Medicare-accepted depth-oriented psychotherapy in San Antonio and online statewide in Texas.

Therapy for Older Adults

Late life is one of the most underserved territories in mental health care. Many therapists do not accept Medicare, and many of those who do are not equipped to do the substantive work that the questions of later life often ask for. The clinical material of this stage is real and considerable — late-life depression and anxiety, grief that accumulates, illness and end-of-life concerns, the long aftermath of caregiving, the reorganization of identity around or after retirement, trauma surfacing late, the questions of meaning that a long life has earned the right to ask. This page is for older adults and seniors looking for a Medicare therapist who can meet that material with the depth it deserves.

Norman Klaunig, MA, LPC, NCC | Texas LPC #89856 | English and German

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At a glance

  • Who this page is for: Older adults and seniors navigating late-life depression, anxiety, grief, illness, caregiving, identity shifts, and the deeper questions that often arrive in later life

  • Insurance accepted: Medicare (traditional Medicare and Medicare Advantage plans from Aetna, BCBS and United Healthcare), Aetna, BCBS, Curative, and United Healthcare. I do not accept Medicaid.

  • Modalities: Individual psychotherapy, in person in San Antonio or by secure online video statewide in Texas (telehealth covered by Medicare for mental health care)

  • Specialized training and clinical focus relevant to older adults: Trauma (Certificate in Traumatic Stress Studies, Trauma Research Foundation), EMDR, IADC® Therapy for grief, existential and meaning-centered therapy, spiritually integrated work, end-of-life and transpersonal phenomena (published in Journal of Near-Death Studies; member of the IANDS Academic and Research Committee)

  • Theoretical orientation: Depth-oriented, existential-relational, trauma-informed, transpersonal — see Depth-Oriented Therapy for the full theoretical detail

  • Therapist: Norman Klaunig, MA, LPC, NCC

  • License: Texas LPC #89856

  • Office: 1528 W Contour Dr, Suite 102, San Antonio, TX 78212

  • Service area: Online statewide in Texas; in person in San Antonio

  • Languages: English, German

A Medicare therapist for older adults in San Antonio and across Texas

Older adults face a particular access problem in mental health care: many therapists do not accept Medicare, and many of those who do are not doing the kind of depth-oriented work that the questions of later life often ask for. I am a Medicare therapist in San Antonio offering both in-person sessions in San Antonio and secure online video sessions for seniors and older adults anywhere in Texas. I accept both traditional Medicare and the Medicare Advantage plans I am paneled with (BCBS and United Healthcare/Optum). I do not accept Medicaid.

The work is not about adjusting to limitations. It is about the questions a long life has earned the right to ask.

Therapy for older adults: what this work is for

The second half of life tends to bring its own clinical territory. Some of it is about loss of spouses, peers, roles, capacities, and communities. Some is about reorganization — what comes after the career, the daily structure, the identity that was given by what you did or who you cared for. Some is about long-buried material surfacing late, often because the noise of working life is no longer drowning it out. And some is about the deeper questions: meaning, mortality, faith, regret, what life has actually been about, and what the time remaining is asking of you.

Senior counseling, in this sense, is not a specialized branch separate from the rest of psychotherapy. It is depth-oriented psychotherapy meeting a stage of life that is particularly rich in material — and particularly underserved.

Who I work with

I work with:

  • Adults in retirement working through the loss of structure, identity, and purpose that retirement can bring, even when retirement was wanted

  • Older adults experiencing late-life depression or anxiety, including depression that has lasted across decades and anxiety that has only surfaced recently

  • Bereaved spouses and partners working through the loss of a long partnership

  • Older adults grieving multiple losses — peers, siblings, friends, family members — that accumulate in later life

  • Caregivers of spouses or partners with cancer, dementia, Parkinson’s, autoimmune or chronic conditions, and other serious illnesses

  • Older adults facing serious illness or end-of-life concerns of their own, including anticipatory grief and the work of life review

  • Veterans of Korea, Vietnam, post-Vietnam, and other eras whose service material may be surfacing later in life (more on this in Therapy for Veterans, Service Members, and Military Families)

  • Older adults reconnecting with religious, spiritual, or existential questions after decades of practical living

  • Adults working with long-buried trauma that is surfacing now that the busyness of working life has slowed

  • Older adults reconsidering relationships with adult children, with long-term partners, and with the family system as it has become

  • Adults navigating late-life transitions that did not arrive on schedule: late divorce, late immigration, late career change, late faith change

I welcome clients of all sexual orientations and gender identities, of all races, heritages, abilities, and belief systems. The work follows you, not a category.

Geriatric counseling: depression, anxiety, grief, and the changes of later life

The clinical concerns that bring older adults to therapy include:

  • Late-life depression and anxiety, including depression that has worsened since retirement, since the loss of a spouse, or since a health change

  • Grief, including the grief of a long-term partner, the cumulative grief of repeated losses, anticipatory grief about one’s own death, and disenfranchised grief that the surrounding world does not fully acknowledge

  • Health changes — adapting to a diagnosis, chronic pain, reduced mobility, vision or hearing loss, and the identity shifts that come with the body changing

  • Cognitive concerns — anxiety about memory, fear of dementia, and the adjustment to receiving such a diagnosis (I provide depth-oriented psychotherapy in this context; cognitive evaluation is a separate scope of practice and is appropriately done by a neuropsychologist, neurologist, or geriatric specialist)

  • Caregiving stress and ambiguous loss when caring for a partner with dementia or another long-term condition

  • Loneliness and isolation, including the kind that accumulates after the loss of a partner, a community, or both

  • Trauma surfacing later in life, often without apparent trigger, sometimes decades after the event

  • Identity work after retirement, including the loss of professional self, the question of what to do with the time, and the search for meaning when meaning was previously supplied by the work

  • Spiritual and religious exploration in later life, including faith returning, faith leaving, faith changing, and the questions about what comes after

  • Existential anxiety and life review — the work of looking back, taking stock, and finding what the life has been about

What is distinct about depth-oriented work in later life

A few clinical features tend to shape work with older adults specifically. They are worth naming because they affect how the therapy actually proceeds.

Disenfranchised grief is more common. Later life accumulates losses the surrounding culture often does not recognize as worthy of full mourning — the friend who was not family, the cousin who was closer than the sibling, the colleague of forty years, the pet who was the steadiest companion, the body that no longer does what it did. Disenfranchised grief is real grief; therapy is one of the places it gets named, attended to, and grieved.

Trauma can surface late. Material that was carried for decades without apparent distress sometimes begins to surface in the sixties, seventies, or beyond — often because the structures that contained it (work, parenting, daily striving) are no longer doing that work. This is not pathology; it is the system finally having room. Depth-oriented therapy and trauma-informed methods (EMDR, somatic regulation, parts work) are well-suited to this.

Depression in later life is often misread. Late-life depression is frequently mistaken for normal aging, for grief, or for early cognitive change. It is its own condition, and it responds to treatment. The clinical work involves careful distinction — what is grief, what is depression, what is a side effect of a medication, what is a normal response to a body changing, and what is something else that wants attention.

Life review is a clinical phenomenon, not a hobby. The process of looking back across a life — what was done and not done, what was meant and missed, what was loved — is a recognized late-life developmental task. Erikson called the polarity integrity versus despair. The work of life review is part of how integrity is found; it cannot be hurried, and it tends to produce real change when given space.

The body, the soul, and the meaning of life are not separate concerns. Late life is where the integration of body, identity, relationships, faith, and meaning becomes most visible as one piece of work rather than several. The integral and meaning-centered frames I draw from are particularly suited to this — they do not require you to address only one part of yourself at a time, and they do not pretend that the questions of meaning, mortality, and faith are separate from clinical concerns.

How this work proceeds

The work begins where you are. We make room for what you bring without me explaining it away or pushing it into a tidier framework than the experience itself asks for. The pace is yours to set; depth-oriented work with older adults tends to be unhurried, in part because the material is often substantial, and in part because there is no developmental rush.

Specific methods used when they fit the work include EMDR for trauma processing; IADC® Therapy for grief, particularly the loss of a long-term partner; parts work (IFS-informed) and narrative approaches, particularly relevant to life review; existential and meaning-centered work for the longer questions; and mindfulness-based approaches and somatic awareness for the body’s role in what you are carrying. Trauma-informed principles govern the pacing throughout.

For the full description of how I think about and work with depth-oriented therapy, see Depth-Oriented Therapy.

Medicare coverage, telehealth, and access

Medicare and outpatient mental health. Medicare Part B covers outpatient mental health care from licensed professional counselors and other approved providers. After your annual Part B deductible, Medicare typically covers a substantial share of the session cost; the exact percentage depends on your plan, the year’s coinsurance rules, and whether you have a Medigap or Medicare Advantage policy. I will work with you to confirm your specific coverage before your first session.

Medicare Advantage. I am in network with Medicare Advantage plans from BCBS and United Healthcare. These are the only Medicare Advantage plans I can accept at this time. If you have Medicare Advantage plans from other companies, it depends on your plan if I can see you as an out-of-network provider. Typically, HMO plans do not cover out-of-network providers. PPO plans might. (Medicare Advantage works in many ways like a regular insurance, not like Medicare.) Of course, I can also see you as a private pay client.

Medicaid. I do not accept Medicaid. If Medicaid is your primary coverage, Texas 211 can help you find Medicaid-accepting mental health providers in your area.

Telehealth for seniors in Texas. Medicare covers telehealth for mental health care across the United States. For older adults with mobility constraints, transportation difficulties, or those living anywhere in Texas outside San Antonio, online sessions are a practical and clinically substantive option. You need a private space, a stable internet connection, and a device with a camera. If you would like help thinking through the setup, we can address that at consultation.

In-person sessions in San Antonio. My office at 1528 W Contour Dr, Suite 102 is on the ground level, with parking immediately adjacent. The restroom is a standard restroom and is not specifically equipped for accessibility needs. If you have particular accessibility requirements, please mention them at consultation so we can address what is and is not workable.

What this work does not replace

This page is about depth-oriented psychotherapy. It is not a substitute for:

  • Medical care. I am not a physician. Health changes should be evaluated by your primary care provider or appropriate specialist.

  • Cognitive evaluation. If memory concerns or possible dementia are part of the picture, evaluation by a neuropsychologist, neurologist, or geriatric specialist is the right level of assessment. Therapy can complement that work; it does not replace it.

  • Crisis services. If you are in crisis, call or text 988 (the Suicide and Crisis Lifeline). If you are in immediate danger, call 911 or go to your nearest emergency room.

  • Substance use treatment when that level of care is needed.

  • Hospice or palliative care. When end-of-life care becomes the priority, hospice and palliative-care teams provide the appropriate medical and supportive infrastructure. I can work alongside that care.

Get in touch

Ready when you are.

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Click this link to choose a day and time for a free, confidential consultation or schedule a session.

Schedule a free 15-minute consultation for therapy online across Texas or in person in San Antonio.

FAQs

Frequently asked questions about therapy for older adults

  • Yes. I am paneled with traditional Medicare and with Medicare Advantage plans from BCBS and United Healthcare. I see clients in person at my San Antonio office and by secure online video for Medicare beneficiaries anywhere in Texas. I do not accept Medicaid.

  • No. I do not accept Medicaid. If Medicaid is your primary coverage, Texas 211 can help you find Medicaid-accepting mental health providers in your area.

  • Medicare Part B covers outpatient mental health care from licensed providers; after your annual deductible, you are typically responsible for the coinsurance percentage set by Medicare for the current year. Medicare Advantage plans may have different copay structures. Bring your Medicare card to consultation, and I will help you confirm specifics.

  • Yes. I see clients statewide in Texas via secure online video. Many of my older adult clients live in rural areas or in cities where finding a Medicare-accepting depth-oriented therapist has been difficult. Telehealth is covered by Medicare for mental health care.

  • For many older adult clients, yes. The technology is simpler than it sounds — a video link, a camera, a private space, a stable internet connection. If you would like help thinking through the setup before committing, we can do the consultation by phone and walk through it together.

  • There is no fixed length. Some clients work with me for several months on a specific concern. Others work with me for years on the longer arc of late-life questions. The pace is yours to set; I do not push clients to stay longer than the work needs them to, and I do not push them to leave before the work is done.

  • No. Some of the most substantive psychotherapeutic work I see is in later life — partly because the material is often substantial, and partly because older clients often arrive with a clarity about what they want from the work that younger clients are still developing.

  • Yes. Anticipatory grief, fear of death, life review, and the existential and spiritual questions that arrive with a difficult diagnosis are central to my work. See also Grief Counseling and Existential Therapy.

  • Therapy with me is individual, not family therapy. Including a family member or partner occasionally may be appropriate where it serves the work, and we would discuss that on a case-by-case basis.

  • Yes. Service material — Korea, Vietnam, post-Vietnam, and later eras — often surfaces in later life, sometimes decades after service. I completed Star Behavioral Health Provider (SBHP) Tier 2 training in military culture. See Therapy for Veterans, Service Members, and Military Families.

  • The office and adjacent parking are on the ground level. The restroom is a standard restroom and is not specifically equipped for accessibility needs. Please mention any specific accessibility requirements at consultation so we can address what is and is not workable.

For fees, insurance, telehealth setup, and in-person availability, see the FAQs.

Further reading

The following are credible sources for reading more about the territory this page covers. The list leans toward books written for the people who would actually read them — older adults, family members, and caregivers — with a few authoritative organizations included for practical questions.

Books

  • Atul Gawande, Being Mortal: Medicine and What Matters in the End.For general readers: a widely read, deeply humane book on aging, illness, and what makes a good late life and a good death. One of the most accessible books on this territory in recent decades.

  • James Hollis, Finding Meaning in the Second Half of Life. For general readers willing to engage with depth-psychological ideas: a Jungian account of the questions that surface in the second half of life and the work of meeting them honestly.

  • Elisabeth Kübler-Ross and David Kessler, On Grief and Grieving.For bereaved readers and families: the classic and still useful book on grief. Helpful for anyone working through a major loss.

  • Mary Pipher, Women Rowing North: Navigating Life’s Currents and Flourishing as We Age.For women in later life: a substantive and warm book on aging, identity, friendship, and meaning, with particular attention to the experience of women.

  • Karl Pillemer, 30 Lessons for Living: Tried and True Advice from the Wisest Americans.For older adults and their families: the Cornell sociologist’s distilled findings from the Legacy Project, which interviewed more than a thousand older Americans about what they had learned. Warm, substantive, and useful.

Authoritative resources

  • Medicare.gov — Mental Health Care. https://www.medicare.gov/coverage/mental-health-care-outpatient — For Medicare beneficiaries and families: official coverage details for outpatient mental health under Medicare Part B.

  • Eldercare Locator (U.S. Administration for Community Living). https://eldercare.acl.gov/ — For older adults and families: federal resource for locating local services, including transportation, in-home support, and caregiver resources.

  • Family Caregiver Alliance. https://www.caregiver.org/ — For caregivers of older adults: national nonprofit with resources on caregiving for spouses, parents, and partners with serious illness.

  • Alzheimer’s Association. https://www.alz.org/ — For families navigating dementia: leading U.S. organization on Alzheimer’s and dementia care, education, and support.

  • CaringInfo (NHPCO). https://www.caringinfo.org/ — For patients and families facing serious illness: the National Hospice and Palliative Care Organization’s public-facing resource on end-of-life care and advance care planning.

move from pain to purpose

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move from pain to purpose —