Kathleen Kawamura, PhD Clinical Psychologist
Kathleen Kawamura, PhDClinical Psychologist

CONTACT INFORMATION

 

ADDRESS: Carlsbad, CA

 

DIRECTIONS

 

APPOINTMENTS/HOURS: ***I am no longer taking clients at this time.***   

 

PHONE: (949) 422-7185

 

Please call for a free phone consultation. I will do my best to return your call within two business days. If I am unable to reach you, I will only identify myself as "Kathy" in the message in an attempt to maintain your privacy as much as possible. If this is not preferable, please leave instructions on my voicemail regarding leaving messages.

 

Please do not use SMS (mobile phone text messaging) or messaging on Social Networking sites such as Twitter, Facebook, or LinkedIn to contact me. These sites are not secure, and I may not read these messages in a timely fashion. Quick administrative issues such as changing appointment times may be done via text so long as there is an understanding that this is NOT a secure or confidential medium.

 

E-MAIL: Kathy@DrKathyK.com
 

Internet is not a secure or confidential medium, and therefore e-mail communication will have to be restricted to matters related to scheduling. All other communication regarding clinical matters should be done over the telephone or in person as emails are retained in logs of your and my Internet service providers. Although it is highly unlikely, the content of your emails are available to be read by your Internet service provider and their system administrators. You should also know that any emails I receive from you and any responses that I send to you become a part of your medical and legal records.

 

EMERGENCY PROCEDURES: If you have a medical or psychiatric emergency, please call 911 or your local hospital emergency room instead of my phone service. As a rule, I  do not keep emergency hours. I understand that some clients may need more availability than I can offer, so please consider this limitation when searching for a therapist that best meets your needs.

 

OFFICE POLICIES AND INFORMATION

 

FEES:

 

$160 per 50-minute session of individual psychotherapy

$200 per 80-minute session of individual psychotherapy.

 

This fee includes the many handouts, worksheets, and readings that I have prepared in advance for you to continue the therapy process at home. This fee also includes the time I spend between sessions to prepare materials and content to facilitate treatment and reduce the number of necessary sessions.

 

My approach tends to be short-term and time-limited, with much of the information about anxiety and treatment strategies provided in the first 6-8 sessions and with many clients seeing improvements in their stress and anxiety. Most cognitive behavioral treatments for anxiety disorders suggest 10-20 sessions for the full treatment of moderate levels of anxiety, but this number can vary depending on severity of anxiety, years with anxiety disorder, life situation, trauma history, and how well cognitive behavioral therapy matches your goals and learning style. When comparing costs of treatment, keep in mind that some talk therapies can go on weekly for months, if not years, with limited information and materials, which may not be ideal for those suffering from an anxiety disorder.   

 

Some sessions may require additional time, especially if we are working through situations that elicit anxiety. In these cases, additional time will be charged at a rate of $40 for each additional 0-30 minute increment. 

 

I have time slots reserved for those in need of financial assistance. If you are suffering from an anxiety disorder and would benefit from the cognitive behavioral treatment of anxiety, we can discuss a reduced fee on a sliding scale.

 

Any other professional services you need, including report writing, telephone conversations lasting longer than 10 minutes, preparation of treatment summaries, or time spent performing any other service you may request are charged $45 for each 15-minute increment, similar to the fee for therapy. Lectures and speaking engagements also operate on a similar fee schedule. However, I do offer many lectures free of cost. Contact me for more details.   

 

INSURANCE:  I do not serve on the panels of managed care companies. With self-pay, you can be assured that you are getting the best available treatment without restrictions and based on your needs and desires. See bottom of page for a more thorough explanation of self-pay vs. insurance.

 

If you prefer to use your insurance benefits, I will provide you with a standard receipt and form that can be submitted to your insurance company. If you choose this option, know that your insurance company will determine whether to reimburse you or not and will likely request personal information about our therapy sessions to determine your reimbursement. If this occurs, know that I will maintain as much discretion and confidentiality as is possible.   

 

If you are going to use your health insurance, call them and ask (there may be a separate phone number for mental health or behavioral health):
 

  • Do they pay for mental health services? Do they pay for the services of a clinical psychologist?  
  • Do they cover out-of-network providers?  And if so, what is the reimbursement rate (amount insurance pays per visit) for an out-of-network provider (vs in-network)? What is the co-pay?
  • Is the coverage for parity and non-parity diagnoses the same? If not, how do they differ (OCD, Panic, and Major Depression are considered parity diagnoses and are covered similarly to medical illnesses whereas other anxiety disorders may not be covered in the same way)?
  • What is the deductible and of the out-of-pocket maximum? How much has already been met?
  • What is the maximum number of visits per calendar year?  Maximum amount paid per calendar year?
  • Is authorization required? Are there any other limitations or exclusions for my coverage?

 

Negotiating payment and insurance can be a confusing process, especially for someone in the middle of a crisis, so if at any time this information becomes too overwhelming, just give me a call as I have helped many previous clients through this process. 

 

CANCELLATION POLICIES: Appointments are made to reserve a specific time slot for you, and therefore, a minimum of 24 hours notice is required for rescheduling or canceling an appointment. A cancellation fee of $50 will be charged for sessions missed or rescheduled without sufficient notification. Most insurance companies will not reimburse for missed sessions.

 

Reasons to not be on a managed care panel:

 

Limitations on length of treatment and type of treatment            Treatment is only authorized by insurance companies if a reviewer determines that the treatment conforms to the policies set by the company. This reviewer assesses the severity of your problem, your motivation for treatment, and whether treatment is necessary, and then determines whether you will be reimbursed. This reviewer need not have any mental health experience despite being responsible for making these very important decisions about your treatment. In addition, managed care companies encourage very brief treatment and favor the use of medication over psychotherapy. 

Choosing your own therapist
  Self-pay and out-of-network benefits allow you to choose a therapist that has the qualities and qualifications you are looking for.
Privacy issues  


To justify treatment and determine reimbursement, insurance companies will require disclosure of information about a client's most dysfunctional behaviors. Treatment plans, progress notes, and a diagnosis may be required. Oftentimes, this information is put into a data bank and it is not always clear who has access to the information (some employers have been able to access information from their employees' insurance companies), how this information is protected, and how this may affect the client's future abilities to acquire insurance coverage in the future (health insurance, life insurance, disability).  

 

Managed care is a business  


Managed care companies will often make treatment decisions based on cost rather than the needs of the clients. Being a business, managed care companies also use profits for advertisements, executive salaries, political lobbying, and shareholders.

 

Labeling sickness  


Managed care companies often require treatment to be "medically necessary" for it to be covered. This means that a psychiatric diagnosis is required regardless of your reason for seeking therapy. Many clients come to therapy for issues such as self-growth, stress-management, or habit change, which are issues that may not warrant a psychiatric diagnosis. 

 


Cost-benefit analysis
 


All health insurance providers will be different but with in-network providers, insurance companies typically cover 80% of the fee set by the managed care company, which usually mean a cost of about $10-20 for the client. Thus, an in-network provider is the most cost efficient choice. I am not on any insurance panels, and thus, am not an in-network provider for any insurance. If a client sees a therapist who is an out-of-network provider, the insurance company usually covers the same 80% of the fee set by the managed care company, but because the therapist may charge more than that set fee, the client is left having to pay the difference. Thus, as an out-of-network provider, an insurance company may pay 80% of $100 (or whatever amount they set) but because my fee is $185, this means a cost to the client of about $105. The savings of $80 can be significant for some, while others feel it is not worth using insurance for this purpose. 

 

CONFIDENTIALITY           

Confidentiality is the cornerstone of mental health treatment and is protected by the law. I can only release information about our work to others with your written permission. Some basic information about diagnosis and treatment may be required as a condition of your insurance coverage. In addition, I may occasionally find it helpful to consult with other professionals. In these circumstances, I will make every effort to avoid revealing the identity of my client. The consultant is also legally bound to keep the information confidential.

 

Exceptions to confidentiality where disclosure is required by law:

 

  • if there is threat of serious bodily harm others, I am required to take protective actions, which may include notifying the potential victim, notifying the police, or seeking appropriate hospitalization.
  • If there is threat to harm yourself, I am required to seek hospitalization for you, or to contact family members or others who can help provide protection.
  • If there is an indication of abuse to a child, an elderly person, or a disabled person, even if it is about a party other than yourself, I must file a report with the appropriate state agency.
  • If you are involved in judicial proceedings, you have the right to prevent me from providing any information about your treatment. However, in some circumstances in which your emotional condition is an important element, a judge may require my testimony.
  • If due to mental illness, you are unable to meet your basic needs, such as clothing, food, and shelter, I may have to disclose information in order to access services to provide for your basic needs.


These situations have rarely arisen in my clinical practice, but should such a situation occur, I will make every effort to fully discuss it with you before taking any action.

PRACTICE STATUS

I work in an office with a group of independent mental health professionals. While the practitioners share an office space, I am completely independent in providing you with clinical services, and I alone am fully responsible for those services. My professional records are separately maintained and no member of the group can have access to them without your specific, written permission.