Frequently Asked Questions
Are services in person or online?
Sessions are in-person or online using a HIPAA-secure video link. Weekend intensives are in-person in beautiful, historic Williamsburg, Virginia.
What does therapy cost?
Insurance is accepted for all services except the weekend intensives. For those who prefer private pay, rates are $150/hour for individuals and $175/hour for couples or $225 for 90 min.
Do you accept insurance?
I am in-network with most commercial insurances. I do not participate in Tricare, Medicare, or Medicaid.
What to know about using insurance benefits for couples therapy:
Insurance requires that a person have a mental health diagnosis with documented medical necessity to be considered for payment. In most cases, relationship struggles create anxiety, depression, and sometimes PTSD. For this reason, the insured will be the "identified patient." Billing, diagnosis, and all medical records will be in their name.
What forms of payment do you accept? Credit, debit, HSA cards (and cash if meeting in-person.) Weekend intensives can be paid in installments.
How many sessions will it take?
The answer is, it depends. Every person and couple is different. For people who are ready to receive feedback and make changes, 6 sessions may be sufficient. Others have higher acuity and defenses that have been around for years and it takes time to unpack. Clients in individual and couples therapy are always encouraged to share with their therapist how they are feeling about the therapy and if they would like to stop or continue.
What does couples therapy involve?
Couples therapy with me (Rosemary Via) is quite different from individual in that I take more of a direct leadership role. I spend time teaching concepts, presenting perspectives that are often new to people, and helping folks understand interpersonal human dynamics. I also engage each person in sharing what they are thinking and feeling and use assessments to increase their self-awareness and insight. We also practice having difficult conversations and assess what went well and what didn't. Each session will build on a prior session and you are never left battling about old grievances with a passive observer. Change occurs when the individuals in the relationship develop more emotional maturity, interpersonal skills, and emotional regulation and are better able to stay calm and centered when things are not going their way. With love, commitment, and growth, couples can become unstoppable.
Do you meet with us individually or together each session?
I prefer to meet with both individuals together as much as possible. There are times when I have intuition about something that I want to address privately or I assess that one party needs additional attention to address a problematic behavior, but I prefer for the individuals to be in the room and hearing the other do the work, share their stories, and watch the transformation happening in front of them.
Will the therapist keep my secret(s)?
I cannot guarantee 100% confidentiality to the individuals within a couple if I meet with them separately although I will use high discretion and wisdom with what is shared. For example, if I learn that one partner is having an affair they did not previously disclose to their partner, I will ask if we can present this information together and give the person time to make a decision.
Is it too late to save my relationship?
Only the two people in the relationship can answer this question. Where there is emotional maturity (developed over time,) grace, forgiveness, and commitment, a relationship can be revived. I am always upfront with couples when I see dysfunctional dynamics that are destroying the relational system and share an honest prognosis based on the responses of the participants.
What do I do if my partner refuses to participate?
Seek individual therapy. Being in a relationship requires two people and it only requires one to royally mess it up! If you are the one who is emotionally underdeveloped, emotionally unregulated, unfaithful, or otherwise behaving in a manipulative or destructive manner, therapy can help! If this describes your partner, you will need to learn important skills to maintain your mental health, self-respect, calm, confidence, and problem-solving abilities to assist you in dealing with it. Sometimes both parties need a tune up but one may get started first and the other may be more willing to follow.
What if I am initiating therapy but I'm not sure I want to remain in the relationship?
That's honest and acceptable. It is common to wonder if we can keep going with the relationship the way it is. Seeking individual therapy and looking more deeply at the strengths and areas for growth in both partners from your perspective can bring clarity which is freeing.
Will I be put on the spot to answer questions I may not want to answer?
No. I always offer the "pass" rule. Therapy is voluntary and saying no is a personal right. I respect that. Your partner, however, may not deal with it well if you refuse to answer their question(s.)
What happens if one partner is more motivated than the other?
This is more common than you would think! Typically, one party is quite vocal in saying "I'm not happy." The other may be passive and quite content. But it doesn't take a rocket scientist to figure out that if your partner isn't happy, they may not stick around with you for long (why people don't seem to believe this until it is too late is an enigma to me.) But here's the deal: If both parties aren't willing to put in the work, ask to be an observer of a couples group therapy session and with the group's permission, you may be able to dip your toes in, see what's involved, and change their mind. On the other hand, if they are totally closed off to receiving help despite your pleas, you will want to seek individual therapy because you are in a one-sided relationship.
Will stirring things up in therapy make it worse?
Let's face it - it's already bad. Maybe you aren't talking about the issues, but something is stirred up or you wouldn't be reading this website. So, yes, couples therapy can be intense but I assure you as the therapist that I will remain in the leadership role to keep sessions safe and productive for all involved or we will end the session and pick up another time. Generally, we are chatting about issues that have been previously discussed and you are learning how to see them with new eyes, new maturity, and new skills.
Will the therapist take sides?
If that's what it takes, absolutely, yes. How many people that are harsh and abrasive or incredibly selfish or entitled admit to these unbecoming traits and behaviors until they are called out, brought to their attention, and shown what it is costing them? None. So with love in my heart for all humankind, I will absolutely share with any man or woman what I am observing, how it is impacting the relationship, and what it is costing them. The person behaving immaturely can decide if they will receive the gift of reality and make changes or throw it back and likely lose their relationship. It does not take two to ruin a relationship - one mean, selfish, evil, or manipulative person can completely destroy another human being and any semblance of a relationship they may have once had. "Who are you to judge," you may ask? The person asking this question is likely the person who does not want to see their own darkness. I share my clinical observations to give my clients a chance to become the mature, loving, connected humans they are meant to be.
Will the therapist tell us to get a divorce?
No. This is the decision of the individuals in the relationship. I may be honest and share a poor prognosis if behaviors do not change, but I believe people can change and with help and motivation, their relationships can change, too.
What if my partner wants a divorce?
There are times when a partner brings their spouse to couples counseling to break the news that they are leaving. They know the partner will need the support. There is nothing we can do to make a person stay. Nor would we want to convince or pressure them. Relationships are based on free will, love given generously, and mutual respect. I will help anyone who is leaving or being left to gain clarity; to make wise choices having thought through the long-term consequences; and to rebuild their life.
I'm a person of faith. Can I talk about it in therapy?
Yes, please! I am also a person of faith - Christian, a follower of Jesus Christ. I am happy to incorporate and discuss Scriptures with you if you ask. If you are of another faith and it is important to you, I invite you to share that with me as well so I may be culturally informed and serve you well. I have worked with people from Christian, Jewish, Islamic, and Hindu faiths as well as those who do not believe in a higher power. Faith is a personal choice, but I do have specialized training in Pastoral Care from Loyola University of Maryland to address spiritual issues.
What do you do differently than other couple's therapists?
By being highly interactive, direct and honest, quickly highlighting the patterns, tones, attitudes and behaviors that are negatively impacting the relationship as they play out in real-time in front of me, I guide motivated people through a change process.
I've always believed that shying away from telling couples the truth only allows the dysfunction to continue. I am kind and thoughtful, yet I draw attention to words, tones, attitudes, body language, and intentions that are driving a wedge between them and those they love.
I join with you in replacing toxicity with mature adult relational skills that you didn't learn in school or growing up.
Because I believe we are all capable of being effective partners when we know what to do differently, are willing to do it, and have a safe place to try it out.
The bottom line is, most of us want to make it work!
We genuinely try to talk through the issues. The problem is, when we are in the muck, we are too close to the situation to see it clearly.
We get stuck in patterns. Messy cycles.
With years of practice and genuine compassion, I tell people directly what I am hearing and observing as we interact in sessions.
Sometimes people ask about bias. There's no bias when the focus is on the relationship itself. Working with one partner more than another may be necessary - not to "pick" on someone but to help them see what is outside of their awareness.
I want to see people succeed in relationships so I point out what may be happening based on what I've learned about your life story.
I point out how and where patterns are repeating, what they are costing the client, and I teach people explicitly how to step into a new way of being and communicating so they can feel and experience love.
(And, in case you were wondering, my theoretical orientations are Relational Life Therapy by Terry Real and The Developmental Model of Couples Therapy by Ellyn Bader. I am grateful for their collective wisdom. More about those on the About page.)
Why Doing Nothing Isn't an Option
There's no violence. It isn't always bad. You're both good people. Sometimes everything seems fine but then it happens again.
Conflict starts, the "conversation" goes around in circles, and there doesn't seem to be any resolution. Again.
It's exhausting and stealing your time, peace, and energy. You feel like running away. But where would you go? And then what? Leave everything? Everything you've worked so hard for? Everything familiar. Leave all of the hopes, dreams, and plans for the future? Your home? How would leaving impact the kids? Extended family? Friends (they will take sides?) And who gets the dog?
Everything would be split. Fairly? Yeah, right.
The lawyers would be the ones winning. Retainer fees. Charges for every email and call, filing after filing, parenting fitness evaluations, custody, division of property, visitation and shared holiday schedules. Oh my. Why?
There is so much at stake as every distressed couple is keenly aware of.
Here is what happens when you work with me:
1. I will conduct an initial pre-screening consultation with you and your partner if they are also participating. This is a time for brief introductions, making sure we are the right fit for each other, and initial information gathering.
2. Together, we will determine the proper level of care.
➡️The lowest point of entry is group couples therapy: A weekly online meeting of personally vetted couples (group size limited) who are able to share with each other and receive targeted expert guidance from the specialist to make changes in their relationships with accountability and support.
➡️The next entry point is weekly 1:1 couples therapy. Online sessions with an expert who will quickly help the couple identify the stuck points, understand the costs of remaining the same, providing healing where needed to improve interpersonal functioning, and practicing new skills with support and accountability.
➡️ A weekend intensive is the highest level of intervention. 14 hours of intense work. It may be used as a stand alone to help a couple gain clarity around their path forward. Or, it may be a launching pad for ongoing 1:1 work - getting an accelerated start on the journey. Because there's a lot of work to do and weekly sessions can feel like forever when you are stuck in the muck!
3. With all levels of care you will receive
✓a relationship diagnosis,
✓personalized assessments as appropriate,
✓new lenses through which to view your relationship,
✓real-time, direct feedback on relational connection skills,
✓concrete tools to keep your work focused and productive,
✓a workbook for future reference and journaling, and
priority scheduling for follow up support through our group or couples 1:1.
(Couples who have completed the weekend intensive will receive a 10% discount on follow up 1:1 sessions)
Or, in the case that reconciliation simply is not possible, people will have clarity and resolution to move forward with confidence and respect.
4. You will receive real-time feedback on how you are communicating, how it is being received, and how you are contributing to the hurts or health of the relationship.
5. You will be shown - very clearly - a better way. (The secret sauce of happy connected couples.)