What are some signs that my child/teen needs therapy?

Some signs that your child/teen could benefit from therapy are:

• They are defiant, disobedient, or angry
• Verbally or physically aggressive or throwing temper tantrums
• Hyperactive, impulsive, unable to concentrate or disruptive at school
• Engaging in unsafe behaviors or could lead to dangerous outcomes or trouble with the law
• Worried, fearful, excessively sad, suffering from low self esteem or having problems making friends
• Your children frustrate you.
• You are struggling to find effective discipline methods.
• You need some support and guidance in gaining confidence in your parenting

What should I tell my child about going to therapy?

Giving your child plenty of information about what to expect will help reduce any anxiety related to going to therapy. There are tips of what to say:

• Tell your child that he/she will come to see someone to help him/her feel better (about school, friends, etc.), feel less (sad, angry, scared...), get along better with (friends, sibling, etc.) or help them with a (change, loss, problem, etc.)

What are somethings that I shouldn't tell my child about going to therapy?

• Don’t tell your child that he/she is bad
• Don’t tell your child that he/she is the problem
• Don’t tell your child that he/she is sick or that they are visiting the doctor
• Don’t tell your child that someone will watch what they do and them give advice
• Don’t tell your child to listen to the therapist whatever he/she is asked to do
• Don’t tell him/her to behave in session (if this is a concern, I'd rather see the behaviors in order to be most helpful)
• After the session, don’t as your child “Did you behave?”, “Did you help with cleaning up”, etc.
• Don’t give your child any pressure to talk about his/her problems, etc.
• Don’t tell your child how much the session costs or that it is expensive, etc. this may increase children’s worries or anxieties about their “performance” in session. This may also lead to the child feeling guilty or blamed.

How should I tell my child that they will be starting therapy?

Kate Scharff wrote a wonderful article for the Huffington Post with some tips. 1) Wait for a calm moment
Don’t raise the issue of therapy when either of you is angry or upset, especially immediately following an argument or crisis (such as suspension from school). If she’s riled up, your daughter won’t be able take in what you’re saying. And if you’re angry, she’ll view therapy as a punishment. 2) Identify the problem
Tell your child what you see that has you worried. Try, “Honey, I know you’ve been getting into a lot of fights at school,” or “Seems like you’ve been having a lot of nightmares lately.” 3. Offer compassion
Tell your child you know he’s unhappy and you want to help. For example, say “It must be upsetting when the other kids are angry at you,” or “Nightmares can be really scary. No one likes to be scared.” 4) Explain therapy
Once you’ve identified the problem and offered compassion, tell your child you’ve found someone who can help. You might offer “Sometimes when children feel scared a lot of the time, it helps to go to a person whose job it is to help kids understand their feelings and worries by talking and playing about them. Mom and I went to meet a person like that last week. Her name is Dr. Kelly and she’s really nice. She’s a doctor for feelings, not for your body. We think if you met with her a few times it might help you understand why you’ve been having those nightmares. Then you won’t have to feel scared anymore.” 5) Don’t get discouraged
No matter how gentle you are, your child may growl “There’s nothing wrong with me!” or “I don’t get nightmares anymore!” Remain calm and stay the course with an answer such as “Ok, if you and Dr. Kelly decide you’re not scared anymore Dad and I will be very happy. But we love you, and for now this is what we think is best.” ONCE THERAPY IS UNDERWAY: 6) Don’t “grill” your child after sessions
It’s a tall order, but resist the urge to ask for reports. Questions like “What did you and Dr. Kelly talk about today?” are likely to produce either silence or an answer designed to please. Let your child’s therapy be a private place, and use your meetings with the therapist to get and share information about how things are going. 7) Remind your child that she has therapy as a resource, but don’t harp on it
When difficulties arise, there’s nothing wrong with gently suggesting that your child talk about them in therapy. If your daughter gets in a fight at school you might say “You know, Honey, if you feel like talking with Dr. Kelly about what happened she might be able to help you with the problems you’re having on the playground.” But try not to bring therapy up too often, or your child will feel you’re intruding or using her therapist as an ancillary parent. If there’s something you want the therapist to know, the best bet may be to get in touch directly. But inform your child beforehand, so she won’t feel the adults are conspiring. 8) Don’t use therapy as a threat or form of discipline
A comment like “If you don’t start cooperating I’m going to have a talk with Dr. Kelly” is counterproductive. Here’s a better approach: “Lately you seem angry whenever I ask you to help out, and we haven’t been able to talk about it. Fighting is no fun. I think it would be a good idea for us to talk to Dr. Kelly about ways we can get along better.”

Do you take my insurance?

I am currently out-of-network for all insurances other than Highmark Blue Cross Blue Shield, and Highmark Health Options. Please see, "what if you don't take my insurance" to utilize your out-of-network benefits with any other insurance company. I will verify your mental health coverage prior to your first session. To do so, I will need the following information. -Your Insurance company -The customer service number on the back of the card -Your member and group IDs -Your (and the main subscriber’s) birthdays **Please note that benefits are an agreement between you and your insurance company. I cannot guarantee any insurance coverage or reimbursement. If you have eligibility concerns or questions, you should contact your insurance provider directly.

What if you don't take my insurance?

Not to worry! Many clients are able to utilize their out-of-network benefits for counseling services and get reimbursed by their insurance company. I will provide you with a copy of a superbill which you can submit for possible reimbursement. I also encourage you to verify your out-of-network benefits prior to your session. If you have access to HRA/FSA/HAS funds, I accept those funds as forms of payment. Depending upon the carrier, reimbursements are usually received between 2-3 weeks after submission. **Please note that benefits are an agreement between you and your insurance company. I cannot guarantee any insurance coverage or reimbursement. If you have eligibility concerns or questions, you should contact your insurance provider directly.

How do we pay?

Fees are paid in full at the time of service. Payment is accepted in the form of cash, check, or credit card (Visa & MasterCard). As a healthcare provider, we accept Health Savings Account (HSA) and Flexible Spending Account (FSA).

How do I verify my benefits?

1) Have your insurance card nearby 2) Call the customer service number listed on your insurance card 3) Speak to a customer service representative, as the automated benefits line does not always include Behavioral Health benefits. 3) Let them know that you need benefits for Outpatient Mental Health with in-network ​and​ out-of-network providers. Currently, Resilient Kids is an in-network provider for Highmark Blue Cross Blue Shield and Highmark Health Options Medicaid. We are an Out of Network Provider​ of Mental Health Care for all insurance providers. Ask them: •“What is the effective date of coverage?”
•“What is the annual deductible?” “How much has been met to date?”
•“What is the percentage paid after deductible is met?”
•“What is the co-payment or co-insurance amount?”
•“Is referral from Primary Care Physician or Medical Group required?” (Usually HMO) (If this is required, ​only ​the member/client is authorized to obtain this referral and should follow through accordingly.)
•“Where do we mail Behavioral Health claims?”
•“Is precertification required?” If no, you're all done, that's it! If a pre-authorization is needed, you have one more step: Obtaining Authorization/Precertification • Know your therapist’s name and credentials (Marissa Lloyd, MS, LPCMH) and mailing address (101 W. Park Place, Middletown, DE 19709). •“What is the authorization number?”
• “What is the authorization start date and end date (Be sure to disclose your first session date, if you know it, so it will be included in authorization.)
• “How many sessions are authorized?"
•“Where do we mail claims?” (IMPORTANT: This is often a different address than the one used in cases where precertification is NOT required). That's it!

Sessions & Rates

All new potential clients receive a free initial 15 minute consultation prior to scheduling an intake session via phone. Initial Intake (45-50 minutes) $150
Individual or Family Therapy session (45-55 minutes) $125 Equine Assisted Psychotherapy (53-60 minutes) $175
No show/cancellation within 24 hours $50 **If we are an in-network provider for your insurance company, we have a special contracted rate. You'll only be responsible for your co-pay, co-insurance, or contracted fee until your reach your deductible. Please contact your insurance company for exact rates. **We are are an out-of-network provider for your insurance company, a portion of this rate may be reinbursed to you. Please see answer for "what if you don't take my insurance?" for more information.

Where is the farm?

The farm is located in Middletown, DE approximately 10 minutes from our office location. Once approved for equine assisted psychotherapy, the address will be disclosed to you.

Can I stop by to see the farm or visit in between sessions?

We totally understand wanting to say "hi" to our horses, we do not allow visits. Due to confidentiality needs of clients, visitors are welcome only during pre-arranged times.

Do you conduct therapeutic riding classes for people with disabilities?

We do not, but The Center For Therapeutic Riding in Townsend, DE does. They also offer programs for the wellness of individuals ​affected by ​cancer, and an adult day program for those living with physical or cogntive impairments. Visit them at : www.thecenterfortherapeuticriding.com

Can I continue to see my therapist and have sessions of Equine Assisted Psychotherapy?

Yes. In fact we are currently only seeing clients who also have an in-office therapist. We follow your therapist's current treatment plan during EAP sessions. If you do not have one, we can discuss seeing Marissa at her at the Resilient Kids office location or provide you with a referral.

How many sessions does it take?

Similiar to other treatment styles, it depends. In general, we have found that a natural ending point usually emerges somewhere between 4 and 10 sessions.

What does it cost?

Since each session requires two professionals, horses and the facility, rates are higher than in-office therapy. Full-cost per-session is $225. A portion of this fee may be reinbursed to you through out-of-network benefits. Please see the "finances" section for more about out-of-network benefits. Through fundraising efforts, we have scholarships available several times a year for those who qualify.

What do I need to bring or wear?

Boots are suggested, but sneakers are fine. No open-toed shoes. You may want to bring a water bottle, a hat and sunscreen.

What about bad weather?

In case of bad weather that requires rescheduling, we will contact you (please check your phone). For some clients, we can provide services inside the barn, even if it is raining outside.

I'm interested... What next?

1) Talk with your current therapist and with Marissa to explore how EAP might be of service to you. 2) Complete and return intake forms (available for download from the client portal). Your therapist must complete and return the referral form. 3) Schedule an appointment.

What is Equine Assisted Therapy?

Equine Assisted Psychotherapy (EAP) is an emerging field that uses horse-human interactive experiences to facilitate emotional growth and learning. Like all experiential approaches, it must be experienced to be understood; the words on this page cannot do it justice. We can say that participants learn about themselves and others by participating in activities with the horses, and then processing (or discussing) feelings, behaviors, and patterns with a trained therapist and equine specialist.

The focus of EAP is not riding or horsemanship. In fact, 100% of EAP takes place purely on the ground. The focus of EAP involves setting up activities involving the horses that require the client or group to apply certain skills – such as assertiveness, self-awareness, patience, creativity, and teamwork – as they interact with the horses. By observing old habits in the arena, and experimenting with new possibilities, people gain practical insight that they can use to change their lives.

Why horses?

People who have been around horses tend to “get” that there is “just something about them” the runs deep. For those that haven’t, here are some insights that might help answer this question… Horses have a large presence that evokes our fears, hopes and yearnings. They are social and curious and interact with people in a variety of ways that inevitably stir up our strengths and weaknesses. Horses see through posturing and aren’t concerned with a person’s class, race or religion; they tune into deeper intentions. Horses are intuitive and present here and now; they respond instantly to the humans around them, almost like biofeedback machines. In essence, horses do naturally what every good therapist strives to do: tune in to peoples’ inner experience, and challenge them to grow.

What are the benefits of EAP?

What are the Benefits of Equine Therapy? Studies have indicated that equine therapy has been successful in helping patients show marked improvements in the following areas:

• Assertiveness
• Emotional awareness
• Empathy
• Stress tolerance
• Flexibility
• Impulse control
• Problem-solving skills
• Self-actualization
• Independence
• Self-regard
• Social responsibility
• Interpersonal relationships
• Respect for self and others
• Improved communication and social skills
• Boundary setting
• Empathy towards others
• Honesty & trust
• Overcoming challenges in a non-threatening atmosphere

Who can benefit from EAP?

Equine assisted psychotherapy is a powerful and effective therapeutic approach that can have incredible impacts on individuals, youth, families, and groups. EAP addresses a variety of mental health and human development needs including depression and anxiety, behavioral issues, eating disorders, interpersonal relationships and anger issues. It can also be used for families —including parenting and relationship conflicts — and as a way to improve teamwork in organizations and businesses. During the initial phone interview, we will determine together if this approach is suitable for your situation.

What goes on in an EAP session?

Clients are invited by the EAP team to engage with the horses in tasks (guiding a horse through an obstacle course, for example). But like life, EAP sessions are unpredictable. Your personality and mood will mix with the personality and mood of the horse(s) and the assigned activity to create a unique experience; one that will inevitably stir up feelings, fears, and relationship dynamics – positive and negative – that are at play in your life. Our horse-therapists are very keen at giving clients what it is they seem to need. Marissa (psychotherapist) and Loretta (equine specialist) will be on-hand to support you in getting the most out of the experience.

How do I get my first appointment?

Please submit an intake request through our form online, or give us a call at (302) 752-0393. We will get back to you within 24 hours.

What do I do to prepare for my intake?

1) Verify your mental health benefits through your insurance. Please see "fees and insurance" if you have more questions. 2) Make sure you have filled out all the required intake paperwork found in your client portal. We’ve streamlined the process so it’s quick, easy and online.

Where is your office located?

We are located at The Center for Conscious Healing at 101 West Park Place in downtown Middletown, DE. We are the last building on the right. When you arrive, please enter through the front door and take a seat in the lobby. I will meet you in the lobby at your appointment time.

What is Teletherapy?

Therapy options are rapidly growing and Teletherapy is center stage of it. Through audio and video over the internet, you can meet with your clinician on-the-go from your desktop, laptop, tablet, or mobile device (iOS or Android) - it's your choice! Telehealth allows us to connect anywhere with secure and convenient appointments that save you time and hassle. There's no need to deal with traffic when you can schedule and attend your appointments directly from a laptop or mobile device. If you’ve ever used Skype or FaceTime, you’ve used the same type of technology teletherapy uses.

Is Teletherapy private?

Yes. Licensed counselors are ethically and legally bound to a privacy protection law called HIPAA. When working with a therapist through teletherapy, they will ask you to use our secure, HIPAA compliant video platform. Your therapist will also be in a private, secure place for the video session with you. Your risk for a privacy breach will largely be in your hands. If you open up your computer in Starbucks for a session, your session will not be private. If you go to a quiet, private space, your privacy will be protected just as it would be in a traditional session.

Does Teletherapy work as well as traditional counseling?

Yes, teletherapy is very effective. Research on the matter shows that video counseling is just as helpful as counseling done in person. Teletherapy is also very convenient and accessible, which helps families with consistency in counseling sessions. Think about being able to fit a therapy session in between football practice, horseback riding lessons, tutoring, or reducing the stress of having to find a babysitter for siblings!

What equipment do I need?

1. Desktop computer with a webcam, speakers, a 2.5 GHz processor, and 4 GB of RAM OR 2. Laptop computer with built-in webcam and speakers, a 2.5 GHz processor, and 4 GB of RAM OR Tablet device with built-in webcam and speakers, OR Smartphone with at least iOS 10 or Android 6.0
(Note: To use a smartphone, you must first download Telehealth by SimplePractice - available for iOS or Android in the app store.) You will also need an internet connection that is at least 10mbps. For optimal results, a reliable, high-speed internet connection with a bandwidth of at least 10 mbps will minimize connection issues and provide the best quality.

How does Teletherapy work?

You’ll be sent a link for the video appointment. Click on it when our appointment is scheduled to start or open it through the Telehealth by SimplePractice app (download free in the app store). You can use the camera and audio on your computer or mobile device.

Why should I try Teletherapy?

We are very excited about this new option because it means no waiting and travel time, and you won’t have to take time off work/other priorities, or find a babysitter. Kids no longer have to give up an extra cirricular activity or sport to make it to their appointment, or miss school time. Plus, it’s 100% HIPAA compliant and secure!

How much will it cost?

Your cost for a video appointment will vary depending on the coverage you have with your insurance provider. Most insurances charge a copayment just like traditional appointments, and it most likely will be the same amount. We can determine your exact coverage and what your copay will be before we schedule an appointment. However, we always recommend contacting your insurance provider to verify that it covers telehealth/teletherapy sessions.

Will the appointments be recorded?

None of our appointments will ever be recorded or stored.