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Frequently Asked Questions

Do you see clients online?

Yes, we offer telehealth services.

Do you see clients in person?

We see a very limited number of clients for in-person therapy in the Dallas/Fort Worth area.  There is currently no availability for in-person appointments.

Integration Therapy

What is Integration Therapy?

The purpose of integration therapy is to assist individuals who have had or are planning to have experiences with psychedelic medicines, meditation, breath work, and/or other practices that result in non-ordinary states of consciousness from the framework of harm reduction and benefit maximization.

People who have had or are planning to have these experiences often benefit from a trained professional assisting them with planning for an experience in a way that minimizes potential harm and maximizes benefit. 

People often also benefit from therapy after an experience to help integrate that experience into their everyday lives.

What is Harm Reduction?

The principles of Harm Reduction acknowledge that people engage in behaviors that are not recommended by their medical and/or mental health professionals.  When and if people do engage in these behaviors, they nevertheless deserve to have access to a professional who can help reduce the potential harm caused by these experiences.

In the context of non-ordinary states of consciousness, we acknowledge that people do use psychedelic medicines and engage in practices that lead to non-ordinary states.

While we do not recommend, endorse, or condone the use of these medicines or practices, we also do not condemn those who choose to do so.  Our approach is non-judgmental.

When people do have these experiences, it is often beneficial to discuss them with a licensed and trained professional to integrate them into their daily lives.

It can also be beneficial to discuss future plans for psychedelic experiences with a licensed and trained professional who can provide information on how to help mitigate some of the risks associated with psychedelic experiences.

Any individual considering the use of psychedelic medicines or practices that result in non-ordinary states of consciousness should consult with their physician regarding the applicable medical risks.

Harm Reduction

What is Benefit Maximization?

Individuals who are planning to have or have previously had experiences with non-ordinary states of consciousness often find it beneficial to consult with a licensed and trained mental health therapist to maximize the benefit of those experiences.

People choose to engage with non-ordinary states for a variety of reasons, including, but not limited to, personal growth, working with past trauma, spiritual development, improvements in relationships with others, or for creativity.

Consulting with a licensed and trained mental health therapist can often be beneficial in achieving these goals. 

A therapist specializing in non-ordinary states of consciousness can assist you with understanding the history of a medicine or practice. They can also provide a space for you to set your intentions and mindset, and can provide information that assists you in creating a setting for an experience that is conducive to your goals.

Any individual considering the use of psychedelic medicines or practices that result in non-ordinary states of consciousness should consult with their physician regarding the applicable medical risks.

Benefit Maximization

How does confidentiality work in therapy?

What you say in therapy is confidential.  It is between you and your therapist, and this is protected health information under HIPAA.  

There are limited circumstances, such as active child abuse that a therapist is aware of, where notification to the appropriate authority is required. 

One question we often get is, "will you inform law enforcement of my drug use?" The adult use of an illegal substance, in and of itself, is not one of the circumstances where notification to an authority is required.

For specific information on confidentiality and your situation, we encourage you to speak with your therapist directly.

You can find our Notice of Privacy Practices here.


How much does therapy cost?

The cost of therapy depends on a number of factors. 

For clients with insurance that covers individual psychotherapy seeing an in-network provider, the cost at the point of service is often a copay as required by their insurance policy.

Clients with insurance that covers individual psychotherapy seeing an out-of-network provider should contact their insurance carrier with specific questions about claims, costs, and coverage.  We do offer "Superbills" for you to file an out-of-network insurance claim.

For patients who are not using insurance, the rate for a 50-minute individual psychotherapy session is $150.

Potential clients who feel that payment may be a barrier to accessing therapy are encouraged to email us at and we will do our best to connect you to available resources.


Do you see clients outside of Texas, Colorado, and Virginia?

At present, we only see clients in the states of Texas, Colorado, and Virginia; however, we are always looking to expand to new states.

If you are a resident in another state who is interested in therapy, we encourage you to join our wait list.

Service Areas

Can you help me locate or source psychedelic medicines?

We do not recommend, endorse, or condone the use of any medicines. We do not recommend that any person engage in illegal behaviors.  We are not able to assist any person in locating or sourcing any illegal medicines.

For clients interested in ketamine-assisted psychotherapy, we partner with medical providers who can prescribe ketamine.  Those providers are not employed by this practice and make their own independent decisions related to the medical care of their patients, including any decisions related to the prescription of ketamine.  As a mental health therapy practice, we cannot and do not prescribe any medications (including ketamine).

The legality of psychedelic medicines varies based on your location and residence.  In the United States, all medicines typically understood as "psychedelic" are either illegal or scheduled at the federal level, meaning that they are either outright illegal or that they would require a medical provider to prescribe these medicines.

Any individual considering the use of psychedelic medicines or practices that occasion non-ordinary states of consciousness should consult with their physician regarding the applicable medical risks.

Sourcing Medicines

What about clinical supervision?

We offer clinical supervision for LPC Associates in Texas.
Maddie provides supervision for select individuals whose experience and/or professional goals align with her own expertise and areas of focus.

Interested LPC Associates, recent graduates, and graduate students in their final semester of study are encouraged to submit preliminary information here.

Clinical Supervision

Are you hiring?

We are not currently hiring or actively seeking independent contract therapists. 

However, we understand that finding the right place to practice your profession can be challenging, and Downstream Counseling & Integration might be the perfect fit for you.  For this reason, we will always consider any proposal from a licensed professional to work as an independent contract therapist at our practice.

If you are a professional counselor, psychologist,  social worker, or marriage and family therapist practicing in the United States, and you would like to discuss becoming an independent contractor, please contact us at with your contact information.


How can I make a referral?

We will consider all referrals from licensed mental health professionals and/or medical professionals for potential clients who might benefit from our unique knowledge and expertise.

Please contact our office and we can discuss your patient or client.  Our contact information is at the bottom of this page.  If we are unable to serve your patient or client, we may be able to connect you to a therapist who is able to do so.

Contact Information
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