Frequently Asked Questions | Madison Messerli, LCSW


I see you only offer telehealth – where are you located?
My location is in San Francisco, and I have a license to practice in California and Nevada. If you live in either of these states, I can see you online! Occasionally, my background will change if I am traveling to visit family.
Do you have an office?
Nope, maybe one day.
I think you might be a good fit for me. Is there a cost-effective way I can see you?

I am considered an “out-of-network provider.” If you want to seek reimbursement from your insurance company for out-of-network services, I can provide you with a “Superbill” for that. Please contact your insurance company to see what their options are for reimbursement.

Here are some helpful questions you can ask when you call:

Do I have out-of-network mental health benefits?
What is my deductible? Has it been met?
How many sessions per year does my plan cover?
What is the coverage amount per session? How much can I expect to be reimbursed?
How long does it take to receive reimbursement once I’ve submitted my claim?
Is a referral required by my primary physician?

What times of day do you have available?
I work Monday – Thursday, most business hours. Occasionally, I will offer a Friday or Saturday appointment if the need and my schedule align.
How quickly can I schedule my first appointment?
Usually, you can schedule within 2-3 weeks of our initial contact.
What is your cancellation policy?
Please let me know if you need to cancel at least 24 hours before your appointment. If your appointment is on a Monday, please let me know by the Friday before. You are not required to pay for sessions that I cancel. I will alert you of my planned time off in advance.
I’m struggling. Can I meet with you more than once per week?
How do I schedule?
Email, call, or text me. I will get back to you within 48 hours, M-F.
What different types of therapy do you do?
I use a combination of traditional talk therapy, behavioral modification, and mindfulness. We will explore your values, thoughts, emotions, behaviors, and the parts of you that you struggle most to accept.
Mindfulness? Are you going to make me meditate?

Meditation likely doesn’t come very easily if you are like most humans. Let’s consider it the vehicle that transports you from the war zone to the spa. You don’t have to meditate; you still have free will after beginning this journey with me. I will give you bite-sized techniques to help you overcome the hurdle of bringing the mind to the present with intentional breath. Did you know you don’t have to sit still to meditate, close your eyes, or sit up straight?

What is the first session like?
During our first few sessions, I will take inventory of your history. This approach creates an excellent base for the rest of our journey. Even if you have done this step before with your previous therapist – you have never shared your story from the person you are today with the tools you have, maturity, life experience, and insight. When you repeatedly tell the story, your relationship with the wounds changes as you grow.
I am nervous about starting therapy. Is that normal?
You are about to embark on significant change and important internal work. Your body is wise; it senses the growth around the corner.
How do I know if this type of therapy is right for me?
You have tried other things that have not offered long-term change. You’re ready to experience a difference ASAP. My research says that the relationship you build is the most significant predictor of change over the ‘approach.’ It may be more beneficial to pay attention to our fit.
How will I know if we are a good fit?
Consider how it feels to talk with me during our consultation phone call. If you experience a connection, a sense of comfort, feel compelled to tell me more, or the overall vibe feels good – we will work well together.
Do your clients receive assignments to work on between sessions?

Yes! I have found that the most growth happens when clients take their therapy work outside the session. Assignments offer an easy way to ensure accountability for your skill development. The best part IMO is that we develop the assignments together, making them highly personalized to support your journey toward your goals. You never know what your assignment may be. It may be to watch a specific movie or listen to a particular song – it won’t be a school assignment in the traditional sense.

EEK! Procrastination strikes again! I didn’t do my homework. Now what?
Take a deep breath. That is all. Part of the homework assignment is that it’s an experiment; you will still learn from not doing it. We may talk about what happened that prevented, derailed, or distracted you or if you avoided it altogether. There is valuable insight to gain from this part of the process.
Have you ever been to therapy?
I sure have. I went for the first time when I was 18. While feeling heartbroken, failing school for the first time, and in the wrong major, therapy helped me sort out a stressful and emotional time. It helped me realize my strengths, and I learned to work smarter, not harder. I have continued my therapy journey on and off since then, depending on what is going on in my life.
Tea or Coffee?
Both! But first, coffee and then tea.
I think I saw you at the store last week. Am I allowed to say hi?

For those local to SF, you are more than welcome to say hi to me, but it is by no means a requirement. I will never be the first to initiate contact in the wild nor be offended if you choose not to say hi to me. Part of my job is to protect your confidentiality!

What is something I would be surprised to learn about you?
I am a ballerina (the kind that stands on my toes) and am known to go looking for dusty art on my bicycle in Black Rock City.