Elizabeth Asta, PhD

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Name: Elizabeth Asta
Address: 1650 38th St, Suite 100E, Boulder, CO 80301 | 740 Burbank St, Broomfield, CO 80020
Phone: 970-591-3256
Mental Health Degree/Licensure/Certification: PhD

Does your practice accept private health insurance payment ? Consumers are advised to contact their insurer regarding insurance coverage for a specific provider.
Yes. Aetna, United Health Care/Optum, and Beacon Health Options.

Do you have a sliding scale for patients with limited resources ?

Please estimate the number of clients you have worked with in each of the following categories : 
Trans Children – 0
Trans Youth  – 2
Genderqueer and  Gender Non-Conforming  – 35
Trans Women  – 10
Trans Men  – 15
Trans Elders  – 0

Do you specialize in particular health issues (e.g. gender identity, trauma related depression and anxiety disorders,  autism spectrum disorders, etc. ) ?
I specialize in working with clients exploring their gender identity and those that are in both early and later stages of gender identification and expression. I also provide gender confirmation support letters for those that are working with medical clinicians who require letters. I also specialize in working with clients who struggle with disordered eating, food issues, and body image concerns. In addition to those specialities, I enjoy working with clients who are struggling with trauma, relational concerns, anxiety, depression, and grief/loss.

Please describe your level of experience (e.g. years,  training, etc. ) in working with Trans and Gender non-conforming  clients ?
I have been working with trans clients for the past 10 years, which included being on the University of Oregon’s Transgender Care team. I also received specialized supervision and training in graduate school to provide gender confirmation support letters to clients seeking those letters. During that time, I kept up on the literature and attended trains to work with this population and understand the changing needs of this population.

Please describe your treatment approach ( e.g., cognitive behavioral, experiential , body-centered, DBT, etc. ).
I tend to work from a feminist interpersonal framework, working to create a collaborative working relationship with my clients. I tend to be transparent about my approach with clients. I welcome my clients’ feedback to best tailor treatment, and integrate deep exploration of issues of oppression and how that may impact clients’ daily experiences. I also tend to explore how past relational experiences may play a role in a client’s resilience or struggles, based on the traumatic or positive nature of those past interactions. I utilize Dialectical Behavioral Therapy strategies when they seem beneficial and applicable to what the client is seeking from therapy.

Do you provide single case assessments ( for individuals not seeking ongoing psychotherapy )  and, as appropriate, letters of eligibility for hormone therapy and gender related surgeries ?
Yes. I do not have a set number of sessions that I require for any gender confirmation letters, and really base that time off of what the client is requesting and the ability have enough time to conduct a full mental health assessment.

On average, how many sessions or hours of assessment do you require to assess eligibility for:

Hormone Therapy: 1-3
Chest Surgery: 1-3
Genital Surgery, if primary letter writer: 2-4
Genital Surgery, if secondary letter writer (when 1st letter is written by client’s primary/ ongoing psychotherapist): 2-3

How do you assess readiness for Hormone Therapy and or Surgery:

Clinical Interview: Yes
Collateral Contacts: No
Psychological Testing: No
Written Questionnaire: Yes

If there have been cases in which you have determined that a client does not meet eligibility requirements  for hormone therapy or gender surgery,  what are the criteria under which you have denied a request for a letter ( or cases in which you anticipate that you would deny a request for a letter) ?
The main reason I would not provide a letter is if there was concern that moving toward medical treatment at that exact time would bring serious or life threatening consequences to the client. Those situations are quite rare, and usually my approach is to provide additional support regarding any mental health concerns that are present to help the client be able to move toward medical transition as soon as possible, as opposed to denying to provide a letter altogether.

Does a coexisting mental condition preclude providing the client with a letter ?
No. A coexisting mental health condition does not preclude providing a client a letter. It is not uncommon that individuals I work with who are seeking letters, may potentially have a mental health condition, often resulting from some of the societal oppression that trans and gender expansive individuals face. It is rare that a client is not given a letter, but if that is the case, it is more related to concern about serious and life threatening consequences to the client if they engage in medical treatment at that time. Most mental health conditions are not life threatening, and so I talk with clients about their hopes for how their mental health struggles will be managed and how that will intersect with their transitions. From there, we can create a collaborative plan (if needed) for how to help the client have as positive a transition experience as they can with any coexisting mental health conditions.

Does your practice have inclusive paperwork (e.g., list more than male and female gender options, allow a place for preferred name, etc.) ?

Paper files that are inclusive ? – Yes.

Electronic Health records that are inclusive ? – Yes.

Does your practice have a system for recording preferred name and pronoun of patients and communicating that to staff, especially scheduling/appointment and reception staff ?

Does your practice have all-gender or gender-neutral restrooms ?

Do you have anything in your physical environment that would be welcoming to a Trans person ( i.e. brochures, pamphlets, magazines, pictures that relate to Trans people and or Trans issues ?

Does your practice have an inclusive non-discrimination policy that includes gender identity and expression, and sexual orientation ?
Yes. I am a practice of one, with no receptionist staff or others to manage. So, I do not have a company policy, but have a personal philosophy that I seek to provide comprehensive, supportive, and social justice oriented care to all of my clients, regardless of various culture identities such as gender, sexual orientation, ethnicity, ability, body size, etc. I regularly elicit feedback from clients about their experience in therapy to try to continually evaluate whether they are getting inclusive care that best matches their cultural experiences and identities.

Do you have a way of protecting the confidentiality of a patients Trans status ?
Yes. I am in a solo practice, so there are not others in my practice that would need to know about my clients’ status or demographics, unless my clients want me to work with insurance companies. If clients do want me to work with their insurance company, I only provide the minimum information needed for clients to utilize their insurance benefits for therapy or assessments.

Have you or your staff attended training or had other education on providing services to Trans patients:

Person responding to survey: Yes.
Other Clinical Staff: N/A
Scheduling/ Appointment Staff: N/A
Reception/Front Office Staff: N/A

Please describe the training noted above, if applicable.
I attended a training from a therapist who provides letters and therapy to trans and gender expansive individuals. The trainer identified as a Trans man and shared about his own experiences in his transition as well as how he works with his clients, and best practices in this area. I have also read and educated myself on my own via articles, books, etc, to stay up to date on education and information in this area. I also was a part of the Transgender Task Force through Division 44 of the American Psychological Association for a year period as they were exploring name changes for their division.

If you have any concerns about the level of intake staff that could create an uncomfortable situation for Trans clients?  Is there someone the patient can contact to assist?
No. I don’t have any intake staff or receptionist. I do all of those services myself.