Willow Tree LCSW Inc

02/25/2026

The Step Child of Healthcare by Dr Sib

No offense to step children. I once heard a colleague say that ‘mental health is the stepchild of healthcare’. It has stuck with me for over 20 years. What she meant was that it often seems like all the money pours into healthcare for the diagnosis that is most frequently in the news. Examples: dementia, cancer.

Now, these diagnoses need money and I’m not saying there shouldn’t be money going to these causes as well. It is very important. However, when you look deeply, you can see that mental health programs are basically divided into two camps. Mental health for the rich (private care) or mental health for the poor (subsidized, county or federally funded). If you are someone who is very mentally symptomatic acutely or chronically (as is often the case with schizophrenia, bipolar, substance use disorder, PTSD, DID, dementia, etc) you will have a very hard time getting your mental healthcare needs met in the ‘typical’ medical system. Even if you require ongoing medication management and therapy, it can be quite difficult for most people to afford unless they have insurance that has significantly robust mental health coverage. If you are a ‘typical’ person who may need therapy sometime in your life it can still be a pretty significant cost and not sustainable for many people, having copays from $25 to 90, deductibles, and many services not covered or partially covered. If you can afford to pay out of pocket for therapy the average cost is $150 per session, weekly sessions can quickly become unsustainable. Approximately 32% of therapists right now are private pay only, dropping off insurance panels or never even trying to get on them. Reasons predominantly include low reimbursement rates and high administrative burden.

My journey as an Entrepreneur began well before I became a therapist. My first venture started when I tried my hand at a small business importing handicrafts from Thailand. I sold them during summer events in New England. I eventually rented a market stall in Salem, Massachusetts. My husband and I have also owed two Thai restaurants together, one in Portland, Oregon and the other in Oceanside, California. All of these ventures had their own set of challenges.

My journey as a private practice therapist has been replete with challenges as well. I started off under the name Life Enrichment Services and worked out of an extra bedroom in my home in Portland, Oregon, eventually sub-leasing an office with a PMHNP. After moving to California I got my own office and continued the business as a Sole Proprietor. Over the years I knew I had to change my business structure to something different. Sole Proprietorship was not the best business type for a professional. In 2024 I started my first S Corp, Willow Tree Licensed Clinical Social Worker. Despite the challenges of increased overhead and liability costs I have managed to survive for my first full year (2025). I think this is an extraordinary accomplishment!

However, due to the changing nature of the mental health business, the overall healthcare system, the medical model of psychotherapy, changing HR and workplace rules, etc. the challenges of being an Entrepreneur still continue.

As your Willow Tree CEO I remain steadfast in meeting our clients’ needs for exceptional care at affordable rates. I have had to make some tough business decisions, however, and have needed to pass some of the cost on to clients and staff (this includes myself). We will need to be more adamant about charging small fees for things like sending medical records, writing letters, renting books or equipment. Many of our insurance contracts DO NOT ALLOW us to collect payment for NO SHOWS or LATE CANCELS. Therefore, we will be asking YOU to help with this very challenging administrative cost as well by giving us sufficient cancellation notice (at least 24 hours). We hope you understand that this is a business and we want to survive to serve you another year!

Have a blessed day,
Dr Sibelia L Chaiyahat, LCSW

Resources:

More than one in five adults in the U.S. live with a mental illness, but only about half receive treatment. Many struggle to find a therapist that will accept their insurance. An NPR/ProPublica investigation found that therapists, psychologists and psychiatrists who join insurance networks often lea...

02/24/2026

Nice quiet morning in the countryside. Listen carefully and you can hear several animals.

01/31/2026

I got over 10 reactions on one of my posts last week! Thanks everyone for your support! 🎉

01/15/2026

Sibelia,



We have great news to share: thanks to your advocacy and congressional champions speaking out yesterday, the Administration told media outlets that they are REVERSING its sudden termination of thousands of grants that fund substance use and mental health care.



This is INCREDIBLE news — and it is all thanks to NAMI leaders across the NAMI Alliance and advocates like you who called on members of Congress to demand this action be reversed.

NAMI advocates from all 50 states and the District of Columbia sent more than 16,000 letters to their members of Congress in under 19 hours to express their outrage and concern. Leaders from NAMI State Organization and NAMI Affiliates jumped into action to bring the impact on their communities directly to their elected officials. And staff at NAMI’s National Office spent all day on the phones with congressional staff and the media to raise awareness of this unprecedented and harmful action.



Thanks to this advocacy — the whole NAMI Alliance coming together to raise our voices — we are relieved that federal grant funding will once again flow into our communities to support lifesaving efforts to expand the mental health workforce, awareness and education programming, crisis response training and services, su***de prevention programs, and substance use overdose prevention and treatment, among other priorities.



We won this fight, but the work isn’t over to protect federal mental health funding. We’ll remain vigilant to ensure this funding continues to flow to our communities to help the people who need it, and we will stand up against any future efforts that would negatively impact all people affected by mental health conditions. Add your name here to stand with us in this effort.



You truly helped make a difference this week. Thank you for your advocacy.



Hannah Wesolowski

Chief Advocacy Officer

National Alliance on Mental Illness

01/13/2026

1/13/2026
Ride Your Ride by Dr Sib

People who ride motorcycles have a saying, ‘Ride your ride’. In this moment I invite you to embrace this motto.

Ride your ride means that you know your bike better than anyone else. You know when the sound of the engine changes, when the tire pressure feels off, when the clutch is tight. You know when you are out of gas.

Ride your ride also means that you know your body and mind better than anyone else. You know when you are tired, you forgot to eat, your fingers are frozen.

When this happens you pull over. You signal to your group. And someone in your group sees you. It is their job to see you. They pull over to see if you need help. There is a ‘lead’ and a ‘sweep’ in your group. These are people who are watching out for you and everyone in your group.

If you happen to be riding solo another motorcyclist will often pull over. They will check on you. It will likely be a stranger.

As 2026 comes barrelling in on a ‘Fire Horse’ I invite you to ‘Ride your ride’. You will encounter someone who, perhaps in a well meaning and compassionate way, tells you there is something wrong with your ride. You are not dressed appropriately. Your bike is too small, or too big. You are riding too fast, too slow. You are not splitting lanes correctly. You should get a full face helmet.

I invite you to tell them to ‘f**k off’. Not in a mean way, in a loving way. If they are not your ‘lead’ or your ‘sweep’ or you are not pulled over on the side of the highway they have no business telling you how to ride your ride.

Tell them, ‘I got this.’ and ‘Thank you.’ If they get defensive, let it go. Ride your ride.

I also invite you to pick a ‘lead’ and a ‘sweep’. The lead could be a partner, a friend, a sponsor, someone who is forging ahead, looking out for potholes, noticing construction, making sure the path forward is safe. A sweep could be another partner, a mentor, a p*er, someone who’s job it is to make sure you are still on the path. You are still moving forward. And if not, if you are on the side of the road, that you are safe. Your bike is not sticking out into the road. You have called AAA. Your bike is upright. You have dialed 911 if need be.

Riding your ride also requires self awareness, courage, and humility. You need to recognize when your riding is off, that your bike is messed up, that you have to p*e and the vibration of the bike is making it worse. You need to stop riding if you are unfit to ride. No one is in a better position to see that but you. I invite you to take a deep breath and take a good look inside. Are you riding your best ride?

Riding your ride also requires empathy, forgiveness, and love. You need to recognize when you are tasked to be the lead or the sweep. You need to be brave enough to say, ‘Are you ok?’ ‘Are you riding your best ride?’ and you need to take the person’s word for it. If they say, ‘I got this.’ and ‘Thank you.’ you need to move on. Ride your ride.

If you are jealous because you can’t ride, that’s your problem. Take a motorcycle safety class. Get a bike. Don’t take it out on people who are out there. Instead, admire them. Maybe you aren’t brave enough to ride. Maybe you had a head injury and your family doesn’t want you to ride anymore. Say, ‘I like your bike.’

You don’t ever need to explain why you can’t ride, what you choose to ride, and with whom you choose to ride, why you ride a Harley vs a Honda, why you like a 1200, a 750 or your 450 engine, why you wear chaps, why you like to ride. You can explain, but it doesn’t help nor is it necessary. Ride your ride.

I invite my friends, my colleagues, my clients, my family, and my enemies (yes I keep you close) to ‘Ride your ride’ on this crisp January 13, the day before I turn 58.

May you be loved. May you be at ease. May you ‘Ride your ride’.

In Gassho,

Sibelia L Chaiyahat

12/03/2025

How's your holiday chaos unfolding so far?

09/05/2025

https://gofund.me/fe4c2c64a
He still could use a little more help!

My son Sittichai is an extremely talented young actor. His birthday is August 11… Sibelia Chaiyahat needs your support for Join Sittichai's Theater Dream Team

11/24/2024

Seeing the show!

'Pacific Overtures,' Stephen Sondheim and John Weidman's 1976 musical about the forcible opening of Japan to foreign trade, is dazzlingly revived by East West Players in one of the best production's of the year.

11/23/2024

Welcome to care in a safe place! In person, on line, or somewhere else!