Here you will find information about our practice from treatment philosophy, fees, and cancellation policy.
A Treatment Team Approach
We believe that eating disorders are best treated from a holistic approach. Our clinicians utilize best practice treatment models which include a multidisciplinary approach to recovery. We work closely with medical and clinical professionals in other disciplines that include but are not limited to physicians, psychiatrists, family therapists, speech/physical/occupational therapists, and treatment centers. This approach ensures the safety and well being of our clients, and is also necessary when treating issues as complex as an eating disorder.
Please know that appropriate referrals may be recommended at your assessment or throughout your time at Reedy River Counseling Associates. We may need a medical doctor to clear a client for treatment in the outpatient setting and aid in providing necessary lab work. We are equipped to aid in these referrals and the steps to ensure you receive the complete care that you need.
A Health At Every Size (HAES) Framework of Care
1. Grounding in liberatory frameworks. Health at Every Size® is not a liberatory framework or social justice movement in and of itself, but rather aims to align with other movements in order to further the journey towards liberation for all. We remain committed to the ongoing learning from liberation thought-leaders in Black liberation, fat liberation, crip/disability justice, queer liberation, womanism, intersectional feminism, and many more known and not-yet-known movements working towards the liberation of all people. Without this commitment, our work risks contributing to the oppression of the most marginalized in the pursuit of a false sense of liberation for the few.
2. Patient Bodily Autonomy. While this concept is more readily applied in healthcare settings as a patient’s right to refuse medical procedures, it is less commonly applied to a patient’s right to choose how they proceed with a treatment plan after being provided with all options and informed of known (and unknown) risks and benefits. Most restrictions based on BMI and the pervasive practice of refusing care until some other criteria is met (e.g. weight loss, trying ‘lifestyle’ intervention first, trying a certain treatment before considering other options, etc.) are violations of patient autonomy in most cases. Health at Every Size®-aligned providers honor patient autonomy in the broadest possible way when ethical to do so.
3. Informed Consent. Patients have the right to informed consent. This concept is also common in the current healthcare system, but is not practiced through the lens of liberation for all. Informed consent must include what we don’t know just as much as what we do know. For example, researchers often exclude people in certain BMI ranges from studies on treatment effectiveness, leading to gaps in our medical knowledge. Fatphobic and healthist ideas influence what we believe is the best course of treatment, or even whether or not providers share certain information. Instead, informed consent must be provided without bias and with a focus on patient autonomy.
4. Compassionate Care. Compassionate care for our patients is about developing empathy (not pity) for the huge range of life experiences that influences an individual’s health status and their relationship to health and the healthcare system. Health at Every Size®-aligned providers seek out stories different from our own to broaden our understanding of the world and the diversity of experiences it contains so that care is provided through the ever-expanding lens of compassion for our patients.
5. Critical analysis, application, and execution of research & medical recommendations related to weight. Anti-fat bias has played a profound role in shaping the medical research and recommendations widely used in today’s healthcare system. One of the main roots of the current Health at Every Size® community was a group of fat activists known collectively as the Fat Underground who began questioning their healthcare experiences and the advice they received from healthcare professionals. They discovered the research on health and weight was not aligned with the recommendations from their healthcare professionals. The issues they brought to light persist today, and in many cases have worsened. Providers must consider the way weight bias has influenced the research design and interpretation of studies underlying their training, clinical recommendations, and policy that impacts fat people.
6. Skills and equipment to provide compassionate and comprehensive care for fat people’s bodies. Developing empathy for others is only one part of providing compassionate care. Providers must also develop the skills to provide care in compassionate and comprehensive ways and provide equipment designed for the full range of fat bodies. From learning appropriate ways to handle asking for a weight to physical exams on larger bodies to skills for administering various treatments on larger bodies, providers must learn what is necessary for Health at Every Size®-aligned care that their training did not cover.
7. Provider Roles and Responsibilities. Health at Every Size®-aligned providers apply ethical and liberatory frameworks to understanding their roles and responsibilities when providing care. This is especially important when the current medical system is set up so that providers hold the keys to accessing many forms of care. Additionally, Health at Every Size®-aligned providers have an ethical framework to guide them in understanding how they will support patients in ways that support harm reduction in a weight biased world.
8. Tools that support wellbeing and healing without contributing to oppression. Health at Every Size®-aligned providers are equipped with tools that support patient health goals without the pursuit of weight loss. This includes relearning tools co-opted by the weight loss industry like nutrition and physical activity, as well as learning the tools to help our patients reframe their relationship with food and movement in alignment with their values. Health at Every Size®-aligned providers learn about and offer treatments for various health conditions that don’t rely on weight loss.
9. Addressing Your Anti-Fat Bias. Providers must examine their internalized and externalized biases related to weight, including fat providers. Everyone holds biases, and addressing our beliefs, attitudes, and practices that may be rooted in bias is critical for making space for a Health at Every Size®-aligned practice.
10. Addressing Systemic Anti-Fat Bias. Health at Every Size® Providers are committed to the ongoing work of addressing systemic anti-fat bias. From our colleagues to workplace and government policy, we must be committed to abolishing the BMI, dismantling the Medical Industrial Complex, and creating the conditions for care of all people to be fully realized.
First Appointment
The first appointment is an initial therapy and/or nutrition assessment where we consider all medical and mental health history. In order to receive our services, we require you to sign our intake paperwork before the start of your first appointment. These forms will be sent to you electronically through our HIPPA-compliant electronic health record system (Healthie).
If you are seeking services for an eating or feeding disorder, we will ask for a consent to speak to your primary care physician/family doctor. In certain cases, we may require you to get a preliminary set of lab work immediately, as eating disorders come with many medical complications and can be life threatening. Your provider will let you know their clinical recommendation as far as frequency of therapy needed and if your level of disordered eating can be managed at the outpatient level of care. This is not definitive and may be subject to change at a later appointment date. We follow the American Psychiatric Association Level of Care Guidelines for Eating Disorders. An explanation of those guidelines can be found here.
The comprehensive initial assessment is 1 hour in length for adults and 2 hours in length for adolescents. We believe in a family-based treatment approach for adolescents and that recovery from an eating disorder is most possible when the entire family is involved. We understand that this is a financial and time investment for the whole family, but we believe this length of assessment gives us the greatest opportunity to create a treatment and action plan to best meet our client and family’s needs. The length of the adolescent assessment will allow time for both client and parents (guardian or loved one) to spend with the clinician.
Subsequent Sessions
Subsequent sessions are typically scheduled for 50 minute increments. At your initial assessment your provider will discuss with you what frequency of services would be appropriate and helpful. This can range from weekly to monthly, on average.
Fees
Initial assessment (1 hour): $175
Initial adolescent (usually 17 and under) assessment (2 hours): $300
Subsequent sessions (50 minutes): $135
Parent/Loved One Consultation (1 hour): $150
Payment for services is expected on the date of service. We do not offer payment plans. Failure to pay for services in a timely manner could result in late fees. We accept debit, credit, HSA, and FSA cards. Your card(s) information is kept securely in our HIPPA-compliant electronic health record system, Healthie.
Financial Assistance
We believe everyone deserves access to compassionate, high-quality care, regardless of financial circumstances. While we are not currently in-network with insurance providers, we are committed to reducing barriers wherever possible. If someone in our community would benefit from using a reduced fee to access services, we encourage them to connect with our office assistant at office@reedyrivercounseling.com to explore available options.
Insurance
We are not in-network with any insurance providers nor do we assist with filing insurance claims. We can provide you with a suitable receipt called a superbill for you to submit to your insurance company. Not all services are covered by all insurance policies. Some companies select certain services that they will not cover. Please contact your insurance company directly for further information regarding your specific coverage.
We know insurance coverage can be confusing and frustrating. Insurance navigation guides are available for free from Project Heal. Also, the National Eating Disorder Association (NEDA) has resources on insurance and legal issues.
The International Federation of Eating Disorder Dietitians (IFEDD) has a free step-by-step tool for helping you draft an appeal letter to your insurance. Visit the site here for more information.
Specifically for nutrition services, please check both your medical and mental/behavioral health benefits. Depending on your insurance plan, it is possible to receive reimbursement from either department for "medical nutrition therapy".
Cancellation / No-Show Policy
A cancelled or no-show appointment affects 3 people: you, your clinician, and another client who could have potentially utilized your time slot. Appointments are scheduled in advance and are a time reserved exclusively for our clients. We see a limited number of clients so we can give you the focus and attention you deserve. When a session is cancelled without adequate notice, we are unable to fill this time slot by offering it to another current client, a client on the wait-list, or a client with a clinical emergency.
In order to provide the highest level of care possible to our clients, we require 48 hours advanced notice to cancel or reschedule an appointment. If you no-show or do not cancel within 48 hours advanced notice, you will be charged the full session fee which is not reimbursable by insurance. A credit card is required to be kept on file and will be charged in the event of a no-show or late cancellation. Your clinician reserves the right to charge the card on file for no-shows or late cancellations.
You can cancel your appointment by calling, emailing, or sending a secure messaging through Healthie to your specific clinician. Weekends and holidays are not considered within 48 hours notice as voicemails and emails are not checked due to the office being closed. Our office is closed on the following holidays: New Year's Day, MLK, Memorial Day, July 4th, Labor Day, Thanksgiving Day, Day after Thanksgiving (Black Friday), December 24-26, and New Year's Eve.
Additionally, please understand that your therapy and/or nutrition appointments should be viewed as important as any other medical appointment would be viewed. While a medical doctor can see 35 patients in a day, clinicians like us generally see a maximum of 6 or 7. We reserve for you, and all our clients, a full hour of our time for the session and clinical notes. If a client cancels with less than a full 48-hour notice, we likely won’t be able to fill that time slot, and we’ll lose an entire hour from our work schedule.
While appointments are a time commitment, this is for your personal betterment and consistency is key in order to achieve this. That being said, two consecutive missed appointments without first reaching out to the clinician, attempting to reschedule, or otherwise indicating clear commitment to treatment, can result in termination of the therapeutic relationship. Cancellations, lateness, frequent rescheduling, and missed appointments can be detrimental to the therapeutic process. The work of therapy is sometimes challenging and when we start approaching difficult topics it can feel easier to want to avoid coming in for treatment. We would prefer we speak about this in session rather than you canceling sessions.