White Pine Behavioral Health

Joel Guarna, PhD
Licensed Psychologist


Office Location:
25 Middle Street
Portland, ME  04101


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Frequently Asked Questions

What is cognitive-behavioral therapy?
Click HERE for answer.

What is ACT (Acceptance and Commitment Therapy)?
Click HERE for answer.

How will my therapy affect my other healthcare?
I will gladly work with your primary care physician and other healthcare providers that you already see. My background as a PhD-level psychologist means that I will not prescribe or recommend medications or have any direct input on your medical care. However, behavioral health and physical health concerns are often intertwined. For example, think back over the last several years. What issues have taken you to your physician? Are there psychological or behavioral issues that impact on your reasons for seeking medical care? Do you eat, drink, use other substances, or smoke to cope with stress? Is your health a high priority in your life, not just in the abstract, but in your day to day life? What do you do to promote better health and wellbeing in your life? Does your daily life demonstrate a sense of balance between your emotional health and physical health?

It may seem like you do not have the luxury to experience such wellbeing. After all, our healthcare system tends to minimize the behavioral aspects of our physical health, even while we know that such policies are short-sighted. For example, this article discusses how high quality psychological care can be cost-effective and support your other healthcare.

How long will I be in therapy?
Time-Limited Therapy. The duration of therapy is difficult to predict. If you are entering therapy for a clear problem and with clear goals, such as coping with anxiety attacks, overcoming a specific fear, or resolving relationship problems, therapy may be direct and short-term. For many common problems, there are a evidence-based therapies that can be conducted within a relatively short period of time. As a cognitive-behavioral therapist, I will use these evidence-based therapies whenever the circumstances are appropriate and if you agree that the treatment is a good fit for you.

Long-Term Therapy. If you are struggling with life-long patterns of unhealthy behavior, if you have been stuck for a long time, or if you are trying to stop an addiction or address a chronic health problem, we may maintain a long-term therapy relationship (to review an interview in defense of long-term therapy, click HERE).  Please note that long-term does not necessarily mean that you will attend sessions weekly or indefinitely. At some point, after goals have been achieved and progress has been made, we may agree to less frequent sessions to help you maintain changes. Or we may take a break from therapy with the option of your returning if you feel a need to do so.

It is also important to remember that you are not committing to any particular course of therapy when you first come in. Therapy is a fluid process and it will always be centered on your needs at the time. If your preferences or your goals change, so will your therapy. When you begin therapy, we can set a reasonable time-limit for re-examining your progress. When this time expires, we will check-in to determine if we are headed in the right direction. If not, we will change course or seek alternatives, such as a different therapy or another therapist.

How much will therapy cost?
The answer to this question, of course, depends on how long you will be in therapy and how you will pay.  (You can view my fees and policies here.)  The primary means of paying is either self-pay or using an insurance or managed care plan. The online article, Why See a Psychologist?, reviews some of the pros and cons of these payment options. If you decide to use an insurance or managed care plan, please consult with them to determine (a) whether your plan will pay for you to see me, (b) your benefits, (c) your co-pays, and (d) any deductibles you may have. This process can be confusing; you may want to use this form to help you navigate the phone call to your managed care company.  If you decide to self-pay, we can discuss ways to meet your needs within your budget.

Which insurance or managed care plans do you accept?
Visit the managed care page for a full and up-to-date listing of plans I accept.  There are several popular insurance plans that I do not currently accept.  If your plan includes out-of-network benefits, you may still be able to see me with such benefits.  Call your insurance provider to determine if you have out-of-network benefits.  You may also choose to self-pay and submit invoices to your plan for reimbursement.  Again, call your insurance provider to see if this is a viable option. 

Why do you not accept my managed care plan?  Why are you not an in-network provider for my plan?
There are several reasons why I may not accept your plan.  Some plans make joining their network or plan difficult or even prevent new therapists and doctors from joining.  Other plans become intrusive, are too involved in patient care, or have unsatisfactory behavioral health coverage, so I choose not to be a member of their network.  Some are too difficult to work with for other reasons.  Others have too few members in this area to warrant going through the application process.  And some plans simply reimburse at levels that are unacceptably low.

Should I self-pay (out-of-pocket)?
Many therapists have observed that a growing number of clients are choosing to pay "out of pocket" for therapy.  There appear to be several factors driving this trend, including concerns about confidentiality when using managed care, frustration with poor service or coverage, rising co-pays and deductibles, restrictive policies that prevent clients from seeing the therapist of their choice, and an overall desire to have more freedom to choose how, when, and with whom to do therapy.  How much these concerns matter to you, and whether you have the ability to self-pay, are individual concerns for you to consider prior to starting therapy.  I will be glad to talk with you about these issues if you would like.

Self-pay: Is the cost worth it?
We could say that a service is “worth it” if its value matches or exceeds its cost. So, to answer this question for yourself, you must first determine the potential value of therapy. Consider the questions below.

  • What do you want or expect from therapy?
  • What would it be worth to move forward with your life?
  • If you could find freedom from your stuck-pattern of anxiety and avoidance, what would that be worth?
  • If you could get through down periods in your mood without your life grinding to a halt, what value would that have?
  • If you could find a way to accept a problematic aspect of your past, to let it go, and to move on, would that be valuable to you?

In his online article, The Value of Therapy, Ivan Miller, PhD, reviews some of the considerations in deciding whether paying for therapy out-of-pocket makes sense.  You may also want to compare the cost/value of therapy with the relative cost and value of other common expenses. 

Office Location & Mailing Address
25 Middle Street
Portland, ME  04101


  Phone: 207-272-8500
Fax: 207-773-7386

Copyright 2006
White Pine Behavioral Health LLC