How We Work

Preliminary Consults
An introductory consult is typically 90 minutes long, though can go longer when health and medical history are complex enough to warrant it.  We need ample time to get to know each other and to discuss the nature of the problem.  During the introductory consult I may make some preliminary recommendations and you will likely leave our session with some ‘action items.’ At least 24 hours in advance of our call or meeting please forward any lab results you would like me to review, any relevant treatment plans, diagnoses, or evaluations from other providers that you would like me to see, as well as answers to the intake questions I provide.

Second Consult – Action Plan
A second consult should take place very soon after the first consult and is typically 60 minutes long.  For the second consult I will prepare a detailed implementation ‘plan’ with suggestions for lifestyle modifications, dietary changes, supplements, and/or laboratory work where applicable.  I may also recommend additional support from a professional or professionals in a different discipline, if applicable.  During the second consult we will review each of these suggestions closely.  Details of this review will include recommended order of action items, what to expect, troubleshooting, and feasibility for your family of the things recommended (with substitutions and adjustments made where necessary).  At the end of the second consult, you should have a clear and actionable idea of what to do next.  I cannot overestimate the importance of this step.  I have found over the years that people sometimes receive very good advice with very few instructions about how to implement that advice and few instructions about what to do if some of the recommendations fail or backfire. 

Follow-Up Consults – Implementation Support
While some families are happy to take an action plan and run with it, many wish for more consistent support.  In a follow-up consult we review your progress in detail.  We look at what is working and what may not be working.  We assess, we readjust, we refine.  And then we refine again.  Follow- up consults are typically 60 minutes long (but can be scheduled for 15 or 30 minute sessions if just a quick update or brief questions are required).  You decide the duration and frequency of follow-up consults.  Know that your needs may shift over time.  In a period of intense implementation your situation may benefit from monthly, bi-monthly or even weekly support.  As your situation becomes more stable less frequent consults are more typical. 

Methylation Profile Consults
If you have received the results of a methylation profile and want to understand more about its possible implication for your or your child’s health situation, you may schedule a separate methylation consult to review that information.  Methylation profile information is always more powerful/impactful when viewed alongside laboratory work and current clinical situation.  On its own, it may set up predispositions and reveal ‘fault lines’ in our systems.  It is not a fate set in stone.  Methylation support is thought to play a crucial role in reversing chronic illness, supporting detoxification pathways, and preventing chronic illness from occurring in the first place.  Please know that I am very committed to taking methylation profile information into account when making diet, supplement, and lifestyle recommendations regardless of whether we consult directly on this matter.  

Conference with Doctor or Other Health Provider
If you are working with a doctor or other health provider and would like me to attend an appointment with you, I am able to do this in person on a very limited basis within the Washington, DC metropolitan area or by phone/Skype.  Hourly consult fees apply (as does a modest travel fee for in person meetings).  It can be helpful to have an additional attentive ear in the room when complex information is being shared, decisions are pending, or you are unsure of what questions to ask.  Or you may simply want the people on your support team to work together. 

Just for Parents
If you are the parent of a chronically ill child it can be very difficult to step back and explore some of your own underlying beliefs about your child’s condition, as well as the emotions that may be attached to those beliefs.  For understandable reasons, parents of chronically ill children often find themselves in ‘crisis mode’, with lots of fears for themselves and the child.  Parents who are able to acknowledge or maybe even overcome these fears may be more equipped to address the child’s needs.  Also, children usually pick up on their parents’ fears, whether they are able to express themselves or not and this can slow the healing process more than many people imagine.  It can be helpful to schedule a consult ‘just for parents’ to explore how their own (conscious or subconscious) attitudes and beliefs may be helping or hindering the child’s progress.  

I offer 15 minute ‘check-in’ phone calls for regular clients who need some quick targeted support.  They are billed at 25% of the current hourly rate.  Sometimes people just need a sounding board for next steps or clarification about something.

Email vs. Email Consults
I am always happy to answer emails and to clarify points from our consults.  Too often people get stuck when they are not sure who or how to ask for help.  Please just send a message!  However I have also found that some clients prefer to do the majority of our follow-up work via email instead of over the phone.  Under the right circumstances this can work out really well, particularly if you are a person who likes to write and keeps good records, wants really frequent concrete feedback about how things are going, or you have too many constraints during the work day.  If you’re interested in working by email we can probably customize a solution that suits both of us.



Hourly Rates
Current rates are $120 per hour and additional time is billed in 15 minute increments at the rate of $30 per 15 minutes.  A preliminary 90 minute consult is $180 and includes my time to review any materials sent in advance of our time together, including current lab work, previous lab work, narrative summaries of the problem and anything you would like me to see before we speak.  Note: If your problem has a long history, and requires the review of multiple sets of lab work, multiple protocols and recommendations, then an additional fee, usually no more than $50, will apply and I will notify you in advance so you can decide whether you would like me to proceed.

Consult Packages
I can often add more value if we meet on a regular basis.  If you commit to meeting twice a month for six months I will reduce my normal fee by 10%.  If you commit to meeting once a month for six months I will reduce my normal fee by 5%.  Many coaches offer a ‘program’ with a pre-set number of meetings, a clear start and a clear end.  I prefer to let your individual situation drive the frequency of our time together.  Sometimes people are surprised when something they anticipated would be hard resolves very quickly.  Others start for one reason but find themselves coming back for another.  And sometimes it turns out that you need something I cannot offer.  There is never any ‘one size fits all’ but if we are going to meet frequently you may want to consider a consult package.
An invoice will be generated for each consult.  Payment can be made by check or by PayPal.  Checks should be made payable to Integrative Health Strategies and, where applicable, mailed promptly.  

Financial Hardship
In a perfect world, financial hardship would not be an obstacle to the reversal of chronic conditions.  In reality, getting support may be quite costly and is out of reach for many families.  I reserve a limited number of spaces for people who are serious about doing the work but not able to pay full fee.  If that describes you, please contact me directly to see what opportunities are currently available.