Frequently Asked Questions

Vickie Starkey is a follower of Jesus who emphasizes Biblical principles while balancing and integrating the science and art of family therapy. She is from Sevier County in Tennessee and grew up in the Smoky Mountains. Vickie graduated from Sevier County High School in 1985 and went on to Carson-Newman University, where she earned a Bachelor of Arts in Sociology and Psychology.

She attended New Orleans Baptist Theological Seminary, graduating with a Master of Divinity in Psychology and Counseling in 1995. After working in a local psychiatric hospital and as a lay leader in her church, she returned to Tennessee in 1999. She obtained her license as a marriage and family therapist in May 2005 and spent over twenty years at Helen Ross McNabb Center before launching The Lion's Lamb Family Therapy in early 2021.

Clients have told her — out of a lifetime of therapists — she is the only one who has made a meaningful impact on their lives. Vickie attributes this to the proven science of emotional healing, her genuine care, and Accelerated Resolution Therapy.

Jesus is depicted as The Lion of Judah in the book of Revelation. Humans are called his sheep — the weakest of which is a small lamb. The name came from a particularly difficult season in Vickie's life.

When a shepherd had a lamb prone to wandering, the shepherd would break the lamb's leg and carry it while it healed — forming an unbreakable bond. Vickie came to see her own season of brokenness as God's way of carrying her close. The transformation in that wilderness is where healing happens.

Three pictures hang over the couch in her office. A lion: "my scars are a reminder of when life tried to break me but failed." A lamb seeing its reflection as a lion. A female child warrior kneeling before a cross, reflecting a lion. Together they tell the story of a lamb who was broken, carried, healed, and set free to fight for others.

Yes. Vickie has been a Licensed Marital and Family Therapist (LMFT) in Tennessee since May 2005. Her license number is 579.

An LMFT requires completion of an accredited Master's degree with a focus on marriage and family therapy, 200 hours of supervised training, and 1,000 hours of clinical work. Tennessee's licensing requirements are maintained by the Tennessee Board for Licensed Professional Counselors, Licensed Marital and Family Therapists, and Licensed Clinical Pastoral Therapists.

Vickie is an LMFT who sees individuals rather than couples. She uses Family Systems techniques and considers the entire family her client — addressing symptoms within the relational system rather than labeling one person as "the problem."

No — Vickie will see anyone. The purpose of her disclaimer is to explain her worldview and bias, not to filter clients. Everyone is welcome.

She prefers the term Bible-based over "Christian" because many people are comfortable with the Bible without identifying as Christian. Her concern is simply giving potential clients the information they need up front. Some people prefer a therapist without a faith perspective, and she respects that — she just wants them to know before the first session.

Her approach is grounded in two New Testament passages: John 8:6–11 (Jesus declining to condemn the woman caught in adultery) and Matthew 7:3–5 (dealing with your own log before addressing someone else's splinter). Kindness and grace, not judgment, are the foundation.

Vickie rarely uses telehealth. She strongly prefers face-to-face appointments because she finds it harder to recognize micro-expressions on a screen — and she finds clients often lack access to a truly quiet, private space at home that lets them speak and feel freely.

That said, she has made exceptions for valid reasons (for example, someone whose vision impairment prevents driving). Click the link and let's talk more about your situation.

Therapists use the question: does this problem cause clinically significant impairment in social or occupational functioning? If you're not sleeping, not eating, or avoiding people, those are clear signs. But you don't need a "hardcore diagnosis" to benefit from therapy.

Therapy is for hard seasons too — adjusting to life changes, gaining insight into your strengths and needs, or improving yourself regardless of what season you're in. Insurance will pay for adjustment disorders, which cover milder symptoms from difficult life events like grief or job loss.

Click the link and schedule a time we can talk more about it.

Absolutely not. The Bible encourages seeking wise counsel, and therapy and prayer belong together. James 5:16 says: "confess your sins to each other and pray for each other so that you may be healed." We were created for community and support.

Truly Bible-based therapy is strong discipleship. The principles taught in the Bible — and techniques like Cognitive Behavioral Therapy and Family Systems Theory — are not in conflict. They complement each other. Schedule a call and let's talk more about it.

You talk about your need and Vickie's expertise — to see if they match. This call is your opportunity to interview her and decide if she can meet your therapeutic needs. You might be dealing with people-pleasing, past trauma, anxiety, or something else entirely. The call lets you determine fit before investing a full session.

It's also an opportunity to discuss cost, insurance, and scheduling. The most important factor in therapy success is the relationship — and the foundation for that begins here. Click the link and schedule a call.

The short answer: you talk, and Vickie listens. She wants to understand what you're experiencing, how difficult it is for you, what your goals are, and how she can help.

You'll cover a few business items — payment, late cancellations, no-show fees, and insurance. Depending on how much you need to share, there may also be time for a brief introduction to Accelerated Resolution Therapy to help you relax before you leave.

Your first appointment may feel a little nerve-wracking, but it doesn't have to be. You're beginning a new journey of hope and healing. Click the link.

The best way is to start with the free consultation call. Listen to Vickie — and listen to yourself — because you will say things you didn't realize you needed to say. From there, consider:

• Will your personalities work together? Vickie can be direct. Do you need straight answers, or someone to soften things?
• Does her worldview matter to you? She is Bible-based.
• Will schedules work? She often has limited availability.
• Can you afford it? Can insurance help?

Click the link and let's figure it out together.

Yes — with important exceptions. Consented exceptions include insurance billing (your insurer receives session information), your electronic healthcare record company, billing staff, and anyone you ask Vickie to share records with.

Non-consented exceptions include:

• Emergencies requiring hospitals to share limited medical information
• Reasonable suspicion of child or vulnerable adult abuse (mandatory reporting per Tenn. Code Ann. § 37-1-403 and § 39-15-510)
• A credible threat to harm another person (duty to warn per Tenn. Code Ann. § 33-3-206)
• A client at imminent risk of suicide
• A court order (Vickie will consult an attorney before releasing anything)

The greatest confidentiality comes from private pay — no insurer involved, no paper trail. Schedule a call to discuss your situation.

• Therapist (LMFT): Master's degree; works with emotions, family systems, and relationship dynamics. Vickie's focus.
• Counselor (LPC): Master's degree; focuses more on the individual; similar work to an LMFT. Seeing both a therapist and counselor simultaneously is not typically recommended.
• Psychologist: Doctorate (PhD, PsyD, or EdD); more focused on testing and research, though can do therapy.
• Psychiatrist: Medical doctor; typically focuses on medication management (~20-minute sessions) rather than talk therapy.

You can see a psychiatrist, psychologist, and therapist simultaneously. Click the link for more.

Most regular therapy either ignores spirituality or encourages beliefs counter to Biblical teaching. Bible-based therapy uses Scripture as the framework for understanding healthy and unhealthy emotions and behaviors.

An excellent summary of the goal is Galatians 5:22–23: "the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, gentleness, and self-control." Bible-based therapy uses evidence-based techniques — CBT, Family Systems Theory, ART — that either support what Scripture teaches or are compatible with it.

Vickie's experience is that clients with a strong belief in Scripture tend to progress faster — though her role is never to force belief, only to help those who have faith grow in it.

Sources: Pastoral Psychology (2026); British Journal of Clinical Psychology (2024).

None of these titles requires legal designation in Tennessee — anyone can use them. Use caution and ask about training and experience.

• Christian counselor: May hold a private certificate; no standardized legal oversight. Quality varies widely.
• Biblical counselor: The Association of Certified Biblical Counselors (ACBC) has training requirements including reading, coursework, and supervised experience — but this is not equivalent to a licensed degree.
• Pastor: Ordained by a church; relies on Bible study and church experience. Variable educational background.
• Licensed therapist (LMFT/LPC): Best for serious mental health diagnoses like depression, anxiety, PTSD, or bipolar disorder. State-regulated, supervised, and accountable.

For serious mental health concerns, a licensed professional is the right choice. Click the link and schedule a call.

Bible-based therapy is far more than verses and prayer. The science of mental health and Scripture are not in conflict — they work together.

CBT, for example, challenges negative thinking and builds positive internal dialogue — which mirrors Philippians 4:8: "think on whatever is good and lovely and right." Eye-movement therapies like ART have peer-reviewed research supporting their effectiveness. You get both the eons-proven wisdom of Scripture and the best of modern clinical science. Click the link and schedule a call.

If you ask, Vickie is always willing to pray with you. She makes it her habit to pray for clients before each session, and she believes God is present in the room. Click the link and schedule a call.

Non-Christian therapists are legally and ethically bound to respect your faith. But understanding and respecting are different things. A therapist without a faith foundation may simply not know how to engage with your spiritual life meaningfully.

Christians and non-Christians often start from different worldviews — for example, Christians believe in original sin (we are born selfish), while many therapeutic frameworks assume people are inherently good. Those different starting points shape the whole conversation. Click the link and let's figure out if we speak the same language.

Vickie's first response to anyone struggling with behavior the Bible calls sin is to remember she sins too. She follows Jesus's example in John 8:1–11 — writing in the dirt and saying "neither do I condemn you" — and Matthew 7:3–5, dealing with the log in her own eye first.

People who are hurting and confused don't need judgment. They need hope and kindness. Vickie will tell you up front about her Biblical bias. If her worldview creates a fundamental incompatibility, she will provide referrals rather than pretend otherwise. Click the link and let's decide together.

That feeling may very well be depression. Bible-based therapy is the place to explore both possibilities. Spiritual oppression and depression share common descriptions — darkness, heaviness, absence of light or hope.

Vickie addresses both angles: prayer and scripture for the spiritual component, ART for the clinical one. She'll also talk with you about medication if appropriate, though she doesn't prescribe — she'll help you build the right questions for your prescriber. Click the link and schedule a call.

ART involves guided bilateral eye movements — you follow a tool (Vickie uses a hitch alignment stick) while focusing on a problem. Developed by Laney Rosenzweig approximately 15–20 years ago from EMDR, ART is believed to stimulate the limbic system and encourage the brain to form new neural pathways, releasing negative feelings and body sensations.

Most clients experience their body relaxing within the first ten minutes. You are not hypnotized — you are simply relaxing, thinking about your problem, and it resolves. Potential side effects include recalling a forgotten memory, a healing cry later in the week, or briefly increased emotions — all signs of real change happening. Click the link and schedule a call.

ART is faster (typically 1–5 sessions) and does not require you to describe your trauma in detail. EMDR generally requires more disclosure and more sessions. Vickie's clients who have experienced both consistently report better results with ART. She recommends ART for most people and only uses ART in her practice. Click the link and let's talk about it.

No. The only question Vickie needs you to answer is: "Does your body feel positive, neutral, or negative?" You decide how much to share. Some clients choose to say nothing at all.

For those who prefer even more distance, ART can be done entirely through metaphor — no need to revisit the actual event. Within a few minutes, the room often shifts to laughter. Click the link and schedule a call.

The primary theory is that bilateral eye movement stimulates the limbic system and promotes the formation of new neural pathways — similar to what happens during dreaming. Laney Rosenzweig, ART's developer, has compared the experience to the dreaming process: dreamlike, imaginative, and capable of reframing old negative memories into something you can move past.

The honest answer: researchers are still studying the exact mechanism. What is consistent is that it works. Click the link and schedule a time to talk.

ART can be used for almost any problem: anxiety, grief, burnout, depression, co-dependency, and more. Vickie has used it for all of these. The heaviness of grief dissipates. The anxiety lifts. The burnout clears.

Clients often text her things like: "The anxiety is better — I drove on the interstate today, thanks!" or "I don't know how you did it, but the burnout is so much better." Click the link and schedule a time.

Most of the time, you'll feel better after a single ART session. A single adverse life event (car accident, loss) often resolves in one session. Complex trauma, depression, anxiety, or co-dependency may take two to five sessions. Addiction and eating issues require a more intensive approach — sometimes twice weekly — plus concurrent medical care.

Some clients heal quickly and move on. Others discover new areas they want to address and keep coming back. There's no limit. Click the link and let's get started.

Yes. The first randomized controlled trial was published in Military Medicine in 2013, showing ART worked for combat-related PTSD. A subsequent study of 148 veterans found an average of 3.5 sessions to complete treatment. Research has since expanded to depression, chronic pain, and complicated grief.

The body of research is smaller than CBT's 50-year head start, but it's growing through independent researchers like Dr. Kevin Kip's team at the University of South Florida.

Key sources: Kip et al., Military Medicine 2013; Kip et al., Frontiers in Psychiatry 2013; Buck et al., American Journal of Hospice & Palliative Medicine 2020. Click the link to discuss.

Yes, and it fits very well. ART was not developed with faith in mind, but it doesn't conflict with Scripture. The Bible says not to fear or be anxious — ART helps release fear and anxiety. The Bible calls us to joy — ART resolves depressed mood. The Bible calls for self-control — ART can help with impulse control in ADHD.

ART uses imagination and imagery — and the Bible is full of both. When working with believers, Vickie often weaves in Scripture-based images and metaphors during the process. Click the link and let's schedule a call.

Trauma is any experience for which you are unable to cope — you become overwhelmed and enter survival mode. PTSD is a diagnosis that occurs when you never leave survival mode, and includes a specific set of symptoms: flashbacks, nightmares, physical reactions to triggers, avoidance, and mood changes.

You can have trauma without developing PTSD, but you cannot have PTSD without trauma. Researchers also recognize Complex PTSD (C-PTSD) for prolonged trauma, and developmental trauma disorder for childhood experiences. Click the link and let's talk.

Vickie's preferred method is Accelerated Resolution Therapy (ART). Unlike exposure therapy, which requires repeated reliving of the event, ART asks you to bring the memory to mind once — for about ten minutes — and more often than not, you are never bothered by it again.

Other options include EMDR and Brainspotting, but based on Vickie's conversations with colleagues who use all three, ART consistently produces faster results with less repeated exposure. Click the link and schedule a call.

No. You're tired of crying. You need relief. Vickie listens, then — when you're ready — she uses ART. Your body starts to relax. The frozen image of your loved one helpless in a bed begins to fade. You find the sweetness of the time you had with them.

The goal is not to change what happened, but to make it past tense in your mind rather than present tense. You don't forget — you get to let go and live the life they wanted you to live. Schedule a time to talk.

ART works very well for anxiety, typically in just a few sessions. Clients often say things like: "I don't know what just happened, but it's gone." After the anxiety lifts, some notice they've changed in ways that surprise themselves — and their loved ones.

Those relationship changes can take some adjusting to. Vickie may recommend some additional talk therapy to help everyone adapt to your new emotional baseline. Click the link and schedule a call.

Medication doesn't erase years of being told you're broken, weird, or that something is wrong with you. ART can help with the emotional baggage of ADHD — negative self-talk, the feeling of being unlovable, and building habits for focus and memory.

Medication is valuable when a doctor determines it's necessary. But it may be possible to need less after ART. ART and medication work together — they're not competing approaches. Click the link and schedule a call.

Tired gets better after a day off or a vacation. Burnout doesn't. Burnout is usually a result of not meeting your own needs over time until you hit a wall — and then keep going anyway. You may feel numb, detached, or like "why bother," even though you're still showing up.

We were made to rest. Christians call it Sabbath. Others call it self-care. Without it, burnout is the natural result. Click the link and schedule a time.

People-pleasing is giving up what you need to give others what they want — hoping to be loved and liked in return. The harm comes when you sacrifice your genuine needs to meet someone else's wants, often making the problem worse for both of you.

Stopping hurts because when you start saying no, you lose people. Sometimes you discover they never really cared about you — they were using you. That realization can feel as painful as grief. Setting healthy limits (often called "boundaries") means letting people sit with their disappointment rather than fixing it for them.

There's no judgment here — Vickie has made the same mistake. Click the link and schedule a call.

No. The length depends on your needs and the treatment approach. Some clients do a single intake session and one ART session and are done. Others with serious or long-standing mental health challenges may benefit from several years of support.

When Vickie combines ART, Family Systems, and CBT, most clients stay in therapy for about six months to a year. With ART alone, some clients tell her after six to eight sessions that they no longer need her. She loves that. Click the link and schedule a call.

Most clients start with weekly sessions. Severe symptoms may call for twice weekly. Seeing a therapist less than weekly at the start tends to slow progress — Vickie doesn't recommend it initially.

The time between sessions is where real change happens. You apply what you discussed, practice new behaviors, and do any homework assigned (journaling, trying new responses, noticing patterns). Without that intentional work in between, gains are slower. Click the link and schedule a call.

Tell Vickie — with your words, directly. She will not be offended. She uses an assessment tool called MyOutcomes that tracks both your progress and the therapeutic relationship, giving you a structured way to provide feedback every session.

If your symptoms are beyond what weekly or twice-weekly therapy can manage, she will act quickly to refer you to a higher level of care. She'd rather lose a client to the right level of help than hold on when someone needs more. Click the link and schedule a call.

Vickie prefers private pay and charges $175 per session. Exceptionally long sessions may be $240.

In-network: Blue Cross Blue Shield, Traditional Medicare, and a local EAP program. Limited availability with Optum, UnitedHealthcare, and UMR.

Out-of-network reimbursement: CIGNA/Evernorth and AETNA may reimburse you for out-of-network sessions; contact your insurer to verify. TherapyNotes submits out-of-network claims on your behalf.

Not accepted: Medicaid (TennCare), Medicare Advantage plans (e.g., BlueAdvantage, AARP Medicare Advantage). Reach out and ask by clicking the link.

A superbill is a coded document containing your therapist's national provider identifier, tax ID, your diagnoses, and session details — which you submit to your insurance company for reimbursement. Vickie uses TherapyNotes, which submits out-of-network claims directly on your behalf, so you typically won't need to manage this yourself. Click the link to talk more.

Address: 523 W Lamar Alexander Pkwy, Maryville, TN 37801

GPS takes you to the front of the building — drive around to the back for the entrance. There is a sign on the right side of the entry door. Ample parking is available. Once inside, Vickie's office is down the hall on the left. If her door is shut, wait in the lobby — she will come get you.

Note: The Blount County Democratic Party also has an office in the building and the lobby is shared. Vickie is not affiliated with them in any way.

Vickie charges the full session fee ($175) for late cancellations (less than 24 hours notice) and no-shows. This charge applies to you directly — not to insurance.

That said, her clients look forward to their sessions. She believes you will too. Click the link and schedule a call.

Email Vickie or book a free 15-minute consultation call. She'd love to hear from you.