~ At my office:
For new clients, my fee is $120 per hour for individuals and $150 for couples.
           
If you cannot pay this amount, let me know and we may be able to negotiate a fee that you can afford.
           
A free half-hour telephone consultation prior to the first in-person session is available when you schedule your first appointment.

~ At your home or office:
If you are unable to travel to my office and need sessions at your own home or office, the fee is $200 for locations within San Francisco, and $250 in Marin County.

If you cannot pay this amount, let me know and we may be able to negotiate a fee that you can afford.

A higher fee is necessary for visits to your home or office to cover my travel time. Certain conditions apply for home visits which we will discuss when you call to schedule an appointment.

Phone & Email Communication

~ Telephone Communication
My voicemail is confidential. You can always leave a personal message for me and I will respond within 24 hours.

Clients who are out of town at the time of their usual appointments can have telephone therapy sessions with me.

For phone therapy sessions, you must be an established client who has attended at least 3 sessions in-person and must continue to attend in-person sessions at least once a month.

Regular in-person contact is necessary for me to maintain awareness of your facial expressions and body language, and for me to communicate with you using eye contact and nonverbal communication.

~ Email Communication
Email may be used to inquire about my services, to schedule or cancel appointments, and to communicate with me between in-person sessions. Established patients who want to use email between sessions must sign a consent form that outlines the risks of using email to discuss personal information.

I do not provide email-only psychotherapy. This policy is based on the fact that without visual and audio communication cues, it is difficult to accurately interpret the meaning and significance of email messages. The benefits of using email are outweighed by the potential for unintentional misunderstandings and the risk of harm if we never meet face-to-face.

Business Policies

~ Financial Expectations
Clients are expected to pay for each session at the time it occurs. Cash or checks are accepted. At this time, I do not take credit cards. Please notify me if any problems arise regarding your ability to make timely payments. If you prefer to receive a monthly invoice, I am willing to bill you after you have established a history of paying bills on time.

~ Insurance Coverage:
I currently accept the following insurance plans: Aetna, Blue Shield, Corphealth, Coventry, First Health, Integrated Health Plan, Magellan, Medicare, PHCS. However, changes may occur at any time and I cannot guarantee that I will be able to accept your insurance.

If you have a PPO plan with a different insurance company, you may have benefits that cover my services as an out-of-network provider. You may also be able to get a few sessions covered by your company's Employee Assistance Program (EAP).

If you want to use insurance to pay for fees, tell me when you first contact me to schedule an appointment so that I can verify coverage, follow authorization rules, identify copays, etc. Each plan or program has different procedures that must be followed.

Having insurance is not a guarantee that your sessions will be paid for by the company. Mental health services are not always covered. If the insurance company does not cover the fees, the client is responsible for payment.

Be aware that using insurance to pay for services involves certain restrictions that you must be willing to accept:

1. The company may only pay if you have a serious mental illness or have particular diagnoses. I cannot give you a diagnosis that is not true just to get it covered by the insurance company.

2. Diagnoses and personal information required by the insurance company may become part of your medical record and may influence your ability to obtain insurance in the future.

3. There is often a strict limit on the number of sessions you are allowed.

4. The company may stop paying for services before you are ready to stop therapy and despite Dr. Diamond's recommendations to continue.

5. You will have to pay for additional sessions out of pocket if you want to continue therapy after the company stops payments.

6. The company will require me to submit personal information about you in order to obtain payment for services.

7. Once your personal information is released to the insurance company or human resources department, I have no control over who sees those records and cannot be held liable for breaches of confidentiality that may occur after such release.

~ Time Management:
Consultations and therapy sessions will generally start and end within 5-10 minutes of your scheduled appointment. This means that you are expected to show up on time. If you are going to be delayed, you are expected to call and give me your estimated time of arrival. If you cannot show up within a reasonable amount of time, your appointment will be re-scheduled.

The benefits of the somewhat strict time management system are that you can rely upon seeing me at the scheduled time without much waiting. You can then make plans for the rest of your day because you know how much time is involved. This system is better than seeing a physician for medical appointments, which typically involve an unpredictable amount of time and a lot of waiting around, which can put your entire day in limbo.

~ Cancellations:
When you schedule an appointment, that time is reserved for you. If you must cancel an appointment and reschedule, you are required to give a minimum of 24 hours notice. 50% of your fee will be charged for missed sessions without such notification.

~ Confidentiality:
Personal information disclosed in consultations and therapy sessions is confidential and will not be revealed without written permission except when disclosure is required by law. Disclosure may be required in the following circumstances: When there is reasonable suspicion of abuse of children or elders; when there is reasonable suspicion that the client is at risk of harming themselves or others; and when ordered to do so by a court in the context of a legal proceeding.

~ Why is it so expensive?
In addition to the time in session with you, my fee also covers time spent in between sessions doing the following work: writing notes to remember important details about you, doing research to find other resources you may need, reviewing notes before your session, tracking your progress, preparing needed paperwork, and most importantly, time thinking about you and figuring out how to best help you. My flat fee also includes all government taxes.

~ Why is it a good idea to select a psychologist who is licensed?
A licensed psychologist is the mental health professional with the most knowledge and experience. A licensed psychologist (a Ph.D. or Psy.D.) is the only professional who is legally allowed to do psychological testing (for example, to measure learning abilities) or neuropsychological assessment (for instance, to evaluate traumatic brain injury or dementia). We have to meet the highest standards and prove that we are proficient and skilled by passing two extremely difficult license exams, each lasting 3-4 hours. To earn the right to take the license exams, we must first earn a Master's degree and a Ph.D. or a Psy.D. Doctorate degree. Then we must work for 3000 hours (at least 2 years) with patients/clients under the supervision of another licensed psychologist, and get written approval of that work. Once we have documented those achievements and proved we have passed certain critical courses, we are eligible to take the license exams.

The first license exam is a national test given to psychologists all over the USA. To earn the right to take the license exams, we must first earn a Ph.D. or a Psy.D. doctorate degree. The national exam covers everything you can possibly imagine about psychology, including brain anatomy, psychopharmacology, child and adult development, how to diagnose every type of symptom, risks and possible benefits of different types of psychotherapy, assessment and testing, ethical behavior, client's legal rights, informed consent, confidentiality, etc.

The second license exam is the California test. This exam covers many of the same topics, with particular emphasis on laws that are specific to California, and on emergency situations where you need to use critical thinking and good judgment.

In addition, a licensed psychologist must take at least 36 hours of continuing education courses every two years. This requirement ensures that our knowledge remains up-to-date and is periodically refreshed. Ethical and legal courses must be taken every two years.

A licensed psychologist is registered with the State of California and our licenses can be revoked if we do not meet ethical or legal standards of care, or if there is confirmed evidence of abuse, mistreatment, or malpractice. Complaints about licensed psychologists are investigated by the California Board of Psychology. If you have a complaint about a licensed psychologist, you can report it to the Consumer Affairs Department at the Board of Psychology. For contact information, see the Links section on this website.

~ Are all licensed psychologists the same?
No. Each licensed psychologist has received similar basic training. However, each individual has their own personality style, special interests, and areas of expertise. Each has a particular therapeutic orientation or perspective, and uses specific types of therapeutic approaches.

Research shows that the key to successful therapy is the right match of therapist and client. Each licensed psychologist is suited for certain types of people or certain types of issues. Each client has preferences, styles, and goals that must be taken into consideration. Discussion of the key factors in the beginning can make a big difference in the outcome.

I am keenly aware of the critical elements in matching therapist to client. I only work with people who I believe I am suited to help. I know my limits and work within them. I maintain an extensive network of other professionals who I believe are excellent and have a variety of styles and areas of expertise. When appropriate, I will make referrals and will explain why I think that someone else would be a better match for you.

~ I'm confused by all the different degrees and titles. What are the differences between a Ph.D., a Psy.D., an M.D., an M.F.T., and an L.C.S.W.?
There are many people offering mental health services and the distinctions between them can be confusing. Let me describe each one.

A Ph.D. is a doctorate degree.This is the highest degree that can be obtained in the field of psychology. A person who has earned a Ph.D. in Psychology has studied everything related to the field. This includes brain anatomy, biochemistry and physiology, psychopharmacology, testing, child and adult development, personality and cultural differences, sex and gender issues, ethical and legal issues, the entire history of psychology, the diagnosis of every possible symptom including hundreds of theories and dozens of different approaches to treatment, the risks and benefits of each treatment, and other topics. A person with a Ph.D. had to do original research that contributes to the scientific field, writing up the results in a dissertation manuscript that is usually hundreds of pages long, and approved by a committee of several other persons with doctoral degrees.

A Psy.D. is also a doctorate degree in psychology. The Psy.D. is a relatively new degree that has only existed for about 10-20 years. So when a person has a Psy.D. degree you know they have been recently trained. The Psy.D. program focuses on clinical training. Psy.D. programs give students more time to practice therapy with clients and they are given credit for that. Psy.D programs typically exclude research and some of the formal scientific aspects of psychology.

An M.D. is a medical doctor, a physician. If you want medication in California, you must get a prescription from an M.D. Any physician can prescribe medication. However, if you want medication, I recommend that you consult a "board-certified psychiatrist". A board-certified psychiatrist has extensive training and experience in the use of medication for different conditions, including medication interactions and side effects. A psychiatrist who is not board-certified may have had only a couple of years training as an intern or resident.

There are specialties within board-certified psychiatry. If you need medication for an adolescent, seek a board-certified adolescent psychiatrist. If you are over 60, look for a board-certified geriatric psychiatrist. Those two age groups have biochemistry that is different than the average adult population upon whom the medications are usually tested. Make sure that the psychiatrist knows how to adjust the dosage for your age, knows which medications are better or worse for your age and other medical conditions, and monitors you in regular check-ups. Medication can have different effects over time and you are likely to have questions about its use over time so it is important to have a psychiatrist who will schedule adequate time for discussion. If you want me to do so, I can talk to the psychiatrist on your behalf or recommend psychiatrists.

Some psychiatrists also do psychotherapy. However, even a board-certified psychiatrist may only get trained in traditional Freudian psychoanalysis. Many other perspectives and approaches have been developed in the last 100 years, and for many types of problems, these other perspectives and approaches are more appropriate. Only a licensed psychologist is trained in the full range of therapeutic treatments and perspectives.

An M.F.T. is a Marriage and Family Therapist. This type of license means the therapist may only have a Master's degree, which typically requires only 2 years of graduate school education, in contrast to a Ph.D. or Psy.D. degree, which requires 6-7 years of graduate school education. A therapist with an MFT license may not have adequate training or experience for complicated problems and a licensed psychologist may be more appropriate. However, some MFTs have special training and/or experience that may make them an excellent choice for a specific type of problem.

An L.C.S.W. is a Licensed Clinical Social Worker. This means the person may only have a Master's degree. Their training and experience typically focuses on identifying the kind of resources that people need and connecting people to those resources. An L.C.S.W. may be appropriate when you need to know how you can get help in the community and need to know what resources are available. An L.C.S.W. may specialize in awareness of particular types of resources within particular communities. Sometimes an L.C.S.W. does counseling within an area of expertise. For complicated or severe problems, or for issues outside their area of expertise, an L.C.S.W. may not have adequate training or experience and a licensed psychologist may be more appropriate. Some LCSWs have special training and/or experience that may make them an excellent choice for a specific type of problem.