FAQs

What is a first session at Desert Wise like?
What is therapy like?
Who can attend my appointments with me?
Given Desert Wise’s military specialty, will my therapist reveal my therapy information to the DoD?
More generally, who will be able to find out that I’m in therapy?
Do I have to be military-connected to be seen at Desert Wise?
Does Desert Wise do one-time evaluations and/or second opinions?
Will I have to take medication as part of my treatment?
What if I don’t feel my therapist is the right fit for me?
Can Desert Wise med-board me or put me on profile?
Will therapy impact my security clearance?
As a military-connected individual, do I need a referral to be seen at Desert Wise?
How does Desert Wise train its civilian clinicians to effectively work with military-connected individuals?
What do I do if I have a concern about how a mental health therapist is practicing or conducting business?
What do I do if I’m feeling suicidal or am worried about a loved one taking their life?


What is a first session at Desert Wise like?

  • The first session will heavily focus on who you are, what your concern is, your background, and what you hope to accomplish in treatment.
  • This session is designed to:
    • efficiently gather a lot of information
    • give both you and the therapist an opportunity to determine whether this therapeutic match is a good fit
    • determine the best course of action for your care
  • You will be given the opportunity to ask questions, state preferences, and address concerns.

What is therapy like?

  • The nuances of therapy vary from one therapist to the next, one therapeutic approach to the next, and one patient to the next. That said, the below descriptors are generalized to best capture the essence of how most Desert Wise clinicians conduct therapy.
    • You will have a standing appointment time (i.e., the same day/time every week or every other week) to optimize consistency and ease of scheduling.
    • The therapy hour is typically 53-55 minutes, which allows your therapist time to write your session note and attend to other tasks prior to starting their next session.
    • Therapy is an active process, so we believe in doing more than talking about recent events. Your therapist will likely check-in on recent events to see if attention is needed there, but they will also continue to return focus to what brought you to therapy, as well as your stated treatment goals.
    • Your therapist will likely want an in-depth account of your life history, as the totality of our life experiences can shape how we see the world, exist in our relationships, respond to adversity, and conceptualize ourselves.
    • Your therapist will see you and your life story through a lens of compassion, and they will help you to see yourself more clearly.
    • Your therapist will help you identify your priorities and core values, and they will help you examine changes you can make to live in better alignment with your values.
    • Your therapist will identify patterns in your behaviors, emotions, thought processes, and defenses, and, together, you will examine where these patterns originated and how unhealthy patterns can be modified.
    • Together, you and your therapist will identify possible solutions to problems, and you will work toward implementing these changes.
    • Your therapist will rarely give you advice, as we believe that preserving your autonomy is essential. Instead, your therapist will help you examine cost-benefit analyses and may point out blind spots, and they will work to empower you in your daily life.

Who can attend my appointments with me?

  • Whether virtual or in person, bringing someone else to your therapy sessions, in general, is something that you and your therapist should discuss and agree upon beforehand, to ensure that it is clinically appropriate, useful, and in your best interest to do so.
  • Desert Wise only permits ADA Service Animals to attend in-person sessions. Pets and emotional support animals should be left at home.
  • We do not permit minors to sit in your therapy session, as this can be disruptive, and the content of the session isn’t likely appropriate for a child.
  • Children should never be left unsupervised in the lobby. Desert Wise is not responsible for the safety of a child left unattended on the premises. Your therapist may ask you to reschedule your appointment if you bring your child.

Given Desert Wise’s military specialty, will my therapist reveal my therapy information to the DoD?

  • When the MTF refers an active duty service member to the network for therapy, the network therapist is required to make certain disclosures.
    • Kirtland AFB, for example, requires that we provide quarterly summaries regarding your treatment IAW AFI 44-172, section 2.6.1. The information we include in these summaries is minimal (e.g., diagnosis, prognosis, progress).
    • The Referral Management Office at the MTF periodically requests records, and for active duty, we are required to comply with these requests.
    • In rare circumstances (e.g., suicidality), personnel at the base Mental Health Clinic may contact us to coordinate your care and safety plan.
    • Even though we are required to comply with the above disclosure requests, your therapist will advise you of these disclosures, and your therapist will always be willing to answer questions or discuss any concerns you have about our clinical documentation. Further, we maintain a full disclosure log for each patient, which enables all patients to request a full accounting of all disclosures made.
  • Spouses of active duty service members are not required to submit to the above disclosures. Spouses are permitted to decline record requests from the MTF, and spouses must sign a release of information for all disclosures to the MTF.
  • Drill status Guardsmen and Reservists are not generally tracked by the MTF and must sign a release of information for all disclosures to the MTF.
  • Civilians must sign a release of information for all disclosures, excluding those outlined in the exceptions listed below.

More generally, who will be able to find out that I’m in therapy?

  • Generally, your treatment status and information are only available to the people you disclose it to. Exceptions include:
    • When a patient reports intent to harm themselves or someone else
    • When a patient reveals abuse to a vulnerable population (e.g., children, elderly, disabled)
    • When there is a court order, subpoena, or other lawful demand
  • Except for the situations above, your mental health therapist generally is not authorized or permitted to release any information about you without your written permission.
  • Your mental health information is protected by the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the HIPAA Privacy Rule, and the federal Privacy Act of 1974 (5 USC § 552a).
  • Some employers, graduate schools, professional boards, or regulatory agencies may ask you for counseling records. It is the patient’s decision to acknowledge whether he or she has received therapy.
  • Note: As described above, active duty service members are subject to different disclosures to ensure fitness for duty, mobility, etc. All Desert Wise providers are equipped to discuss the nuances of military disclosures with you and address any concerns you may have. 

Do I have to be military-connected to be seen at Desert Wise?

  • No. While we do specialize in providing treatment for military-connected individuals, all of our therapists were initially trained as generalists, which equips us to provide therapy for the general population. We welcome civilians at Desert Wise.

Does Desert Wise do one-time evaluations and/or second opinions?

  • Yes. Desert Wise staff conducts one-time evaluations for various purposes. We have experience in the following types of evaluations:
    • Fitness for duty evaluations for employers and programs needing to ensure their staff and/or trainees are safe/able to complete their jobs
    • Diagnostic evaluations for veterans pursuing VA benefits
    • Diagnostic evaluations for individuals seeking waivers for military service or specialty employment (e.g., FAA, medical professional boards)
    • Functional evaluations for individuals attempting to return to work following short-term disability leave
    • Second opinion evaluations (e.g., DoD CDEs, MEBs)

Will I have to take medication as part of my treatment?

  • No. Desert Wise emphasizes the autonomy and agency of all of our patients, so none of our staff will pressure you to pursue meds as part of your treatment. If you and your therapist are discussing the potential benefits of medication, your therapist will recommend you consult with your primary care provider or an independent psychiatric professional for additional information. Desert Wise does not currently employ any prescribers.

What if I don’t feel my therapist is the right fit for me?

  • The quality of the therapeutic relationship is the single best predictor of therapy effectiveness, which means that how well you fit with your therapist can significantly impact your response to treatment. If you believe that your therapist is not a good fit for you, you should talk with them about seeing someone else. Therapists are trained to help and support patients in this situation and will refer you to another therapist and/or modify their own approach to meet your needs.
  • If you feel a different Desert Wise therapist would be a better fit, your current therapist can assist in determining if the transfer is possible.
  • If you would prefer to be seen by another therapist outside of Desert Wise, your current therapist can provide guidance, as well as a warm hand-off (i.e., with your permission).
  • To learn more about the various types of mental health professionals, read our blog on the topic: https://www.desertwise.com/mental-health-credentials/

Can Desert Wise med-board me or put me on profile?

  • No. Desert Wise is not a DoD entity and, therefore, cannot initiate an MEB or DLC. If, however, you and your therapist determine that it is no longer in your or the DoD’s best interest to retain you, your therapist can provide this written recommendation to the MTF/MDG.
    • Note: Our general policy is that we don’t make this recommendation without your explicit buy-in and permission. In other words, we won’t go behind your back to make this recommendation.

Will therapy impact my security clearance?

  • In our experience, the mere fact that a person is engaging in therapy and/or has a mental health diagnosis will not negatively affect their clearance. A high proportion of Desert Wise patients have TS/SCI and/or Sigma-level clearances, and we have never had a single patient lose their clearance or have their clearance suspended.
  • Clearance agents are most concerned with your reliability and your vulnerability to become an insider threat. Thus, they want to know if you’re honest, exercise prudence and good judgment, are vulnerable to blackmail, etc. Engagement in therapy or diagnoses such as PTSD, anxiety, depression, etc. do not, in and of themselves, impair one’s honesty, judgment, vulnerability, etc.
  • In fact, engagement in treatment demonstrates good judgment and reliability, which serves as a positive mitigating factor for clearance adjudicators. Avoidance of treatment can have the opposite result. 
  • We encourage patients to be honest with clearance entities about their therapy status and to follow all regulations regarding self-reporting. Question 21 on your clearance application will provide additional information.
  • All said, Desert Wise does not release information to or have conversations with clearance agents or other entities without your written permission.

As a military-connected individual, do I need a referral to be seen at Desert Wise?

  • The answer to this question can change over time based on which company has the TRICARE contract or based on insurance carrier changes in policy. As of February 2023, the referral requirements are as follows:
    • Active duty service members (including AGR; Title 10/Title 32) are required to have a referral for therapy outside of the MTF. They generally obtain these referrals from their PCM or the MTF’s Mental Health Clinic. The referrals authorize a specified number of sessions (e.g., 8 or 26), after which the service member will have to request a renewed referral. This system enables the DoD to maintain surveillance of its personnel’s mission readiness.
    • Drill status Guardsmen and Reservists generally aren’t required to have a referral, which means they can independently seek and engage in therapy.
    • Military dependents (e.g., spouses) aren’t required to have a referral and can independently seek and engage in therapy.
    • Veterans who are beneficiaries of the VA are often eligible to seek network therapy through the VA’s Community Care Network (CCN). A referral is required to ensure the VA covers the cost, and these referrals can be requested through your VA PCM or the VA Mental Health Clinic. In our experience, VA CCN referrals are good for a year. In the Albuquerque area, the VA CCN insurance is TriWest, which is separate and different from the DoD’s TRICARE-West insurance.
    • Most civilians with commercial insurance can self-refer to therapy. Civilians with commercial insurance need to check their insurance company’s policies on and coverage of mental health therapy.

How does Desert Wise train its civilian clinicians to effectively work with military-connected individuals?

    • When we realized how significant the need was for a larger pool of therapists who are competent to work with military-connected individuals, we knew we had to find a way to meaningfully train civilians in military cultural competency. (Our military colleagues called this “the great experiment.”) Most of what was already out there was unfortunately Military 101, so we have worked to develop a more robust learning experience. At Desert Wise, our training of civilians is multifaceted:
      • We have curated a blended team of veterans, current service members, military spouses, and civilians to provide an integrative learning environment.
      • We hire civilians who are agile, curious, and demonstrate cultural humility, as these qualities equip them to engage in efficient, complex learning.
      • We veterans and service members talk and write as normal to give our civilians an immersive experience.
      • Our director of clinical supervision is a veteran and expertly integrates lived experiences into his teaching and mentoring.
      • Our founder is in the process of writing a military manual, which provides reference materials and a candid, in-depth look at military culture. Our staff is given access to each draft iteration.
      • Our operating manual includes chapters specific to military considerations (e.g., clinical note writing).
      • We host a weekly clinical case conference in which we collectively discuss military-relevant issues.
    • In our experience, our civilian personnel are able to seamlessly understand complex military language and nuances within their first year of work at Desert Wise. You might be surprised when you learn the therapist sitting in front of you isn’t a veteran!

What do I do if I have a concern about how a mental health therapist is practicing or conducting business?

      • If both possible and safe, you should first speak directly to your therapist about your concerns, as mental health professionals are trained to expect and respond appropriately to patient feedback.
      • If speaking to your therapist is not possible or turns out to be ineffective, you can consider requesting another therapist (i.e., if your therapist is in a group practice) or speaking to the agency’s Patient Advocate, if applicable. If your therapist is a solo practitioner, you might be best advised to seek another therapist in the community.
      • If you feel your therapist is conducting business unethically, engaging in inappropriate billing practices, or violating your rights, contacting their licensing or regulatory board might be the next best step.
      • If you’re not sure about whether you should be concerned, you might take the time to review the Ethics Code of your therapist. The Code will vary based on which type of professional you see, but their respective Ethics Code should be easy to find on the internet.
      • Additional resources for concerns are included below:
      • If you feel your privacy rights have been violated, you can file a complaint with the agency below:

What do I do if I’m feeling suicidal or am worried about a loved one taking their life?

      • Seek immediate assistance.
      • You can call 911 or go to your nearest Emergency Room.
      • Veterans can call: Veteran’s Crisis Line at 988 (option 1) or text: 838255
      • Active duty service members can utilize any of the resources for veterans or civilians, but Desert Wise also encourages them to contact their Shirt. 
      • Albuquerque & New Mexico residents can also call:
        • Bernalillo County Crisis Line 1-855-NMCRISIS (1-855-662-7474)
        • New Mexico Statewide Crisis Line 1-866-HELP-1-NM (1-866-435-7166)
        • AGORA Crisis Center (505) 277-3013
        • US National Suicide Hotline 988
        • Text: Crisis Text Line by texting “Go” to 741741
      • Desert Wise does not provide emergency services. If you are experiencing an emergency, use an appropriate option listed above.
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