Frequently Asked Questions

The first step is scheduling a free 15-minute online consultation.

This gives us an opportunity to briefly discuss what you are looking for, answer initial questions, and determine which counselor or service may be the best fit.

You can schedule your consultation here or call our office at 210-294-4264.

You do not have to figure that out on your own.

We consider what you want help with, the type of treatment you are interested in, scheduling needs, location, insurance or payment preferences, and therapist availability when helping you select a counselor.

Sometimes the best clinical fit may not be the first person you initially considered, and we are happy to help you sort through your options.

You can view all of our Clinical Care Team Here

Your first full counseling session is primarily an assessment and planning appointment.

Your counselor will review the concerns that brought you to therapy, relevant history, current symptoms, strengths, previous treatment experiences, and what you would like to change.

Together, you will begin developing treatment goals and discussing what approach may best help you reach them.

You are not expected to tell your entire life story during the first appointment.

Most clients begin with weekly sessions, particularly when symptoms are significantly affecting daily life or when beginning a structured treatment.

As progress is made, session frequency may change based on your needs, treatment goals, and clinical recommendations.

Consistency matters, especially early in treatment.

There is no single timeline that applies to everyone.

We generally ask clients beginning treatment to commit to at least eight sessions so there is enough time to establish goals, begin treatment, and evaluate whether meaningful progress is occurring.

Progress is reviewed throughout therapy, with more formal evaluation of treatment goals completed periodically. Together, you and your counselor will determine whether to continue treatment, reduce session frequency, complete therapy, or consider another service or provider.

Our goal is not to keep you in therapy indefinitely. Treatment should have a clear purpose and measurable direction.

Progress should be more than simply feeling like sessions went well.

Depending on your concerns, we may look at changes in symptoms, relationships, emotional regulation, behavior, daily functioning, avoidance, decision-making, or progress toward specific treatment goals.

Your counselor may also use standardized measures when appropriate.

Treatment goals are reviewed throughout counseling so that we can determine what is improving, what still needs attention, and whether the treatment plan needs to change.

Tell us.

A strong therapeutic relationship matters, and not every counselor will be the right match for every client.

Sometimes concerns can be addressed directly with your counselor. Other times, transitioning to another counselor or treatment approach makes more sense.

If you feel the need to transition to another counselor, HOPE’s leadership team can assist in that process. We would rather help you find a better fit than have you remain in treatment that is not working for you.

Not everyone who comes to counseling necessarily meets criteria for a mental health diagnosis. However, if you choose to use insurance, your plan will require a qualifying diagnosis and documentation showing that counseling is medically necessary.

If a diagnosis is assigned, your counselor will discuss it with you as part of the assessment and treatment-planning process. They can explain what the diagnosis means, the symptoms or criteria that support it, how it relates to your treatment plan, and answer any questions you have.

A diagnosis is not intended to define you. It is a clinical tool used to organize symptoms, guide treatment, and, when applicable, meet reimbursement requirements.

If your diagnosis changes during treatment as more information becomes available, your counselor will discuss that with you as well.

Coverage depends on your insurance plan, the clinician you see, and whether the service meets your insurer's requirements for medical necessity.

Visit our Fees Page for information about insurance plans accepted by our practice.

If we are considered out-of-network with your insurance company, we may provide a superbill that you can submit for possible reimbursement. Out-of-network reimbursement varies by plan, so we recommend contacting your insurance company directly to understand your benefits.

You may choose to pay privately for counseling.

Some clients prefer self-pay because they do not want treatment submitted to insurance, do not meet medical-necessity requirements, or are seeking a service their plan does not cover.

Our Fees page provides additional information about payment options.

Yes. Information discussed in counseling is generally confidential.

There are specific legal and ethical exceptions, including certain situations involving immediate safety concerns, suspected abuse or neglect, court requirements, or other circumstances required by law.

Your counselor will review confidentiality and its limits with you before treatment begins.

Children and adolescents need an appropriate level of privacy for therapy to be effective, while parents and legal guardians also have important responsibilities and rights.

The amount of parental involvement depends on the child's age, treatment needs, safety concerns, and the type of counseling being provided.

Your counselor will explain how confidentiality, parent communication, and treatment updates will work at the beginning of services.

Yes.

We offer both in-person and telehealth counseling. Online counseling is available to eligible clients located in Texas at the time of the session.

Telehealth sessions should take place in a private location where you can participate without significant interruptions or distractions.

We currently offer in-person counseling at:

San Antonio
16170 Jones Maltsberger, Bldg. 100
San Antonio, TX 78247

Schertz
1996 Schertz Pkwy, Suite 402
Schertz, TX 78154

Telehealth Counseling is also available throughout Texas.

Yes, although availability varies by counselor.

Our general business hours are Monday through Friday from 9:00 AM to 7:00 PM and Saturday from 9:00 AM to 1:00 PM.

If you need a particular day or time, let us know during your consultation so we can help identify counselors whose schedules match your needs.

We understand that schedules change.

Appointments must be canceled or rescheduled at least 24 hours in advance to avoid applicable late-cancellation or no-show fees.

Because regular attendance is an important part of treatment, repeated cancellations or missed appointments may also need to be discussed with your counselor.

You will receive intake paperwork before your first full counseling session.

Please complete the requested forms before your appointment so your counselor has time to review important information about your concerns, history, medications, previous treatment, and goals.

Completing paperwork ahead of time also allows more of your first session to focus on you rather than administrative questions.

Sometimes a person's needs change or an assessment indicates that a different level of care would be more appropriate.

If we believe you would benefit from specialized treatment, medication evaluation, intensive outpatient treatment, emergency services, or another provider, we will discuss those recommendations with you and help identify appropriate next steps when possible.

Outpatient therapy is valuable, but it is not the right level of care for every situation.

No. HOPE Therapeutic Alliance is an outpatient counseling practice and is not an emergency or crisis service.

If you are experiencing an immediate mental health emergency or believe you may be unable to keep yourself or someone else safe, call 911, go to the nearest emergency department, or contact the 988 Suicide & Crisis Lifeline by calling or texting 988.