Kathleen Kawamura, PhD Clinical Psychologist
Kathleen Kawamura, PhDClinical Psychologist 

Office Information

ADDRESS:

  • Carlsbad Office - 3150 El Camino Real, Suite C; Carlsbad, CA 92008
    • Suite C is a space shared by several therapists who practice indepedently. Once in the waiting room, look to the left and there will be a call button with my name on it. Press the button and that will let me know you are waiting.
  • San Marcos Office - 100 East San Marcos Blvd, Suite #404; San Marcos, CA 92069
    • The 4th floor of the Gateway Building is shared by various professionals in independent practice. There is a receptionist as you exit the elevator. Let her know you are there to see me, and I will come out to meet you.
    • After 5pm, there is no receptionist, so please take a seat in the waiting area outside of the elevators and I will come out at our scheduled time.  

 

PHONE: (760) 295-3988

  • Please call for a free phone consultation. I will do my best to return your call within two business days. Please do NOT send text messages to this number. This phone number is a landline and thus is NOT equipped to receive SMS (normal mobile phone text messages). Any text messages sent via SMS will NOT be received on my phone. 

 

TEXT MESSAGING:

  • You can message me regarding quick administrative issues such as changing appointment times via the Signal Private Messenger app at (760) 295-3988. Signal is a free, open source, and secure alternative to standard texting that works on a smartphone.  

 

E-MAIL: Kathy@DrKathyK.com

  • Internet is not a secure or confidential medium. Therefore, do not send by email any information which you consider confidential. Email communication will have to be restricted to matters related to scheduling, and all other communication regarding clinical matters should be done over the telephone or in person. 

 

EMERGENCY PROCEDURES:

  • If you have a medical or psychiatric emergency, please call 911, your local hospital emergency room such as the Tri-City Emergency Room at (760) 940-3505, or the San Diego Crisis Line at (888) 724-7240. 
  • As a rule, I do not keep emergency hours and my concern is that messages regarding urgent matters may end up reaching me later than would be desired or, in rare cases, not at all. I understand some clients may need more availability than I offer, so please consider this limitation when searching for a therapist that best meets your needs.

 

OFFICE POLICIES AND INFORMATION

 

APPOINTMENTS/HOURS: Mondays - San Marcos; Wednesdays and Fridays - Carlsbad

 

FEES: $180 per 60-minute session of individual psychotherapy or $220 per 90-minute session of individual psychotherapy.

  • If you are suffering from an anxiety disorder and are in need of financial assistance, please inquire about my sliding scale fees.
  • My fees include the many handouts, worksheets, and readings that I have prepared in advance for you to continue the therapy process at home. The fees also include 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 leading to improvements for many clients during this time. 
  • For the full treatment of moderate levels of anxiety, most cognitive behavioral treatments for anxiety disorders suggest 10-20 sessions, and I find that this is also reflected in my practice though 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.   
  • Lectures and speaking engagements are charged at $40 for each 15-minute increment, similar to the fee for therapy. However, I do offer many lectures free of cost. Contact me for more details.

 

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. 

 

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.

 

INSURANCE 

  • I do not serve on the panels of managed care companies which means that you will be responsible for paying all fees in full at the end of each session. With self-pay, you can be assured that you are getting the best available treatment without restrictions and based on your needs and desires.
  • If you prefer to use your insurance benefits, I will provide you with documentation that can be submitted to your insurance company as you may be able to receive some reimbursement with me as an out-of-network provider. 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, I will maintain as much discretion and confidentiality as is possible.   

 

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

  • 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. 

 

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, with an out-of-network provider, an insurance company may pay 80% of $100 (or whatever amount they set) but because my fee is $180, this means the cost to the client is still about $100. The savings of $80 can be significant for some, while others feel it is not worth using insurance for this purpose.