Supervision
I offer LMHC supervision, which can be counted toward Massachusetts supervision hours. Supervision is provided for LMHC-eligible music therapists as well as other LMHC-eligible clinicians. I am comfortable providing supervision for clinicians working in a variety of settings. In addition to routine supervision topics, supervision sessions can also include LMHC exam preparation, developing a music therapy or expressive therapies program within an existing program, and logistical aspects of being an independent contractor or clinician in private practice. Note: I am not qualified to provide financial or legal advice, but will share how I have handled various situations in my own practice.
I provide a limited amount of pro bono LMHC supervision and exam preparation for clinicians of marginalized/underrepresented experience (BIPOC, trans/queer, autistic, disabled, refugee, adoptee, former foster youth, other). Please contact me for availability.
Individual and group services
I am licensed in Massachusetts and can provide services to anyone physically located in Massachusetts.
I work almost entirely via telehealth (Zoom), aside from some types of more involved evaluations in which I may complete on-site observations in the greater Boston area, as well as providing expert testimony in courts in the greater Boston area.
I can provide private-pay consultations of a nature that are not considered a medical service to those located anywhere in the United States (with other locations on a case-by-case basis depending on my cultural familiarity).
I do not provide regularly scheduled long-term therapy services at this time, but have a network of likeminded colleagues who do.
As I am in private practice and not connected with any hospital network, documentation I create and diagnoses I give are not seen by any other providers unless you share them or sign a release authorizing me to share them. If using insurance, diagnostic codes are shared with your insurance company, but cannot generally be accessed by other providers.
Sub-acute assessment and referral services, i.e., "your child needs to be in services"
I especially understand that trans youth, youth of color, neurodivergent youth, and youth with disabled parents are particular targets for overreaction from providers and often face unnecessary contact with crisis, hospitalization, law enforcement, DCF, etc. As such, I am able to see children who are presenting with new or increased concerning behaviors (mood symptoms, disordered eating, autistic burnout, school refusal, troubled peer relations, self-injury...) for an initial consultation and to establish a professional relationship within a week, and can begin the process of diagnostic assessment and recommendation of further services. My aim whenever possible is to keep youth in their familiar environment with appropriate supports. I am able to provide safety-planning services and document a formal safety plan with families. I am a creative problem-solver and work with families to "fight fires" through means such as enrolling a child with school fear in an accredited online school, initiating the accommodation process at public or private school, and so forth, so that families can focus on attending to their child's needs rather than worrying they will be punished for doing the best they can. This service can be billed to insurance as psychotherapy.
Gender-affirming care letters
I am typically able to provide these in one session, sometimes needing two or three sessions if we need to gather documentation and/or if someone needs flexibility due to neurodivergence or other circumstances. These can be billed to insurance as a psychotherapy evaluation and followup, as we will be completing basic screening tools around mood and gathering a history. If I don't take your insurance, I can usually do these at no cost. I believe in autonomy and self-determination and while there are sometimes cases where I need more information, I cannot think of any instances in which I would decline to provide such a letter to someone who is living as trans/nonbinary and approaching me in good faith. Note that I am required to take a history and do basic screenings as my license requires these things any time I am seeing a client and attesting to things. My preference would be to be write letters stating any adult can do anything they choose, but this unfortunately is not how the law works.
Disability documentation
I can provide updated documentation of long-term psychiatric, learning, and neurodevelopmental disabilities through a combination of interview, records review, and brief assessment. I may be able to provide documentation of other types of disabilities when these are either obvious or when documentation exists for instance from a school or workplace but an individual is needing a current letter specifically from a healthcare provider. I can update documentation based on past records as needed to reflect current name/gender, to provide only information relevant to current accommodation needs while omitting sensitive history, and so forth. This can generally be billed to insurance as a psychotherapy evaluation and followup, as I will be taking a history and administering brief normed tools. I understand that the medical model of disability expects that anyone who has a disability or history of certain risk factors is "seeing someone for that" despite no current clinical needs; as such, I am happy to serve as someone's provider of record and see them on an infrequent consultation basis.
Developmental evaluations
I am a certified early intervention specialist in addition to an LMHC, and can provide brief developmental assessment of children of any age, billed to the child's insurance. I do not perform in-depth neuropsychological testing. I am happy to provide second opinions for school assessments or early intervention assessments, or provide assessments for families who are wondering about their child's development but are not sure they wish to identify their child to these systems quite yet. My assessments aim to strike a balance between appreciating neurodiversity and understanding there are many different valid ways of approaching the world, while naming and documenting certain differences that may present a true functional deficit that can be improved through targeted communication or motor therapy, or which may signal a medical condition. I have particular experience in pediatric eating and feeding disorders and practice from a Health At Every Size model.
Adult diagnostic evaluations
I provide comprehensive adult diagnostic evaluations. I do not perform in-depth neuropsychological testing. My assessments are strengths-based and neurodiversity-affirming and include detailed narratives of what a person can do well and what supports they do not appear to need, in addition to limitations they may have and supports they may need. These can typically be covered by insurance. Depending on a few factors, I can usually include formal assessment of life skills such as home management and community use if this is needed, for instance, for a disabled parent looking for documentation that they have ways of addressing their family's needs.
Parenting evaluations
I provide in-depth parenting evaluations to be used in Care & Protection proceedings (or prevention of such action). Evaluations are arranged through CPCS contract for parents who have a court-appointed attorney, or through private pay for parents who have a private attorney. These services cannot be covered by insurance. I do not generally provide services for divorce/separation cases without DCF involvement, and I do not under any circumstances support foster/pre-adoptive/guardianship families seeking to prevent a child from reunifying with their family or from being placed with kin.
Court expert services
I have been qualified as an expert in a number of Massachusetts juvenile courts. I am able to be contracted via CPCS or through private pay. Topics include normative child development, pediatric feeding and nutrition, developmental and other disabilities (children and parents), transgender and gender-expansive children, responsible homeschooling, attachment disorders, and others.
Parenting support
I provide assessment and short-term guidance with trauma-informed and disability-positive parenting, drawing from my clinical training as well as my experience as a foster parent and parent of disabled children. I have particular experience in supporting neurodivergent parents and/or parents who have a trauma history. This can also take the form of short-term counseling around navigating a parent's or child's new disability, or around adjustment to supporting new family members (including extended/multigenerational households, blended families, kinship families, foster families, and so forth). This can generally be billed to the parent's or child's insurance depending on several factors.
Support groups for LGBTQ youth and young adults
I am currently running several online social/support groups for LGBTQ youth 6-18 and young adults 18-24. The youth groups are $15 per week and young adult groups are no cost. These are not therapy groups and cannot be reimbursed by insurance. These groups are open to any youth regardless of location. The groups tend to be mostly U.S.-based folks, but I have had young people from 24 different countries join. Members tend to mostly identify as neurodivergent. Groups include open/free chat, online gaming, Dungeons and Dragons, adulting 101, book club, arts-based, and others.
Payment options:
I am a CPCS vendor for Massachusetts court evaluations/consultations. Individuals with a court-appointed attorney can have their attorney contact me to determine whether we might be able to work together via this route.
I can accept most private Massachusetts insurance plans. Check if I take your insurance here. I am continuing to work on taking MassHealth and ConnectorCare plans, but this is unfortunately difficult as a solo practice. If I don't appear to take your insurance, please contact me as it is still possible I do, or possible we can work something out. I do also take United/Oxford/Oscar/Optum, but through a different billing system.
I can provide superbills for potential reimbursement from private insurance that I do not take. I am happy to work with clients around revising superbills to meet insurance requirements (within reason and within ethical constraints of course).
Note that some types of more in-depth evaluations are not always covered by insurance, particularly those that are primarily educational or forensic in nature. I will work with you to provide something that is both affordable and serves the purpose it needs to.
I accept private payment payment via PayPal account (including debit/credit card) here and can discuss other options (Venmo, Zelle, etc.) I am flexible with invoicing practices when contracting with state agencies or healthcare/educational organizations.
I am able to provide sliding scale rates, using The Green Bottle approach (credit Alexis J. Cunningfolk, more details and screenreader-friendly text available on their site here). I only ask for a conversation about finances and will not ask for detailed documentation.
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Trainings and consultation
I am flexible in terms of ongoing or one-time services, as well as format and size of trainings or consultations.
Trainings are individualized to the needs of the particular students or professionals being trained. Here is a sample of topics on which I have provided trainings or consultation:
- Autism and related profiles: Recognizing, referring, accommodating, respecting neurodiversity (always co-presented with an autistic individual, or a panel, depending on needs)
- Performing assessments of individuals and families in a manner that is culturally competent with regards to race, class, religion, gender, gender identity, sexual orientation, family structure, disability, neurotype, and other important factors
- Providing age-appropriate leisure and recreation opportunities to individuals with disabilities
- Dispelling myths we are taught regarding child welfare system: A look at how providers and educators can work most effectively within an outdated system much need of reform
- LGBTQ+ issues 101 or transgender 101 trainings for clinicians, physicians, human resources personnel, educators, courts, or any others
- Developmentally appropriate use of music with young children
- Overview of mandated reporting laws and standards from an abolitionist standpoint: How mandated reporters can take steps to follow applicable laws while minimizing harm to families
- Effectively supporting children who have experienced trauma and loss: For clinicians as well as educators, parents, and others
- Recognizing and avoiding bias in assessing, treating, and referring
- Adoption myths and realities: Overview of types of adoption and common issues in adoption, from a perspective that honors and empowers adoptees, first families, and adoptive families, co-presented by adopted individuals, former foster youth, and families who have had children removed (typically co-presented with an adoptee, former foster youth, or first parent)
- Use of music in therapy for the non-musician and/or non-music-therapist
- Reviews of clinical documentation, group curriculum, training handouts, or other written material to detect and remediate bias, insensitivity, or outdated terminology
A note on the image: This is a multimedia image I created in around 2000 to accompany an article regarding gender and its intersection with other identities. I am noticing in 2021 that the imagery might resemble ableist puzzle-piece imagery used by anti-autistic groups, and wanted to provide additional context.
About me
I am a licensed mental health counselor and certified early intervention specialist in the state of Massachusetts and a
board-certified music therapist in the United States. I am based in Boston, on land stolen from the Massachusett people.
My résumé is available on my LinkedIn profile.
My curriculum vitae is available upon request.
contact: erika @ erikashira . com
General philosophies that guide my practice:
I practice from a social justice and liberation health standpoint. I recognize that most situations in which people lack support or material resources are a matter of a society failing to support its people, not a personal failure. I recognize that systems, including (especially?) the system of medical and mental health providers, are inherently oppressive. I constantly contemplate the power I am given as a licensed professional in these systems, experience frequent discomfort with it, and always aim to take it seriously. I support work toward the eventual abolition of oppressive and carceral systems, while also choosing to work cooperatively-but-cautiously with what we currently have. I do not share any information with law enforcement or government agencies unless absolutely legally required to do, and in such instances, I share the minimum information needed to legally satisfy their requirements. When speaking to any third parties, I never share any impressions I have not already clearly communicated to my clients. I firmly believe in voluntary community supports as a first/second/third/etc. resort and I leave law enforcement and involuntary services as an absolute last resort.
In my work with children and families, I am a firm believer in "good-enough" parenting. My view in general is that I raise my family my way, you raise yours your way, and we always keep in mind that kids turn out basically fine coming from all sorts of situations. I of course have plenty of suggestions and ideas for any family to optimize outcomes and well-being (that's what I do after all...) and there definitely are times I see something dysfunctional and we will talk about how it needs to shift, but I always strive to do this within the framework of respecting existing family culture.
I follow a Health At Every Size framework*. I believe all bodies are good bodies. I do not engage in food moralizing and I challenge others to eliminate this as well. I am happy to provide families and professionals with ample resources demonstrating that diet culture, body stigma, and food moralizing cause more harm in the long run than an imperfect diet, and that body size is not a great measure of health or of habits. (*I choose to include the HAES terminology at this time as it is the most well known; I recognize that this formal institution has a lot of problems, and I am committed to learning size liberation and diet liberation from the more diverse and up-to-date folks in these fields.)
I learn from the neurodiversity and disability pride movements. I believe in learning my clinical skills from disabled and/or neurodivergent folks, not from abled medical providers. I listen to disabled voices who tell me their brains and bodies are not something to be pitied, changed, or cured and that they sometimes have specific functional deficits they would like clearly diagnosed and documented and sometimes improved upon with their enthusiastic consent. I believe that disability is not a bad word. I am passionate in advocating that someone absolutely cannot do a certain thing no matter how hard they try and that they are an autonomous fully capable human being who gets to make their own decisions. I respect that sometimes people can do a thing, but it is at too much of an emotional or energy cost, so it is best they not push to do the thing. I am client-led in terms of which of various applicable diagnostic frameworks is most helpful for an individual in being understood and appropriately accommodated by imperfect systems.
I understand that "we welcome everyone" isn't the same as seeing minoritized and racialized folks for who they are. I absolutely do see color. I am engaged in ongoing anti-racist learning. I stay open to being educated and corrected, though I strive never to put my clients in the place of needing to educate me. I listen to Black and brown voices as the authorities on their own experiences. I am aware of racial health disparities in my community and at large. I am sensitive to how people of the global majority view healthcare and government systems, and I strive to reflect this in my practice.
I support queer liberation including for those who have not yet identified as queer. I believe that we do harm when we view LGBTQ-inclusive practices as something that only applies to people after they have specifically identified themselves as members of our community. I ask all people age-appropriate open-ended questions about their gender and sexual orientation. I ask about the terms used by all clients, family members, and collaterals rather than assuming. I use inclusive language and examples with all people, not just in queer spaces, and I normalize the many ways of being in this world.
I am a firm believer that one size does not fit all. In many cases, "whatever medical-model clinician/program has the first opening" is likely to do more harm than good. I generally advocate against recommendations of "being in treatment ASAP to check off a box" until a resource can be located that is appropriately racially competent, trauma-informed, disability competent, as needed. I have a knack for writing evaluations explaining why there is not currently anything available/accessible that will help more than harm, and helping families cobble together community-based and culturally-affirming supports that can come closest to meeting someone's needs. Likewise, I frequently advocate against boilerplate recommendations such as hospitalization for people who can be kept safe in a less-restrictive more familiar setting, or "diagnostic" school or residential placements that are primarily for clinician convenience and are not truly needed for safety.
Privilege and marginalization acknowledgements:
I am white
I am religiously Jewish
I am genderqueer/agender, though I typically experience cisgender privilege
I am in a long-term same-sex marriage
I am a transracial foster and adoptive parent
I have parented children with invisible disabilities and obvious disabilities
I have a history of medicalization, but currently experience health privilege and abled privilege
I have neurotypical privilege
I have educational privilege
I have lived in poverty and in the upper-middle class as an adult
I generally experience class privilege regardless of income
I have a fair degree of size privilege
I am an American citizen by birth
I am middle-aged
My family and I have experienced victimization by systems, though were able to leverage financial and educational privilege to work with attorneys to largely manage this
I am happy to discuss any of these and how they may play into my interactions.
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