Therapy that doesn't wait for your deductible.
One flat monthly rate, no insurance, no claims, no surprise bill. You come when you need to, not when your insurance says you can.
Dr. Joshua T. Westby, DSW, LICSW-S · 15+ years in practice · HSA and FSA cards accepted
Some weeks you need two sessions. Some months you need none.
Traditional therapy asks you to book the same hour every week whether you need it or not. Membership allows for the flexibility you need. Your rate is the same in a difficult month and a quiet one.
Two ways to pay.
Every rate is posted here. No intake fees, no deductibles, no copays, no surprise bills. No hidden costs of any kind.
Membership · how most people work with me
For steady work over time
- 55-minute sessions, scheduled as often as the calendar allows
- Same rate whether you come twice this month or five times
- Encrypted email between sessions for brief questions
- Cancel any time, no term commitment
- Card on file, charged the same day each month
- Add a second hour in a single session for $50
Or pay per session
For occasional or short-term work
- Full 55-minute session, charged the day of the appointment
- No minimum and no package to buy up front
- Between-session email is not included
- Move to membership whenever the pace picks up
- Add a second hour in a single session for $50
Membership wins once you are coming three or more times a month. Below that, per-session costs less. I'd rather you know the math up front than discover it surprised you in month two.
You book one appointment at a time. After it finishes, you schedule the next one. There's a 24-hour minimum between sessions, so neither of us ends up double-booked and your week stays under your control. No three-month planning required, no guess work on your part.
The first conversation is free.
Fifty-five minutes, no charge, no card, nothing to lose. Bring whatever is on your mind and we will figure out together whether this is the right place for it. If I am not a fit, I will tell you plainly and point you somewhere better.
Book the free intakeFour steps, and none of them involve a claims department.
Book the free intake
Pick a time online. You will get a secure video link and a short set of forms to sign electronically before we meet.
We meet for 55 minutes
Video, from wherever you are in Idaho or Washington. No charge, no card required to hold the appointment.
Choose how you want to pay
Membership or per session. You can move between them, and you can stop either one whenever you want.
Book the next one when you are ready
One appointment on the calendar at a time. Book the next at the end of each session, or later that week when you know what you need.
Your HSA and FSA cards work here.
HSA and FSA accepted
Therapy with a licensed clinical social worker is generally a qualified medical expense. Run your HSA or FSA card the same as any other card, and you will get an itemized receipt for your records. Plans differ, so confirm coverage of membership fees with your plan administrator before you enroll.
Card on file, charged monthly
Your card is stored securely with our payment processor. Membership charges run on the same date each month. Per-session appointments are charged the day of your visit. Card numbers are never stored on our end.
Receipts for your records
You will get an itemized receipt after each month or session. If you have out-of-network benefits, you can submit the receipt yourself to your plan for possible reimbursement. Whether they reimburse you is between you and your plan.
Good faith estimate
Because you are paying without insurance, federal law entitles you to a written estimate of expected charges before your first paid session. You will get one every time you enroll or change plans.
This works well for some people, and poorly for others.
A good fit if you
- Have a high-deductible plan and pay full price for therapy anyway
- Are uninsured, self-employed, or between plans
- Want a diagnosis and treatment record that stays out of an insurer's hands
- Need the freedom to come often for a stretch, then taper off
- Live somewhere with a thin list of local therapists
Not a fit if you
- Are on Medicaid or Medicare, which cannot be combined with this model
- Need psychiatric medication management or prescribing
- Are in active crisis or need same-day or emergency care
- Need a higher level of care such as inpatient, residential, or intensive outpatient
- Are looking for court-ordered evaluations or forensic assessment
Joshua Westby, DSW, LICSW-S
- Doctor of Social Work · Licensed independent clinical social worker in Idaho and Washington
- 15+ years in clinical practice
- Associate Clinical Professor · WSU Elson S. Floyd College of Medicine
- Clinical supervisor for social workers pursuing licensure
I spent fifteen years inside systems that decide how much therapy a person is allowed to have. Integrated primary care, crisis response, and a group practice I helped build and run. The clinical work was good. The machinery around it took more and more of the hour.
This practice is the version without the machinery. No panels, no prior authorizations, no session limits set by someone who has never met you, and no note written to satisfy a reviewer. A card on file, a schedule that is genuinely yours, and one person who knows your history because he was there for all of it.
My work is practical and direct. I will tell you what I think, I will give you something to try between sessions, and I will not spend your money keeping you in therapy longer than you need to be.
Learn more about meThe things people ask first.
Is this insurance?
No. This is a direct agreement between you and me for therapy services. It is not health insurance, it does not cover hospitalization, medication, or any care outside of my sessions with you, and it does not satisfy any coverage requirement. You should carry health insurance for everything else.
How quickly can I actually get in?
Most members book their next session within one to two weeks. I keep the panel deliberately small so that stays true. If wait times start slipping, I stop taking new members rather than let the promise erode.
What if I want to cancel?
Cancel any time from your account or by telling me. Your membership runs through the end of the month you have paid for. There is no cancellation fee and no term you are locked into.
Do you see people in person?
No. This practice is fully virtual by design, which is what keeps the price where it is. You need a private space and a reliable connection, and you need to be physically located in Idaho or Washington at the time of the session.
Can I use my insurance at all?
Not directly. I do not bill insurance and I am not in network with any plan. If you have out-of-network benefits, I will give you a superbill you can submit yourself for possible reimbursement.
What about couples or family sessions?
Membership covers individual therapy. Reach out about couples work and we can talk about whether I am the right fit and what it would cost.
Is what I say confidential?
Yes, with the limits every therapist has: imminent risk to you or someone else, suspected abuse of a child or vulnerable adult, and a valid court order. Without an insurer involved, no claim, diagnosis, or treatment record goes to a third party.
Ready to start.
Book a time that works for you, or reach out with questions.
Email booking@drwestby.com