Frequently Asked Questions

Who will I be working with?

Tier One Counseling Collective is founded and currently led by Misty Kirby, LCSW. At this time, all clinical services are provided directly by Misty. As the practice grows, additional carefully selected clinicians may join the collective, allowing us to expand services while maintaining the same standard of compassionate, high-quality care.

What ages do you work with?

I work with clients ages 16 and up, including teens, young adults, and adults across the lifespan.

What concerns do you treat?

I support clients navigating trauma, anxiety, depression, mood disorders, bipolar disorder, ADHD, OCD symptoms, grief, relationship challenges, and major life transitions.

What therapeutic approaches do you use?

I use an integrative, trauma-informed approach that draws from several evidence-based modalities and is tailored to each client’s needs, goals, and pace. Therapy is collaborative and flexible rather than one-size-fits-all.

My work often incorporates Accelerated Resolution Therapy (ART), a trauma-focused approach that uses guided eye movements to help the brain process distressing memories, reduce emotional intensity, and promote lasting relief. ART can be especially effective for trauma, anxiety, and unresolved experiences that feel “stuck.”

I also integrate Cognitive Behavioral Therapy (CBT) to address unhelpful thought patterns, DBT-informed strategies to support emotional regulation and distress tolerance, and mindfulness-based approaches to build present-moment awareness and nervous system regulation. Depending on the client, therapy may also draw from attachment-based, skills-based, and insight-oriented techniques.

Rather than relying on a single method, I adapt the approach as therapy evolves while offering structure when helpful, depth when needed, and practical tools that support meaningful change both in and outside of sessions.

Do you offer virtual or in-person sessions?

At this time, I offer secure, HIPAA-compliant virtual therapy sessions. I am actively working toward offering an in-person option in the future and will share updates as this becomes available.

What insurance plans do you accept?

Tier One Counseling Collective is in-network with most major commercial insurance plans and Medicare.

Insurance benefits are verified prior to the first appointment, and clients will be informed of their coverage details as part of the intake process.

A limited number of Medicaid plans may be accepted based on clinical fit and availability. Prospective clients with Medicaid coverage are encouraged to submit an inquiry to determine eligibility.

Self-pay options are also available. Upon request, superbills may be provided for potential out-of-network reimbursement; however, reimbursement is determined by the individual insurance carrier and cannot be guaranteed.

What is your cancellation policy?

I require 24 hours’ notice for cancellations or rescheduling. Late cancellations and no-shows are subject to a fee, as this time is reserved specifically for you and cannot be offered to another client.

How often will we meet?

Most clients begin with weekly or biweekly sessions, depending on clinical needs and goals. As progress is made, sessions may be spaced out to support ongoing growth or maintenance.

How long are sessions?

Standard therapy sessions are 53–60 minutes. Extended sessions may be offered when clinically appropriate, including for trauma-focused work.

Do you prescribe medication?

No. I do not prescribe medication. If medication is indicated, I can collaborate with or refer you to a psychiatric provider or primary care clinician.

Is therapy confidential?

Yes. Therapy is confidential and protected by HIPAA and state law. There are limited exceptions related to safety and legal requirements, which are reviewed during the first session.

Do you offer resources outside of therapy?

Yes. Through Resilient Mind Market, which I offer guided workbooks and digital resources designed to support insight and growth between sessions. These tools are optional and intended to complement therapy, not replace it.

How do I get started?

You can begin by clicking Request an Appointment or completing the contact form. I’ll reach out with next steps and scheduling options.

What if I’m not sure therapy is right for me?

That’s completely okay. Starting therapy is a personal decision, and it’s normal to have questions or hesitation. I encourage you to reach out and we can talk through what you’re looking for and whether Tier One Counseling Collective feels like a good fit.