About Our Practice

This information can help you decide if psychotherapy and our practice might be right for you.

What is a Psychologist?

People outside of the mental health field are often not familiar with the differences between psychologists, psychiatrists, social workers, master’s level clinicians, and life coaches. The more generic terms counselor, therapist, and psychotherapist can add to the confusion. The differences are significant, so read this section if you’re not already familiar with the particular professions.

A psychologist has a doctoral degree in psychology (a PhD, EdD, or PsyD), requiring approximately six years of formal education and training beyond a four year college degree. Clinical and counseling psychologists have intensive instruction in the practice of psychotherapy and in the psychological underpinnings of human behavior. Psychologists are licensed by the State. They do not prescribe medications.

A psychiatrist is a medical doctor (MD) and has specialized training in the biological bases of behavior. Some psychiatrists do provide psychotherapy and all can prescribe medications. Psychiatrists are licensed by the State.

A social worker has a master’s degree in social work (MSW, or LICSW when licensed), requiring three years of formal education and training beyond a four year college degree.

A master’s level clinician has a two-year degree in psychology and is certified by the State.

No special education is required for someone to be a life coach. Life coaches work largely from their own experiences, though they can complete certification programs, generally in less than 100 hours. They are not regulated by the State.

The terms counselor, therapist, and psychotherapist are non-specific. These terms can be used to describe practitioners in all of the fields above.

Psychologists' Backgrounds

Dr Roll and Dr Mills each hold a PhD in Clinical Psychology from the State University of New York at Buffalo, a doctoral program accredited by the American Psychological Association. Each is licensed by the State of Washington to practice psychology (Dr Roll, license number 2241; Dr Mills, license number 2075).

Dr Roll provides psychotherapy for adults, and views psychotherapy as a route to personal growth and development by which people can learn to let go of reoccurring fears, pain, and suffering so that they can live their lives more fully in each present moment. Dr Roll treats a wide range of difficulties involving feelings of anxiety, depression, anger, and distress. Dr Roll’s area of expertise is with people who have histories of trauma and abuse.

Dr Roll is eclectic in her approach to psychotherapy, believing that no single model of human emotion and behavior entirely encompasses every problem faced by every person. In her work, she draws from many diverse schools of psychology, including psychodynamic, interpersonal, cognitive-behavioral, Jungian, sensorimotor, biopsychosocial, and cross-cultural. Regardless of the treatment perspective, Dr Roll sees the therapy relationship as a collaborative one: Your work in therapy is shaped by you and what you bring to each session, with you and Dr Roll working together as a team.

Dr Roll has been a psychologist in Washington State since 1998. Prior to private practice, Dr Roll’s professional experience included work in a mental health center, a university psychological services center, a day-treatment center, a psychiatric hospital, and a medical center. Her previous research focused on post-traumatic stress.

Dr Mills works primarily with children, adolescents and their families, and also sees younger adults with anxiety and attention difficulties. He has wide experience in the assessment and treatment of childhood disorders, particularly those involving anxiety, attention, and problematic behaviors at home and in school. He has strong interests in the relationships between parents and their children/adolescents, and the role of positive discipline in guiding young people to healthy adulthood.

Because every young person and every family is unique, Dr Mills is flexible in his approach to psychotherapy, choosing treatment strategies that best fit the current situation. In every event, he believes that psychotherapy works most effectively when it is a collaborative effort. Regardless of age, as a client you will have the opportunity to shape your treatment, and your participation and feedback will be important to the outcome of your therapy. In the case of children, the participation of parents or guardians is seen as essential, not optional. Adolescents have significant rights to confidentiality, but parent input and participation are both sought and encouraged.

Dr Mills has been a psychologist in Washington State since 1997. Prior to private practice, Dr Mills’ professional experience included work in a university medical center, a therapeutic preschool, a day treatment center for children and adolescents, a residential treatment facility, and a university psychological services center.

The Structure of Therapy

Your therapy begins with an assessment interview, during which your psychologist will gather background information in order to fully understand the difficulties you are experiencing. Your initial interview session will last approximately 60 minutes.

Typically, therapy sessions following the assessment session are scheduled weekly. Each regular therapy session lasts either 45 or 60 minutes. The frequency and length of your therapy sessions will depend on the nature of your issues, the urgency of your situation, and your own goals. The exact structure of your therapy will always be a matter you decide jointly with your psychologist, who will make recommendations to you based on his or her understanding of your current situation.

At times, we may be running groups. Group sessions are scheduled on a weekly basis, with sessions lasting at least 90 minutes.

Professional Ethics

Dr Joseph R. Mills and Dr Carolyn N. Roll are members of the American Psychological Association and the Washington State Psychological Association. They adhere to the ethical code as established by the American Psychological Association, and the professional standards as described in the Washington State Psychology Licensing Laws (RCW 18.83, 18.130, and WAC 308-122). If you have any concerns about the treatment you receive, please discuss them with your psychologist. If he or she fails to respond to your satisfaction, you have the right to register a complaint with:

Washington State Examining Board of Psychology
The Department of Health
PO Box 47869
Olympia, WA 98504
(360) 236-4910

You may also register a complaint to the Ethics Committee of the Washington State Psychological Association at (206) 547-4220.

Rights, Responsibilities, and Risks

As a client of a psychologist, you have a number of rights. You have the right to full information about your psychologist’s training, qualifications, and treatment philosophy, as well as an explanation of the fees for services you are receiving. You have the right to ask questions about your therapy, to refuse any course of treatment suggested by your psychologist, and to terminate therapy at any time, without penalty. You have the right to request access to your treatment records and to request a copy of those records or to request to correct those records. You also have the right to request in writing that no treatment records be maintained. You have the right to have your psychologist release appropriate information from your treatment records to another entity, provided you sign a release of information. You have the right to discuss your treatment with anyone you choose. If you choose to use insurance, please see the sections on confidentiality and insurance for limits insurance companies may place on your rights as a client.

You have the responsibility to choose a therapist you feel is a good fit for you and for the issues that brought you into therapy. You have the right to change therapists. You have the right to terminate therapy when you choose.

All effective treatments carry risk. During psychotherapy, people may have periods in which they are in touch with painful feelings, possibly for the first time. Though often part of the growth and learning process, this can temporarily lead to feeling worse. Psychotherapy can lead people to question their lives, choices, and relationships, and this can result in life-changing decisions that were not anticipated at the start of treatment. Sometimes anger or disappointment is experienced with the therapist. Even if the relationship ends, there may be significant benefit from exploring with the therapist what went wrong and why. Sometimes people will return to therapy after a break, possibly with a new therapist, to re-examine issues that could not be dealt with initially. Each of these possibilities presents an opportunity, but also a potentially difficult challenge.


With the few legal exceptions described below, any and all information regarding your treatment, including the fact that you are in therapy, is confidential and will not be released to anyone without your written consent. The following are the legal exceptions to your right to confidentiality:

  • If your psychologist has reason to believe that you are in imminent danger of harming yourself or another person, necessary action must be taken by your psychologist to prevent that harm, including—but not limited to—informing friends or family members, contacting police or other officials, or contacting the county designated mental health professional.
  • If your psychologist has a reasonable suspicion, based on information you provide, that there is a child, vulnerable adult, or developmentally disabled person being abused or neglected, your psychologist must inform the appropriate state protective service of that information. In the case of possible child neglect or abuse, your psychologist must inform Child Protective Services. It may be important for you to know that if you reveal that you were abused as a child and your abuser still has access to children, your psychologist must inform Child Protective Services.
  • If your psychologist is ordered by a court to release your records, your psychologist must release those records.
  • Under the Uniform Health Care Information Act of 1992, your psychologist does not require written consent to confer with current, prior, or future health care providers for purposes of continuity of care, or to confer with a member of your immediate family. Our policy is to do so only in the event of an emergency.

The competent and ethical practice of psychology requires that your psychologist consult periodically with other licensed mental health professionals. Should your psychologist consult with a colleague regarding your treatment, he or she will omit any extraneous identifying information (name, address, employment), so that your anonymity is preserved.


If you are using insurance to pay for therapy, your rights as a client may be limited by your benefit company. That company may limit the number of sessions available to you, the length of your treatment, or your choice of psychologist. Also, insurance companies usually require that your psychologist provide information about you before they pay for sessions. The information required varies by benefit company, but usually includes any diagnoses for which you meet criteria. They may also request specific treatment plans and periodic progress reports, and occasionally require copies of your treatment records. If you wish to use your benefits, you must sign a consent to release information to your benefit company. Your benefit company may have less strict policies on confidentiality than the ethical and legal standards upheld by psychologists.

Because of the above, we encourage clients to discuss with us the benefits of not using insurance to pay for therapy.


We support your right to end your treatment when you choose. We also strongly urge you to talk with your psychologist about your thoughts of terminating when you are considering ending therapy. Whether the decision to terminate is a result of feeling that the issues that led you to therapy are resolved, or a feeling that treatment is stalled, our foremost desire regarding termination is for a good ending. Often, the last few weeks of therapy are quite productive, as loose ends are tied up. And if you are feeling frustrated with the progress of therapy, discussing this feeling can often lead to substantial progress with your current therapist, or an informed referral to another professional who may be more helpful to you.

Fees and Appointments

Initial assessment: $200.00
45 minute session: $140.00
60 minute session: $175.00

Payment, or insurance co-payment, is due at each appointment.

If you use insurance, you are responsible for providing the information needed to bill your insurance company. Complete all insurance information on our forms carefully so that your bill is paid appropriately by your benefit company. If a check from an insurance company is mailed to you, you are responsible for paying that amount at your next appointment.

Appointment Cancellations

When you make an appointment with a psychologist, you are reserving that time for yourself. Please know that if you are late for your session, the session will end on time. If you cancel an appointment with more than 24 hours notice, this allows your therapist time to fill the space, and you are not charged. If you cancel with less than 24 hours notice, you will be responsible for paying the full charge (insurance cannot be used) for the missed appointment at our next session. Similarly, if you miss your session entirely, you will still be responsible for paying for the time, and payment will be due at the beginning of the next session.

Contacting your Therapist

You may leave a voice mail message for your psychologist at any time by calling the office at (206) 545-7500 and choosing the appropriate extension (“1” for Dr Mills and “2” for Dr Roll). Listen carefully to the recorded messages, since there will be days of the week when your psychologist will not be in the office. Calls received on off days, or received on business days after 5 pm, will be returned on the next business day. Both Dr Mills and Dr Roll will make every effort to return your call at the earliest possible opportunity.

You can also email your psychologist. Note that email is not considered secure. By choosing to communicate with your psychologist by email, you will assume the risk of a confidentiality breach.


If an emergency involves imminent risk to yourself or to someone else, call 9-1-1 immediately.

If the situation is not life-threatening, contact the crisis line at (866) 427-4747.

If you are a current client, meaning you have had at least one intake session with Dr Roll or Dr Mills, you may leave a voice mail (206) 545-7500 for Dr Mills (press “1”) or Dr Roll (press “2”). State in your message that your call is urgent. Your psychologist will call you back as soon as possible, but if you need to speak with someone immediately, call the crisis line after leaving your psychologist a message.

When your psychologist is out of town, another therapist will be available in the event of an emergency, and Dr Mills or Dr Roll will discuss this with you ahead of time.