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Frequently Asked Questions

Frequently Asked Questions will primarily address questions related to individual therapy.

Questions related to Autism Assessments can be found here.

Are you accepting new clients?

I am accepting clients for individual therapy. I have space for 2 people for weekly sessions.

I am scheduling Autism Assessment appointments and consultations with colleagues.

How do I schedule an assessment?

You go to the scheduler tool and select "Affirming Autism" for your appointment. Please review this page before booking an appointment.

How long are therapy sessions?

Sessions are typically 55 minutes long. The last 5 minutes are for me to take care of admin tasks or run to the bathroom between clients. 


Sometimes, I shorten sessions due to energy needs. Sometimes that means you’ll have a 40-45 minute session. If you use insurance that means you’ll still owe your copay and I’ll be reimbursed less for the session. If you use cash to access therapy then I charge less for the session.

What is a superbill?

A special receipt a medical or mental health provider can give to you so that you can seek reimbursement from your insurance provider directly when the therapist is out of network. Payment is not guaranteed.

Do you accept insurance?



1. Blue Cross Blue Shield 

2. Blue Care Network.

Who do you work with?

Autistic people (Adults). Especially those who have masked their traits throughout life.

Fat and queer folks. Polyamorous people.

Social workers and healers.

How much do you charge?

For therapy: $175/hour.

However, most people pay their rent, utilities, and healthcare costs each month. Why should therapy bill be different? So I encourage people to think about therapy as a monthly cost and factoring it into the budget, because usually I work with people on average about 1-3 years. Sure we may meet one hour at a time, but generally speaking we’re embarking on a deep intentional relationship that will probably be a long-term project over a few years.

Here is a link to my fee page.

What's your style?

Many therapists are eclectic. Meaning that they use several different tools at their disposal to get the job done. I would describe myself as eclectic.

Common tools that I use include:

  • Attachment theory

  • Mindfulness

  • Liberation-focused framework

  • Motivational Interviewing 

  • Somatic exercises and polyvagal theory

Do you have a waitlist?

I do not. When I get ready to open up my books for either individual or group therapy, I announce it on my webpage and to my colleagues with a date that people can email me. I then reach out to people until my books are closed. Books are open at this time.

How do I set up a therapy appointment?

Please feel free to use this script when reaching out about individual therapy.

Send an email  with the following information:


Address: (we need to establish that you're in MI or ID)

Date of birth:

Method of payment: Insurance / cash. If insurance, I will need you to take a picture of your insurance card and send it to me, or you can use the secure portal to give me your insurance information. *

Availability: when are you available for appointments?

Access: Do you have access needs related to seeking care? One example would be captions.

*Verification of insurance is required prior to an appointment. If I cannot verify your insurance you will be responsible for paying for the session with cash and I will provide you with a superbill at the time of session.

Do you offer free consultation?


I am willing to answer questions via email. My intention with radical transparency about myself and my practices on my website is for you to determine quickly if my words and style resonate.

Consultations are a paid service for colleagues seeking advice.

How does insurance work?

Here is an article that explains some of the basics of a deductible, copay, etc.

This video is essentially insurance 101.

Do you have captions?


Here is a link for instructions for  chrome captions. This is what I use with Theraplatform, which offers video visits and a health record.

Do you offer sliding scale?

All my sliding scale slots for therapy are closed at this time. 

I offer sliding scale for every 4th Autism Assessment.

What are your Covid-19 Precautions?

This is a telehealth practice so we will not be exposing each other to covid. Talking to people about covid exposure and consent regarding creating pods or polyamorous agreements is something that I am happy to engage in.

I am vaccinated and boosted.

This is a link to my plague page.

Limitations & Scope of Practice

Image by Evgeni Evgeniev

Ruth Spalding, LMSW

Here is a link to my about page.

I am Autistic, bisexual, fat, and disabled. My lived experience informs my practice.

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