General Information Frequently Asked Questions
What is Counseling?
Counseling is a partnership in healing formed in the professional relationship between a counselor and a person, couple, or family to create positive change in a safe, comfortable environment. Interested in exploring how to live a more satisfying life? We can work together to open up more freedom and possibility, even when things are difficult. Life can feel like a dimly lit hallway with only one door at the end. Therapy is about turning on the lights together so that more doors come into view. It is our personal philosophy that the same challenges that bring one into therapy can also provide powerful opportunities to create change in ones life. Through the skills that therapy offers, future challenges are more easily addressed and personal goals are more readily met.

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What can I Expect from You as my Counselor?
As your counselor, you can expect that I will work with you every step of the way from developing goals to deciding together when the work has been completed. I will provide a comfortable, respectful, safe environment. I will respect your privacy by maintaining your confidentiality within the legal limitations that we will go over during your first appointment. You may take a look at the forms at the bottom of this page for instances when I am mandated to break that confidentiality. I believe encouragement and compassionate empathy should always be part of the counseling process. In addition, I will answer any questions or concerns you have at all stages of the counseling process. Finally, the counseling relationship is a professional relationship, which means that unlike other relationships I will not socialize with you and your family or discuss your private concerns with others. Finally if you are bringing your child for counseling, I will make efforts to include you in family therapy sessions at various times to encourage your child's sharing with you insights that they have gained from counseling.

If you ever leave a session mad at me as your counselor or upset about your counseling experience, please remember that I consider a gift for you to come back or contact me about your concern. This gives me the option to repair or make it right if I have insulted you in any way.

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What Is Expected of Me?
As a counselor, I expect my clients to be committed to counseling and work toward their own best interest. As we work together, I want you to be comfortable in telling me what is working, what is not working, and continuously challenge themselves to make the changes and growth they desire. I welcome this feedback as it has been incredibly helpful in making me a more effective helper! I expect you to arrive on time and to be sober during the counseling session. I also request that you give me 24 hours advanced notice if you will be unable to attend your counseling appointment. I will try to make accommodations for a different time if this is possible. Finally for parents who bring their children for counseling, I request that you do not ask your child about what they talked about during their counseling session. This can make them feel uncomfortable with continuing to share difficult thoughts and feelings in sessions with me.

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Your First Appointment
Your first session is typically an intake appointment that takes 60-90 minutes and includes a brief interview and the completion of various forms that are provided at the bottom of this page. It may be helpful to print and fill out these forms before your initial appointment; however this is not necessary. The goal of the intake is to inform you of your rights as a client and get all the necessary history and information to together create a strategy for healing. After the intake, we will agree on a standard appointment time that usually occurs on a weekly basis. Because each therapist has a unique style and philosophy of treatment, it may be helpful to discuss this prior to starting counseling with me.

Some folks like to arrive a few minutes before their first appointment to complete the intake paperwork, which will be waiting for you in the lobby. Please feel free to enter via the red door into the lobby and begin filling out this paperwork if you would like. The intake paperwork is also available for you to fill out electronically. Please see the forms tab for more information

While most appointments will last 55 minutes in length; however the intake appointment typically may last longer than this time. Longer and “marathon” appointments are also available upon request.

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Information about telehealth counseling
Many of my clients are living far from the office and thus are not able to attend sessions in office. For these clients distance counseling, which is also known as telehealth services are available. This type of counseling takes place as a video session from your computer to your device. In order for this type of session to work you must have a computer with a screen, microphone, camera, high speed internet, and speakers. Many computer, tablets, or cellphones have these standard features already. The software used is HIPAA compliant and secures the connection between our computers to ensure your privacy. If interested, please feel free to contact me!

Please note that some insurance companies do not currently reimburse for counseling services provided remotely. Services are not available in states where I do not hold a license.

For more information about telehealth, please see: If interested please email me. Services are conducted through either a program called VSEE Messenger or the website Doxy. You can click on the vsee link to goto their website where you put in your email and sign up for a free account. After you have signed up, please download their program, which we will use for distance sessions. This program provides a secure video and text messaging connecting for conducting sessions while ensuring your privacy.

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Information about Social Media Policy
Please feel free to download the Notice of Privacy Practices, which includes policies and procedures in the informed consent section at the bottom of the document. My social media policy is currently:

I protect your privacy by Protecting your confidentiality on any social media websites by actively avoiding any contact on these sites or apps. When that is not possible, I will not respond to any communications on such sites or apps. This is due to any communication via social media representing a potential violation of your confidentiality. If you choose associate yourself (like, follow) with my social media websites, please be aware that you will loose a degree of confidentiality. Any personal sites are strictly private and hidden to the degree possible. If you find me on public social media or apps, I request that you do not connect with me on that medium in any manner including swiping left and avoiding contact.
If you have any questions about potential confidentiality concerns or connecting on social media, please contact me directly by telephone before connecting with me through these electronic mediums.

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Electronic Communication Policy
Please also remember the electronic communications policy that is also in the notice of privacy practices:

Email, text messaging, and other electronic communications are not secure mediums and therefore, confidentiality cannot be assured. Please use discretion when sending information that is sensitive in nature. Out of session electronic communications may only to be used for appointment scheduling. Text and Email conversations other than for scheduling appointments may compromise your confidentiality and should be avoided. If you are in a crisis, please call me rather than text or email me. When electronic messages are sensitive in nature, I request that you telephone me so that I may verify your identity rather than text message this content. Otherwise I may be unable to respond to your message. I will not respond to your message except during posted business hours and when I am not in session. You may also choose to receive counseling via telehealth (via the application vsee) or in office; however not all insurance companies reimburse for telehealth.

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HIPAA Privacy Officer Information
If you have any concerns about privacy, please feel free to contact the Families First Therapy designated HIPAA Privacy Officer, Stephen Ratcliff in person or via the following: Telephone (505) 504-5449; Fax (844) 840-7345; Email steve@familiesfirsttherapy.org; Mailing Address: PO BOX 35937 Albuquerque, NM 87176; or in person at your next appointment.

Non Discrimination Policy
Families First Therapy is an equal-opportunity provider. Families First Therapy prohibits discrimination and harassment based on kink, relationship configurations (e.g. polyamory, swinging, open, etc.), race, ethnicity, creed, religion, sex, national origin, citizenship, marital status, age, disability, sexual orientation, gender identity and gender expression, veteran status, or any other status protected by applicable law to the extent prohibited by law. Families First Therapy provides an atmosphere of respect, dignity, acceptance and safety for all clients. Furthermore, no client will be discriminated against based on referral source. Families First Therapy is open to clients from a number of referral sources including, but not limited to, self-referrals, juvenile probation referrals, child protective services referrals, referrals from primary care physicians, and both public and private health insurance based referrals.

Complaint Policy and Procedure
If you are unsatisfied with the services you have received at Families First Therapy, I welcome you to inform me in person. I consider it a gift if you bring up your concerns so I can make amends if need be. However you may also address a written compliant to: PO BOX 35937 Albuquerque, NM 87176

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Therapy Forms

Couples Therapy Intake Forms

General Forms

Safety and Coping Information

  • Technology Safety Recommendations: In the era of technological breaches, these data security recommendations can be helpful to protect your privacy online.
  • Coping During COVID 19: Based upon a training I attended recently, I have put together some suggestions for coping during the COVID 19 pandemic.


Please choose from the categories below for the type of community resources that you are current seeking. Please feel free to Email me or call me at (505) 504-5449 if you have any questions or concerns.

Addiction / Substance Use Resources

Because we all need help and support from others to support and sustain change, I also encourage individuals and families to participate with self-help groups or to educate themselves through online resources and self-help resources. Some of the support groups available in Albuquerque include the following:

12 Step Based Support Groups Secular Support Groups General Addiction Resources
  • SAMHSA - Government organization with lots of research, self-help resources, and clinical resources
Resources for Problematic Gambling Resources for families

Grief and Loss Resources

Kink, Polyamory, and other Consensual Non-Monogamy Resources

LGBTQ+ Resources

Listed below are a variety of LGBTQ resources in the Albuquerque area and Nationally. A part of getting help often involves connecting to affirming and supportive community and national resources, which can help us feel less isolated or alone.
Albuquerque Local Resources
  • Transgender Resource Center of New Mexico - Support groups and many other resources.
  • UNM University LGBTQRC Resource Center - University resource center and support services.
  • Equality New Mexico - Education and advocacy organization.
  • U21 - Youth under 21 and their allies support and social group. Lots of events on their website!
  • NM Power - Support and Social groups for individuals age 18-29. They can be reached at (505) 504-8205.
  • Casa Q - Youth homeless shelter for age 14-18. They can be reached at (505) 872-2099.
  • UNM Truman Clinic - Offers medical treatment in two clinics one specializing in working with patients diagnosed with HIV / AIDs and a second clinic dedicated to helping transgender individuals age 16+.
National Resources

Suicide / Self Harm Crisis Resources

Many of us feel such a severe pain that some times it feels like there is no way out. Suicidal ideation has been described as feeling like you are trapped in a burning building and the only exit you can find is suicide. Self harm often includes a desperation to escape or soothe underlying emotional torment. Utilizing crisis resources is one of many ways to keep us living while we find in treatment the alternative paths to suicide or self harm that help ameliorate our pain and anguish.

Upcoming Seminars

I provide a number of continuing education seminars at local venues such as conferences, agencies, and at different schools.

Please feel free to call me at (505) 504-5449 or Email me if you have questions.

  • Kink and Neurodiversity
    TASHRA Presentation
    November 2023

    Because of the risk of stigma for both neurodivergent and kinky individuals, the unique experiences of the multiple minority intersections of kinky neurodivergent folks is imperative for educators, counselors, and therapists to be aware of. Specifically in this presentation, we will review how two common forms of neurodivergence, ADHD and Autism, intersect with kink in the lives of some sexually diverse folks. Building on both clinical experience and the common community experience of kink and neurodivergence intersecting, we will seek to better understand the experiences of folks with these multi-minority intersecting identities. Avoiding an over-pathologizing stance, we will seek to note both potential benefits and challenges of neurodivergent kinky folks.

    Specifically, we will begin by briefly reviewing relevant literature on ADHD and Autism. Next, we will discuss the limited literature and bountiful experiences attesting to the overlap of these minority identities. Notably, we will discuss the emerging insights in the intersections of kink and neurodivergence coming out of TASHRA’s International Kink Health Study. We will conclude with a discussion of how some neurodivergent people may use kink to facilitate psychological wellness.

Academic Research

I am interested in academic research in gender, sexual, and relationship diversity (GSRD) populations. Information on current and past research projects will be posted here as it emerges.
Date Description
2023 - Present: Dissertation I am conducting a scoping review of kink literature to identify gaps, missed intersectional populations, and the prevalance of pathologizing in the literature.
04.2022 - Present: Volunteer I began volunteering with the Gilead funded HIV reesearch conducted by TASHRA (The Alternative Sexual Health Research Alliance). This research is currently in the planning stage.
01.2022 - Present: Research Scientist I began volunteering with various research projects in January 2021 with TASHRA. In December 2021, I was appointed at a Research Scientist at TASHRA (The Alternative Sexual Health Research Alliance). Currently, we are planning a qualitative study examining power exchange relationships in the kink community.
10.2010 - Present: Lead Research Associate Since October of 2010, I have been participating with the International Kink Health Survey that is lead by TASHRA (The Alternative Sexual Health Research Alliance) researchers Dr. Sprott and Dr. Randall.
01.2007 - 09.2009: Masters Research While attending my master's graduate program, I participated with a designing and piloting of an anger management curriculum for instruction in jails and prisons.
09.2007 - 12.2007: Program Pilot Test During my Master's program, I participated in an unpublished research project examining variables that effect cell phone use will driving.

Payment Information

All fees, copayments, and deductibles for counseling services are due at the time of the appointment. If you wish to bill your insurance company, this must be set up in advance of your counseling session. Any sliding scale arrangements must also be made in advance.

New Mexico Insurance Accepted:
  • Blue Cross / Blue Shield
  • NM Medicaid
  • Presbyterian
  • Western Skies Community Care
Oregon Insurance Accepted:
  • OR Medicaid (Direct Medicaid Only)
  • Pacific Source (Not Medicaid)
  • Providence Health Plan
  • Care Oregon (PENDING)
  • Moda (PENDING)
Florida Insurance Accepted:
  • Blue Cross / Blue Shield
Deductibles and Copays:
Most insurance companies will pay for your counseling services. If your insurance company refuses to pay for counseling, then you will be responsible for paying for these services. Some insurance companies will require you to pay a copay or a deductible. A deductible is the amount you have to pay out-of-pocket for counseling before the insurance company will cover any of the costs. If you do have a deductible, you will be responsible for counseling costs until the deductible is met. A copay is a small amount of the total fee for counseling that your insurance company does not pay. Copay amounts vary based upon your insurance plan. All copays and deductibles are due at the time of service.

If you have any questions about your copays, deductibles, or if your insurance company will pay for counseling, please contact your insurance company prior to your first appointment.

Good Faith Estimate of Services / Fees for Services:
Without prior arrangements for sliding scale or insurance coverage, the fees for services are noted below. Please note that some services such as telephone support, records preparation, and cancellation / no show fees typically are not covered by your health insurance plan.

Price Individual and Family Therapy
$250 Intake Assessment
$200 55 min. Individual / Family Counseling Session
$200 55 min. After Office Hours Counseling
$200 55 min. Extended Counseling Session
$200 Crisis Counseling Session
Individual therapy clients paying the full rate of $200 are offered a $25 discount for paying at the time of service.
Please also note that because I do not provide a diagnosis during couples therapy and there is no established American Medical Association code for billing for couples therapy, insurance cannot be billed or reimburse for these services.

Price Relationship Therapy
$175 55 min. Relationship Therapy
$45 Relationship Assessment Fee (1x per couple)
$475 1/2 Day Relationship Therapy (3 hrs) $50 Savings!
$925 Full Day Relationship Therapy (6 hrs) $75 Savings!

Price Miscellaneous Items
Inquire Workshops and Seminars
$500 per Hr. Legal / Court Involvement for a Client
Inquire Expert Testimony
$100 per Hr. Professional Clinician Consult
$25 per incident Late Cancellation / No Show Fee
$50 per Check or Credit Card Charge Return Fee
$25 per 15 min. Miscellaneous Services

Payment Forms Accepted:
  • Check
  • Credit Card
  • HSA (Health Savings Account)
  • FSA (Flexible Spending Account)