating on a DBT consultation team are not considered to be providing DBT.

Question 7

Does Dr. Gould provide comprehensive DBT in her practice?

Accepted Answer

No.  While Dr. Gould has had extensive training in DBT (including 10-day intensive training through Behavioral Tech and 5-day advanced intensive training with Dr. Linehan) and experience delivering DBT, she does not provide all the components of standard DBT in her current practice.
 
Dr. Gould routinely uses her knowledge of DBT to help her better understand factors that may be contributing to issues you may be having. Dr. Gould’s experience with DBT also helps her be open to different points of view and look for dialectical solutions to problems.  If you are currently enrolled in DBT, Dr. Gould’s understanding of the treatment model helps her collaborate most effectively with your therapist.  If you are not enrolled in DBT but would benefit from this form of treatment, Dr. Gould can help you find a qualified therapist.

Question 8

What questions can I ask to see if a therapist has adequate training and is providing comprehensive DBT?

Accepted Answer

The following questions may be helpful (the answer to each should be ‘yes’ for comprehensive DBT).  Dr. Gould may also be able to assist you in finding a qualified DBT therapist.
 
Have you completed either DBT certification through Linehan’s Board of Certification, a 10- day Intensive DBT Training OR 5-day Foundational DBT Training?
Are you currently a member of a DBT consultation team?
Do you offer DBT skills classes weekly?
Do you practice Behavior Chain Analysis?
Do you provide Phone Coaching?
Do you use Diary Cards?