(415) 688-4608

Practical Information to Get Started With Therapy

Choosing A Therapist

For many people, finding the right fit with a psychotherapist involves considering the answers to several questions:

  • Do I feel comfortable and have an easy connection with the therapist that will allow me to feel safe opening up?
  • Does the therapist have expertise with the particular concerns I want to work on?
  • How does the therapist see their role in the therapy process?  Does this align with the kind of therapeutic relationship I would feel comfortable with?
  • What are the therapist’s beliefs about how change occurs as a result of psychotherapy?  Do I find this convincing?
  • What approaches does the therapist use? Does that feel like something that would work for me?
  • What distinguishes this therapist from others?
Beginning Therapy

It is very important to find a great fit with your therapist so that you feel safe exploring things that may be difficult to talk about.  I hope the information on this site has been helpful for you in assessing whether I might be a good choice for you.  I’ve also suggested some questions that you can ask yourself as you consider your choice. If you’re ready to take the next step, then I encourage you to schedule a free 15 minute phone consultation with me.

On this call, we’ll talk briefly about what brings you to seek therapy and discuss any questions you have about how we would work together.  If you feel comfortable proceeding after that, then we would schedule your first appointment. Prior to coming to my office for the first time, I will direct you to a couple of forms to fill out to provide some background about you to help me get to know you, and to explain important aspects of treatment.

You may feel anxious or nervous about meeting me or beginning therapy.  From the very start of our work, I will work to create a welcoming, compassionate, and nonjudgmental environment for you to share what’s troubling you. We’ll begin in the first couple of sessions with me asking questions to learn more about what brings you in and to help me get to know you.  It will also be important to make sure that your questions about the therapy process are answered.  At the end of that time, we’ll agree on your goals for treatment and how we will assess progress in meeting them.  After that, we’ll work on your goals. I will likely talk less, and your experience in and out of the therapy room will be the focus of our sessions.

Fees and Insurance

Your initial 15 minute phone consultation is free of charge.

Following that, my fee is $350 for a 45-50 minute session.

There is no charge for sessions canceled with at least 24 hours’ notice.  Late cancellations (less than 24 hours’ notice) are subject to payment in full.

Payment is expected at the time of service and is accepted in the form of cash, check, or credit card.


I do not participate in any health insurance networks, however I am happy to provide you with a superbill statement which you can submit to your insurer for out-of-network coverage.  You may also use Health Savings Account dollars to pay for therapy.  I advise you to research the nature of your benefits for out-of-network coverage before commencing therapy so as to understand what kind of reimbursement you may expect.  Insurers will require an official psychiatric diagnosis before determining coverage of your therapy, which will then become part of your record, and they may also request and review your file, including the progress notes from your therapy sessions.  Not all diagnoses are covered.  Insurers may also limit the number of sessions and the nature of treatment, which may adversely affect the optimal course of therapy.  Some clients choose not to use mental health insurance benefits to avoid these issues.

Notice of Privacy Practices

Hilary Beech, PhD MBA

CA PSY27566



I. MY PLEDGE REGARDING HEALTH INFORMATION: I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:

  • Make sure that protected health information (“PHI”) that identifies you is kept private.

  • Give you this notice of my legal duties and privacy practices with respect to health information.

  • Follow the terms of the notice that is currently in effect.

  • I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU: The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your person health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.

Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.


  1. Psychotherapy Notes. I do keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your Authorization unless the use or disclosure is: a. For my use in treating you. b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy. c. For my use in defending myself in legal proceedings instituted by you. d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA. e. Required by law and the use or disclosure is limited to the requirements of such law. f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes. g. Required by a coroner who is performing duties authorized by law. h. Required to help avert a serious threat to the health and safety of others.

  2. Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI for marketing purposes.

  3. Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course of my business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION. Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:

  1. When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

  2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.

  3. For health oversight activities, including audits and investigations.

  4. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.

  5. For law enforcement purposes, including reporting crimes occurring on my premises.

  6. To coroners or medical examiners, when such individuals are performing duties authorized by law.

  7. For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.

  8. Specialized government functions, including, ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or, helping to ensure the safety of those working within or housed in correctional institutions.

  9. For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.

  10. Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.


  1. Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.


  1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.

  2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

  3. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.

  4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost based fee for doing so.

  5. The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost based fee for each additional request.

  6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.

  7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.


This notice went into effect on 1/1/2021

Notice of Right to Receive a Good Faith Estimate of Expected Charges

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost.

Under the law (No Surprises Act, 2021), health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

•You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

•If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate inwriting within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the healthcare provider or facility gives you a Good Faith Estimate in writing within 3business days after you ask.

•If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.

•Make sure to save a copy or picture of your Good Faith Estimate and the bill.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.

Frequently Asked Questions

Are conversations in therapy confidential?
Trust is a critical factor in successful therapy.  You will likely be sharing very personal things with me in session, perhaps things you have never told anyone or even admitted to yourself.  For clients over 18, everything that we discuss in therapy remains confidential, with a few exceptions.  By law, therapists are required to break confidentiality if what you share indicates that there is a reasonable suspicion of child abuse or elder abuse by you or someone you speak about in session, or that you pose a threat of harm to an identifiable individual.  We may also do so if you pose a danger to yourself unless protective measures are taken.  If you submit a claim to your insurance company, records of your treatment may be requested by the company.  Therapists may also be compelled to testify in a case by court order.  When subpoenaed, the therapist first invokes client-therapist privilege, which you may choose to waive.  If not waived, the judge may choose to order the therapist to testify, despite your invocation of privilege.
How discreet is your setting?

Both my offices are located in mixed-used buildings. Each is in a suite of other psychotherapy offices, with a shared waiting area.

How often will I attend therapy?
Therapy works most effectively when there is consistent attendance.  I typically see clients once a week.  In some cases, I may suggest that you come in more than once a week if you are in crisis or your particular concerns are best addressed through more intensive treatment.
How long are sessions?
Sessions run 45 minutes.  A punctual start to the session is very important to me out of respect for the time and money you are committing to the process.
How long does therapy take?
The length of treatment depends on what brings you to therapy.  Early on, we will work together to clearly articulate your main concerns and identify goals for treatment.  This will allow us to get a sense of how long treatment may take.  Sometimes, clients find that in the course of treatment they deepen their understanding of themselves and uncover areas they feel motivated to continue exploring.  In this case, we may revise the treatment goals and extend treatment.  I have expertise in brief psychotherapy to address a very focused concern in the course of about 10 sessions.  Depending on your needs, this may be an appropriate option, which we can discuss in your free phone consultation.  I believe strongly that therapy should empower you to feel confident in being able to maintain the progress you make in treatment so that you can continue on your own.
How will I know if therapy is working?
We will jointly establish your goals for therapy early on in our work together and determine how to assess progress against these.  We will revisit these periodically.  Often, clients spontaneously share progress they have noticed from week to week, such as reductions in symptoms (e.g. less depressed or anxious) or behaving in new ways that are having positive effects in their lives (e.g. more harmonious relationships, less fear about asserting themselves at work).  In addition, I encourage you to discuss any concerns you may be having with the therapy in session so that we can understand what may be impeding our work.
I’ve had a bad experience with therapy in the past. Why would this be any different?
You may have tried psychotherapy in the past and felt dissatisfied with the experience for a number of reasons.  Most commonly, clients report a poor fit with the therapist, and not feeling a sense of forward motion or seeing change.  I have worked with many individuals in this situation and have been gratified to find that we were able to work effectively together, address what didn’t work in the past, and establish a relationship and process that allowed for progress and change.  There are many different approaches to psychotherapy, and therapists with doctoral credentials (PhD, PsyD) may offer different approaches to those with Master’s level credentials.  Some styles and approaches may not resonate with you so it is important to assess that in choosing a therapist.  I would encourage you to review my suggestions regarding how to consider your fit with a therapist, and to schedule a free 15 minute phone consultation with me to discuss any concerns about past therapy or my way of working.  I feel strongly that psychotherapy can be a very important process for healing and growth and would like you to experience that, particularly if you have been disappointed in the past.
What facilitates good therapy outcomes?
  • Creating a trusting relationship between us, so that you can feel safe exploring vulnerable areas.
  • Understanding that the time needed to heal and grow is variable and will depend on the nature of the challenges you bring to therapy.
  • Establishing a shared view of the main concerns and goals for treatment and then assessing progress against those goals.
  • Being willing to share freely in session, particularly the experience you are having with me in the moment.
  • Attending therapy consistently and talking in session about things that may be making it difficult to come to therapy.
  • Giving yourself the gift of using your therapy time to focus on yourself.