I am currently adding information that I think will be helpful, so please return again. For more information about my approaches to trauma treatment, see EMDRIA.org and SensorimotorPsychotherapy.org.
How can therapy help me?
Therapy can give support, problem-solving skills, enhanced coping strategies, and even resolution for
- Depression, grief, loss,
- Anxiety, panic
- Trauma, post-traumatic stress disorder (PTSD),
- Relationship problems of all kinds,
- Unresolved childhood issues,
- Stress management,
- Body image issues
- Creative blocks.
People also find that counselors can help with
- Managing personal growth,
- Interpersonal relationships,
- Family concerns,
- Marriage issues, and
- The hassles of daily life.
Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. Other possibilities include:
- Attaining a better understanding of yourself, your goals and values;
- Developing skills for improving your relationships;
- Finding resolution to the issues or concerns that led you to seek therapy;
- Learning new ways to cope with stress and anxiety;
- Managing anger, grief, depression, and other emotional pressures;
- Improving communications and listening skills;
- Changing old behavior patterns and developing new ones;
- Discovering new ways to solve problems in your family or marriage;
- Improving your self-esteem and boosting self-confidence.
How do I decide if I need therapy?
We all have problems. Over time, most of us have learned how to handle many of our problems. However, sometimes life overwhelms us—
- Too many bad things happen at once;
- We lose our support system;
- We experienced bad things growing up;
- We didn’t learn the kinds of coping skills we need now;
- An accident, a series of bad events, war changed everything;
- We have physical problems that fuel anxiety or depression;
- And the list goes on.
In these instances, we could all use help. My belief is that everyone has inherent strengths that make it possible for them to deal effectively with their problems. Sometimes people come into therapy simply to re-discover their strengths.
In other cases, people simply have not had the developmental opportunities, the experiences, or the help they need to find and develop these strengths. Sometimes there are obstacles standing in the way of our using what we know. Sometimes these obstacles—these experiences, emotions, memories--have to be resolved before we can move on. Psychotherapy can help.
However, psychotherapy is not a quick fix. Instead, it calls for an active effort on the your part. To be most successful, you, the client, will need to engage in reflection and self-examination; you will need to work on things we talk about both during our sessions and outside of our sessions. Curiosity about yourself, your thoughts, feelings and patterns will help a lot. Experimenting and observing will speed the process; e.g. you can try out a new behavior, a different response, or a new way of thinking about an old problem and then observe the results—your feelings, the responses of others, what changes and how.
Given enough time, commitment, and therapeutic support, I believe people can learn and change. They can find ways to deal with negative emotional and life patterns; they can develop new perspectives, build new skills, and lead richer, more satisfying lives. They can enjoy life more.
What actually happens in therapy?
Psychotherapy varies depending on the personalities of the psychologist and the client, as well as the particular problems brought to therapy. I have a variety of approaches that I may use to help you and we will collaborate on how to create healthy change.
I believe that psychotherapy is a partnership. Over the first couple of sessions as I evaluate your needs, I will be able to offer you some impressions of what our work will include if you decide to continue with therapy. During those sessions, you should be making your own evaluation. Since therapy involves a large commitment of time, money, and energy, it is important for you to select someone with whom you can work well and feel comfortable.
Examples of the kinds of things we might do include challenging and replacing dysfunctional beliefs, attitudes or behaviors; helping you gain insight into negative patterns; exploring grief or loss and resolving the emotional pain; and psychoeducation and problem solving. I also use approaches which can sometimes quickly resolve long-standing patterns of reaction to difficult and traumatic events—EMDR and Sensorimotor Psychotherapy.
I will likely give you "homework" or experiments to expand on what we are doing in our sessions. Homework emerges from the work we are doing and could include any number of activities--experimenting with new skills, journaling, drawing, attending outside meetings, or practicing mindfulness techniques. The research on mindfulness meditation is impressive in recent years and its use has expanded throughout our field.
How long am I likely to be in therapy?
The answer to that depends on many factors. We can choose to work on a very clear and limited problem or issue and do that in a few sessions. Or we may go deeper, especially if the issues are long-standing and the result of repeated and deep-rooted patterns.
In either case, we will devise a treatment plan to guide our work and we will periodically refer to it to evaluate how we are doing. If you have questions about my procedures, we should discuss those questions whenever they arise. When I miss something that is important to you--expectations, insights, experiences, beliefs, or questions--then it is important for you to bring those things up and for us to talk about them.
In the course of evaluating your needs and drawing up a treatment plan, I may request additional information such as testing, consultation with other professionals such as your doctor, or other records such as prior treatment records. We will discuss these possibilities as the need arises.
Most of my clients see me once a week for 3 or 4 months, then we reassess. For some problems, clients may come more often than once a week or for longer sessions. After 3 or 4 months, some clients come in less often for several months; others continue for much longer, again depending on the issues and the client's goals. Clients also sometimes take a “vacation” from therapy giving themselves time to assimilate what we’ve done. They may then come back for more intense work on similar problems or to work on other problems. We can be flexible in how we work so that therapy is most effective for you.
Finally, therapy does end. Termination, as we call it, is an important step. It is a chance to reflect on what you have done and to consolidate your gains. It is a chance to think about using your skills in the future. I may suggest ending therapy or you may feel that you are ready. In either case, I will request that we spend at least one last session reflecting on our work together, considering the ramifications of termination, and finally reflecting on where and how you will go from here.
How is couple's and family therapy different?
There are similarities as well as differences when therapy is with a couple or family rather than an individual. Some of the process of therapy, the particulars and expectations, will be pretty much as described above. The main difference is the focus of attention; with couples and families, we will usually be looking at the dynamics of the relationships. My primary approach to couple's therapy is the Gottman Method.
As with individual therapy there are benefits as well as risks. Particularly in couple's therapy, one or both partners generally enter therapy with specific expectations for certain outcomes. There are no guarantees. The one certainty is that there will be change. That change could mean many things--one possibility being the dissolution of the relationship. On the other hand, the relationship could become stronger and richer with both partners experiencing more of their needs being met. Much depends on the commitment of both of the people involved.
Another possible outcome of couple's and family therapy is that one or more of the participants may become aware of problems that are better dealt with in individual therapy. If that happens, we will discuss the options.
What about medication vs. psychotherapy?
It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness. Working with a psychologist and your medical doctor you can determine what's best for you. In some cases a combination of medication and therapy is the right course of action.
Do you take insurance, and how does that work?
I take a limited number of insurances. I will, however, help you obtain payment through your out-of-network benefits. To determine if you have mental health coverage through your insurance carrier, the first thing you should do is call them. Check your coverage carefully and make sure you understand their answers. Some helpful questions you can ask them:
- What are my mental health benefits?
- How do my out-of-network benefits work?
- What is the coverage amount per therapy session?
- How many therapy sessions does my plan cover?
- Are there any other limitations to my coverage that I should know about? (e.g. coverage of pre-existing conditions)
- Is approval required from my primary care physician?
Does what we talk about in therapy remain confidential?
Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office. Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone. This is called “Informed Consent”. Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your Physician, Attorney, Physical Therapist), but by law your therapist cannot release this information without obtaining your written permission.
State law and professional ethics require therapists to maintain confidentiality except for the following situations:
- Suspected past or present abuse or neglect of children, adults, and elders to the authorities, including Child Protection and law enforcement, based on information provided by the client or collateral sources.
- If the therapist has reason to suspect the client is seriously in danger of harming him/herself or has threated to harm another person.
- Some legal or regulatory situations.