General FAQs

  • Yes, my practice is 100% remote (i.e., teletherapy). I do not offer in-person therapy. Research has demonstrated telehealth can be as effective as in-person therapy. Telehealth also confers additional advantages such allowing for greater geographical reach and increased flexibility in terms of scheduling (i.e., eliminates commute time and cost). Read more: Online Therapy.

    My online counseling platform uses secure video conferencing to enable face-to-face conversations. The video call is completely secure (HIPAA-protected) and confidential, and nothing is recorded or kept in any way. The video platform is also available on an app, so you can use your tablet or smartphone to connect.

    All you need is a device and an internet connection, as well as a quiet and well-lit space with no distractions. A set of headphones or earbuds will improve the audio.

    I am able to offer teletherapy services for teens, and adults in Oregon, Nevada, California, and all PSYPACT states (AK, AL, AZ, CO, CT, DE, DC, FL, GA, ID, IL, IN, KS, KY, ME, MD, MI, MN, MO, MS, MT, ND, NE, NH, NJ, NC, OH, OK, RI, PA, SC, SD, TN, TX, UT, VA, VT, WA, WV, WI, & WY).

  • General onboarding process: After receiving your inquiry form or a phone call at (702) 530-6134, I will email you or call you to chat for 10-15 minutes so that we can determine together if I am a good fit for your needs. The consultation also allows us to clarify any questions or logistical matters before becoming an official client.

    Scheduling: You may also schedule a 15-minute video consultation directly through my website (which helps us avoid playing phone tag).

    Paperwork: If we determine that we are a good fit, then we will find an available appointment time that might work for you on an ongoing basis (typically weekly). You’ll also be invited to complete the intake and consent forms in the client portal. These are all digital and don’t require printing or emailing. Before your first appointment (and every appointment after that), you’ll receive an email with a link to our video session.

  • Session #1 & (Maybe) #2: I will gather information from you about what problems you are facing and what you’d like to get out of therapy. By the end, I will tell you how I conceptualize your situation and what I think I can offer you.

    Subsequent Sessions: you’ll share the problem areas to be worked on and I’ll use my knowledge to help you make the changes you want to make. We will periodically examine whether we are following a path that is helpful for you.

    Depending on your reasons for seeking therapy, I will teach many concepts in-vivo so that you can integrate them. This means we will do the exercises in the session, not just learn about them. It might feel awkward at first, but like everything in life, we must step outside of our comfort zone if we want to improve our lives. We will also identify various exercises and goals for you to work toward outside of therapy.

    Read: How To Get The Most From Therapy.

  • Appointment slots are able to be scheduled:

    • Monday through Wednesday between 8 a.m. to 12 p.m. and 1 p.m. to 7 p.m. (PST).

    • Thursday between 8 a.m. to 12 p.m. and 1 p.m. to 6 p.m. (PST).

    • Fridays: limited/by request.

    You can view my current availability when requesting an appointment or consultation through the client portal.

  • Almost everything is considered confidential in therapy. You may disclose a wide range of behaviors (e.g., illicit substance abuse, past crimes, etc.), and, generally speaking, mental health providers are not allowed to disclose anything to other people, including police.

    Can a therapist break confidentiality? If so, when is it considered appropriate to break it? Only under specific circumstances can a therapist break confidentiality. The main limits of confidentiality include:

    • Intent to die by suicide: For example, if a client is preparing or planning to kill themselves or is otherwise unable to assure the therapist that the client can keep themselves alive. In such cases, the therapist must break confidentiality such as by contacting emergency services, in order to ensure the client's safety.

    • Intent to harm or kill others: If the therapist is made aware of an identifiable person(s) that the client intends to harm or kill, confidentiality must be broken to ensure the safety of others.

    • Abuse or neglect of vulnerable populations: Confidentiality must be broken to ensure the safety of vulnerable populations (e.g., people with disabilities, minors, elderly people, etc.) in cases of abuse or neglect.

    • When mandated by a court or judge: Usually, clients will know if they are involved in these types of legal proceedings.

    There are also state-specific laws that govern when someone can break confidentiality. For example, in Washington State, a therapist must also break confidentiality if they learn from you that another medical or mental health professional is performing their job incompetently or unethically. In Nevada, there is a statute that confidentiality can be broken if a client is going to seriously "mutilate" themself.

    Other areas where confidentiality can be broken include purposes of treatment and referral to other health professionals and billing purposes (e.g., insurance, collections).

  • For many of my clients, therapy typically begins with one appointment, each week for 3 to 6 months. Regular weekly sessions, particularly in the early stages of therapy, have been associated with improved outcomes, as consistent engagement helps in building therapeutic momentum and addressing issues more effectively (Erekson et al., 2015). Certain treatments, such as those for OCD, benefit from sessions twice a week to achieve faster progress (Foa et al., 2012). Depending on your reasons for seeking therapy, your goals, and the progress you have made, we might decide to switch to shorter appointments (e.g., 30 minutes) or spaced-out appointments (e.g., every 2 weeks). I only want to keep you in therapy as long as you feel that you are gaining value from it or are making progress toward your goals.

    Other people may seek therapy for personal growth reasons or assistance in navigating life transitions and may wish to continue individual therapy for longer periods of time.

    I will check in periodically to ensure you are still getting what you need out of therapy and making progress toward goals. If you are, then great! If not, then great (because that could mean you have made a lot of progress already). If you feel therapy isn’t working for you, then I will make referrals or other recommendations as appropriate.

  • International therapy: On a case-by-case basis, I can work with clients living in or visiting Costa Rica, Ireland, India, Iran, Japan, Kenya, Kuwait, Nigeria, Pakistan, the Philippines, Poland, Russia, Singapore, Thailand and Turkey.

 Payment FAQs

  • Standard Rates:

    • 45-minute session: $250

    • 30-minute session: $190

    • Initial evaluation session with family (90-minutes): $385

    If you choose not to submit reimbursement claims directly to your insurance yourself, I have partnered with Thrizer as an optional service, which will file claims on your behalf. Read more on the Rates page.

  • I am not an in-network provider with any insurance company. However, many insurance plans include out-of-network (OON) benefits that may reimburse a portion of the cost of therapy.

    You can use the OON benefits estimate tool on the Fees & Insurance page to get an initial estimate of your benefits. Because coverage varies by plan, you should ultimately confirm your OON mental-health and telehealth benefits directly with your insurance company.

    If you have eligible OON benefits, I automatically provide a monthly superbill that you can submit to your insurer for reimbursement. Thrizer is also available as an optional service for clients who prefer assistance with the OON reimbursement process.

    Note: Insurance reimbursement is often contingent on receiving a medical or mental health diagnosis and certain diagnoses may not qualify. I do not accept responsibility for collecting payment from your insurance company and cannot guarantee that you will be reimbursed or that you will qualify for a reimbursable diagnosis. When you use insurance to help pay for counseling services, they require that I assign you a diagnosis code and then provide them with this information. Having certain mental health diagnoses may interfere with obtaining some forms of employment (e.g., jobs that require security clearance) or being able to obtain some types of insurance such as health, disability, or life insurance.

  • While I am an OON provider and do not participate in formal Single Case Agreements (SCAs) or standard insurance claims processing, I am open to accepting direct third-party payment from health plans, third-party administrators (TPAs), or employer-sponsored groups seeking specialized care for their members (e.g., OCD, BFRBs/Habit Reversal Training, or Gender Affirming Care).

    Services provided under this arrangement are typically billed at my standard practice rates. Payment must be remitted directly to my practice at the time of service via corporate credit card or ACH transfer, eliminating the need for formal claims submission.

    If you are a case manager or health plan representative seeking specialized care for a member under my standard rates and a direct billing arrangement, please contact me at LukeAllen@Lrallen.com to verify current session availability.

  • If your insurance plan includes OON benefits, it may reimburse you for a portion of the cost of therapy after any applicable deductible has been met.

    Here is a simplified example:

    • Therapist's standard fee: $250

    • Insurance company's allowed amount: $180

    • Insurance pays: 80% of the allowed amount ($144)

    • Your share of the allowed amount: $36

    • Difference between the therapist's fee and allowed amount: $70

    • Your total cost in this example: $106

    These figures are only an example. Your actual reimbursement depends on the terms of your specific insurance plan, including your deductible, allowed amount, coinsurance, and other OON provisions.

    By default, you pay the full session fee at the time of service. I automatically provide a superbill on the 3rd of each month, which you can submit directly to your insurance company if you have eligible OON benefits. Superbills are available in your client portal under the Billing & Payments tab.

    If you are unsure about your benefits, this guide to checking OON coverage may help. You can also learn more and use the OON benefits estimate tool.

  • I keep a credit card securely on file for payment. For standard private-pay/OON billing, the card on file is charged after each appointment. If you have eligible OON benefits, I automatically provide a monthly superbill that you can submit to your insurance company for possible reimbursement.

    If you prefer assistance using your OON benefits, Thrizer is available as an optional alternative. Depending on the Thrizer option you select, you may be able to pay only your estimated portion of the session cost upfront rather than paying the full fee and waiting for reimbursement.

    You can learn more about OON benefits, Thrizer, and estimated costs on the Fees & Insurance page.

  • Please note that as a solo practitioner, I have a cancellation policy in place to ensure the smooth functioning of my practice and provide the best possible care to all my clients.

    To allow for proper scheduling and accommodate others who may be in need of my services, I kindly request at least 24 hours' notice if you need to cancel or reschedule your appointment. For non-emergency cancellations or rescheduling requests made with less than 24 hours' notice, a cancellation fee equal to the cost of the scheduled session will be applied. Insurance (whether in-network or out-of-network) does not reimburse for the cost of late cancellations or missed appointments.

    This cancellation fee, equal to the session price, is implemented to respect my time and expertise, ensure fairness to both of us, encourage commitment to therapy, and maintain a sustainable practice. Your scheduled appointments are reserved only for you and a cancellation made on short notice deprives me of the opportunity to fill that time slot with another client who may be in need of assistance.

    If you are an existing client, you can cancel, reschedule, or request new appointments through the client portal if the request is made at least 24 hours prior to the scheduled appointment time.

    Thank you for your understanding and cooperation. If you have any questions or concerns, please feel free to discuss them with me.

  • Yes. To help make therapy more financially sustainable for a wider range of clients, I reserve six slots in my practice for reduced-rate fees.

    How it works: I offer six "access slots" priced between $150 and $200. These are intended for clients who are uninsured, have no out-of-network (OON) benefits, or have a prohibitively high deductible.

    A Note on Insurance & Value: If you have OON benefits, it is often more cost-effective to pay my standard rate ($250) and seek reimbursement. Once a deductible is met, many OON plans reimburse around 40% to 60% of the session cost. This often results in a comparable or even lower "out-of-pocket" expense than my sliding scale rates.

    Important Considerations:

    • OON Claims: Sliding scale rates are a private-pay agreement. If you choose a sliding scale slot, these sessions cannot be submitted for insurance reimbursement.

    • Availability: These slots are offered on a first-come, first-served basis based on financial need.

    • Duration: To ensure I can support as many people as possible, sliding scale therapy is generally structured for 10 to 24 sessions.

  • Yes. Thrizer is available as an optional service for clients with eligible OON benefits who prefer assistance with the reimbursement process.

    Depending on the option you select, Thrizer may allow you to pay your estimated portion of the session cost upfront rather than waiting for reimbursement, or it can assist with submitting claims after you pay the full session fee.

    You do not need to use Thrizer to use your OON benefits. By default, I provide monthly superbills that you can submit directly to your insurance company yourself.

    You can learn more about Thrizer and its current options and fees here.