Question 1

What's therapy actually going to be like with you?

Accepted Answer

Great question!

Look, I get it! Meeting a new therapist for the first time and spilling your guts can be incredibly nervewracking! Here are some things you can expect while we work together:

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Me:
I'm a pretty warm, casual, laid back, direct, compassionate, humorous, socially conscious and justice-informed human. You get the authentic, yet professional, Ashley. I am usually wearing jeans and sitting cross-legged in my chair while chugging down a coffee, because keeping it real, I am not a morning person!

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My Office:
Comfort is my jam, and I have set my office up much like my own personal den and living room.

My space is small, yet cozy. I have a comfy couch, lots of lamps and plants, pillows and blankets galore, and plenty of fidgets and fun things to tinker with.

I want to make sure your needs are met so you feel comfortable and safe. Don’t hesitate to let me know if there’s anything you need!

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The Process:​

The intake session (session #1):

A therapy intake assessment is really just a casual first meeting where you get to know your therapist and they get to know you.

Think of it as more of an interview.

I'll ask you questions about your life, your current situation, any struggles you've been facing, and what you'd like to get out of therapy.

It’s a chance for me to understand your background, any mental health history, and overall lifestyle, so I can get a full picture of how best to support you.

Regular sessions:

We usually spend the first 10-15 minutes getting updates from your week before diving in and processing.

I usually ask you what's been on you mind, or what you feel you need to work through that day.

I may ask questions that help you see things from a fresh perspective, point out patterns you might not have noticed, or suggest ways to cope.

You drive the bus. I'm just the lady helping you navigate in the passengers seat. You decide what we talk about and what our focus is.

The pace is yours to set, and the goal is to create a safe (yet brave!), comfortable space where you can feel truly heard and supported.
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Question 2

What's your availability?

Accepted Answer

I am available Monday - Thursday evenings, 7-10 PM CST and 5 PM - 10 PM PST, exclusively through Telehealth.

Question 3

How long is each therapy session?

Accepted Answer

My sessions run between 45 - 60 minutes, depending on the need and how much we have to process that day.

Question 4

How much do you charge for a session?

Accepted Answer

For an intake assessment, I charge $200/hour.

For an individual session, I charge $175/hour.

Question 5

Do you take insurance?

Accepted Answer

I am able to take most major insurance plans in Iowa and Minnesota.

At this time, I am private pay and sliding scale only for Washington clients as I work to get credentialed with insurance panels - stay tuned!
 
Below are the plans I can take:​​​​​​​​​​​​​​​​​​​​​​​​​​
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Wellmark Blue Cross Blue Shield
(*Excluding UnityPoint plans)
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United Healthcare (UHC)
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UMR

Oscar Health
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Health Partners 
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Midlands Choice

Medica
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Aetna

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If I don't accept your insurance, I can provide a superbill for you to submit for out-of-network (OON) reimbursement. The full session fee of $175 will be charged at date of service. Please be sure to read the OON portion of my consent for services document to better understand OON benefits.
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For those who wish to not use their insurance and to pay privately, I charge $200 for an intake session and $175 for a general therapy session, which will be charged at the date of service.

Question 6

Do you offer a sliding scale?

Accepted Answer

Yes, I do have a sliding scale.

Brave Space Healing
Sliding Scale
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A sliding scale is a flexible fee structure that adjusts the cost of therapy based on a client’s financial circumstances.

It’s often used when I am not in-network with someone’s insurance or if a client chooses not to use their insurance (for privacy, flexibility, or personal reasons).
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Instead of one fixed rate, I offer several fee tiers. Clients select the tier that feels most accurate to their financial situation.

This system helps make therapy more accessible while still allowing me to sustain my practice.
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No matter which tier you select, you’ll receive the same level of care. The difference is simply how the fee is structured.
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This system is designed to balance equity, sustainability, and access to care.
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Part of why I use a sliding scale is to balance accessibility with sustainability. Therapy isn’t just the time we spend together — there are also costs like rent, insurance, taxes, continuing education, technology, and the behind-the-scenes work that keeps my practice running.

My rates reflect both the value of the care I provide and the real expenses of maintaining a private practice.

By choosing the tier that fits your situation, you’re helping me continue offering therapy that’s accessible to more people while also allowing me to make a livable income.
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This is an honor-based system. No financial documentation is required.

However, I conduct seasonal (quarterly) check-ins to ensure that the chosen tier remains appropriate, given that financial circumstances may shift over time.
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​Sliding Scale Rates
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💚 Tier 1 — $175 
Approx. household income: $100,000+

✨ This is you if…
You own your home or rent without financial strain.
You have retirement accounts, investments, or savings.
You can take vacations, attend events, or buy new electronics without stress.
You can afford to eat out, shop, or pay for hobbies regularly.
You can take unpaid time off work without risking stability.

🚫 Not for you if…
You live paycheck-to-paycheck or feel constant pressure to cover bills.
An unexpected $500 expense (car repair, ER bill) would destabilize your finances.
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💚 Tier 2 — $150
Approx. household income: $75,000–$100,000

✨ This is you if…
You rent or have a mortgage that requires budgeting but is manageable.
You can afford occasional extras (concerts, travel, dining out), but you plan carefully.
You have some savings, though it may not feel like “enough.”
You have student loans, medical bills, or childcare costs that limit flexibility.
You can handle an unexpected $500 bill, but it causes stress.

🚫 Not for you if…
You have significant assets (property, trust funds, large savings).
You can afford frequent travel, luxury purchases, or discretionary spending without stress.

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💚 Tier 3 — $125 
Approx. household income: $50,000–$75,000
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✨ This is you if…
You are able to cover essentials but have little to no savings.
You live paycheck-to-paycheck, and debt (student loans, credit cards, medical bills) weighs on you.
You may have health insurance, but copays and deductibles feel heavy.
You can afford small non-essentials (a meal out, new clothes) occasionally.
An unexpected $500 bill would require credit cards or payment plans.

🚫 Not for you if…
You are steadily saving for retirement or have a strong emergency cushion.
You regularly spend on travel, dining, or leisure activities while meeting all basic needs.
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💚 Tier 4 — $100
Approx. household income: $30,000–$50,000
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✨ This is you if…
You often worry about making rent, utilities, or loan payments.
You work hourly, seasonal, or freelance jobs with inconsistent income.
You sometimes delay bills or put off medical/dental care due to cost.
You rely on credit cards to cover shortfalls.
Vacations, concerts, or hobbies are not realistic right now.
An unexpected $250 expense would be destabilizing.

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🚫 Not for you if…
You have reliable employment, savings, or financial support that covers emergencies.
You can consistently afford discretionary spending without financial anxiety.

💚 Tier 5 — $75 
Approx. household income: under $30,000

✨ This is you if…
You are unemployed, underemployed, a student, or on disability/assistance.
You regularly worry about meeting basic needs like rent, groceries, or medication.
You have little to no savings and are often in survival mode financially.
Emergencies (car breakdown, medical bill) create immediate crisis.
Therapy would be completely out of reach without this tier.

🚫 Not for you if…
You have stable income and discretionary spending power but simply want to save money.
You can afford regular luxuries (travel, new electronics, shopping) while covering essentials.

Gentle but Firm Notes

These examples are guidelines, not absolutes. Debt, caregiving, and systemic barriers matter too.

You choose your tier based on your lived reality. No proof required.

If it seems your spending and chosen tier don’t match, I’ll bring it up — not to shame, but to keep the scale fair for everyone.

Same care at every tier. What changes is cost, not quality.

I understand that life circumstances don’t always fit neatly into categories. If your situation doesn’t quite match the examples listed, or if you’re facing a temporary hardship, please reach out. In some cases, I’m able to make individual arrangements on a case-by-case basis.

Question 7

Do you offer in-person sessions?

Accepted Answer

No, at this time, I am only offering telehealth sessions.

Question 8

Do you offer telehealth sessions?

Accepted Answer

Yes, I do! I believe therapy must be accessible, and I offer telehealth sessions to anyone living in Iowa or Minnesota.

I even offer EMDR virtually, provided that you have a working computer.

To make telehealth therapy work smoothly, you’ll need a quiet, private space where you feel comfortable talking, a reliable internet connection, and a device with a camera and microphone (like a phone, tablet, or computer).

Grab some headphones if you want extra privacy, and make sure you're ready to log in on time. It’s also helpful to have an open mind and a willingness to engage in the process—just like in-person therapy!

Question 9

How does confidentiality work?

Accepted Answer

Confidentiality is vital for therapy. Therapy is like “Emotional Vegas”  -  what happens in therapy, STAYS in therapy. That means that what we talk about stays between us.

There are a few exceptions to this rule, like if I believe you're at risk of harming yourself or others, if there’s suspected abuse of a child or dependent adult, or if I'm required to share information by law
(like in a court case).

Otherwise, your privacy is my priority, and I’ll only share information with your written consent. If you have any questions or concerns about confidentiality, let’s talk about them! It’s important you feel safe and informed.

Question 10

What if I run into you out in public?

Accepted Answer

To protect your confidentiality and privacy, if we ever run into each other "in the wild" I will not approach you or greet you - not because I don't enjoy our work together, it's just best practice. However, you are always welcome to say hi to me first - I try to keep the exchange brief with a smile and a wave, because professional and personal boundaries are important.

If for whatever reason we run into each other at a local event or social gathering, I will pretend I have never met you before, and I may quietly excuse myself. Des Moines IS small, and sometimes, dual-relationships are difficult to avoid. If at any time things are "too close for comfort" we will discuss it in session and try and figure out if I need to refer you out to someone else due to conflicts of interest.

Question 11

Do you write ESA letters?

Accepted Answer

I’m happy to consider writing letters for emotional support animals (ESAs), but I want to ensure the request is thoughtful and appropriate for your needs.

To do that, I require clients to work with me for at least six sessions before I can evaluate if an ESA letter is clinically appropriate.

This allows us to build a strong therapeutic relationship and gives me time to understand your situation fully.

It’s important that this process is thorough and rooted in genuine commitment to therapy. If you have any questions about this, feel free to ask!

Question 12

How does therapy work?

Accepted Answer

Therapy is like having a GPS for your mind, and it works in three main steps:

1
Verbal processing:
We start by talking things out—your thoughts, feelings, and experiences. This helps you understand what's going on and how you got to where you are. Think of it as clearing up the fog to see the road ahead more clearly.

2
Using insights for change:
Once you've processed your experiences, you can start applying what you've learned. It’s like upgrading your mental toolkit so you can shift how you think, feel, or react in certain situations. This helps you steer through life with more confidence.
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3
Building healthy coping skills:
Life is full of surprises, and therapy gives you practical strategies to navigate the ups and downs. It's like building your own resilience toolkit—complete with new skills that help you handle whatever comes your way.

For those who are working through trauma, EMDR is like a specialized route that can help you process those intense memories and move forward with more ease.

So, therapy isn’t just about talking; it’s about discovering, changing, and growing so you can live life more fully.
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While I work hard in our sessions to support you, help you gain insights, and give you tools, the real transformation happens outside the therapy room. That’s where you apply what we’ve explored—whether it’s changing how you think, feel, or act, or learning to accept and make peace with the tough stuff.

I like to think of myself as a guide or facilitator, not a magician. I’m here to walk alongside you and help you uncover the growth and change that’s possible when you show up and do the work.

Together, we’ll create a space for healing, growth, and meaningful change.

Question 13

How will I know therapy is working?

Accepted Answer

Therapy is working if:

Life feels more stable and peaceful
You notice fewer
“What the hell just happened?!”
moments in life.

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You pause before reacting
Kind of like a cat deciding if that laser pointer is really worth it.
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Your relationships feel less like reality TV drama
and more like a well-rehearsed improv scene.
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Your emotions and triggers feel more like waves to ride than tsunamis to survive.
You take your struggles in
stride, and not everything
feels like a crisis.
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You're responding instead of reacting.
You catch yourself saying,
“Wow, past me would’ve lost it, but I handled that!”
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Your brain’s inner critic sounds more like a quirky sidekick than a villain.
You notice you are able to challenge
your negative self talk more
easily and you can find compassion
for yourself.
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Life still has ups and downs, but you feel like you’ve got better hiking boots and a solid map.
You're managing and navigating
your day-to-day better and
with more ease.
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You're less stuck in the past.
Your mind isn't
constantly replaying painful memories like
an annoying song stuck in your head.
You can think about your experiences without them taking over your day or your mood.
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You’re starting to feel safer.
Your sense of safety and trust is gradually growing. You might notice you’re more comfortable in your environment or more confident in handling unexpected situations.
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You’re more in touch with your emotions.
Instead of feeling numb or disconnected, you’re able to identify and feel your emotions more clearly. This doesn’t mean everything is always easy, but you can name what you’re feeling and know what’s going on.
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Your life feels fuller.
You’re able to do things that you used to avoid or didn’t think you could, like having conversations, trying new things, or connecting with people. You’re living more in the moment, not just surviving.
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If you’re feeling more connected, steady, and capable, therapy’s definitely pulling its weight!

COMMON QUESTIONS ABOUT WORKING WITH ME