Most individuals begin therapy due to some type of emotional discomfort. They may be looking for a change in themselves, family or child but need assistance and/or support to do so. There are many excellent reasons to begin therapy, including life changes, transitions, emotional difficulty, stress, conflict (among many others). If you are committed to making changes and feeling differently, therapy can help you to reach your specific goals. Back to the Questions.

An appointment with Dr. Pacos is usually available within 1-2 weeks of contacting the office. However, under special circumstances an appointment can be scheduled sooner. Please go to the Contacts Page and fill out a request to schedule an appointment. Back to the Questions.

For a therapy appointment, Dr. Pacos requires 24-hour advance notice if you are unable to keep the appointment, Clients are expected to be financially responsible for sessions that are cancelled with less than 24-hours notice. For an evaluation appointment, Dr. Pacos requires 72-hour advance notice if you would like to cancel a scheduled assessment. Clients are required to pay a cancellation fee of $200 for evaluation appointments that are cancelled with less than 72-hours advance notice. Back to the Questions.

Dr. Pacos does not accept health insurance, however health insurance companies frequently provide coverage for "out-of-network" treatment. If your insurance company allows you to receive treatment out-of-network, you can submit receipts from treatment to your insurance provider for reimbursement. Before starting any form of therapeutic work, it is important to check with your provider to understand the coverage provided in your policy. Dr. Pacos will be happy to provide you with an itemized list for each service that is provided and will assist you with the insurance submission process.

Importantly, Dr. Pacos' practice is NOT a high volume managed care insurance panel practice. By being an independent provider, Dr. Pacos is able to see a smaller amount of clients and provide a high level of quality care rather than seeing a large volume of patients and abiding to a particular insurance carrier' guidelines regarding billing and limitations on the approved number of sessions. Dr. Pacos' clients usually come from the professional referrals of pediatricians, family physicians, community leaders, as well as, other satisfied families and individuals. Back to the Questions.

In the vast majority of cases, the content of what is discussed in session is confidential. Psychologists are bound by ethical principles outlined by the American Psychological Association to ensure the confidentiality and privacy of personal information. However, there are three important exceptions to this rule that you should be aware of before meeting with a psychologist.

First, psychologists are ethically and legally required to breach confidentiality in cases where the client is at risk for causing harm to themselves or to others. If a psychologist determines that the risk of harm is too high, confidentiality will be breached and the appropriate healthcare and law enforcement authorities will be contacted and asked to intervene in your care.

Second, psychologists are also ethically and legally required to share treatment information when a client is involved in a legal dispute and a judge requires the psychologist to offer testimony under subpoena. In these cases, judges can require psychologists to share their opinions and their therapy notes with the court.

Lastly, for those clients that meet with a psychologist and pay for those services using health insurance, it is important to recognize that confidentiality is limited under these circumstances as well. For example, your insurance company can legally request to view your treatment records for auditing and quality assurance purposes that would limit the extent to which your treatment remains confidential. Back to the Questions.

A psychiatrist has an MD (Doctor of Medicine) or DO (Doctor of Osteopathy) degree and specializes in the branch of medicine that focuses on mental health disorders. While some psychiatrists use talk therapy as a means of treating their patients, most psychiatrists treat mental health disorders through the use of prescription medication. Psychologists do not prescribe medication and use talk and behavioral therapy and psychological testing as their primary means for assessing and treating mental health concerns of their clients. Psychologists and psychiatrists often work together as a team in addressing more severe or chronic mental health concerns for an individual. Back to the Questions.

Clinical Neuropsychology involves the study, evaluation, and treatment of known or suspected brain disorders using the methods of psychology. Neuropsychologists investigate brain-behavior relationships using non-invasive tests and methods, interviews, one-to-one interactions with patients, and collection of reports from collateral sources (e.g., parents, teachers, physicians). They evaluate patients' neurocognitive, behavioral, and emotional strengths and weaknesses and their relationship to normal and abnormal central nervous system functioning. This information is used to identify and diagnose neurobehavioral disorders, and to plan and implement intervention strategies. Back to the Questions.

Neuropsychological assessments provide objective documentation of an individual's capabilities in a number of neurocognitive areas which may include (depending on the diagnostic question):

• Intelligence
• Learning
• Attention and Executive Control (organization, planning, focus, flexibility, and regulation)
• Motor Functions (strength, dexterity)
• Sensory Functions (for example, vision, auditory processing)
• Language Abilities
• Nonverbal Abilities
• Memory (verbal and nonverbal)
• Psychological Functions (mood, anxiety, personality, thinking, regulation)
• Social Skills
• Behavior

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Full psychological and neuropsychological batteries can take anywhere between 4-8 hours to administer. In some cases, the battery may be administered over multiple sessions. Back to the Questions.

• Tell him/her about the evaluation and if possible, the reason for the evaluation (e.g. to better understand how he/she sees things.
• Explain that the evaluation will be conducted by Dr. Pacos and that it is different from a medical exam. The evaluation is painless and is more like going to school. If your child is anxious about meeting a stranger, show him/her a picture of Dr. Pacos and the office beforehand.
• Inform your child/adolescent that the evaluation can take anywhere from half a day to a full day, but that there will be breaks and snacks available.
• Make sure he/she is well rested and eats breakfast before the evaluation.ÊHe/She should be dressed comfortably.
• Check with Dr. Pacos regarding any medications your child/adolescent is using or will be using.

Back to the Questions.