Holly Altson, Psy.D.

Clinical Psychologist, Licensed in Oregon and Washington


All Are Welcome Here

Hello. I'm Dr. Holly Altson, a clinical psychologist licensed in Washington and Oregon. My pronouns are she/her/hers. If you're reading this, you've probably decided that you want or even need someone to talk to. Perhaps circumstances or even your own emotions feel overwhelming right now. Maybe you’re experiencing grief or depression, are going through a change in your life, wrestling with anxiety, are feeling the impact of trauma and/or PTSD, or seeking a safe place to explore gender or sexual identity. You might be dealing with relationship issues, or wondering if there is such a thing as a sex-positive, kink-friendly, polyamory-affirming psychotherapist. (There is!) We all need someone to talk to, at some time or other, and seeking the help of a professional can be an important step towards healing, growth, or getting back on your feet. If this sounds like you, contact me. Let's make a time to talk.

If you’re looking for a therapist in Oregon Washington State, I'm accepting new telehealth patients. I do work with people on Oregon Health Plan (OHP). I look forward to hearing from you.

About Dr. Altson

What people seem to most often want to know about a therapist is what it's like working with them. That can mean a lot of different things to different people, but that basic question is what I am going to try to answer here.

I think one of the qualities people most often reference when describing their experience of me as their therapist is "warm." Similarly, they refer to me as "easy to connect with," and "non-judgemental." I make it a priority in my practice to shape my interactions with each person specifically around what that individual is bringing into session. A somewhat cliché way of saying this is that I try to "meet people where they are." Maybe it is cliché, but I think it's probably a good way of putting it.

Most of the time, therapy sessions with me look like conversations. It is important to me not to waste your time, but there can be benefits to what seems like "just chatting," namely that we are building a rapport, creating a safe space to make it possible for you to discuss what can sometime be difficult topics. I also believe that there are times when seemingly random or inconsequential topics and ideas show up in session for a reason. I try to pay attention carefully and listen for connections which might not be so obvious. One of the ways to do this is to allow our interactions to be fluid and organic. Some of the best breakthroughs come out of allowing discussion to meander.

If any of this sounds like it might work for you, please contact me to discuss working together.

Practice Information

Getting Started

The First Step

Sometimes the hardest step is the first step. If you've been thinking about therapy, if you've searched the Internet and found this site, maybe now is the time to take a risk. I call it a risk, because that's exactly what it is for most of us: making contact with a stranger, hoping they will take care in their responses to our questions or concerns, feeling unsure about whether it's better to just keep doing what we're doing and forget the whole thing.

The thing is, you don't have to do all of the steps right now. Just the first one. If, after reading through what I've written on this site, you feel I might be a good fit for you, I encourage you to contact me. If you don't feel I'm a good fit but you'd like some guidance finding someone, I also welcome you to contact me about that. Not every therapist works for every individual. Finding a good enough fit is what is most important.


Per Session

My current fee for talk therapy sessions is $190. This covers sessions up to one hour in length. A typical session is around 50 minutes to one hour. (I will try to keep this information up to date on this site. I have not changed my fees often. It is possible that I might do so in the future, in which case the Web site will be out of date, hopefully only for a short period of time. Feel free to ask if you have questions.)

Sliding Scale

"Sliding Scale" refers to reduced fees, lower than a therapist's usual fee, usually on a case-by-case basis. I maintain a limited number of sliding scale spots in my schedule. At this time, these are all full, and I am not offering reduced fees to new patients.

That being said, if you are concerned about the out-of-pocket cost of therapy, feel free to reach out. There are potentially options besides reduced fees. It varies by circumstances, but I have found it's usually worth exploring the options before giving up!


I am out of network with all insurance providers. This doesn't necessarily mean you can't use your insurance, though. Curious about how? Read on!

OHP (Medicaid)

If you are an OHP (Oregon Health Plan, aka Medicaid) member, I can submit a request for a preauthorization. If approved, you will likely pay nothing out of pocket for your therapy! I have had a lot of success with this and usually have several patients utilizing OHP at any given time.

Private/Commercial Insurance

If you have insurance through your employer or anything else that isn't OHP, I am happy to work with you to try to make use of your benefits. This usually means providing me with your insurance information (copy of front and back of your insurance card). I would then contact the insurance provider and find out whether or not your plan has provisions for out-of-network psychologists. Insurance plans vary widely, but some possibilities include:
  • Insurance covers some, but not all, fees for sessions right from the start
  • Insurance covers no fees for sessions at first but, once your deductible is met, they begin covering some
  • Insurance will not cover any treatment for out-of-network providers
Based on this information, we would then figure out whether it's a situation that can work for you.

About Psychotherapy

First, a bit of a caveat. Psychotherapy is different for each person and often changes over time as circumstances — and the relationship with the therapist — change. It is more accurate to say that the therapeutic experience will be different for each pairing of patient and psychotherapist. Choosing a therapist doesn't have to be incredibly difficult, but it's also very important to recognize that some therapists might not fit well with some patients. Like any relationship, a certain amount of flexibility is realistic to expect to make it work well. And "ruptures" in the relationship can actually create opportunities to make it stronger, though this depends heavily upon the therapist's skills in navigating such situations and much less on the patient.

All that being said, there are many different theories and models for understanding human psychology. This leads to different ways of working with them and different ideas about what the goals of treatment should be. You may encounter terms and acronyms like, "psychodynamic/psychoanalytic," "CBT," "DBT," "ACT," just to name a few. There is often overlap among them, and, in practice, it is sometimes difficult to distinguish between therapy sessions done based on one basic foundation versus another. Research supports the idea that what makes the most difference in therapy is actually the therapeutic relationship between psychotherapist and patient. This isn't all there is: clinicians attend school and years of training and are expected to continue learning throughout our careers for a reason. There is such a thing as therapy that isn't working, isn't going anywhere, and might even be doing harm. But if the therapist is skilled enough, as well as attuned enough to the patient, and if the patient is willing to work towards gradually being open to change (please note the careful wording of that phrase), and the rapport between them is good enough, there's a good chance for successful therapy to take place.

You may have noticed that all this is pretty vague. That's because, for reasons I've mentioned above, it's difficult to say for sure what your own experience in therapy will be like with whichever psychotherapist you choose. You are a unique individual, psychotherapists are unique individuals, and there is flexibility in how therapists do their work. If you are open to trusting the process, and if you mostly feel you have a therapist who is a close enough match for you, therapy can be a very rewarding experience. There are risks involved. Even helpful changes can be disruptive. You will be invited to be vulnerable. It may be difficult to trust the therapist. Sometimes your job will be to simply show up, and at other times you will have to dig deeper than that if anything is going to happen. There are some therapists who subscribe to the idea that "resistance" is a factor of patients being unwilling or reluctant to do the work. I do not take this view. As I see it, a large part of my job is to create a safe space and wait patiently for when people are ready to open up. When they don't, it is helpful information to observe and something to be worked through. It does not lead to an automatic conclusion that a person is unsuitable for therapy. I believe this work is worth it, but I also know it is not always easy or comfortable.

If, after reading all this, you feel ready to embark on this exciting path, please reach out and let me know if you think I can help.

Contact Dr. Altson

If you would like to contact Dr. Altson, feel free to fill out the following short form. (Be aware that this is not for emergencies. Call 911 or 988 if you are experiencing an emergency situation.) Alternatively, you can reach out using any of the methods below. Free 15-minute consultation appointments can also be requested directly at her patient portal.


+1 (503)998-5234



Patient Portal


Mailing Address

3055 NW Yeon Ave #869
Portland, OR 97210


+1 (888)920-1837