Frequently Asked Questions

Therapy, also known as counseling, is a form of treatment for mental health conditions that involves communication, emotional processing, and improved self-awareness with the support of a licensed professional. The goal of therapy is to help individuals overcome challenges and improve their overall mental health and wellbeing. Depending on the individual's specific needs and goals, therapy can be short-term or long-term and can involve varying degrees of emotional difficulty. While therapy can be challenging at times, it can also be incredibly rewarding and transformative for those who are committed to the process. At Spark and Pivot Counseling, our team is dedicated to providing compassionate, evidence-based therapy services to help you achieve your goals and live your best life.

We believe that therapy is a unique and personal journey for each individual. Our therapists use evidence-based practices tailored to your specific needs and goals. During your first session, you and your therapist will discuss your history, current concerns, and what you hope to gain from therapy. From there, you will work together to develop a treatment plan and establish goals for your therapy. Your therapist will provide you with tools and resources to help you cope with challenges and improve your mental health. Sessions typically last 50 minutes and can be scheduled weekly or bi-weekly. We encourage open and honest communication with your therapist throughout the process to ensure that your therapy experience is positive and effective.

There are 5 typical stages of readiness as it relates to pursuing change and personal growth (see table below for details). It is helpful to consider where you may be within these stages, but it is important to remember that as you pursue change you may go in and out of stages as you face different challenges and develop new skills. Meaning, change is rarely as linear as a change model may suggest. If you are researching therapists, chances are you are ready. Source: Hilton Head Health

An LPC-Associate (Licensed Professional Counselor Associate) is a fully trained therapist who has completed a graduate-level counseling program, passed required licensing examinations, and is actively working toward full independent licensure in Texas. The "Associate" designation does not mean they are a student or a trainee in the traditional sense. It means they are a licensed professional completing a required period of supervised clinical practice before obtaining their full LPC license. In Texas, the path to full LPC licensure requires a minimum of 3,000 hours of supervised clinical experience after graduate training. LPC-Associates are fully qualified to provide therapy, assess clients, develop treatment plans, and deliver evidence-based interventions (including EMDR) under the oversight of a licensure supervisor (designated as an LPC-S in their credentials). At Spark + Pivot, our LPC-Associate is Jana Leeper, who holds a Master of Arts in Counseling and Human Development and serves as our lead EMDR therapist. She practices under the supervision of Lauren Gastorf, M.Ed., LPC-S. Choosing to work with an LPC-Associate at Spark + Pivot also typically means a lower session fee, making it a meaningful option for clients navigating cost considerations without sacrificing clinical quality.

Supervision in the context of clinical mental health practice is a formal, structured process in which a fully licensed clinician (the supervisor) provides ongoing oversight, guidance, and consultation to a less experienced clinician (the supervisee). It is a required component of the licensing process in Texas and most other states, and it is one of the primary mechanisms through which clinical quality and ethical standards are maintained in the profession. Supervision means a fully licensed clinician regularly reviews your therapist's cases, including yours. Your counselor's supervisor is aware of your treatment, your progress, and any clinical decisions being made. Your counselor's supervisor does not have access to your records outside of what is clinically necessary, and the same privacy protections that apply to your therapy relationship apply to supervision. This formal relationship ensures you are receiving ethical care, and that if something complex or unexpected arises in your care, your therapist has an experienced clinician to consult with. This is not a compromise in your care; it is a structural safeguard that many clients actually benefit from, since their therapist has access to a second clinical perspective at all times. At Spark + Pivot, supervision is taken seriously and we offer two levels of supervision. Jana Leeper is supervised to prepare for her final licensure by Lauren Gastorf, M.Ed., LPC-S, an experienced licensed supervisor in Texas. She is also supervised by Megan Parks DuBose, M.S., LPC, NCC for her clinical work at Spark + Pivot Counseling. Our pre-license counseling interns (through our partnership with Southern Methodist University's Masters in Counseling Program) are supervised directly by Megan Parks DuBose, MS, LPC, NCC, our clinical director, as well as receiving supervision through a clinical professor at SMU. Supervision sessions are regular and ongoing, for both levels, so you are getting active involvement and indirect support from experienced, fully licensed clinicians. The details of any supervisory relationships are clearly stated within your informed consent, and we welcome any questions that you have during consultation or intake.

Yes, and we want you to feel comfortable telling us what you need, because your well-being and ability to accomplish counseling goals is inextricably intertwined with the trust and rapport you have with your counselor. Therapeutic fit is one of the most significant factors in whether therapy is effective, and we would far rather you work with a different clinician on our team than stay in a relationship that doesn't feel right out of politeness or inertia. If at any point you feel that your current therapist isn't the right match, because of personality, clinical approach, communication style, or simply a sense that something isn't clicking, we encourage you to say so. You can bring it up directly with your therapist, which many clients find opens a productive conversation about what would work better. You can also reach out to our Clinical Director (Megan Parks DuBose, M.S., LPC, NCC) directly to ask about transitioning to another clinician on the team or taking more of a team-like approach to your care. Switching therapists within Spark + Pivot does not mean starting from scratch. Our team communicates internally and can facilitate a warm handoff that preserves clinical continuity and ensures the incoming therapist has the context they need to support you well from the beginning. We also recognize that raising concerns about fit can feel uncomfortable, particularly for neurodivergent clients who have a history of masking their needs or people-pleasing to avoid conflict. We try to make this as low-pressure as possible. Your care comes first. Full stop.

The honest answer is that our free 20-minute consultation is specifically designed to help you figure this out, and it's the best starting point for anyone who isn't sure. During the consultation, you'll speak with a member of our team, discuss what you're looking for, and get a genuine recommendation about which clinician is the best fit for your goals, your presentation, and your practical needs including schedule and budget. That said, here is a general guide to how our clinicians' specialties map to different client needs: Megan Parks DuBose is best suited for clients who are navigating newly diagnosed or exploring ADHD, autism, or AuDHD; the effects of chronic masking and late diagnosis; trauma using EMDR; career challenges and workplace stress; or who are seeking career assessments. Megan also works with neurodivergent women and LGBTQ+ clients specifically. Jana Leeper is best suited for clients who are ready to move through trauma rather than just talk about it; who want EMDR as their primary therapeutic modality; who are navigating career uncertainty alongside emotional or mental health challenges; or who have found traditional talk therapy insufficient or overwhelming. Cassandra Holt Kimbell is your provider if you are seeking diagnostic testing for ADHD, autism, or AuDHD rather than ongoing therapy. If you read her profile and credentials, and know you want to work with her, you can book intake directly and get started. If you have a few more questions, and don't feel ready to schedule intake yet, Megan handles her free 20-minute consults. Natalie Newton is best suited for clients navigating relationship challenges, life transitions, and identity questions, particularly neurodivergent individuals who have felt chronically misunderstood, and neurodiverse couples navigating the relational dynamics that arise when one or both partners are neurodivergent. Natalie also offers the most accessible fee structure on the team. If you're still not sure after reading through the team bios, book the free consultation with Megan. That's what it's there for: sparkandpivot.sessionshealth.com/request.

Yes. Virtual therapy (telehealth) is available throughout Texas for all of our therapy services, including EMDR therapy, ADHD counseling, therapy for autistic adults, and therapy for neurodivergent women. Career counseling is also available virtually throughout Texas, and our diagnostic testing services are available virtually in both Texas and California. Virtual sessions at Spark + Pivot work exactly the same way as in-person sessions: same clinicians, same approach, same level of care - just a different format. For many neurodivergent clients, working from their own environment actually supports the therapeutic process by reducing sensory load, eliminating commute-related stress, and allowing clients to be in a space where they feel genuinely comfortable and regulated. If you're located in the Dallas area and prefer in-person sessions, our office at 8330 Lyndon B Johnson Freeway Frontage Road, Suite 737 is available for in-person therapy appointments. Many clients also choose a hybrid approach, coming in person for some sessions and meeting virtually for others depending on their schedule and needs. To get started, book a free 20-minute consultation at sparkandpivot.sessionshealth.com/request. We'll talk through your preferences and help you determine which format and which clinician is the right fit.

Yes. We offer virtual therapy and career counseling throughout Texas, and our diagnostic testing services are available virtually in both Texas and California. If you're located outside the Dallas area, virtual sessions work exactly the same way as in-person: same clinicians, same approach, same level of care. Many of our virtual clients find that working from their own environment actually supports the therapeutic process, particularly for clients with sensory sensitivities or social anxiety. If you're based in Dallas or the surrounding area and prefer to come in person, our office is located at 8330 Lyndon B Johnson Freeway Frontage Road, Suite 737, Dallas, TX 75243.

Several things set us apart, but the most significant is the depth of specialization we bring to neurodivergent care. Many therapy practices describe themselves as "neurodiversity-affirming." We've built our entire practice around it. Every clinician on our team has additional training and significant clinical experience adapting counseling methods to be more affirming for ADHD, autistic, and AuDHD clients.  We also understand that neurodivergence and trauma are rarely separate issues. ADHD and autistic adults experience trauma at significantly higher rates than the general population, and many of our clients carry both. Our team is trained to hold that complexity, not treat it as two separate problems requiring two separate referrals. A few other things that distinguish our practice: our Dallas office was specifically designed for neurodivergent nervous systems, with adjustable lighting, minimal sensory distractions, and a genuinely low-pressure environment. We don't use ABA or compliance-based approaches. We offer sliding scale pricing and scholarship opportunities to make care more accessible. And every interaction with Spark + Pivot has been designed with psychological safety in mind, because we know we have to earn your trust and we don't take that lightly.

Yes. All of our clinicians work exclusively with adults. This isn't a limitation, it's a deliberate choice that makes us better at what we do. ADHD and autism present very differently across the lifespan, and the diagnostic criteria, therapeutic approaches, and life challenges relevant to adults are distinct from those relevant to children and adolescents. Because we work only with adults, we have deep familiarity with how decades of masking, late diagnosis, and navigating neurotypical systems shape the adult neurodivergent experience, and we bring that understanding to every evaluation and every session. If you're looking for support for a child or adolescent, we're happy to provide referrals to providers who specialize in that age group.

Megan Parks DuBose, M.S. LPC, NCC completed her graduate training at Southern Methodist University's Masters in Counseling Program. She maintains a close relationship with the clinical program, consults with the Department Chair, and regularly collaborates with SMU Counseling Alumni due to the culture of excellence that challenges Spark + Pivot to maintain the highest standards of ethical, innovative, and effective practice. This is not only Megan's opinion. The Counseling Program at SMU has received numerous awards and recognition, including being named Top 5 Counseling Programs in the United States. Importantly, this relationship enables the Spark + Pivot team to engage talented counselors to provide low-cost counseling to the community. As a result of their high quality didactic training and clinical supervision, SMU Counseling Interns have excellent clinical skills, are extremely motivated, and provide a level of ethical care that is unmatched in North Texas. The internship placements at Spark + Pivot are highly competitive due to our compensation model and investment in specialized neurodiversity training, so we are able to select very talented clinicians to supervise for our low-cost counseling services. Simply stated: this partnership ensures neurodivergent adults can access effective counseling at a lower cost. For more information about clinical supervision, what it means, and how the supervisory relationship benefits clients, please visit the FAQ "What does it mean to be supervised?" Our pre-license counseling interns are supervised directly by Megan Parks DuBose, MS, LPC, NCC, our clinical director, as well as receiving supervision through a clinical professor at SMU.

Finding a therapist who genuinely understands neurodivergence—not just one who lists it as a specialty—requires knowing what to look for. The best neurodivergent therapists in Dallas are those who take a neurodiversity-affirming approach rather than a pathologizing, deficiency-focused approach. We recommend looking for clinicians who: Pursued specific training and clinical experience with ADHD, autism, and AuDHD and have a demonstrated commitment to continued education; Understand how neurodivergence intersects with trauma, identity; Have experience supporting clients through the particular challenges of navigating neurotypical systems as an adult; and Apply compassionate, strengths-based adaptations to evidence-based counseling methods to help you accomplsh your goals. At Spark + Pivot Counseling, our entire practice is built around neurodivergent adults. Our clinical team includes: Megan Parks DuBose, MS, LPC, NCC, who specializes in autistic, ADHD, and AuDHD adults navigating trauma, life transitions, and career challenges; Jana Leeper, M.A., LPC-Associate, who serves as our lead EMDR therapist with specialized expertise in trauma-informed care for neurodivergent nervous systems; and Natalie Newton, a pre-license counseling intern who works with neurodivergent individuals and neurodiverse couples. We also offer comprehensive diagnostic testing through Cassandra Holt Kimbell, LPC, NCC, Psy-D Candidate, who leads all ADHD and autism evaluations. What distinguishes our practice is the depth of specialization across every service we offer, including therapy, diagnostic testing, and career counseling, all grounded in the same neurodivergent-affirming, trauma-informed approach. Our Dallas office was also specifically designed for neurodivergent nervous systems, with adjustable lighting, minimal sensory distractions, and a low-pressure atmosphere where stimming is welcome and eye contact is never required. To find out whether Spark + Pivot is the right fit for you, book a free 20-minute consultation at sparkandpivot.sessionshealth.com/request.

Finding a therapist who truly understands ADHD (not just its diagnostic criteria, but what it actually feels like to live with an ADHD brain in a neurotypical world) makes an enormous difference in whether therapy is useful. The right ADHD therapist won't tell you to try harder, use a planner, or set better priorities - because you've already tried that. They'll understand interest-based motivation, rejection sensitive dysphoria, executive dysfunction, the exhaustion of chronic masking, and the particular grief that often accompanies a late or missed diagnosis. At Spark + Pivot Counseling in Dallas, ADHD therapy is led by Megan Parks DuBose, MS, LPC, NCC, who specializes in working with ADHD, autistic, and AuDHD adults, particularly those who are high-performing on the outside and quietly struggling on the inside. As a neurodivergent clinician herself, Megan brings both clinical training and lived understanding to this work. Jana Leeper, M.A., LPC-Associate, also works with ADHD clients, with a particular focus on the intersection of ADHD and trauma using EMDR. Our ADHD therapy goes beyond symptom management. We address the full picture including the identity questions, internalized shame, relationship challenges, career instability, and trauma that frequently accompany a lifetime of living with an unrecognized or unsupported ADHD brain. If you're also exploring whether ADHD explains your experience and haven't yet been formally evaluated, our diagnostic testing services are available in Dallas and virtually throughout Texas. Book a free 20-minute consultation at sparkandpivot.sessionshealth.com/request to talk through what support would be most useful for where you are.

Yes. Spark + Pivot Counseling is located in North Dallas and offers neurodiversity-affirming therapy for adults in person and virtually throughout Texas. Autism-affirming therapy means something specific at Spark + Pivot. We do not use ABA or compliance-based approaches focused on making autistic adults appear more neurotypical. We don't work toward "passing." Our clinical work is rooted in understanding your neurotype, helping you reconnect with your authentic self after years of masking, developing practical self-accommodation and self-advocacy strategies, and processing the grief, anger, and relief that often accompany late or missed diagnosis. Megan Parks DuBose, MS, LPC, NCC leads our autism therapy services, with a specialization in autistic adults, particularly women, LGBTQ+ folks, and high-masking individuals who have spent years being told they don't "seem autistic." Jana Leeper, M.A., LPC-Associate also works with autistic clients, with a focus on trauma-informed care and EMDR for autistic nervous systems. Natalie Newton works with autistic individuals navigating relationship challenges and identity questions, as well as neurodiverse couples. Our Dallas office was designed with autistic nervous systems in mind: adjustable lighting, comfortable seating, minimal sensory distractions, and a genuinely low-pressure environment where stimming is welcome and eye contact is never required. Virtual sessions are also available for clients who prefer to work from their own space. Our office is located at 8330 Lyndon B Johnson Freeway Frontage Road, Suite 737, Dallas, TX 75243. To book a free 20-minute consultation, visit sparkandpivot.sessionshealth.com/request.

Spark + Pivot Counseling in Dallas specializes in exactly this intersection. Our entire practice is built on the understanding that neurodivergence and trauma are rarely separate issues. ADHD and autistic adults experience trauma at significantly higher rates than the general population, and many of our clients carry both. Treating them as separate problems requiring separate referrals doesn't reflect how they actually live in the body. Our clinical team brings trauma-informed care to every service we offer. Megan Parks DuBose, MS, LPC, NCC specializes in working with neurodivergent adults navigating trauma, chronic masking, and career-related stress, and uses EMDR alongside talk therapy in her practice. Jana Leeper, M.A., LPC-Associate is our lead EMDR therapist, with specialized expertise in adapting trauma-informed approaches (including EMDR) for neurodivergent nervous systems. Her approach specifically addresses how the mind-body connection and sensory processing differences shape the trauma therapy process for autistic and ADHD clients. Trauma-informed care at Spark + Pivot means more than acknowledging that trauma exists. It means building genuine psychological safety before any trauma processing begins, moving at a pace that respects your nervous system, understanding how C-PTSD and PTSD symptoms overlap with and complicate neurodivergent presentations, and never treating your history with anything other than care and respect. Our Dallas office is located at 8330 Lyndon B Johnson Freeway Frontage Road, Suite 737, Dallas, TX 75243. Virtual therapy is available throughout Texas. To book a free 20-minute consultation, visit sparkandpivot.sessionshealth.com/request.

Yes. Spark + Pivot Counseling's Dallas office was specifically designed with neurodivergent nervous systems in mind because we understand that therapy is only as effective as the sense of safety you have in the space. Our office features adjustable lighting so the environment can be tailored to your sensory needs, comfortable and flexible seating, minimal auditory distractions, and a calm, low-pressure atmosphere. Stimming is welcome in session. Eye contact is never required. If something about the space doesn't work for you—the temperature, the seating, the lighting, anything—we want to know and we will adjust. Your sensory comfort is not a secondary concern; it's part of the clinical work. We also offer virtual sessions for clients who prefer to work from their own environment, which many neurodivergent clients find reduces sensory load and supports the therapeutic process. Virtual therapy is available throughout Texas. Our office is located at 8330 Lyndon B Johnson Freeway Frontage Road, Suite 737, Dallas, TX 75243. To schedule a free 20-minute consultation and learn more about what to expect from your first visit, book at sparkandpivot.sessionshealth.com/request.

Culturally-sensitive counseling refers to a therapeutic approach that takes into consideration a person's cultural background, values, beliefs, and experiences when providing mental health services. It recognizes that the way people view and cope with mental health issues may be influenced by their cultural identity, social context, and historical experiences. Culturally-sensitive counseling involves developing an understanding of the client's cultural worldview, communication style, and unique needs, and tailoring the therapy to meet those needs. It also involves acknowledging and addressing cultural barriers that may prevent individuals from seeking or receiving mental health services. We strive to provide culturally-sensitive counseling services that are inclusive, respectful, and empowering for clients from diverse backgrounds. Cultural factors may include (but are not limited to): language, spirituality/religion, regional background, ethnicity, race, affectional/sexual identity, and gender identity. Helpful resources on this topic: https://www.psychologytoday.com/us/therapy-types/culturally-sensitive-therapy# https://www.counseling.org/resources/library/ACA%20Digests/ACAPCD-24.pdf https://www.latimes.com/california/newsletter/2023-01-17/what-it-means-to-have-a-culturally-responsive-therapist-why-it-matters-group-therapy

The full diagnostic evaluation process at Spark + Pivot typically involves three to four appointments spread over several weeks. Here's what that generally looks like: The first appointment is a 50-minute intake session where Cassandra gets to know your history, your current concerns, and what you're hoping to understand from the evaluation. You'll also complete some clinical intake forms and screeners in advance of this session, which Cassandra will review with you during the appointment. Testing itself typically takes place over one or more sessions depending on your goals, the complexity of your presentation, and your capacity and preferences on a given day. Some components of the evaluation can also be completed on your own time between sessions—we build the process around your bandwidth, not the other way around. The final appointment is a dedicated feedback session where Cassandra walks you through your results, discusses your diagnosis, and reviews personalized recommendations for therapy, accommodations, and next steps. This session is collaborative: it's a conversation, not a report being read at you. From intake to feedback, the full process typically spans four to eight weeks, though the timeline can be adjusted based on your schedule and needs. If you are ready to get started, you can book your 50-minute intake appointment with Cassandra at sparkandpivot.sessionshealth.com/request If you have additional questions or want to discuss what the process might look like for your specific situation, book a free 20-minute consultation with Megan at sparkandpivot.sessionshealth.com/request.

Receiving a diagnosis as an adult can bring a complicated mix of emotions, including relief, grief, anger, clarity, and sometimes all of them at once. There is no single right way to process it, and at Spark + Pivot, the feedback session is designed to hold space for whatever comes up rather than rushing past it toward next steps.  In practical terms, here is what a diagnosis makes possible: A clearer understanding of your history. Many adults describe their diagnosis as the moment their entire life finally made sense: the jobs that didn't work out, the relationships that felt harder than they should have, the chronic exhaustion of never quite fitting. A diagnosis doesn't change the past, but it reframes it in a way that replaces self-blame with genuine understanding. Access to accommodations. A formal diagnosis from a licensed clinician provides the documentation needed to request workplace accommodations under the ADA or academic accommodations through your institution. Our evaluation reports are specifically written to support this process, with clear, actionable accommodation recommendations tailored to your presentation and context. Treatment that actually fits. Many neurodivergent adults have tried therapy, medication, or other interventions that didn't work as expected, often because they were designed for a different neurotype or a misdiagnosis. A correct diagnosis opens the door to approaches specifically designed for how your brain works, including neurodivergent-affirming therapy, EMDR, and medication management through a psychiatrist who understands neurodivergence. A community and an identity. For many adults, diagnosis is also the beginning of finding others who share their experience, whether through advocacy organizations, online communities, or simply the language to describe themselves accurately for the first time. At Spark + Pivot, the diagnostic process doesn't end with the feedback session. We provide referrals, coordinate with other providers, and offer ongoing therapy support for clients who want to continue working through what their diagnosis means for their life, their relationships, and their sense of self.

Psychological evaluation at Spark + Pivot Counseling costs between $1,000 and $3,000, depending on your goals, the scope of the evaluation, and the number of testing appointments involved. While this is a significant investment, it is notably lower than the market average for private practice diagnostic testing, which frequently ranges from $2,500 to $5,000 or more in Texas. We recognize that cost is a real consideration, and we are transparent about it from the very first conversation. Immediate following your 1-hour intake appointment, Cassandra will confirm the scope of the evaluation and you will then receive a a clear estimate of what the evaluation is likely to cost based on your specific situation before you commit to anything. You may also request a Good Faith Estimate after your intake session, which provides a written cost estimate for the full evaluation process. Spark + Pivot does not accept insurance or participate in insurance programs for diagnostic testing. This is a deliberate choice as it allows us to conduct thorough, individualized evaluations without the constraints of insurance-mandated timelines or documentation requirements, and it keeps your records confidential. Diagnostic testing is not eligible for out-of-network reimbursement through Thrizer, but you may be able to use a flexible spending account (FSA) or health savings account (HSA) to cover testing costs. We recommend checking with your FSA or HSA administrator to confirm eligibility. If you are ready to get started, you can book your 50-minute intake appointment with Cassandra at sparkandpivot.sessionshealth.com/request If you have additional questions or want to discuss what the process might look like for your specific situation, book a free 20-minute consultation with Megan at sparkandpivot.sessionshealth.com/request.

Adult autism evaluations are available at Spark + Pivot Counseling in Dallas, Texas via full psychological evaluation. Our diagnostic testing is led by Cassandra Holt Kimbell, LPC, NCC, Psy-D Candidate, who specializes in comprehensive, trauma-informed evaluations designed specifically for adults. Unlike many practices that use brief screeners or standard diagnostic checklists, our evaluation process and methods account for the ways masking, trauma, and decades of adaptive coping can shape how autism presents in adults, particularly women, BIPOC individuals, and LGBTQ+ folks who are frequently missed by traditional diagnostic frameworks. The evaluation process typically involves three to four appointments, including an intake, one or two testing sessions, and a feedback session where results are reviewed together and next steps are discussed collaboratively. You won't leave with just a label, you'll leave with a clear understanding of what your diagnosis means, along with personalized therapeutic and accommodation recommendations. Evaluations are available in person at our Dallas office and virtually throughout Texas. To get started, book a free 20-minute consultation at sparkandpivot.sessionshealth.com/request.

Spark + Pivot Counseling offers comprehensive ADHD evaluations for adults in Texas, available in person in Dallas and virtually throughout the state. Our evaluations are led by Cassandra Holt Kimbell, LPC, NCC, Psy-D Candidate, whose approach goes well beyond standard screeners to examine the full picture of your experience, including how anxiety, depression, trauma, and masking may be influencing your presentation. This matters because ADHD is frequently misdiagnosed or missed entirely in adults, particularly those who developed strong coping strategies early in life. It's also commonly confused with—or co-occurring alongside—anxiety, PTSD, and autism. Our evaluation process is designed to sort through that complexity, not collapse it into a single checkbox. The process includes an intake appointment, one or more testing sessions, and a collaborative feedback session where Cassandra walks you through the results and what they mean for your life, your work, and your next steps. To get started, book a free 20-minute consultation at sparkandpivot.sessionshealth.com/request.

EMDR (Eye Movement Desensitization and Reprocessing) is a structured, evidence-based therapy that helps the brain process distressing memories and experiences that have become "stuck," continuing to trigger emotional and physical responses long after the original event. It is recommended as a first-line treatment for trauma and PTSD by the World Health Organization, the American Psychological Association, and the U.S. Department of Veterans Affairs; but has also proven effective for treatment of a broad range of anxiety- and stress-related disorder.  The underlying framework of EMDR is the Adaptive Information Processing model, which proposes that psychological distress is often the result of unprocessed memories stored in an isolated way in the nervous system. When a memory hasn't been fully processed, encountering related triggers can cause the brain and body to react as if the original experience is happening again, producing anxiety, hypervigilance, intrusive thoughts, or physical symptoms that feel disconnected from the present moment. EMDR works by pairing focused attention on a distressing memory or belief with bilateral stimulation (typically guided eye movements, alternating taps, or audio tones) while keeping one foot in the present moment. This bilateral stimulation appears to activate the brain's natural information processing system, allowing the memory to be integrated in a less distressing way. Over time, the emotional charge attached to the memory decreases, and the negative beliefs associated with it—"I am not safe," "I am not enough," "It was my fault"—can shift toward more adaptive ones - “I am safe now,” “I am enough,” “I did the best I could." EMDR has eight distinct phases, beginning with history-taking and preparation and moving through assessment, desensitization, installation, body scan, closure, and re-evaluation. The preparation phases are especially important at Spark + Pivot for our neurodivergent clients because we prioritize building a strong foundation of nervous system regulation and psychological safety before any reprocessing begins.

No. While EMDR was originally developed to treat trauma and PTSD, the research base has expanded significantly to support its use for a wide range of anxiety and stress-related conditions. At Spark + Pivot, we use EMDR with clients navigating generalized anxiety disorder, OCD, social phobia, panic disorders, phobias, night terrors, grief, chronic stress, and more, not only those who identify as trauma survivors. In fact, some of the most meaningful outcomes we see are with clients who wouldn't describe themselves as having "real" trauma but whose nervous systems are nonetheless stuck in patterns of chronic anxiety, hypervigilance, or emotional overwhelm that talk therapy alone hasn't been able to shift. If you've done the cognitive work in understanding your patterns intellectually, but your body keeps responding the same way, EMDR targets exactly that gap. The reason EMDR is effective across such a range of conditions is that it works at the level of the nervous system, not just cognition. Anxiety disorders, OCD, and stress-related conditions often involve the same mechanism as trauma: a nervous system that has learned to respond to certain triggers as if they represent genuine threat. EMDR helps the brain update that response, regardless of whether the original learning came from a single acute event or years of accumulated stress and experience.

The honest answer is that it depends, and any provider who gives you a firm number before understanding your history and goals is oversimplifying. That said, here's what we can tell you about what typically shapes the timeline. EMDR treatment at Spark + Pivot generally spans anywhere from six weeks to six months, depending on several factors: the complexity and severity of what you're processing, how many distinct memories or experiences need to be addressed, your current level of nervous system regulation and emotional stability, and your readiness and sense of safety with your therapist. Single-incident trauma (a specific event with a clear before and after) typically resolves more quickly than complex or developmental trauma, which involves repeated experiences over time and often requires more extensive preparation before reprocessing begins. For neurodivergent clients specifically, we often spend more time in the preparation phases than standard EMDR protocols assume. Building the mind-body connection, developing personalized nervous system regulation strategies, and ensuring genuine psychological safety before reprocessing begins is not extra time is what makes the reprocessing effective and safe. After your intake session, your therapist will give you a clearer estimate of what a realistic treatment arc might look like for your specific situation. You may also request a Good Faith Estimate at that point so you understand the financial commitment before you begin.

EMDR is a genuinely different experience from talk therapy, and many clients aren't quite sure what to expect going in. Here's what the process typically feels like from the inside. The early sessions focus on preparation: getting to know your history, identifying the experiences and beliefs you want to work on, and building the coping tools you'll use to stay regulated during reprocessing. This phase often feels more like traditional therapy, and for neurodivergent clients it tends to be more extensive since we prioritize establishing a strong foundation before moving into deeper work. When reprocessing begins, your therapist will ask you to hold a target memory or belief in mind while following a series of bilateral stimulation, typically guided eye movements, taps, or tones. This part of the session can feel unusual at first. You may notice your thoughts, images, emotions, or physical sensations shift and change as the bilateral stimulation continues. Some clients describe it as watching scenes from the window of a moving train—present, but with some distance. Others notice physical sensations releasing, unexpected memories surfacing, or emotions moving through them more quickly than they do in ordinary life. It's important to know that EMDR doesn't require you to describe the traumatic experience in detail or relive it fully. You are always in control of the pace, and your therapist is with you throughout. Sessions typically end with a closing exercise to bring you back to a regulated state before you leave. Some clients feel tired or emotionally tender after sessions; this is normal and usually resolves within a day or two as the processing continues.

Yes, EMDR can be a safe and effective treatment for Autistic and ADHD clients when delivered by a therapist who understands neurodivergence and does not rush the process. That said, standard EMDR protocols were designed with neurotypical nervous systems in mind, and there are important adaptations that make the process safer and more effective for neurodivergent clients. At Spark + Pivot, our lead EMDR therapist Jana Leeper specializes specifically in EMDR for neurodivergent clients. Two adaptations are central to her approach. First, many autistic and ADHD clients experience the mind-body connection differently, as they may have limited awareness of physical sensations, difficulty locating emotions in the body, or a history of dissociation that makes standard body-scan exercises feel confusing or inaccessible. Jana works carefully with each client to build that connection before any reprocessing begins rather than assuming it's already in place. Second, sensory processing differences can make certain memories feel more intensely overwhelming for autistic and ADHD clients than they might for neurotypical ones. Jana builds personalized, sensory-informed coping strategies to help regulate the nervous system before and during reprocessing so clients feel genuinely equipped rather than flooded. The result is an EMDR experience that moves at the right pace for your nervous system, not the pace a standard protocol assumes. For neurodivergent adults who have found traditional talk therapy insufficient or retraumatizing, EMDR adapted in this way can offer a genuinely different kind of relief.

The most fundamental difference is how the work happens in your nervous system. Talk therapy, including approaches like cognitive behavioral therapy and psychodynamic therapy, primarily works through language, insight, and conscious reasoning. You explore your patterns, examine your history, and develop new ways of thinking about your experiences. This is genuinely valuable, and for many people it produces real change. But for others—particularly those whose distress stems from trauma or whose nervous systems have been shaped by years of chronic stress—insight alone doesn't produce relief. You can understand exactly why you feel the way you do and still have your body brace for impact in the same situations, still feel the same anxiety spike, still respond to certain triggers as if the original experience is happening now. That gap between knowing and feeling in your body is where talk therapy can hit a ceiling. EMDR works below the level of conscious reasoning, targeting the nervous system directly. Rather than talking through a memory or analyzing its meaning, EMDR helps the brain complete the processing that got interrupted when the original experience occurred, changing not just how you think about it, but how your body holds it. Many clients describe a noticeable shift in how a previously distressing memory feels after EMDR; not erased, but no longer charged in the same way. The two approaches aren't mutually exclusive. Many clients benefit from integrating EMDR with talk therapy, and our clinicians at Spark + Pivot are trained in both.

Yes, and this is an area of particular specialty at Spark + Pivot. Megan Parks DuBose is one of relatively few EMDR providers who specifically uses EMDR for workplace-related trauma and stress, and it's an application with strong outcomes for the right clients. Workplace trauma can take many forms. It might be a single acute event, such as witnessing something traumatic on the job, experiencing a sudden termination or public humiliation, or having a panic attack during a work trip or presentation. It can also be cumulative: years of working in a hostile or high-pressure environment, chronic discrimination or harassment, sustained emotional abuse from a manager, or the slow erosion of self-worth that comes from receiving feedback that never quite makes sense no matter how hard you work. For neurodivergent adults in particular, the workplace is frequently a site of significant trauma, not because they aren't capable but because most professional environments were not designed for how their brains work. The combination of masking pressure, sensory demands, unspoken social rules, and performance standards that reward neurotypical working styles can produce a trauma response that shows up as anxiety, avoidance, intrusive thoughts about work, physical symptoms, or a complete inability to return to a similar environment. EMDR helps by processing the specific memories, experiences, and beliefs that are keeping the nervous system stuck, allowing clients to return to functioning, rebuild confidence, and approach their professional lives without the weight of unprocessed workplace experiences driving their responses.

Career coaching and career counseling are often used interchangeably, but they are meaningfully different and the difference matters most for clients whose career challenges are entangled with mental health, trauma, or neurodivergence. Career coaching is a goal-oriented process focused on professional development, strategy, and performance. A career coach helps you identify strengths, set goals, develop action plans, and navigate specific professional challenges. They may help you rewrite your resume, practice job interviewing skills, or develop new strategies for navigating significant change in the work place and will focus on the here-and-now information.  Career counseling is led by licensed mental health counselor and can go where coaching cannot. While many career counselors are able to do everything described in career coaching, a licensed counselor can help you explore how your career struggles may be rooted in trauma, anxiety, rejection sensitivity, burnout, internalized shame, or the cumulative effects of chronic masking. A coach has neither the training nor the clinical tools to address what's actually driving the problem. A licensed counselor can hold the emotional and psychological dimensions of career work alongside the practical ones, processing what's underneath while building toward what's ahead. At Spark + Pivot, our career counseling clients frequently come to us having already worked with coaches and found the process frustratingly surface-level. They understood their goals but couldn't move toward them, or kept hitting the same walls, or found that talking about career strategy without addressing the fear, shame, or nervous system responses underneath it produced insight but not change. That's the gap clinical career counseling is designed to fill.

Yes, and for neurodivergent adults in particular, therapy is often the most important intervention available for career burnout because the burnout itself is frequently a symptom of something deeper than overwork. For many ADHD and autistic adults, what looks like career burnout is actually the cumulative result of years of masking in environments that weren't built for them, receiving feedback that didn't match their effort, suppressing their natural working style to meet neurotypical standards, and absorbing the chronic stress of never quite fitting. That kind of burnout doesn't resolve with a vacation or a boundary around email. It requires a real examination of what has been depleting the nervous system and a genuine restructuring of how you work, where you work, and what you're working toward. Therapy at Spark + Pivot approaches career burnout clinically, which means we look at the full picture, including the role of masking, trauma, executive dysfunction, and sensory load in how you arrived here. We also distinguish between career burnout and autistic burnout, which are related but distinct and require somewhat different approaches. And where burnout is intertwined with trauma, EMDR can be a powerful tool for processing the experiences that have accumulated in the nervous system alongside the more practical work of rebuilding a sustainable professional life.

Career counseling for neurodivergent adults is a clinical process designed to help ADHD, autistic, and AuDHD individuals build professional lives that work for how their brains actually function, not how neurotypical workplaces assume they should. Standard career counseling was developed with neurotypical clients in mind. It assumes consistent motivation, linear career paths, stable executive functioning, and relatively lower need for values alignment in work. None of those assumptions reliably hold for many neurodivergent adults. When they don't, standard tools produce frustration rather than clarity. At Spark + Pivot, career counseling for neurodivergent adults accounts for the specific ways that ADHD and autism shape professional experience: interest-based motivation rather than priority-based motivation, executive dysfunction that makes initiating and sustaining tasks difficult regardless of intention, rejection sensitive dysphoria that makes certain workplace interactions genuinely painful, sensory environments that drain energy before the work even begins, and the cumulative toll of chronic masking in professional settings. Our approach is also clinical and strategic. Because neurodivergent career challenges are frequently entangled with trauma, burnout, and mental health, our career counselors are licensed clinicians who can hold both the emotional and practical dimensions of this work. Services include career assessments, career exploration and decision counseling, and goal setting and action planning, each of which can be pursued independently or as part of a connected process.

Finding a career that genuinely fits a neurodivergent brain requires a different process than the one most career resources describe because most career resources were written for neurotypical people. The starting point isn't a job title or an industry. It's understanding your neurotype well enough to know what actually energizes you versus what depletes you, what kinds of cognitive demands you thrive under, what environmental conditions allow you to do your best work, and what you need in terms of autonomy, structure, social interaction, sensory load, and flexibility. For many neurodivergent adults, this self-knowledge has been obscured by years of operating in the wrong environments and internalizing the feedback they received there. Career assessments are often the most efficient way to begin building that clarity, particularly assessments administered by a clinician who understands neurodivergence and can account for the ways masking, burnout, and chronic stress may be distorting your self-perception. From there, career exploration counseling helps you translate that self-knowledge into real options, researching industries, roles, and organizational cultures that are most likely to be a genuine fit rather than another environment to survive. At Spark + Pivot, Megan Parks DuBose leads all career assessments and brings both clinical expertise in neurodivergence and extensive professional experience in career development to that process. If you're ready to begin, a free 20-minute consultation is the best starting point: book at sparkandpivot.sessionshealth.com/request.

Career assessments are structured evaluation tools that help you develop a clearer, more grounded picture of your professional strengths, interests, values, and working style. At Spark + Pivot, they are administered by Megan Parks DuBose and designed specifically for neurodivergent adults, which means the process accounts for how masking, burnout, and years of operating in the wrong environments can distort your professional self-perception. The assessment process at Spark + Pivot typically involves three stages. The first is an intake and goal-setting session, where Megan learns about your background, your career history, and what you're hoping to understand. Together, you determine which assessment tools are the right fit for your goals, which may include strengths and skills inventories, interest and values assessments, personality and cognitive style instruments, and career-specific screening tools. Some assessment components can be completed on your own time between sessions. The second stage is the assessment and exploration phase, which typically spans one to three sessions. This is where the actual assessment work happens and where Megan works with you to develop a personalized framework for gathering and evaluating information about the careers, roles, and environments you're curious about. The third stage is a dedicated feedback session where results are reviewed together, translated into language that's meaningful to you, and connected directly to next steps. You won't leave with a stack of data and no guidance. The goal is practical, actionable clarity about what a fitting career actually looks like for your neurotype and your life. Hard costs for assessment tools range from $300 to $500 depending on your goals and are estimated transparently before you commit.

Yes, and this is one of the most common experiences that brings neurodivergent adults to career counseling at Spark + Pivot. A pattern of job instability, frequent departures, or the persistent feeling of never quite fitting in despite genuine effort is one of the most consistent features of unrecognized or unsupported ADHD and autism in the workplace. It's not a character flaw or a lack of commitment. It's often the result of repeatedly landing in environments, roles, or organizational cultures that weren't compatible with how your brain works, without ever having had the tools to understand what compatibility would actually look like for you. Career counseling can help you make sense of that pattern through looking back across your work history with an informed lens to understand what has and hasn't worked, and why. What environments have felt more sustainable? What kinds of work have produced genuine engagement versus chronic drain? What feedback have you received that never quite made sense, and what does it actually tell us about fit rather than fault? From there, the work shifts toward building forward: developing a clearer picture of what you need in a role and environment, identifying options that are genuinely worth exploring, and building the confidence to pursue them. If you haven't yet explored whether ADHD or autism may be a factor in your career history, diagnostic testing can be a powerful first step that reframes the entire picture.

Yes, and it's an area of particular clinical depth at Spark + Pivot. Megan Parks DuBose is one of relatively few clinicians who combines expertise in neurodivergence, EMDR, and career counseling, which means she can address workplace trauma not just strategically but therapeutically. Workplace trauma is more common than most people recognize, and it takes many forms. It can stem from a single acute event, such as a sudden termination, public humiliation, a panic attack during a high-stakes presentation, or witnessing something traumatic on the job. It can also be cumulative: years of working in a hostile or high-pressure environment, chronic discrimination or harassment, sustained emotional abuse from a manager, or the slow erosion of self-confidence that comes from receiving feedback that never made sense no matter how hard you worked. For neurodivergent adults, the workplace is frequently a site of compounded trauma. Chronic masking, sensory demands, unspoken social rules, and performance standards that don't account for neurodivergent working styles can produce a nervous system response that makes it genuinely difficult to return to similar environments even when you want to. At Spark + Pivot, career counseling for clients with workplace trauma integrates clinical therapy and EMDR alongside the more practical dimensions of career work. This means processing what happened and its impact on your nervous system and sense of self, alongside rebuilding your professional confidence, identifying environments more likely to be safe and sustainable, and developing the self-advocacy tools to navigate your career differently going forward.

According to Nick Walker (2021, Neuroqueer.com), neurodiversity is the diversity of human minds, the infinite variation in neurocognitive functioning within our species. It is a necessary and critical part of our functioning and survival as a species, and has been found in other species. In this podcast, Dr. Maureen Dunne describes neurodiversity in a very approachable and helpful way, and explains how research in bee hives has illuminated how it shows up in other speciies.

Neurodivergence is a term to describe individuals whose brains interpret or process information differently than most people. It is a flexible term that can be used to encapsulate different diagnoses (such as, but not limited to): autism, ADHD, AuDHD, dyslexia, sensory processing disorder, and Tourettes. A helpful overview can be found here. It is important to note that every neurodivergent person's experience is unique based on the environments and people they interact with daily, and therefore their strengths and challenges may look very different depending on the person and the context. Said simply, no single "type" of neurodivergence exists.

The neurodiversity-affirming approach is built on principles that advocate for personal agency, respect for unique neurological needs, and fostering environments that empower neurodivergent individuals. It is based on principles of the Neurodiversity Paradigm, and will take shape in many different ways depending on the personal experience and needs of the client. To hear Megan speak more about what neurodiversity-affirming mental health care looks like in her practice, watch the video below and read this blog post.

Megan is most experienced working with autistic, ADHD, and AuDHD women and LGBTQ+ folks. She has also supported people with dyslexia, and challenges herself to regularly research and consult with professionals and organizations that help her advance her learning about other forms of neurodivergence. If you identify as neurodivergent and would like to discuss with Megan what treatment might look like, please schedule a free 20-minute consult.

Autistic burnout is a state of profound physical and emotional exhaustion that results from the sustained effort of navigating a neurotypical world, including chronic masking, sensory overload, social demands, and the relentless energy required to appear "normal" in environments not built for autistic brains. It is distinct from general burnout or depression, though it can look similar from the outside. Autistic burnout can manifest as a loss of skills or abilities you previously had, increased sensory sensitivity, withdrawal from activities and relationships you used to care about, difficulty with executive functioning, and a flatness or emptiness that's hard to explain to people around you. For many autistic adults, burnout is the thing that finally brings them to therapy or to diagnosis, if they haven't received one yet. Treatment for autistic burnout at Spark + Pivot begins with identifying the masking behaviors and environmental demands that have been depleting your nervous system. From there, therapy focuses on reducing the pressure to perform neurotypicality, developing genuine self-accommodation strategies, rebuilding at a sustainable pace, and addressing any co-occurring trauma, anxiety, or depression. EMDR can also be effective for autistic clients whose burnout is intertwined with trauma histories. Recovery from autistic burnout is possible, and requires a therapist who understands what it is, and doesn't mistake it for laziness, depression, or lack of motivation.

Masking refers to the conscious or unconscious suppression of autistic or ADHD traits in order to appear neurotypical. It can involve a wide range of strategies that develop early in life to cope with neurotypical expectations, and may include masking, camouflaging, scripting, and mimicry. It can look like forcing eye contact, scripting conversations in advance, mirroring others' body language, suppressing stimming, performing emotions you don't feel, or working extremely hard to follow social rules that don't come naturally. For many neurodivergent adults, masking begins in childhood as a survival strategy—a way to avoid bullying, criticism, or rejection—and becomes so automatic that it's hard to recognize as something separate from who you are. The mental health cost of chronic masking is significant. Research consistently links heavy masking to higher rates of anxiety, depression, autistic burnout, and suicidality in autistic adults. It also creates a profound disconnect from authentic identity; when you've spent years performing a version of yourself designed for other people's comfort, it can be genuinely difficult to know what you actually think, feel, want, or need. Unmasking—the gradual process of reconnecting with your authentic self and reducing the pressure to perform—is a central part of the therapeutic work at Spark + Pivot. This doesn't mean abandoning all social skills or strategies. It means developing the self-awareness and safety to choose when and how to adapt, rather than masking compulsively out of fear. Therapy, and sometimes a formal diagnosis, can be a powerful catalyst for that process.

ADHD was historically studied almost exclusively in hyperactive young boys, which is why the stereotypical picture of ADHD (impulsive, disruptive, obviously struggling) still dominates public understanding. Women and girls with ADHD often present very differently: more inattentive than hyperactive, more internalized than externalized, and far more likely to have developed sophisticated masking strategies that hide their symptoms from teachers, employers, and clinicians. As a result, ADHD in women is dramatically underdiagnosed. Many women don't receive a diagnosis until their thirties, forties, or later, often after a child is diagnosed, or after a major life transition strips away the coping systems that had been holding things together. In the meantime, the struggles are often misattributed to anxiety, depression, mood disorders, or personal failings. ADHD in women also frequently intersects with hormonal fluctuations. Many women report significant worsening of symptoms during perimenopause, the luteal phase of the menstrual cycle, or postpartum. Rejection sensitive dysphoria, the intense emotional pain triggered by perceived criticism or rejection, also tends to be more pronounced and more recognized as a feature of ADHD in women. At Spark + Pivot, we specialize in working with women and femme-presenting adults whose ADHD was missed, misdiagnosed, or minimized, and we bring that understanding directly into both our diagnostic evaluations and our therapy.

The first important thing to know is that the clinical community's understanding of these two diagnoses is constantly and rapidly changing thanks to ongoing research efforts from the scientific community. For now, we understand ADHD and autism as distinct neurological conditions, with enough overlapping traits that they are frequently confused with each other. In fact, until 2013, a clinician could not diagnose both ADHD and Autism together, but contemporary research shows a meaningful pre-valance of the diagnoses co-occuring in some people. Understanding the difference matters for treatment, because while there is significant overlap in how the conditions can feel from the inside, the underlying neurology and the most effective therapeutic approaches differ in important ways. ADHD is primarily characterized by differences in attention regulation, executive functioning, impulse control, and emotional regulation. It often involves an interest-based nervous system—where focus is driven by novelty, urgency, passion, or challenge rather than importance or intention—as well as time blindness, difficulty with task initiation, and rejection sensitive dysphoria. Autism involves differences in social communication, sensory processing, and cognitive style. Autistic individuals often have strong pattern recognition, intense interests, a preference for consistency and predictability, and sensory sensitivities that can make everyday environments genuinely overwhelming. Social differences in autism are often less about disinterest in connection and more about a fundamentally different communication style that doesn't map neatly onto neurotypical norms. Where things get complicated: both conditions can involve emotional dysregulation, executive dysfunction, social difficulties, and sensory sensitivities. Both are associated with masking, and both are frequently accompanied by anxiety, depression, and trauma. A thorough diagnostic evaluation where oneaccounts for the full complexity of your history and presentation is the most reliable way to understand what's actually driving your experience.

Yes, and it's more common than most people realize. The co-occurrence of autism and ADHD, sometimes called AuDHD, is estimated to affect a significant portion of both autistic and ADHD populations. Until 2013, the DSM actually prohibited diagnosing both conditions in the same person, which meant that many people who had both were diagnosed with only one or neither. That exclusion has since been removed, but its legacy lingers in the form of missed and incomplete diagnoses. AuDHD presents its own unique profile that can be difficult to untangle. The two conditions can amplify each other in some areas while appearing to cancel each other out in others, which can make the overall presentation confusing to assess. Some people find that their ADHD traits mask their autism and vice versa, leading to a presentation that doesn't fit the "classic" picture of either condition. If you suspect you might be AuDHD, a comprehensive diagnostic evaluation that specifically looks for both conditions is essential. At Spark + Pivot, our evaluations are designed to assess for the full picture, including how autism and ADHD interact in your specific presentation, rather than stopping at the first diagnosis that fits.

Yes. We believe that financial barriers should not be the reason someone doesn't get support, and we have built several options into our practice to make care more accessible. Sliding scale fees are available on a case-by-case basis for therapy sessions, with rates starting as low as $45 per session. Sliding scale availability is determined based on income and financial need, and is discussed during the intake process. If cost is a concern, we encourage you to bring it up during your free 20-minute consultation. We would rather have that conversation than have you not get support. Scholarship opportunities are available for clients who need reduced-fee or completely free counseling. These are limited and awarded on a case-by-case basis. Contact us by emailing info@sparkandpivot.co or by calling 214-785-8762 to inquire about current availability. Low-cost counseling is available through our pre-license counseling intern program in partnership with the Masters in Counseling program at Southern Methodist University (SMU). The counseling interns work under the supervision of Megan Parks DuBose, MS, LPC, NCC, and offer individual therapy and couples counseling at significantly reduced rates. Working with a supervised intern is a clinically sound, ethically structured option. FSA and HSA funds can be used to pay for all services at Spark + Pivot, which can meaningfully reduce out-of-pocket costs for clients with these accounts. We recommend checking with your FSA or HSA administrator to confirm eligibility. We do not accept insurance or file in-network claims for any of our services. For therapy sessions, we partner with Thrizer to help clients access out-of-network benefits, which can reduce the effective cost of sessions by an average of 70% after your out-of-network deductible is met. Note that diagnostic testing and career counseling are not eligible for Thrizer or out-of-network reimbursement. To discuss cost and find the right option for your situation, book a free 20-minute consultation at sparkandpivot.sessionshealth.com/request.

The cost of your counseling depends on your goals and the level of training your clinician has. Intake sessions are 80-minutes and range between $60 - $250, and existing patient appointments range between $45 - $200 per hour. We want to provide accessible care when possible, so we offer a sliding scale fee based on income, with a minimum fee of $45 per session on a case-by-case basis. Please contact us for more information on our fees and payment options. Our services are private pay, meaning we do not accept insurance. However, if you have out-of-network benefits for counseling services via your insurance provider, I have partnered with Thrizer to handle the claims process automatically for you. You will still need to make payment, but with Thrizer, you will only have to pay a copay for our sessions after hitting your out-of-network deductible, instead of paying my full fee and waiting for reimbursements. This typically allows clients to save on average 70% upfront on our sessions. During our intake process, I can help you verify if you have out-of-network benefits and how much your copay would be. ​ *Please note that diagnostic testing and career counseling sessions are not eligible for Thrizer pay / out-of-network reimbursement.

We offer individualized career counseling services tailored to fit your unique needs and goals. To get a better idea of pricing, schedule a free consultation or contact us. During the consultation, we will discuss your particular needs and goals and work with you to create a personalized career counseling plan that fits your budget. To get an idea of typical pricing: Intake sessions are 50-minutes and cost $250. If career assessment would be a helpful part of your career counseling process, Megan will work with you to determine which type(s) of assessment(s) are most appropriate. Assessment (including administration, analysis, and a 80-minute interpretation session) ranges between $300-$500 depending on your goals. Client appointments are typically 50-minutes and cost $200. Megan can also structure career counseling intensives in which we work in larger blocks of time (2- to 6-hours) to tackle a broader scope of career counseling tasks. Please contact Megan directly if you are interested in learning more about that option.

No, currently Spark and Pivot Counseling does not participate in insurance programs. Our approach is to provide mental health services without the constraints of insurance company requirements and diagnoses - and to keep your records confidential at a time where certain diagnoses are being stigmatized in a damaging way. We will provide you with a superbill each month that provides information that is typically required to see "out of network" benefits with your provider. If you have out-of-network benefits for counseling services via your insurance provider, I have partnered with Thrizer to handle the claims process automatically for you. You will still need to make payment, but with Thrizer, you will only have to pay a copay for our sessions after hitting your out-of-network deductible, instead of paying my full fee and waiting for reimbursements. This typically allows clients to save on average 70% upfront on our sessions. During our intake process, I can help you verify if you have out-of-network benefits and how much your copay would be. ​ *Please note that diagnostic testing and career counseling sessions are not eligible for Thrizer pay / out-of-network reimbursement. Additionally, you may use flexible savings accounts (FSAs) or health savings accounts (HSAs) to pay for our services.

You have the right to request your health care records at any time and to file a complaint if you have concerns about our services. For detailed information about: Requesting your records Contacting our licensing board (Texas Behavioral Health Executive Council) Filing a consumer complaint Please visit our Client Rights + Information page.