West Des Moines, Iowa
West Des Moines, Iowa
Pebble is a solo practice for young children and the adults raising them. Children play and talk with Carmen Alcantara, and at the end of each visit you hear what she saw, in plain words.
Visits
All three are in person, in the play room or the quiet room for the adults.
For ages 3 to 6. A child plays with sand, blocks, puppets and figures while Carmen follows. A parent joins for the last few minutes.
See play therapy
Drawing, board games and talking, at a pace the child sets. Parents get a short update at the end of the visit.
See ages 7 to 10
Time for the adults alone with Carmen, to talk about what is happening at home and what to try next.
See parent sessionsWho we see
Better to know from the first call.
Age
Your child is 3 to 10
Who comes
A parent or guardian can join parts of visits and come to parent sessions
What you want
A steady weekly place to play and talk
How soon
You can wait for a first visit on the office schedule
Age
Your child is a teen. We give you names of colleagues.
Who comes
No adult can bring the child or give consent
What you want
A custody, school or court evaluation. Carmen does not write those.
How soon
Someone is in danger now: call 988 or 911
The play room
A walk through the room where children play: the sand tray, the puppet shelf, the art table and the quiet corner. The adults' room is in it too.
Founder and play therapist, LMFT
She sees children 3 to 10 and the adults raising them, in English and in Spanish.
Carmen starts with the adults. In the first visit she listens, explains how the play room works and what stays private, and answers what you ask. She speaks English and Spanish with families, and a visit can use both. Her Iowa license is listed at the foot of every page.
Licensed Marital and Family Therapist (LMFT) · IA Lic. # 000000
How parent sessions work
The adults are never left in the hall wondering. This is the rhythm.
You and Carmen talk without your child. You say what you notice, ask your questions and hear how the play room works.
Your child meets the room with you nearby. Carmen follows what the child chooses. There are no tests and no wrong way to play.
Carmen tells you what she saw in the play, in plain words, and sometimes one small thing to try at home.
A longer talk about what is happening at home and how the adults are doing. You and Carmen decide how often.
A play visit
Young children often show what is on their mind in play before they can say it.
Carmen sets out the room and the child leads. She watches, puts words to feelings she sees in the play and keeps the room safe. What happens in the play is private to the child. She shares themes with you, not a play-by-play.
50-minute visits
A parent joins at the end
The child chooses the play
In person
One office with a play room, a quiet room for the adults and a small waiting area.
Parking is in the lot behind the building. Ask us for the step-free route.
Get directions to the Pebble Child and Family Therapy officeLicense and languages
Her Iowa license is listed with the board that issues it.
Licensed Marital and Family Therapist (LMFT)
IA Lic. # 000000 · Iowa Board of Behavioral Science
Required to practice marital and family therapy in Iowa
English
Visits and paperwork
Spanish
Visits and paperwork
What we do not do
Pebble is not a crisis service, a school or a court. Carmen does not write custody, school placement or court reports, and she does not test or diagnose in a first visit.
When a child needs something Carmen does not offer, such as testing, a medication review or a school evaluation, she gives you the names of colleagues and, with your written permission, talks to them.
Teens are outside what Pebble does. Ask us for names of colleagues.
The answers to what parents ask before a first visit.
We bill some commercial plans and are out of network with others. We do not bill Medicaid or Medicare. If your child has Medicaid, we give you the names of colleagues who take it.
Some commercial PPO plans
Out of network with other plans
No Medicaid or Medicare
Carmen's fee depends on the length and kind of visit. If you pay without insurance, you get the fee in writing before the first visit. You pay by card at the end of each visit, and HSA and FSA cards work. A limited number of reduced-fee spots are open: ask how to request one. We ask for 24 hours' notice to change an appointment.
Each month we can give you an itemized receipt (a superbill) with the dates and kind of visit, to send to your plan. Your plan may reimburse part of out-of-network care, and the receipt carries a diagnosis code your insurer can see. Reimbursement is not guaranteed: ask your plan before you start.
If you pay without insurance, you have the right to receive a written Good Faith Estimate of what care will cost before you start, and we give you one before the first visit. If the final bill is $400 or more above the estimate, you can dispute it. The estimate is not a contract.
For plans we bill, we check your benefits before the first visit and tell you what you will owe. For other plans, call yours and ask about out-of-network mental health benefits for a child; we give you the questions to ask.
Questions
We bill some commercial plans and are out of network with others, and we do not bill Medicaid or Medicare. How fees work has the details, and we check your benefits before the first visit.
If you pay without insurance, you have the right to a written estimate of what care will cost before you start. We give you one before the first visit. If the final bill is $400 or more above it, you can dispute it. The estimate is not a contract.
The first visit is for the adults only. You and Carmen talk, you ask your questions, and she explains how the play room works and what stays private. Your child comes to the second visit, with you nearby.
Visits are 50 minutes, usually weekly. Carmen sets the pace with you and does not promise a number of visits.
Call or text 988, any time, or call 911 in an emergency. This site and our messages are not watched around the clock.
Carmen shares themes and what she sees with parents, not a play-by-play. She explains in writing, before you start, what stays between her and your child and when she must share, such as a risk of serious harm or a report the law requires.
Ask for a call
We reply within one business day, in English or Spanish, by the method and at the time you choose.