Hello, I'm Emily Althoff!

If you or someone else is in immediate danger, call 911 or go to the nearest emergency room.

If you are experiencing suicidal thoughts, emotional crisis, or urgent mental health distress, call or text 988 to reach the Suicide & Crisis Lifeline. Support is available 24/7.

River Haven Counseling can provide professional mental health support, but the appointment request form is not intended for emergencies and may not be reviewed immediately. If you need urgent help, use emergency or crisis resources right away.

Yes. Counseling is private and confidential, with some important legal and safety exceptions. Your therapist will review confidentiality with you so you understand what is private, what information may be shared for insurance or care coordination, and when a therapist may be required to act for safety reasons.

Common exceptions can include situations involving immediate risk of harm to yourself or someone else, abuse or neglect reporting requirements, court orders, or certain insurance documentation requirements.

If privacy is one of your concerns, you can ask your therapist about confidentiality at your first appointment. It is completely appropriate to understand how your information is protected before sharing more.

Self-pay rates for counseling at River Haven are typically between $270 and $310 for a 55-minute session. River Haven accepts card and cash, and also works with several insurance providers.

Your actual out-of-pocket cost may depend on whether you use insurance, your benefits, your deductible, your copay, the type of service, and the clinician you see. Some services, such as couples counseling, may not be covered by insurance and may need to be paid out of pocket.

If you have questions about cost, insurance, or what applies to your situation, you can connect with the River Haven team before or after requesting an appointment.

Yes. River Haven Counseling works with several insurance providers, including Aetna, Cigna, Blue Cross Blue Shield, Medicaid, Sanford Health Plan, and Health Partners.

Coverage can vary depending on your plan, therapist, type of service, diagnosis requirements, deductible, copay, and whether the service is covered by your benefits. Couples counseling, in particular, is often not covered by insurance and may be an out-of-pocket expense.

Because every plan is different, you are encouraged to contact your insurance company directly to verify your mental health benefits. The River Haven team can also help answer questions as you get started.

No. You do not need to live in Fargo to work with River Haven Counseling. The office is located in Fargo, North Dakota, and virtual counseling may be available for people who live in North Dakota or Minnesota.

In-person appointments are available at the Fargo office, located at 4143 26th Ave. S. Ste. 100 in Fargo.

If you live outside Fargo and are not sure what options are available to you, request an appointment or contact the team for clarification.

Yes. River Haven Counseling offers virtual counseling for people who live in North Dakota or Minnesota, depending on the service and clinician fit.

Online counseling can be a helpful option if you do not live near Fargo, have a busy schedule, have transportation challenges, or simply feel more comfortable meeting from home. In-person counseling is also available at the Fargo office.

If you are interested in online counseling, mention that when you request an appointment so the team can help you understand your options.

River Haven Counseling provides support for individuals, couples, children, adolescents, and families. Areas of care include relationship conflict, divorce support, co-parenting, substance use concerns, anxiety, depression, trauma, grief, parenting challenges, high-conflict family situations, foster care and adoption dynamics, caregiver support, ADHD, self-harm, and adolescent mental health concerns.

Services include individual counseling, couples counseling, family-centered counseling, and child and adolescent counseling.

If you are not sure whether your concern fits neatly into one of these categories, you can still reach out. The team can help you determine whether River Haven is the right place to start.

Yes. You can begin counseling by yourself even if the main concern involves your marriage, family, parenting, co-parenting, or another important relationship.

Individual counseling can help you slow down, understand your role in the situation, clarify what you want, improve communication patterns, and make thoughtful decisions about next steps. In some cases, couples or family counseling may also be recommended, but you do not need everyone else to be ready before you start getting support.

If you are unsure which type of care makes the most sense, you can explain your situation when you request an appointment.

The right therapist fit often depends on what you are hoping to work on, the kind of support you are looking for, and which counselor has experience with your specific concerns.

River Haven's team includes therapists with experience in areas such as couples counseling, divorce, substance use, anxiety, depression, grief, trauma, adolescents, parenting, foster care and adoption, high-conflict families, eating disorders, caregiver support, and family-centered care.

When you request an appointment, you can choose a preferred counselor or select "first available." The River Haven team can help match you with someone based on your needs and availability. You can also learn more about the team on the About page.

No. You do not need to come in with a polished story, a clear diagnosis, or a perfect explanation of what is wrong. Many people start counseling with a general sense that they feel overwhelmed, disconnected, anxious, hurt, angry, exhausted, or unsure what to do next.

Your therapist can help you sort through what is happening and identify the patterns, stressors, relationships, or experiences that may be contributing to how you feel.

It is okay to start with something simple, like "I am not sure where to begin." That is enough to begin the conversation.

Your first counseling appointment is usually a chance for your therapist to get to know you, understand what brought you in, and begin identifying what kind of support would be helpful. You may talk about your current concerns, your relationships, your history, your goals, and what you would like life to look like moving forward.

You do not have to share everything all at once. Your therapist will help guide the conversation and move at a pace that feels appropriate. River Haven's approach is warm, down to earth, and collaborative, so the goal is not to judge you or rush you. The goal is to understand what you are facing and begin building a plan that fits your needs.

For many people, the first appointment is simply the first step toward creating clearer direction.

After you submit the appointment request form, someone from the River Haven team will follow up with you about next steps. They can help you understand availability, possible wait times, which therapist may be a good fit, and what information is needed to get started.

The request form asks for basic information, what type of therapy you are looking for, whether you have a preferred counselor, and anything else you would like the team to know. You do not need to have the perfect words or a full explanation before reaching out.

If you have a specific question before submitting the form, you can also connect with the team.

No. You do not need to wait until things feel unmanageable to ask for support. Many people begin counseling because they can tell something is not working and they want help creating healthier patterns before the situation gets worse.

Counseling can be helpful when you feel stuck, overwhelmed, disconnected, uncertain, or tired of having the same conversations or conflicts without resolution. It can also be a place to slow down, understand what is happening, and make decisions with more clarity.

If you are wondering whether your situation is "serious enough," that is often a good sign that it may be worth talking with someone.

Counseling may be a good fit if something in your life, relationships, parenting, work, or mental health has started to feel difficult to manage on your own. You do not need to have everything figured out before you reach out.

At River Haven Counseling, we work with individuals, couples, children, adolescents, and families who are navigating challenges like anxiety, depression, grief, trauma, relationship conflict, divorce, substance use concerns, parenting stress, foster care or adoption dynamics, and high-conflict family situations.

If you are unsure where to start, the best next step is to request an appointment. Our team can help you understand whether River Haven is a good fit and what next steps may make sense.