Frequently Asked Questions

Unfortunately, at this time we do not offer a sliding scale or reduced fee schedule for our services.

However, we do run a training practicum for PhD students that is directly supervised by our expert clinicians. We charge a reduced fee for these services (though these services are not offered all of the time or  in all of our treatment programs). If you are interested, please contact our office at 206-374-0109 to find out more.

 From Interstate 5 Northbound:

• Take the Seneca Street exit (#165) on the left.
• Merge onto Seneca Street West.
• Turn right onto 4th Avenue.
• Turn right onto University Street.
• Turn right onto 5th Avenue.
• The IBM tower will be on the left between University and Seneca Street.

From Interstate 5 Southbound:

• Take the Union Street exit (#165B).
• Go forward onto Union Street.
• Turn left onto 5th Avenue.
• The IBM tower will be on the left between University and Seneca Street.

From SR 520 Westbound:

• Take the I-5 South exit toward City Center.
• Merge onto I-5 South.
• Take the Union Street exit (#165B).
• Go forward onto Union Street.
• Turn left onto 5th Avenue.
• The IBM tower will be on the left between University and Seneca Street.

From Interstate 90 Westbound:

• Take the I-5 North exit (#C2) toward Vancouver, BC.
• Take the Madison exit.
• Turn left onto Madison Street.
• Turn right onto 4th Avenue.
• Turn right onto University Street.
• Turn right onto 5th Avenue.
• The IBM tower will be on the left between University and Seneca Street.

Via Light Rail:

• Exit at Union Street/Symphony Station.

Initial Evaluation – Billing CPT Code: 90791

Recurring Sessions – Billing CPT Code: 90834 (38-52 minute session) or 90837 (53-60 minute session)

DBT group/skills training sessions – Billing CPT Code: 90853

Our front office is staffed Monday through Friday, 8:00 am – 6:00 pm. We respond to calls from 9:00 am – 5:00 pm. Evening sessions may be available for ongoing therapy. Please speak to your therapist about their availability.

Payments Accepted

EBTCS accepts payment at the time of service. Our policy is to have a Visa or Mastercard on file. Clients are responsible for all fees.

HSA/FSA Card Policy

Clients may also choose to have an additional Health Savings Account (HSA) or Flexible Spending Account (FSA) card on file. In the event an HSA or FSA is the primary card on file, we require a Visa or Mastercard as a back up.

Our policy is payment in full at the time of service and requires a credit card to be placed on file prior to starting services with EBTCS.

If you are meeting with one of our psychiatrists for medication management and have insurance coverage with Regence or Premera, we are considered in-network providers. This means we will courtesy bill your insurance directly for psychiatry appointments only. All of our therapists are considered out-of-network providers.

Clients are responsible for all charges incurred, whether or not insurance provides coverage. We provide clients with a monthly billing statement for the services provided and fees paid to submit to insurance companies for out-of-network reimbursement.

Therapy Cancellations

If it is necessary to cancel an appointment, you must cancel 24 hours before your scheduled appointment time. You will be charged the regular fee for the session if you have not notified our office of your cancellation 24 hours before the time of the appointment. All voicemails are dated and timestamped. If your appointment is scheduled for a Monday, please leave a voicemail over the weekend to confirm your cancellation.  If you have a contagious illness which might lead you to miss a visit, please call our office at 206-374-0109 to inquire whether telehealth is available to help avoid a late cancellation charge.

Psychiatry Cancellations

EBTCS Psychiatry policy requires 48-hour notice to cancel or reschedule an appointment for any reason. There is a late cancellation fee for any missed or cancelled appointment with less than 48-hour notice. If you have a contagious illness which might lead you to miss a visit, please call our office at 206-374-0109 to inquire whether telehealth is available to help avoid a late cancellation charge.

Clients at EBTCS are responsible for submitting their own statements/paperwork to insurance for out-of-network reimbursement. EBTCS will not bill insurance companies on behalf of clients for out-of-network claims.

We find that receiving treatment from two therapists at once can be very confusing, and in some instances, actually harmful. For this reason, our clients take a break from working with their former individual therapists while in DBT; we are happy to facilitate a return to that therapist after DBT has been completed.

Skills training group is a formal part of DBT for many of our clients. Skills group is designed to teach you new ways of responding, and is therefore considered a very important part of our treatment program. However, there are exceptions. For example, some of our clients only need training in one module, or have already learned many of the skills in another setting. Each client will have a treatment plan tailored specifically to their needs, so this question will be best answered by your provider.

Yes! You may work out your appointment schedule with your provider, but most of our providers offer at least some evening appointments. We do not typically offer weekend appointments.

DBT is the most researched treatment for borderline personality disorder. Although there are a few other treatments with promising data, DBT has the most solid evidence at this time.

DBT is a form of CBT. DBT uses all of the strategies from CBT, with much more emphasis on emotion than is found in traditional CBT. Learning how to identify emotions, experience them effectively, regulate them, and increase pleasant emotions are all strongly emphasized in DBT.

Additionally, while CBT is typically designed for a particular problem or psychiatric diagnosis, DBT is designed for individuals with several chronic problems and/or diagnoses. DBT’s target hierarchy allows the provider to target multiple problems in a structured way. If we think there is a less intensive, briefer treatment that will work for you, we will be sure to discuss that option with you.

Because DBT is designed to address multiple problems, our DBT therapists are well trained and experienced in a wide variety of CBT treatments. As needed your therapist will use other evidence-based treatments for the diagnoses and problems relevant to you.

Most research suggests that individuals with multiple, chronic problems related to emotion dysregulation typically benefit from one year of DBT. However, length of treatment can vary widely. You and your therapist will discuss an estimated length of treatment in your first few sessions. You may successfully complete therapy before that date, or you may choose to stay beyond that date to work on additional targets, but typically we aim for one year.

Dialectics refers both to a means of communication and to a world view. Both are central to the DBT model. This is a complex topic, so we will just give a brief answer here. If you have more questions about this, please be sure to ask your provider.

In brief, a dialectic exists when two opposites co-exist. Instead of focusing on which position is “right” and “wrong,” dialectics would assume there is validity in both points. When one thinks dialectically, one assumes something is being left out from any one point of view; instead of assuming one is correct, one considers what is missing in one’s own perspective, seeks out the opposing view, and can hold both sides as true at the same time. For example, when one is cut off in traffic, instead of thinking, “What a jerk!” one could consider both that they don’t like being cut off AND there are reasons why the other driver did so. Dialectical thinking can be extremely helpful in increasing flexibility and decreasing “black and white” or rigid thinking that can lead to intense emotions.

There are many examples of dialectics in DBT, but the primary dialectic is that of acceptance and change. Rather than focusing only on acceptance or only on change, DBT puts equal, intense emphasis on accepting an individual just as they are AND working hard to change the responses (emotions, thoughts, overt behaviors, etc.) that are causing problems.

A dialectical world view also emphasizes the interconnection of all things. A relevant example relates to the “identified patient” in a family. Instead of laying blame on a particular person (e.g., the client, the parents, etc.), a dialectical world view suggests that each family member’s behavior influenced the other members, and that with enough interactions over time, both sides can have significant influence on the other. In other words, our responses are caused by events, and our responses in turn cause other events; we can understand and change these patterns without judgment and blame.

There are many other ways dialectics arise in treatment, including creating balance in one’s life and in one’s therapy sessions. Your DBT therapist will discuss this concept with you and provide more examples.

Our goal is to help you build a life worth living. We want to help you develop and reach your own personal goals by understanding your own reactions to distress and using DBT skills and other strategies.