Questions people ask before they book
Practical answers, written out in full. Nothing here is hidden behind a click, and nothing is more polite than it is accurate.
Do I have to be in Florida?
Yes. Alan Romano, LCSW is licensed in Florida only, and clients must be physically located in Florida at the time of session. That applies to sessions held by video as well as sessions in the Vero Beach office: what matters is where you are sitting when the session takes place, not where you usually live. If you are traveling out of state, we reschedule rather than meet.
Do you take insurance?
This practice is private pay and out of network, so no insurer is billed directly. You pay for the session and receive a superbill, an itemized receipt you can submit to your insurer for possible out-of-network reimbursement. Whether anything is reimbursed depends on your plan. The rates page explains how out-of-network reimbursement works and lists the questions to ask your insurer before you start.
What happens in a first session?
Mostly listening and orienting. You describe what has been going on and what brought you now rather than a year ago, and I ask about the shape of your ordinary week: sleep, work, who is around you, what sets things off and what settles them. You are not required to describe your worst experience in the first hour, or ever on a schedule set by me. Toward the end we talk about what the work would involve and how often we would meet, so you leave with a clear picture rather than a vague one.
Do you prescribe medication?
No. I am a licensed clinical social worker, not a physician or a prescriber, and I do not prescribe, adjust, or manage medication. Those decisions belong to your medical provider. Where you are working with a prescriber, I am glad to collaborate with them, with your written permission.
Do you provide psychedelics?
No. I do not provide, prescribe, administer, sell, or facilitate access to illegal substances.
Where a qualified medical provider is treating you with ketamine, I can work as the psychotherapist alongside that treatment. Every medical decision, including screening, dosing and medication management, remains with the treating provider. That work is described on the ketamine-assisted psychotherapy page.
What is the difference between ketamine-assisted psychotherapy, psychedelic preparation, and psychedelic integration?
They are three separate services, and they are easy to confuse.
Ketamine-assisted psychotherapy is psychotherapy provided alongside ketamine treatment delivered by a medical provider. Locally that is Treasure Coast Ketamine and IV Nutrition Center in Vero Beach, where Greg McCracken, CRNA, determines the appropriate course of ketamine treatment and administers the medicine. My part is the psychotherapy: preparation, support during the session, and integration afterwards.
Psychedelic preparation is talk therapy before an experience. What you are hoping for, what your history suggests you may meet, what support is actually in place, and whether the timing makes sense.
Psychedelic integration therapy is talk therapy after an experience you have already had, whether it was helpful, confusing, or frightening.
Preparation and integration involve no substance of any kind, and no arranging of access to one.
Can I work with you before an experience?
Yes, within the limits of a Florida clinical license. Preparatory work is talk therapy: looking honestly at what you are hoping for, what your history suggests you may encounter, what support you have around you afterwards, and whether the timing makes sense given everything else in your life. It is not planning, arranging or endorsing access to any illegal substance, and I will not help you obtain anything.
Can you help if my experience was frightening or destabilizing?
Yes. That is one of the most common reasons people come for integration work. You do not need to describe the experience as positive, spiritual, or healing.
Where something has left you shaken, sleepless, derealized or frightened of your own mind, the early work is not about meaning at all. It is about stability: sleep, food, grounding, and a reliable rhythm to the week. Meaning, if it comes, comes later and on its own terms.
Do you see couples and families?
Yes, alongside individual work. Couples work looks at the repeating pattern between two people rather than treating one partner as the problem. Family work addresses the household arrangement, particularly where one member's difficulty has reorganized everyone else's behavior. Some people move between formats over time, and that is discussed openly rather than arranged quietly.
How do I start?
Book a free consultation. Your first conversation is free, with no obligation to continue. It is a phone call, and it is not a therapy session, an assessment, or a commitment. You describe what is going on, you ask whatever you want to know, and we decide together whether this is a fit. If it is not, I will say so and point you toward something that might suit you better.