What types of therapy does Lotus Patch Counseling offer?

Lotus Patch Counseling offers Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Rational Emotive Behavior Therapy (REBT), Person-Centered Therapy, and mindfulness-based interventions.

Does Lotus Patch Counseling accept insurance?

Yes. Lotus Patch Counseling accepts BlueCross BlueShield, Anthem, Humana, United Healthcare, Optum, Aetna, Cigna, Tennessee State Employee Insurance, and EAP plans. A superbill is provided for out-of-network reimbursement. Self-pay session fee is $150.

Does Lotus Patch Counseling accept BlueCross BlueShield?

Yes. Lotus Patch Counseling is in-network with BlueCross BlueShield and Anthem BlueCross BlueShield.

Is telehealth available at Lotus Patch Counseling?

Yes. Secure, HIPAA-compliant videoconference sessions are available for clients who prefer remote therapy throughout Tennessee.

What ages does Lotus Patch Counseling serve?

Lotus Patch Counseling serves adolescents age 16 and up, as well as adults of all ages.

Where is Lotus Patch Counseling located?

Lotus Patch Counseling is located at 750 Old Hickory Blvd, Building 2, Suite 150 in the Nashville metro area (Brentwood postal address), Tennessee 37027. Convenient to Nashville, Franklin, and the greater Davidson and Williamson County area.

Does Lotus Patch Counseling treat borderline personality disorder (BPD)?

Yes. Lotus Patch Counseling specializes in Borderline Personality Disorder (BPD) using Dialectical Behavior Therapy (DBT), which is the evidence-based gold standard for BPD treatment.

How do I schedule an appointment at Lotus Patch Counseling?

You can schedule online at lotuspatchcounseling.clientsecure.me (select 'I'm a New Client'), call 615-200-0995, or email info@LotusPatch.org. A free 20-minute consultation is available by phone, video, or in person.

Lotus Patch Counseling LLC

Licensed professional counseling clinic in Brentwood, Tennessee serving Nashville, Franklin, and greater Middle Tennessee. Led by Justin Nixon, LPC/MHSP (Tennessee License 3069, NPI 1851678080). Group NPI: 1710835699.

Specialties: Borderline Personality Disorder (BPD), Dialectical Behavior Therapy (DBT), mood disorders, depression, anxiety, panic disorder, substance use, anger management, life transitions, LGBTQ+ affirming therapy.

Therapy modalities: DBT, ACT, CBT, REBT, Person-Centered Therapy, mindfulness-based interventions.

Insurance accepted: BlueCross BlueShield (BCBS), Anthem BCBS, Humana, United Healthcare, Optum, Aetna, Cigna/Evernorth, Tennessee State Employee Plans, Magellan Health, EAP programs. Self-pay: $150 per session. Superbill provided for out-of-network reimbursement.

Location: 750 Old Hickory Blvd, Building 2, Suite 150, Brentwood, TN 37027. Phone: 615-200-0995. Email: info@lotuspatch.org.

Hours: Monday through Thursday, 8am to 5pm. In-person and secure HIPAA-compliant telehealth statewide.

Serves adolescents age 16 and older, and adults of all ages. Free 20-minute consultation available.

Accepting New Clients

Committed to reducing suffering and improving quality of life

Serving Nashville & Middle Tennessee · In-Person & Telehealth

Evidence-based, compassionate counseling for adolescents (16+) and adults across Middle Tennessee. Nashville, Brentwood, Franklin, and the greater Davidson and Williamson County area. In-person and secure telehealth available.

Schedule an Appointment ↗ Ask a Question

15+Years Experience

Free20-Min Consult

9+Insurance Plans

Free 20-Minute Consultation

Not sure where to start?

A free 20-minute consultation, by phone, video, or in person, gives you a chance to ask questions, share what's brought you here, and see if we're the right fit. No pressure. No commitment.

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Your privacy is protected. Scheduling through our portal is encrypted and HIPAA-compliant. This website uses no cookies, no analytics trackers, and does not identify you in any way. Reaching out does not add you to any marketing list. You may browse and schedule confidentially.

Areas of Focus

What we treat

Clinicians at Lotus Patch Counseling have deep experience with a range of mental health and behavioral concerns, across genders, ages (16+), backgrounds, and cultural contexts.

Mood Disorders

Depression, bipolar disorder, persistent depressive disorder, and cyclothymia, evidence-based approaches focused on stability and quality of life.

NIMH ↗

Anxiety & Panic

Generalized anxiety, panic disorder, social anxiety, OCD-spectrum, and intrusive thoughts. Building genuine freedom from the anxiety cycle.

NIMH ↗

Personality Disorders

Specialized treatment for Borderline Personality Disorder (BPD) using DBT skills. Also experienced with narcissistic, antisocial, and histrionic presentations.

NIMH ↗

Anger Management

Understanding the roots of reactivity, developing regulation skills, and repairing relational damage, without shaming the emotion itself.

APA ↗

Substance Use

Addiction and problematic substance use including co-occurring mental health concerns. Motivational, values-based, and harm reduction approaches.

SAMHSA ↗

Self-Harm & Suicidality

Specialized DBT-informed work with self-harm, suicidal ideation, and crisis stabilization. Safety is addressed directly and collaboratively.

988 Lifeline ↗

Existential & Spiritual

Questions of meaning, purpose, identity, and grief. Transpersonal perspectives integrated when relevant, including religious, atheist, agnostic, and nihilist frameworks.

APA Div. 32 ↗

Adolescents (16+)

Individual therapy for teenagers navigating mood, identity, peer dynamics, school stress, and family conflict. A non-judgmental space is essential at this stage.

NIMH ↗

Our Team

Meet our clinicians

Lotus Patch Counseling is a growing clinic built on the principle that the therapeutic relationship is the foundation of all good therapy. Every clinician here shares that commitment.

View All Clinicians →

➕

We are growing. Licensed clinicians interested in joining Lotus Patch Counseling are welcome to inquire at admin@LotusPatch.org

Symbol & Meaning

The language of the lotus

The lotus rises unstained from muddy water to bloom in full color. Each hue carries a distinct spiritual and psychological resonance, select a flower to explore its meaning and connection to the healing journey.

White Lotus

Purity of Mind & Spirit

The white lotus is the "Buddha's flower", representing spiritual perfection and total mental purity. It symbolizes the possibility of emerging from darkness without being marked by it.

In Therapy We work toward seeing thoughts and emotions as they truly are, not through distorted lenses, cultivating a relationship with yourself that is honest, clear, and self-compassionate.

Clinical Approach

How we work

An eclectic, evidence-based practice, modalities chosen for clinical fit, not formula. Therapy here is collaborative, paced by you, and never one-size-fits-all.

"Committed to reducing suffering and improving quality of life."

The founding mission of Lotus Patch Counseling LLC

Lotus Patch Counseling was founded on the belief that therapy works best when the client and clinician form an authentic connection. We hold space for the full range of human experience, across cultures, identities, and belief systems.

Meet Our Clinicians →

Our Space

A welcoming place to do the work

Located in Building Two at 750 Old Hickory Blvd, Brentwood, a professional, calm, and private environment. In-person and telehealth sessions available.

Building Two at 750 Old Hickory Blvd, Brentwood, Tennessee, entrance with 'TWO' signage and ADA accessible parking

Building Two · 750 Old Hickory Blvd

Suite 150 Entrance

Reception desk at Lotus Patch Counseling, warm wood desk, floral artwork

Reception Area

Therapy Office

Get Started

Schedule an appointment

Our online portal lets you view available times and book directly, no phone call required if that feels easier. New clients are always welcome.

Request Appointment

Online Portal (Recommended)

View available appointments and schedule at lotuspatchcounseling.clientsecure.me, secure, HIPAA-compliant, 24/7. New clients: select "I'm a New Client."

Phone

615-200-0995. Voicemail returned within 48 business hours.

info@LotusPatch.org. For general inquiries. Please do not share sensitive health details by email.

Practice Details

Address750 Old Hickory Blvd, Building 2, Suite 150
Brentwood, TN 37027
View map ↗

Session Fee$150 self-pay · Insurance accepted · Superbill provided for OON reimbursement

Free Consultation20 minutes, in person, video, or phone. No obligation.

TelehealthSecure, HIPAA-compliant video sessions statewide

Ages ServedAdolescents 16+ and adults · All genders and backgrounds

HIPAA Notice: All clinical communications are conducted through secure, encrypted channels. This website does not collect or store personal health information.

Self-Pay & Out-of-Pocket

Why some clients choose to pay out of pocket

Using insurance for therapy is a practical choice for many people. But there are real, meaningful reasons why some clients, including many with excellent coverage, choose to pay privately instead.

Complete privacy and confidentiality

When you use insurance, your insurer has the legal right to audit your records. A diagnosis becomes part of your permanent insurance file. Self-pay clients receive identical clinical care, but their records remain entirely between them and their therapist, with no third-party access.

No required diagnosis

Insurance coverage for therapy requires a billable mental health diagnosis. This then appears on your health record. Many people seeking support for life transitions, stress, relationship concerns, or personal growth don't need or want a psychiatric diagnosis to justify their care.

No session limits or treatment restrictions

Insurance companies can, and do, limit the number of sessions they cover, require preauthorization, or deny coverage for specific treatment approaches. Self-pay gives your therapist the clinical freedom to recommend what's actually right for you, for as long as you need it.

Protecting future insurability

Mental health diagnoses on your insurance record can affect life insurance applications, certain professional licenses, security clearances, and in some contexts, disability coverage. For some clients in specific professions or situations, keeping therapy private is not paranoia, it's prudent planning.

A direct relationship between you and your therapist

Self-pay eliminates the insurance company as a third party in your care. No managed care coordinator reviewing your case. No utilization review. Just you, your therapist, and the work, on your terms.

Superbill for potential reimbursement

If you have out-of-network benefits, Lotus Patch Counseling provides a superbill, a detailed receipt you submit to your insurance company for potential partial reimbursement. Many PPO plans reimburse 50–80% of out-of-network therapy costs. Check your plan's out-of-network mental health benefit.

Self-Pay Rate

$150

per 50-minute session

Free 20-minute consultation, no charge, no commitment
Superbill provided for out-of-network reimbursement submission
No diagnosis required for self-pay clients
No session limits or insurer preauthorization
Records stay strictly between you and your therapist
In-person or telehealth, your choice

Schedule Now ↗

Not sure which option is right for you? Bring it up during your free consultation, there's no pressure either way. Some clients use insurance for ongoing therapy and self-pay for more sensitive concerns. We'll work with whatever fits your situation.

Coverage

Insurance & payment

Lotus Patch Counseling is in-network with major insurance carriers serving Middle Tennessee. If you don't see your plan listed, contact us, coverage changes frequently and we are continually expanding our panel.

BlueCross BlueShield

In-Network · Includes Anthem BCBS

Find a provider ↗

Anthem BlueCross BlueShield

In-Network · BCBS affiliate

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Humana

In-Network · Includes ChoiceCare

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United Healthcare / UHC

In-Network · Includes AARP MedAdvantage

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Optum / OptumHealth

In-Network · Includes Oscar Health, Golden Rule

Find a provider ↗

Oscar Health

In-Network · Optum network

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Aetna

In-Network · Includes CVS Health Plans

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Cigna / Evernorth

In-Network · Includes Evernorth Behavioral

Find a provider ↗

TN State Employee Plans

In-Network · TCRS · SWHP · State & Local Gov

Find a provider ↗

Magellan Health

In-Network · Includes Beacon Health Options

Find a provider ↗

EAP Programs

In-Network · Most major employer EAPs · ComPsych · Lyra · Spring Health

Learn about EAPs ↗

Medicare

Verify with office · Medicare Advantage varies

Medicare Care Compare ↗

Self-Pay / Out-of-Pocket

$150 per session · Superbill for reimbursement

Why self-pay? ↓

Note: Insurance panel information is updated regularly but please verify your specific plan and benefits directly with your insurer and our office before your first appointment. Not all plans from listed carriers may be in-network. We are happy to assist with verification, call 615-200-0995 or email info@LotusPatch.org.

Your privacy is taken seriously here

We understand that seeking therapy can feel vulnerable, and that some people are understandably cautious about technology and digital records. You are not being tracked on this website. No advertising pixels. No retargeting. No data brokers. Scheduling is encrypted and HIPAA-compliant. Your clinical information stays within the treatment relationship.

No tracking pixels
No ad retargeting
HIPAA-compliant portal
Encrypted telehealth
No marketing lists
Cookie-free analytics

Read our full Notice of Privacy Practices →

Practice Assistant

Have a question?

Our practice assistant can answer common questions about services, scheduling, fees, insurance, and what to expect in therapy. It can also help you get to the right place to book.

Important: This assistant is for general information only, not therapy, not clinical advice, not part of any medical record. If you are in crisis, please call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.

Lotus Practice Assistant

General info only

Hello! I can answer questions about Lotus Patch Counseling's services, fees, insurance, scheduling, and what to expect in therapy. How can I help?

Just now

General info only · Not therapy · Do not share health details

Frequently asked questions

Whether you're considering therapy for the first time or looking for the right fit, these questions come up often. Browse by topic or read through, there are no wrong questions.

How do I know if I need therapy or counseling?

There's no single threshold for when therapy becomes "necessary." A useful test: is something causing you meaningful distress or limiting how you function day-to-day? If so, therapy is likely worth exploring. Common reasons people start include persistent sadness or anxiety, relationship difficulties, major life transitions, grief, trauma, anger they can't manage, or simply wanting to understand themselves better.

Therapy is not exclusively for crisis. Many people find it most valuable as a regular practicesimilar to the way people exercise or see a physician. You don't have to be in crisis to deserve support.

How do I choose the right therapist for me?

Research consistently shows that the quality of the therapeutic relationship, specifically how safe, heard, and respected you feel, predicts outcomes more than any specific technique or credential. Fit matters enormously.

Practical things to evaluate: Does this person have experience with your specific concerns? Do you feel comfortable being honest with them after the first session? Are their treatment approaches evidence-based? That first session is as much your interview of them as theirs of you. A reputable therapist will welcome that.

What if I'm nervous about starting therapy?

Nervousness before a first session is nearly universal, even among people who've been in therapy before. It's completely normal to feel uncertain about opening up to a stranger about difficult things.

A few things that may help: Start with a free consultation rather than a full session. Write down what brought you to seek help before you arrive, you don't have to know what you want to say. Know that a good therapist will meet you exactly where you are and won't push you faster than feels safe. The first session is usually more of a conversation than anything clinical.

What questions should I ask a therapist before starting?

Good questions to ask during a consultation or first session:

What experience do you have treating [your specific concern]?
What therapy approaches do you typically use, and why?
What does a typical session look like with you?
How do you handle it if a client feels we're not making progress?
What are your cancellation and communication policies?
How do you handle insurance, billing, and payment?

A confident, ethical therapist will answer all of these directly and without defensiveness.

Does therapy really work?

Yes, the evidence base for psychotherapy is robust. Meta-analyses across hundreds of studies consistently show that people who receive therapy improve significantly more than those who don't. For specific conditions like depression, anxiety, and BPD, structured therapies like CBT and DBT have effect sizes comparable to medication.

That said, therapy is not passive. Outcomes improve when clients are engaged, willing to try things between sessions, and feel genuinely connected with their therapist. The work happens both in and outside the room.

Can I switch therapists if we're not a good match?

Absolutely, and a good therapist will support you in making that change if it serves you. You have no obligation to continue with any therapist who doesn't feel right. It's worth distinguishing between the discomfort that comes from doing real therapeutic work (which is normal) versus a genuine mismatch in style, values, or approach.

If you're uncertain, try raising it directly: "I'm not sure this is working for me, can we talk about it?" How a therapist handles that conversation tells you a great deal about their quality. You can always request records and a referral.

Should I tell my therapist everything?

In general, the more openly you share, the more effective therapy can be. Therapists are professionally trained not to judge, and confidentiality laws protect nearly everything you share. That said, you control the pace. You never have to share more than feels safe, especially early on.

The one area requiring transparency: if you're having thoughts of harming yourself or someone else, your therapist needs to know. This information helps keep you safe, and it's exactly what they're trained to help with, not something that will be used against you.

Is it normal to feel worse before feeling better in therapy?

Yes, which is one of the most common surprises people encounter. Early in therapy, bringing difficult things to the surface can temporarily increase distress before it decreases. This is a sign that real work is happening, not that therapy is making things worse.

Think of it like physical therapy: working an injured area is initially painful, but that's how healing happens. The key is maintaining open communication with your therapist about how you're feeling, including if things feel too intense or too slow.

What if I don't like talking about my feelings?

Therapy doesn't require you to be fluent in emotional language. Many effective approaches, including CBT and DBT, are skills-based and practical. They focus on specific behaviors, patterns, and tools more than emotional processing. Some people do better with structured homework and concrete goals than open-ended reflection.

Share this with your therapist upfront. A good clinician will adapt their style to how you actually engage, not insist you become a different kind of person to access care.

What are red flags in a therapist?

Genuine red flags, not just discomfort from doing real work, include:

Sharing excessive personal information or blurring professional boundaries
Making you feel judged, shamed, or dismissed
Refusing to explain their treatment approach or answer your questions
Avoiding any discussion of goals or progress
Contacting you outside of sessions in inappropriate ways
Suggesting any kind of dual relationship (social, business, romantic)
Billing fraud or pressure to continue beyond clinical need

If something feels wrong, trust that instinct. You can always consult the Tennessee Department of Health to verify a license or file a complaint.

How much does counseling cost in Tennessee?

Private practice therapy in Middle Tennessee typically runs $100–$200 per session depending on the provider's credentials, specialty, and location. At Lotus Patch Counseling, the self-pay rate is $150 per 50-minute session. Insurance copays vary widely, anywhere from $0–$60 depending on your plan and deductible status.

Community mental health centers and training clinics often offer sliding-scale fees based on income if cost is a significant barrier.

Can I see a therapist if I don't have insurance?

Yes. Most private practice therapists, including Lotus Patch Counseling, accept self-pay clients. The self-pay rate at Lotus Patch is $150 per session. If cost is a significant barrier, you may also explore:

Community mental health centers (often sliding-scale based on income)
University training clinics (supervised graduate students, reduced fees)
SAMHSA's treatment locator at findtreatment.gov
Open Path Collective for reduced-fee therapy
TennCare / Medicaid if you qualify

Does insurance cover therapy in Tennessee?

Most major insurance plans are required by federal law (the Mental Health Parity and Addiction Equity Act) to cover mental health services at the same level as physical health services. In practice, this means most plans with medical coverage include outpatient therapy benefits.

However, coverage varies: your plan may have a deductible to meet first, a copay per session, session limits, or preauthorization requirements. The best way to know your specific benefits is to call the member services number on the back of your insurance card and ask specifically about outpatient mental health/behavioral health benefits.

How do I talk to my insurance company about therapy coverage?

Call the member services number on your insurance card and ask these specific questions:

Does my plan cover outpatient mental health or behavioral health services?
Is [provider name] in-network with my plan?
What is my copay or coinsurance for outpatient mental health?
Do I have a deductible to meet first, and how much remains?
Is preauthorization required?
Are there session limits per year?
What are my out-of-network benefits if I want to use a provider not in my network?

Get a reference number for the call. Insurance representatives can give incorrect information, having documentation protects you.

Why might someone choose to pay out-of-pocket instead of using insurance?

Several meaningful reasons lead clients to self-pay even when they have coverage:

Privacy: Insurance claims create a record. Insurers have the legal right to audit your clinical records. Self-pay keeps your treatment entirely between you and your therapist.
No required diagnosis: Insurance billing requires a mental health diagnosis on your medical record. Many people seeking support for stress, relationships, or personal growth prefer not to carry a psychiatric diagnosis.
No session limits: Insurers can cap the number of covered sessions or require preauthorization for continued care.
Insurability and career considerations: Mental health diagnoses can affect life insurance, security clearances, and some professional licenses.
Superbill option: If you have out-of-network benefits (common with PPO plans), you can still submit receipts for partial reimbursement, often 50–80%, while maintaining the privacy benefits of self-pay.

Is therapy worth the cost?

The ROI of effective therapy is genuinely significant. Research on untreated depression and anxiety shows substantial costs in lost productivity, relationship breakdown, physical health deterioration, and, in serious cases, crisis intervention that costs far more than prevention. Effective therapy changes the trajectory of people's lives in ways that compound over decades.

That said, therapy works best when it's the right match. A free 20-minute consultation at Lotus Patch Counseling lets you make an informed decision before committing financially to a full course of treatment.

What should I expect in my first therapy session?

The first session, often called an intake or assessment, is primarily a conversation. Your therapist will ask about what brought you in, your history, what you're hoping to achieve, and relevant background (family, health, previous therapy). You'll also cover practical matters: confidentiality, fees, cancellation policy, and communication preferences.

You don't need to prepare an organized narrative. Come as you are. It's fine to say "I'm not sure where to start", a good therapist will help you find your footing.

What should I bring to my first counseling session?

If you're using insurance: your insurance card and a valid photo ID. Most practices complete intake paperwork before the first session through their client portal, check if forms were sent to you ahead of time.

Beyond the practical: bring yourself. If helpful, jot down a few notes about what's been most difficult lately, what you're hoping changes, and any past therapy experience you've had. But this is optional, you won't be graded on preparation.

How often should I go to therapy?

Most outpatient therapy begins at once per week. This frequency allows for meaningful continuity, enough time between sessions to practice what you're learning, but close enough to maintain momentum and return to difficult territory before it closes off again.

As things stabilize, sessions often shift to every two weeks, then monthly for maintenance or as-needed check-ins. The pace is always a clinical decision made collaboratively. There is no single right answer.

How long does therapy usually take?

It depends significantly on what brings you to therapy. Brief, problem-focused therapy for a specific concern (phobia, adjustment to a major life change, skills-building) may take 8–16 sessions. More complex issues, long-standing depression, personality disorders, trauma, substance use, typically involve longer-term work, often 6 months to several years.

There's no clinical virtue in either short or long therapy. The right length is whatever produces genuine, lasting change for you. Progress is worth discussing explicitly with your therapist on a regular basis.

How long before I notice changes from counseling?

Some clients notice shifts within the first few sessions, often a sense of relief simply from articulating something they've held alone. Measurable behavioral or emotional change typically becomes noticeable between 6–12 sessions, though this varies significantly by issue and individual.

If you're 8–10 sessions in and see no improvement and feel no connection with your therapist, that's worth raising directly. Effective therapy should produce some evidence it's working within the first few months.

When is it time to leave my therapist?

Therapy ends well when you've reached your goals, developed skills you can apply independently, and feel genuinely stable, not just tolerating things, but actually living more fully. A good therapist will actively work toward your independence, not dependency on sessions.

It also ends when it's simply not working. If therapy hasn't produced meaningful change after a reasonable period, exploring a different therapist, approach, or modality is appropriate, not a failure.

Can I bring someone to my therapy session?

In individual therapy, sessions are typically private, just you and the therapist. This boundary exists for good clinical reason: you're more likely to be open and honest when you know the conversation stays between you and your therapist.

However, there are situations where a therapist might invite a family member or partner for a specific session, to address a relationship dynamic, improve communication, or as part of a planned transition. This is always discussed and agreed upon beforehand. If family involvement feels important to you, raise it with your therapist.

What happens if my therapist thinks I'm a danger to myself?

If your therapist believes you are at imminent risk of harming yourself, they have both a legal and ethical obligation to take steps to keep you safe, this may include contacting emergency services or facilitating a voluntary or involuntary hospitalization in serious situations.

In practice, most conversations about suicidal thoughts don't result in hospitalization. Therapists are trained to assess actual risk level carefully, collaboratively, and without overreacting. Having thoughts of suicide is not the same as being in imminent danger, and an ethical therapist will distinguish between them. Being honest with your therapist about suicidal thoughts allows them to help you, not punish you for disclosure.

What types of therapy are available?

There are dozens of evidence-based therapy approaches. The most commonly practiced include:

CBT (Cognitive Behavioral Therapy): Addresses the relationship between thoughts, feelings, and behaviors. Highly researched, structured, and skills-based.
DBT (Dialectical Behavior Therapy): Originally developed for BPD. Focuses on mindfulness, distress tolerance, emotion regulation, and interpersonal skills.
ACT (Acceptance and Commitment Therapy): Values-based; helps you accept difficult experiences rather than fight them while committing to meaningful action.
REBT (Rational Emotive Behavior Therapy): Identifies and challenges irrational beliefs driving emotional suffering.
Person-Centered Therapy: Non-directive approach emphasizing the therapeutic relationship and the client's own capacity for growth.
Psychodynamic: Explores unconscious patterns and early relational experiences that shape present behavior.

Most skilled therapists blend approaches based on what works for you specifically, rather than rigidly applying a single model.

Should I see a therapist or a psychiatrist?

The key difference: psychiatrists are medical doctors who specialize in mental health and can prescribe medication. Therapists (LPCs, LCSWs, psychologists) provide talk therapy and behavioral interventions but cannot prescribe.

For many conditions, depression, anxiety, PTSD, BPD, therapy alone is highly effective and is often the first-line recommendation. Medication may be appropriate alongside therapy for moderate-to-severe conditions, or when therapy alone isn't producing sufficient improvement. Many clients work with both a therapist and a prescriber simultaneously. Your therapist can help you think through whether a psychiatric evaluation might be beneficial.

What is a therapy intake appointment?

An intake is typically your first full session. The therapist gathers comprehensive background information, current concerns, mental health and medical history, family background, substance use, previous treatment, and what you're hoping to achieve. It may feel more structured and question-driven than later sessions.

An intake also covers the practical and legal side: your rights as a client, confidentiality and its limits, consent for treatment, fees, and how to reach your therapist between sessions. Most practices also send intake paperwork in advance through their client portal, completing it beforehand saves time.

What's the difference between a life coach and a therapist?

Therapists are state-licensed professionals with graduate-level clinical training, bound by ethical codes, and authorized to diagnose and treat mental health conditions. Licensing requires supervised clinical hours, passing standardized exams, and ongoing continuing education.

Life coaches are unregulated, anyone can call themselves a life coach regardless of training. Coaching is future-focused and goal-oriented, and can be valuable for professional or personal development. However, coaching is not appropriate for clinical mental health conditions and is not a substitute for therapy. If you're experiencing depression, anxiety, trauma, or other clinical concerns, you need a licensed clinician.

Is counseling confidential?

Yes, with specific, legally defined exceptions. Your therapist cannot disclose what you share without your written consent, except in these situations:

You present an imminent threat of harm to yourself or a clearly identified other person
There is reasonable suspicion of child abuse, elder abuse, or dependent adult abuse
A court orders your records (with legal protections still applying)
You are using insurance, in which case your insurer has claim review rights

These exceptions are explained in your informed consent document at the start of treatment. If you're uncertain about any of them, ask your therapist directly.

Can my employer see that I'm going to therapy?

In most circumstances, no. Your employer cannot access your therapy records or be informed of your attendance. HIPAA and state privacy laws prohibit disclosure without your written authorization.

Two situations where nuance applies: If you use an EAP (Employee Assistance Program) provided by your employer, the EAP may share aggregate utilization data with your employer, though not identifying information. If you use employer-sponsored health insurance, your insurer can audit claims, and an HR department with access to claims data (rare in large organizations) could theoretically see mental health claims. If this concerns you, self-pay is the cleanest solution.

Are therapy records private from my employer?

Yes. Psychotherapy notes, the therapist's private process notes, have the highest level of legal protection under HIPAA and require specific written authorization even for other treating providers to access. Your employer has no right to these records.

The one exception is if you sign a release, for example, for a disability claim, worker's compensation case, or a court proceeding you initiate. You control your records.

How do I know if I have a mental health condition?

Mental health conditions are diagnosed by licensed clinicians through clinical interviews, history-taking, and validated assessment tools, not online quizzes. If you're wondering whether what you're experiencing rises to the level of a diagnosable condition, the most reliable path is a proper clinical evaluation.

That said, you don't need a diagnosis to benefit from therapy. Many people in therapy don't have a formal diagnosis, they're dealing with life circumstances, relationship difficulties, grief, or existential questions that are genuinely hard. You deserve support regardless of whether your experience fits a diagnostic label.

Is online therapy as effective as in-person counseling?

For most conditions and most people, yes, the research on telehealth therapy is increasingly strong. Multiple randomized trials show equivalent outcomes for depression, anxiety, PTSD, and other common presentations. The therapeutic alliance (the quality of the relationship) develops effectively via video, which appears to be the active ingredient rather than physical proximity.

That said, some individuals and some presentations do better in person. If you're in acute crisis, have significant interpersonal difficulties, or find technology a barrier to genuine engagement, in-office work may be clinically preferable. Many clients do both, telehealth when convenient, in-person during more intensive periods.

Can I do therapy online if I live in Tennessee?

Yes. Lotus Patch Counseling offers HIPAA-compliant video sessions to clients throughout Tennessee. You'll need a private space, a reliable internet connection, and a device with a camera. All sessions are conducted through a secure, encrypted platform, not through general video apps like Zoom or FaceTime.

Telehealth is especially useful for clients in rural Middle Tennessee, those with transportation barriers, parents with young children, or anyone whose schedule makes commuting to an office difficult.

Can I have therapy sessions online if I live out of state?

Generally, therapists are only licensed to practice in the state(s) where they hold licensure, and the relevant state is where the client is physically located during the session. Lotus Patch Counseling is licensed in Tennessee, so telehealth services are available to clients who are physically located in Tennessee at the time of the session.

If you have relocated outside Tennessee, your care would need to transition to a provider licensed in your new state. Some interstate compact agreements (like the Counseling Compact) allow limited exceptions, ask your therapist if this applies to your situation.

How do I prepare my space for a virtual therapy session?

The key is privacy and minimal interruption. Find a room where you can close the door. If others are home, let them know you're unavailable for 50 minutes. A white noise machine or a fan outside the door can help with sound. Use headphones if possible, they improve audio quality and add privacy.

Have your device charged and propped at eye level rather than looking down. Good lighting (facing a window or lamp, not backlit) makes the session feel more natural. Log in a few minutes early to troubleshoot any technical issues.

How do I find a therapist in Middle Tennessee?

Several paths work well for Middle Tennessee:

Psychology Today's therapist finder (psychologytoday.com), filter by location, insurance, and specialty
Your insurance company's provider directory, search for in-network therapists near your zip code
SAMHSA's treatment locator at findtreatment.gov
Tennessee Department of Mental Health (tn.gov/behavioral-health) for community mental health resources
Primary care provider referral, your doctor often knows local therapists

Lotus Patch Counseling sees clients across Davidson and Williamson counties and offers telehealth throughout Tennessee.

I'm moving to Nashville, how do I find a good therapist?

Start by verifying that any therapist you're considering holds an active Tennessee license, check the Tennessee Department of Health's online verification at apps.health.tn.gov/Licensure/. This confirms they are legally authorized to practice in the state.

Nashville has a robust mental health community with practitioners across Davidson, Williamson, and surrounding counties. Telehealth is also an excellent bridge while you're settling in, many clients begin telehealth when moving and transition to in-person once they're established. A free 20-minute consultation with Lotus Patch Counseling can be a low-pressure starting point.

How do I find emergency mental health services in Tennessee?

If you or someone you know is in crisis:

Call or text 988, the Suicide and Crisis Lifeline, available 24/7
Crisis Text Line: text HOME to 741741
Centerstone Crisis Line (Nashville): 1-800-681-7444
Vanderbilt Psychiatric Emergency: 615-327-7000
Tennessee Statewide Crisis Line: 1-855-CRISIS-1 (274-7471)
911 or your nearest emergency room for immediate danger

Lotus Patch Counseling is an outpatient practice and is not a crisis service. If you are in immediate danger, please call 911 or go to your nearest emergency room.

Does Lotus Patch Counseling offer therapy for men's mental health?

Yes. Justin Nixon has experience working with men across a wide range of concerns, anger management, depression that presents as irritability or withdrawal, substance use, relationship difficulties, career stress, and identity questions. Men are statistically less likely to seek mental health support and more likely to delay until a crisis, which often makes everything harder.

The approach at Lotus Patch is straightforward, non-pathologizing, and clinically direct. You don't have to speak a particular emotional language to benefit from therapy here.

Is Lotus Patch Counseling LGBTQ+-affirming?

Yes. Lotus Patch Counseling provides a non-judgmental, affirming environment for LGBTQ+ clients. Sexual orientation and gender identity are not treated as problems to be solved, they are part of the whole person who brings whatever is actually causing them distress.

Justin Nixon has experience working with clients across diverse identities, backgrounds, and cultural contexts. If you have specific questions about approach or fit, the free 20-minute consultation is a good opportunity to ask them directly.

Does religion or spirituality matter when choosing a therapist?

It can, depending on how central your spiritual framework is to your identity and the concerns you're bringing to therapy. If your faith, values, or spiritual questions are closely tied to what you're working on, having a therapist who can engage with that meaningfully, rather than treating it as peripheralis worth considering.

Justin Nixon is not a religious counselor but integrates transpersonal perspectives when clinically relevant and welcome, working within any belief system, religious, secular, agnostic, or otherwise. The goal is always your healing, not converting you to a particular worldview.

How do I find a therapist who understands my cultural background?

Cultural competence matters. A therapist doesn't need to share your background to work effectively across cultural differences, but they should demonstrate awareness, curiosity, and humility about how your culture shapes your experience and how you experience the therapeutic relationship itself.

Good questions to ask a prospective therapist: "What experience do you have working with clients from [your background]? How do you approach cultural factors in therapy?" Their answer, and their openness to the question, tells you a great deal.

What's the difference between an LPC, LCSW, and LMHC?

All are licensed mental health clinicians with graduate degrees and supervised clinical experience. The primary differences are in training background and licensing board:

LPC (Licensed Professional Counselor): Tennessee's primary mental health counseling license. Graduate training in counseling, psychological assessment, and treatment. In Tennessee, the highest tier is LPC-MHSP (Mental Health Service Provider), which authorizes independent practice and diagnosis.
LCSW (Licensed Clinical Social Worker): Graduate training in social work with a clinical focus. Emphasizes systems-level thinking, family, community, and social context alongside individual therapy.
LMHC (Licensed Mental Health Counselor): Used in some states; Tennessee uses LPC. Equivalent scope of practice.

For most therapy purposes, the credential matters less than the clinician's specific training, experience, and fit with your needs.

What credentials should my therapist have?

At minimum, your therapist should hold an active state license to practice mental health counseling (in Tennessee: LPC, LCSW, or licensed psychologist). You can verify any Tennessee mental health license at apps.health.tn.gov/Licensure.

Beyond the license: look for graduate-level education (master's or doctoral degree), supervised clinical experience prior to licensure, and ongoing continuing education. Specialty certifications (like DBT certification or trauma training) are a plus when they match your needs, but they are secondary to the quality of the practitioner and the therapeutic relationship.

Understanding therapist licensing rules in Tennessee

Tennessee licenses mental health counselors through the Tennessee Department of Health, Board of Counselors and Therapists. The license tiers are:

LPC-MHSP (Licensed Professional Counselor. Mental Health Service Provider): Full independent license. Can diagnose, treat, and supervise. Requires a master's degree, 3,000+ supervised hours, and passing the NCE or NCMHCE exam.
LPC (Licensed Professional Counselor): Full licensure without the MHSP designation. May not independently diagnose or supervise in all contexts.
LMSW / LCSW (Licensed Master/Clinical Social Worker): Licensed through a separate board. LCSW requires additional supervised hours and authorizes independent clinical practice.

Anyone providing therapy in Tennessee without a license is practicing illegally. Verify at apps.health.tn.gov/Licensure.