How do I choose my Therapist or Coach:

Choosing a therapist is an important task. There are many excellent mental health professionals available in Greater Saint Louis and other metro areas with lots of differences between them---as in most professions. Here are tips to facilitate your choice.  Check out each tip and identify your priorities, values, needs, and preferences to build a profile of your best match. Here are7 tips for you:

1. Recommendations from Trusted Others 

Read more

2.     Education/Degree Level-Highest to Lowest 

Read more

3.     Professional License 

There are five mental health licenses available in Missouri.* Providers in each field meet licensing qualifications set by state statute involving degree, curriculum, experience, and internships**. If you think you might need prescription medication, note that not all licensed mental health providers are licensed to conduct a medication evaluation or issue a prescription.*** When the therapist you choose does not prescribe, you can ask your Primary Care Physician (PCP) or visit another provider (for one example, a psychiatrist) to handle the medication portion of your therapy. {The list below refers to Missouri. Other states have the same or similar titles (and potentially additional ones) for their licenses.}


Marriage and Family Therapist- LMFT



Social Worker-LCSW

* You can check your state licensing board for the licenses available in your area. . 

*** Check your licensing board to learn what professions in your state are licensed to prescribe medication in addition to physicians. 

Read more

4.     Length of Experience/Professional Membership 

Read more

5.     Specialties 

Read more

6. Personal Fit

Read more

7. Financial Aspects

Private practice mental health providers vary in the business models they choose sliding scale, managed care, in-network managed care insurance contracts, out-of-network benefits, private pay, packages of services at negotiated rates, and other variations. 

Use of managed care insurance

Many beginning therapists along with expert and experienced mental health professionals choose a business model of contracting with managed care insurance companies. This approach might be a financial bargain for you. Lists of in-network providers may be a time saving way to locate a qualified provider in your insurance.

 But considering only  in-network  providers may not include the best fit therapist for YOUR needs.  

How might you benefit from a private pay model?

Consider dedicating out-of-pocket funds to your mental health and well-being---which does not necessarily "cost" more. Consideration/selection of an out-of-network or private pay therapist can deliver unexpected dividends such as expanded choices, more specialists, no insurance hassle, greater geographic accessibility and possibly a better fit with your therapist which may enrich or expedite your success. 

This business model give you more privacy for your  therapy and  records. Without insurance reimbursement, less information is shared and your therapy records "travel less". Your  “diagnosis” is not required to be shared with managed care/insurance to justify payment of benefits. 

Many expert and experienced mental health professionals have  never accepted or have left managed care and choosing a private pay business model.  If your budget permits and you have discretionary funds for expenses such as  a trainer, yoga instructor, weekly salon visits, high end travel, and such, allow yourself  the possibility of searching from a full list of providers.  Consider not limiting your options to providers who are on the “in-network” list provided by your insurance carrier. 

Investigate and cover all the bases by researching any out-of-network insurance benefits you may have.  Evaluate whether that well-qualified “in-network” therapist you are about to schedule can help you accomplish your goals as well as the well-qualified "out-of-network"/private-pay specialist with whom you sense you have the best fit.

How do providers benefit from a private pay business model?

When mental health providers do not join or opt out of managed care contracts and adopt a “private pay model”, they  safeguard the sustainability of their professional practice. They become less financially vulnerable because, with managed care contracts, providers must accept both the lack of control over business expenses which steadily rise and the lack of control over reimbursement rates which remain flat. The managed care contractual fee schedule is generally standardized, non-negotiable, and typically does not offer a cost of living allowance (COLA) Providers have no voice. 

Additionally, managed care companies have not increased reimbursement for the "added value” of services to clients from  providers with expert specialties/training nor those with extensive years of professional experience and time of service in their own managed care contract network system. Private pay professionals with expertise and lengthy experience may be a “bargain” considering all the factors of choice

What is Dr. Patt’s Policy?

STLEQ and Dr. Patt changed business models and discontinued all managed care company contracts after 25 years of participation. STLEQ adopted a private pay model with the option lower cost pre-paid service bundle  packages for therapy. This business decision was made because of the unfairness of the managed care system and the negative impact that managed care contracts imposed on financial stability and growth of business.

We know that a number of our therapy clients have health insurance  and may prefer to use it. We keep our qualifications up-to-date and have an active listing on the National Provider Index (NPI). This step potentially helps our clients who want to try to utilize their out-of-network benefits for insurance coverage of our counseling services To stay on this list with her NPI number, Dr. Patt  quarterly documents credentials. Your insurance company can go to identify through this nationally recognized resource to verify eligibility of services for coverage. Dr. Patt’s NPI# is 1427 1251 03.

What else might I consider ?      

As financially feasible, consider  re-evaluating  any “economic value mind set” (you may have) that “if my insurance doesn’t pay for his/her services, I shouldn’t go there.”  Ask yourself whether you should shift your budget. Don’t you deserve your top choice for your mental health and well-being? Consider what you may spend  for other optional personal services such as hair care, fitness training, massage, nail salon, and recreational expenses. How does your mental health and wellness stack up as a priority?

NOTE: Here is an additional consideration some may feel important when choosing a mental health provider. When you choose an in-network provider and/or utilize your health insurance benefits coverage for counseling/therapy, you create a medical record for yourself of a mental health diagnosis from the Diagnostic and Statistical Manual of Mental Disorders that the therapist must provide to the insurance. Private Pay treatment does not require does not involve sending a mental health diagnosis anywhere. Decide whether this privacy and control of your records matters to you.

Do I get what I pay for when I pay out-of-pocket for therapy? 

Only you can decide.

With due respect to and an exception for the highly experienced and skilled providers who  continue to participate in managed care contracts (some of whom are my esteemed colleagues), you may "get what you pay for" (or less) when you have limited options of providers when you use managed care for mental health services. In-network provider contracts are also frequently the starting point for licensed providers who are beginning their practices to get established. 

There are distinct reasons clients self-pay for  professional services. You will recognize if any apply to you personally.

  • Some clients with insurance self-pay because they want to preserve their privacy. They prefer not to have a mental health service on their medical records with the required mental health diagnosis. This is the choice of a number of people who consider themselves in “sensitive” positions—personal or employment.
  • Others are unable to find skilled, highly qualified, and well- experienced providers listed in their insurance networks who meet their needs and with whom they feel they have a “fit”. They make it a priority to use discretionary funds for their important mental health and wellness needs. Instead of spending those dollars elsewhere, clients choose Dr. Patt’s professional services and self-pay.
  •  Clients who research many therapists before selecting one, often find that great credentials, lengthy experience, and unique approach to be “just-the-right fit” for them. The question of insurance reimbursement becomes a secondary concern or not a consideration at all. High quality professionalism and that “fit” are their top criteria to take care of their mental health and wellness needs.

In addition, Dr. Patt feels honored that her clients, family, friends, and colleagues often refer their family, friends, and co-workers to her for counseling services. The strength of their referrals makes insurance reimbursement a “non-issue” for those they refer to Dr. Patt.

Why do clients pay out-of-pocket for Dr. Patt’s services?

Many former clients who came to Dr. Patt and paid only a co-pay when she was an in-network managed care insurance contractor returned for her services. They self-pay and  explain why they do. Paraphrasing, here are the frequent reasons offered: **

  • We have a great fit.
  • Many counselors I tried  in my insurance seldom talked much. They only listened and asked how I felt.
  • I found that you often get what you pay for.
  • I learned more from Dr. Patt in one session than I did from others in many visits.
  • Dr. Patt helped me think of things in ways I never had before.
  • When Dr. Patt dropped managed care insurance, I stopped coming to her because I wanted to save money. I saw several providers in my insurance plan  for my $25 co-pay but did not accomplish anything with them.  I am back to see her. Dr. Patt is worth the money.
  • Dr. Patt is sensitive, funny, and gets right to the point

 ** Past results are not a guarantee of future results.

Read more

Have questions? Call me at 314-250-8114 OR 877-447 -3262 for a 10-minute phone consult for answers about our "fit".

What else can I do to decide? 

Read more

Get the therapy ball rolling. You deserve to be your best and happy self!

How can therapy help me?

Read more

I can usually handle my problems. Do I really need therapy?  

Read more

Why do people go to therapy and how do I know if it is right for me?

People have many different motivations for coming to therapy.   Some may be going through a major life transition (unemployment, divorce, new job, etc.), or are not handling stressful circumstances well.  Some people need assistance managing a range of other issues such as low self-esteem, depression, anxiety, addictions, relationship problems, spiritual conflicts, and creative blocks.  

Therapy can help provide some much needed encouragement and help with skills to get them through these periods.  Others may be at a point where they are ready to learn more about themselves or want to be more effective with their goals in life.   In short, people seeking psychotherapy are ready to meet the challenges in their lives and ready to make changes in their lives. 

Read more

What is therapy like?

Read more

Does what we talk about in therapy remain confidential?

Confidentiality is one of the most important components between a client and therapist/counselor. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office.   Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone.  This is called “Informed Consent”.  Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your Physician, Naturopath, Attorney), but by law your therapist cannot release this information without obtaining your written permission.

However, state law and professional ethics require therapists to maintain confidentiality except for the following situations:

* Suspected past or present abuse or neglect of children, adults, and elders to the authorities, including Child Protection and law enforcement, 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 themselves or has threated to harm another person.

Read more

Contact Me Today



In Person Appointments are limited. All appointments are reserved & subject to our cancellation policy fees. Please inquire.


By Appointment Only


By Appointment Only


By Appointment Only


By Appointment Only


By Appointment Only





#adult coloring #relationship quotes #couples workbook #nongender