For those in urgent need or crisis, please call your local mental health hotline. Dial 988, or in Portland, dial direct: 503-988-4888. Note: If you suspect stalking, please see the security page to find out how to remove evidence of your visit here.
While covid dramatically reduced turnover, the wait list is now been coming down since 2023. In 2018, I began a separate wait list to accommodate the often urgent timeline required by couples on the verge of breakup. As of today (December 2025), the couples list is caught up. Individuals can expect to wait at least 6 months, and the list length has come down to 50. While I will do my best to provide referrals, many times there will be none. For those in crisis, please call your local crisis helpline. (For Portland, this is 503-988-4888. Otherwise, dial 988, and you'll be directed to your local line.) Especially with the rise during covid times and the influx after covid, many therapists are keeping wait lists, and the most direct strategy may include requesting inclusion on multiple wait lists.
Each state and country regulates the licensing and practice of therapy differently. Some allow cross-border therapies while others do not. Some countries do not regulate at all, which actually brings its own set of issues. Unfortunately, I do not have time myself to study the laws of each state and country, so if you would like to attend remote sessions, I will ask you to please provide a link to official documentation that shows your local laws and requirements regarding out-of-state outpatient mental health. Oregon law, at the time of writing this, does allow for cross-border therapy by Licensed Professional Counselors (LPC) as long as laws on the remote end are respected. Separately, insurance companies provide different coverage to different regions, and even with covid exceptions many will not pay for out-of-state mental health. Payment options may require negotiation.
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I use a body-based approach that relies on visual connection and attention to senses, including touch. Attachment work is actually body work. We are tracking one another constantly for non-verbal cues of acceptance, welcoming, curiosity, judgment, rejection. As such, this approach works best in person.
(Note - I closed my full-time office during covid and plan to update this section when I find an office that fits part-time demand for in-person therapy. Currently, full-time teletherapy is available.)
1. My office is not wheelchair accessible. It is located on the second floor, and the building has no elevator.
2. For those sensitive to mold or odors, while my room itself is ventilated through HVAC, the building you'll walk through does produce mold during rainy season. Also, while I attempt to keep odors out of my office, I do work in a suite of offices, and neighbors sometimes use products necessary for their practice (incense, body oils, etc) that could be physically triggering for some individuals.
I do provide service (and enjoy doing so) to those working in mental health.
Security, Privacy, and Informed Consent
Federal HIPAA and HITECH legislation set standards in place to protect your privacy rights. Particularly with communication, these laws establish an expectation of...
encryption of all protected health information, both at rest and in motion
contracted collaboration across industries to provide that and to share risk/responsibility
full disclosure and informed consent for those protected
Federal law requires healthcare providers to inform you as soon as possible of potential security risks inherent in various communication methods and to provide fully-secure options should you wish to use them. Weighing risk and convenience, it is then your right to choose any communication option(s) that work best for you.
(Note: Security does not equal HIPAA-compliance, and vice-versa.)
Potential methods of contact...
(Note: A Business Associate's Agreement (BAA) is required between health care providers and any company that has potential access to protected health information. This legal agreement shares a level of responsibility with the contracted company to audit access, guarantee respect of confidentiality by all employees, and disclose any detected security breaches. More at HHS.gov ...)
1. (4pts)
(HIPAA-compliant when ensuring informed consent)
Form will not show unless cookies and SSL encryption are enabled and active.
Encrypted end-to-end (PGP for message and SSL for connection), No evidence stored in your 'sent' email
No BAA at front end (industry norm for web hosting companies)
No BAA at front end, usually no encryption, record of contact
Always encrypted once received, including BAA with Proton Mail
Can be made fully HIPAA compliant and very secure (encrypted start, end, and connections, with BAA) by signing up for a free account at Proton Mail (5pts)
Or can be made more secure by setting up your current email client to send encrypted messages, using my (Jeremy's) public key, which you can download here
Or can be made more secure through use of encrypted attachments (password-protected pdf files, available through many print-to-pdf apps) with an agreed password (already optionally included as part of the intake paperwork)
(calls generally exempt from HIPAA, voicemail and fax HIPAA-compliant when ensuring informed consent)
No BAA at front end, usually no encryption for message or connection, record of contact
Call records, fax, and voicemail always encrypted once received, including BAA with Spruce Health
While a typical initial contact call to a provider may be considered HIPAA-exempt, further calls, without informed consent, may remain very limited in content and duration. These calls can become very secure and open to greater scope of communication (encrypted start, end, and connections, with BAA) by signing up for an account through the free-for-you Spruce Health App using this invite link . (5pts)
No BAA at front end, usually no encryption for message or connection, record of contact
End Point (Spruce Health App): Records always encrypted once received, including BAA
Can be made HIPAA compliant and very secure (encrypted start, end, and connections, with BAA) by using the Spruce Health App for free with invitation code (5pts)
5. (5pts)
(HIPAA-compliant, though usually reserved for connection after initial contact using other methods)
Encrypted video and/or audio conversation, optional file transmission, no records kept, no registration required, with BAA at Doxy (Sign in here )
6. (0 to 3pts)
(Not HIPAA-compliant or confidential)
Depending on platform, may not be encrypted. No BAA. Often creates a record over which neither of us have control, and often remains viewable to general public. (Plus I may never even see the message.)
7. Snail-mail (so far, considered HIPAA compliant)
8. In-person (most secure method)
Scoring Method (5 points maximum):
Encrypted at rest = 1pt (potential 2 points if encrypted at start and end points)
Encrypted in motion = 1pt
BAA = 1pt (potential 2 points if BAA at start and end points)
Note: Online intake forms are encrypted end-to-end with BAA (5 pts)
Also note: Services are listed here, not as advertisements or endorsements, but to ensure compliance with HIPAA. They are not sponsors. I am not an affiliate, and I receive no financial benefit from your use of these apps or clicks on these links.
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