Welcome to Pillars of Change LLC

• Pillars of Change LLC was founded in 2022 by Sarah Tremblay, LMHC, LABA, MHP, CPG

Sarah holds dual Masters degrees and specialty certifications: 

• Masters of Science in Clinical Counseling & Abnormal Psychology
• Masters of Arts in Applied Behavioral Analysis
• Certification in Applied Behavioral Analysis
• Certification in Guardianship and Conservatorship
• Certification in Critical Incident Response

Sarah holds multiple specialty licensures and credentials including:

• Licensed Mental Health Counselor
• Licensed Assistant Behavioral Analyst
• Mental Health Professional
• Certified Professional Guardian

Sarah has special interest and experience in the treatment areas of:

• Geriatrics (age 65+)
• Alzheimer's and Dementia
• Autism, Asperger's, and Developmental Disabilities
• Depression
• Anxiety
• Situational Anxiety
• Situational Adjustment Disorders
• Grief, Loss, and Bereavement
• Anticipatory Grief or Loss Secondary to Medical Condition (AIDS/HIV, Stroke, Multiple Sclerosis, Parkinson's, Dementia, Cancer, Cerebral Palsy, Epilepsy, Diabetes, etc.)
• Medical Staff and/or Caregiver Support 
• Medical Staff and/or Caregiver Burnout Prevention
• Crisis Intervention and/or Critical Incident Response
• Stress Management
• Divorce and Betrayal Recovery
• Family Dynamics/Single Parenting
• Caregiver Support, Caregiver Fatigue, and Caregiver Burnout

• Sarah brings 20 years of experience in counseling and behavioral health including voluntary and involuntary treatment processes, medical and psychiatric case management, and crisis stabilization work for adult persons in a variety of marginalized populations.
• Sarah brings 15 years experience in care coordination and advocacy for adults who are: developmentally or intellectually disabled, geriatric, medically fragile, and whom were experiencing psychological or behavioral dysregulation. 
• For the past five years, Sarah served as the Supervisor of the Complex Case Management Team managing complex patient needs at seven local hospitals before venturing into private practice. 
• Sarah is passionate about equality and proudly serves as a board member for Pierce County Coalition for Developmental Disabilities.

• Sarah is the single parent of 2 teenage children; one with special needs.
• Sarah was raised in a small town where taking care of others was an instilled way of life.
• Sarah grew up volunteering at Rainier State School, a residential facility for the developmentally and intellectually disabled.  
• Sarah personally and professionally understands the importance of compassion, acceptance and inclusion for all. 

With the exception of critical incident stress management response and debriefing services, Pillars of Change LLC serves adult clientele ages 18 to geriatric.   

Pillars of Change LLC accepts all adult client populations but specializations in the following client populations:

• Alzheimer's and Dementia
• Geriatrics (age 65+)
• Nero Divergent (Autism Spectrum Disorders including Asperger's Syndrome)
• Intellectual or Developmental Disabilities
• Chronically or Terminally Ill
• Medically Complex and/or Compromised
• Caregivers (formal or informal)

Appointments can be requested by submitting an email request on our "Contact Us" page or by calling the office at 253-285-0606.  When requesting appointments please specify which days of the week and times work best for your schedule. 

Professional consultation or critical incident stress management response services can be requested by submitting an email request on our "Contact Us" page or by calling the office at 253-285-0606.  When requesting services, please specify type of service; a brief explaination of the case, behavior, or event requiring attention; and the desired timeframe for completion of required services. 

Pillars of Change LLC offers regular and extended sessions:

• A regular session is approximately 50 minutes in duration.  
• An extended session is approximately 80 minutes in duration and can only be requested and scheduled in advance.  

At this time, Pillars of Change LLC is only offering telehealth appointments via a secure virtual platform.  In person sessions are anticipated to resume in late 2022 but currently Pillars of Change LLC is offering a onsite in person sessions at client residential facilities within 25 miles of office location.  Onsite sessions at residential facilities has additional travel fee of $10.00 base rate and $0.75 per mile (calculated round trip).   

Due to the unique outcome goals of consultation services and critical incident response services are provided in a variety and combination of formats to best meet the client's needs.  Such methods include, but are not limited to: 

• Telephonic
• Video or audio recordings
• Virtual platforms
• Documentation review
• In person (face-to-face)
• In person (direct observation)

At this time, Pillars of Change LLC is not accepting insurance plans.  All services are provided under a private pay basis.

Please check back regularly for updates as to insurnance plans being accepted as this will be updated frequently. 

All payments can be paid by:

• Credit card (Discover, MasterCard, Visa)
• Debit card
• ACH Bank Transfer
• Business or Corporate Check (at the discretion of Pillars of Change LLC)
• Cash (only for in person counseling sessions)
• Venmo

All counseling session payments are due at the time of service.

All behavioral intervention, professional consultation, and critical incident response service payments are:

• Invoiced monthly and/or upon completion of agreement terms should services not last greater than one month.
• All invoices must be paid on a Net-15 basis (within 15 days) from the date of invoice. 
• All invoices not paid in full within Net-15 terms are subject to a 5% late fee.  

 Session Fees:

• Regular Session (50 minutes) is $90.00
• Extended Session (80 minutes) is $135.00
• Onsite sessions at residential facilities has additional fees including travel fee of $10.00 base rate and $0.75 per mile (calculated round trip), and any accrued transportation or commute related costs including but now limited to metered or paid parking, toll costs, or ferry costs.er to this item.

Consultant Service Rates: 

• Consultant Services are $125.00 per hour + transportation rates + investigation fees
• Consultant hourly rates apply to direct observation, client and collateral contact interviews, background research, agency collaboration, report writing, staff training, participation in care conferences or required meetings, court testimony, preparation of petition related documentation, and preparation and execution of alternative arrangement documentation. 
• Rates do not include identification of proposed guardian/conservator nominee as such service is not provided by Pillars of Change LLC. 

Transportation Rates are billed at a rate of:

• $50.00 per hour traveled and
• 75 cents per mile (round-trip) 
• Any accrued transportation or commute related costs including but now limited to metered or paid parking, toll costs, or ferry costs.

Investigation Fees are billed at market rates based on type of background investigation required per terms of executed consultative agreement.  Investigation fees can include, but are not limited to:

• Lexis Nexus report fee
• LINX fee
• Court Documentation fee
• Background Search fee
• Credit Report fee
• Marriage Licenses fee
• Birth or Death Certificate fee
• Property Search fee
• DNA or Family Genealogy fee
• Criminal Background Search fees

Responder Service Rates:  Unless services are provided through a contracted Employee Assistance Program (EAP), all critical care incident stress management response and debriefing services are billed at the following rates:

• Responder Services are $125.00 per hour + transportation rates 
• Responder hourly rates apply to direct one-on-one or group counseling and crisis response services, incident debriefing, agency collaboration, report or notes writing.
• Responder Services are billed at a minimum of 2 hours block time duration and are billed on hourly not per individual basis. 

Transportation Rates are billed at a rate of:

• $50.00 per hour traveled and 
• 75 cents per mile (round-trip)  
• Any accrued transportation or commute related costs including but now limited to metered or paid parking, toll costs, or ferry costs.er to this item.