Frequently Asked Questions

What can I expect from counseling?

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It may be very nerve-wracking to finally make the decision to contact a therapist. You may be experiencing feelings of guilt, embarrassment, and shame about your difficulties and concerns. These feelings are all normal. The first thing you can expect is to talk with a mental health clinician who is experienced in your particular area of concern, and most importantly is non-judgmental. You can expect to speak with someone who is familiar with your situation, even if you may believe that your concerns are completely unique in the world, or that no one could possibly understand you.

In your first session, you can expect to be greeted warmly and to be provided with a safe, confidential environment where you can feel free to discuss your concerns. During the initial stages of treatment, the therapist will get an idea of the presenting issue(s), as well as make a preliminary plan for how treatment should proceed. In subsequent sessions, you will continue to develop the working relationship, exploring areas that may have caused your difficulties, as well as working through issues in the present that continue to present you with challenges.

As treatment continues to progress, you may begin to see subtle, but specific changes.
Since the root of your difficulties may have been created a long time ago, therapy is not a quick cure. It is typically a gradual process. As you begin to feel confident and overcome specific challenges, you may then want to explore other areas of improvement that have come to your attention through therapeutic process. In all cases, you can expect to be treated with the utmost of confidentiality and respect as you work with a highly-trained clinician who is dedicated to the resolution of your particular issue(s).

Is counseling confidential?
Yes, all of your communication with our counselors is confidential. Your privacy and confidentiality in are protected legally and ethically. There are a few situations where our counselors would be legally obligated to break confidentiality.

These scenarios are:
*If the counselor believes you are an immediate danger to yourself or others.
*If abuse of a minor, the elderly, or a vulnerable adult is suspected.
*If a judge court orders any information from your records.

Do you accept health insurance?
Dr. Noelle is in-network Tricare Standard. At this time, we do not accept other insurance for our services. For those paying our counselor’s standard rate, they can provide you with a monthly “superbill” to request reimbursement or that your session fees be applied to your insurance deductible.

Please note that if you choose to submit this “out-of-network” claim with your insurance company, your private medical information will be released.

How much does counseling cost?
Our standard rate is $125 per session of individual counseling. Rates for other types of sessions will be discussed with you during your initial phone consultation. Counseling fees, which are payable by cash, personal check, or credit card, are due at the end of each session.

Do you write letters for Hormone Replacement Therapy or Sexual Reassignment Surgery?
Dr. Noelle and Dr. Melissa are advocates for non-gender conforming individuals. Since most physicians require one or more evaluations by mental health providers in support of Hormone Replacement Therapy or Sexual Reassignment/Confirmation Surgery, Dr. Noelle and Dr. Melissa are happy to perform these evaluations. They meet with individuals and discusses their goals, history, and support system. We are frequently asked how long this process takes or how many sessions a person will need to attend. The answer is: it varies from person to person. Letters written in support of HRT or SRS are included in the cost of evaluation sessions.

Dr. Noelle and Dr. Melissa have extensive training in evaluation for HRT and SRS. They follow the guidelines recommended by the World Professional Association for Transgender Health (

What is your cancellation policy?
Please contact your counselor if you need to cancel or reschedule a counseling session. Cancellations must be made with 24 hours notice in order to avoid being charged in-full for the session.