Dr. Judi Sprei and Associates - MD and Metro D.C. Area Therapists Specializing in DBT & Trauma

         Adult, Young Adult, and Adolescent DBT Program Description
Program Structure:  
We offer three treatment options. The vast majority of clients who contact us for DBT benefit most from the first option, Comprehensive DBT.  
1.       Comprehensive DBT:  If someone recommended DBT to you, this is the treatment that they probably meant. Comprehensive DBT is the evidenced-based treatment that is recommended for people who want to more effectively cope with issues of emotional dysregulation. Comprehensive DBT includes four (or 5) components:
a.       DBT Individual Therapy - once a week individual therapy based on DBT philosophy and practice. This is not the same as individual therapy with a -DBT therapist.
b.      DBT Skills Training – usually in a group format, but can be taught individually if needed. See description below.
c.       DBT Phone Coaching – brief phone conversations with your individual DBT therapist to generalize the use of skills in your everyday experiences and to help prevent crises from developing or accelerating between sessions.
d.      DBT Consultation Team – DBT therapists participate in a DBT Consultation team to further enhance treatment.
e.      Parent Group – For adolescents and young adults who are living at home. Teaches DBT skills for parents. This group is highly recommended and often required for parents. It is not required but highly recommended, for parents of adults and for parents of young adults who are not living at home.    
2.      DBT Informed Therapy: We offer DBT informed therapy on a case-by-case basis after collaborating with you and, where applicable, your current therapist and carefully considering whether or not this would be an effective form of therapy for you. DBT Informed Therapy might mean attending a skills group while having weekly individual therapy with a -DBT therapist. Sometimes, DBT informed therapy means being seen once a week for a session combining individual therapy and skills acquisition.
3.       Advanced DBT: Some clients have already participated in DBT skills groups and know and use the skills, but would like further individual therapy to work on other issues. We also offer advanced DBT skills groups for clients who know the skills and would like additional group experience to work on further enhancing using the skills in life situations.   
      Advanced Group – Tuesdays: 430 – 6    1x month          Dr. Judi Sprei
4.       Adult Skills Groups.  DBT skills groups are where you learn the skills to regulate your emotions. DBT Skills Groups are taught in a cycle. By the end of each cycle, clients have been taught all of the DBT skills. Clients may enter a group at various points in the cycle. We ask each client who is entering a group to come in with the expectation of remaining in the group for at least one complete cycle although our expectation and the research on DBT’s effectiveness is based on participants staying in the group long enough to go through each session in the cycle at least twice. Most members do remain in the group for at least two cycles. Cycles vary by group, but usually last from 24-36 weeks. Clients join the group after completing their individual orientation sessions (usually 3-4 sessions.) Your individual therapist will help you decide if you are ready and have the commitment and motivation needed to join a group. To prevent quick turnover and to give each person a chance to really experience the group beyond those initial few sessions when many people are understandably nervous and apprehensive about being in a new group experience, we require all new group members to commit to paying for 8 session, payable one week at a time, regardless of whether they remain in the group for 8 sessions.
Most group sessions are 90 minutes long. Our groups usually have one therapist and 6 - 7 group members. All group members are required to participate in weekly individual psychotherapy.
We know that many people are apprehensive about joining a group. We also know that most people who come to our groups end up loving them and benefiting from them!   
               Group Times:
We currently offer adult DBT groups on the following days and times (please ask for updated information since new groups are sometimes formed when these are full.)
               Tuesdays:   6:45 – 8:15 p.m.    Dr. Alisa Breetz  - young adults
               Wednesdays  2:30    Dr. Judi Sprei (waiting list for next day time group)
                Thursdays: 4:00 – 5:30 p.m.   Dr. Judi Sprei
                Thursdays: 6:45 - 8:15 p.m.    Dr. Alisa Breetz
 We do not always have openings in all of our groups. We will let you know which groups are available when we have further contact with you. Additional adult, young adult, adolescent and parent groups will be started as time and space permit.
Adolescent, Young Adult, and Parent DBT Program Description
Adolescents:  We have 3 therapists in the practice who offer individual DBT to adolescents. Our adolescent skills groups are run by Mark Becker, LCSW, and Amanda Jacob Pezzanite, LCSW. In addition to Mark and Amanda, Hope Qi offers individual therapy for adolescents and will start a Sunday skills group if needed. If these groups are full or do not meet your schedule, we start a new group, coordinate with one of the other Comprehensive DBT programs in the area or offer DBT skills training on an individual basis.
The times of our adolescent groups change periodically so are not listed here. When we talk with you, we will let you know the current times and types of groups that are available to you.
                 
Parents: We offer individual therapy and skills training to parents to help you learn the skills that are being taught to your children and to support you in dealing with your own emotions/behaviors in dealing with your child’s emotional dysregulation issues. The parent’s group is facilitated by Dr. Deborah Zlotnik and is currently held on Wednesday evenings. The focus of these sessions is on helping parents of children of all ages learn skills to more effectively handle your own emotional reactions and behaviors. This group is very strongly recommended and often required for parents of adolescents and young adults who are living at home. The group is optional for parents of adults and for parents of young adults who do not live at home. Parents are understandably hesitant to add another therapy appointment to their busy, often overwhelming, lives. Yet, most parents soon say that attending this group has helped them tremendously and actually leads them to feel less overwhelmed and less alone. The group is a supportive place to learn how to cope with the enormous stresses involved in helping a beloved child in their struggles.      
The group is also open to parents who have young adults away at college and perhaps in a DBT program somewhere else. It is highly recommended that all parents of adolescents/young adults in DBT participate in a parent psychoeducational program either on an individual or group basis. 
                  Parent Group – Wednesday evenings    Dr. Deborah Zlotnik
 
Couples/Families: We offer DBT for couples and families who would benefit by using DBT to enhance their relationships.
Multifamily Group: In this skills group, parents and adolescents meet together and learn the skills at the same time.  We currently do not have an active Multifamily skills group. If you are interested in this type of group please let us know and we will put you on our wait list for a future group.  
Parent Coaching: This option allows parents to have their own DBT coach to call when they are feeling emotionally dysregulated and need coaching so that they can most effectively and skillfully interact with their child (of any age.) Several sessions with the coach usually required prior to starting phone coaching.
Finances
Insurance:  We are out of network for all insurance. You will be given a bill at each session that you can submit to your insurance company for out of network reimbursement. We do not participate in Medicare. Dr. Sprei and Mark Becker have signed opt-out agreements with Medicare thus allowing Medicare clients the option of signing a contract agreeing to self-pay and not submit their bills to Medicare. The other members of the practice are currently unable to see Medicare clients, even if the client wishes to self-pay. Per Maryland law, we are unable to see Medicaid patients even if you want to self-pay. 
Fees:  We are out of network providers for all insurance.
Payment in full is expected at the time of service. We provide a bill that has all the information needed in order for you to submit the claim to your insurance company. You might want to check with your insurance company to find out how much they will reimburse you for out of network therapy for procedural codes 90791 (Initial psychiatric diagnosis evaluation); 90834 ( Individual psychotherapy) and 90853 (Group therapy.) Most weeks you will have one individual and one group session. 
Please note that we prefer to be paid by check or cash. However, we now accept credit cards. A surcharge is added to all credit card transactions. The surcharge is no greater than our cost of acceptance in using credit cards and will usually be approximately 2% of the total fee if the card is swiped and 3.5% if it is keyed in. This comes out to approximately $5 per session.
We require that all clients have a credit card on file with authorization to charge your credit card for missed appointments and past due balances. If you prefer to not have a credit card on file we offer the option of making a prepayment on your account equal to two week’s worth of services. This prepayment will need to be replenished if it is used to pay for missed appointments. The prepayment will be applied to your last two weeks of services with us or refunded to you upon the completion of therapy. 
Reduced Fees:  We offer some reduced fee therapy for people in financial need. However, these spots are quickly filled and do not open up very often. We do not put people on a waiting list for reduced fee openings since the wait would often be over 2 years and we do not want anyone to wait that long to start addressing their issues. If you cannot afford our services, we suggest you either find someone in your network who offers a combination of cognitive behavioral therapy and mindfulness or talk to us to see if you might benefit from DBT informed therapy where you participate in one of our DBT groups while seeing an in-network -DBT therapist for your weekly individual sessions. To the best of our knowledge, there aren’t any in-network comprehensive DBT therapists in the DC Metro area.     
 
Single Case Agreements/Exception: Some clients are able to obtain a special arrangement with their insurance company to receive more than usual reimbursement for a specialty service such as DBT. Sometimes you end up only paying the same copay as if you went in-network while your insurance pays the remainder of the fee. This is often called a Single Case Agreement or a Single Case Exception. Please make sure to check our website (dbtpsychologist.com) and look under “Talking to your insurance company” for more information about this option. Based on prior experience, we will only accept this type of agreement if the insurance company directly reimburses you and you still pay for your sessions yourself. We will not accept direct reimbursement from insurance companies except where required by law. If your insurance company takes a long time or makes it difficult for you to obtain services recommended, we suggest you contact the Maryland Insurance Agency since they are there to help you and to protect your rights. If you do this please send a copy of your letter to Dr. Sprei
 
We hope this answers your initial questions regarding our DBT services. For further information about DBT and our approach to treatment please visit our website. If you have further questions or would like to schedule an appointment please contact us at judisprei@gmail.com or (301) 229-0063.
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