A framework
People come into therapy for many reasons. One person may be feeling depressed. For another something is missing. Still a third is struggling with addictions, a fourth with cancer and bankruptcy. Many come in response to the financial and social stressors in our society. Some people have lived through traumas, and are naturally affected. Some come to deal with disruptive psychological symptoms, others to figure out how to get along better with others and in life. People come because of problems in relationships. Or because of life changes like unemployment, death, and birth, and "the full catastrophe" (Ezra Pound) that life throws at us. Others come to therapy to release their doubts and fears and learn to realize their dreams and figure out what their lives mean.
When coping skills are overwhelmed by guilt, doubt, anxiety, or despair, therapy can help. Therapy can provide support, problem-solving skills, and enhanced coping for issues such as depression, anxiety, lack of confidence, relationship troubles, unresolved childhood issues, bereavement, spiritual conflicts, stress management, body image issues, and creative blocks. People seeking psychotherapy are willing to take responsibility for their actions, work towards self-change and create greater awareness in their lives.
What can I expect in a therapy session with you?
During sessions you will be addressing the primary concerns and issues in your life. A session is usually 50 minutes. It can be difficult to describe what occurs in a "typical" session, because it depends on the needs, goals and preferences of the client. Generally, we will be focusing on a particular issue. For example, if you are in crisis, we are likely to work together to problem solve and get some stability going. However, if, for example, you are creatively blocked, you may find yourself playing with the table sand box. If we have mutually agreed to work on releasing certain fears, habits, traumas, and conflicts, or strenghtening/healing the self, we may be doing specific experiential exercises and therapies including EMDR (Eye Movement Desensitization and Reprocessing: See Links ). There is also talking out your feelings, fears, conflicts, dilemnas, and feeling heard. There is experimenting with different perspectives, and with mindfulness. Generally, weekly sessions are best for doing a piece of work that relieves symptoms, or works out an issue. Some people who are in crisis or extreme distress need more than one session per week, until the crisis passes. Sometimes, longer intervals between sessions make sense towards the end of therapy. During the time between sessions it is beneficial to think about and process what was discussed. At times, you may be asked or decide to take certain actions outside of the therapy sessions, such as reading a relevant book, keeping records, practicing certain exercises. For therapy to "work," you must be an active participant, both in and outside of the therapy sessions.
What benefits can I expect from working with a therapist?
A number of benefits are available from participating in psychotherapy. Often it is helpful just to know that someone understands. Therapy can provide a fresh perspective on a difficult problem or point you in the direction of a solution. Many people find therapy to be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, and the hassles of daily life. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:
- Attaining a better understanding of yourself and your personal goals and values
- Developing skills for improving your relationships
- Finding resolution to the issues or concerns that led you to seek therapy
- Find new ways to cope with stress and anxiety
- Managing anger, depression, and other emotional pressures
- Improving communications skills - learn how to listen to others, and have others listen to you
- Getting "unstuck" from unhealthy patterns - breaking old behaviors and develop new ones
- Discovering new ways to solve problems
- Improving your self-esteem and boosting self-confidence
What if I don't know what my goals are for therapy?
If you aren't sure what your goals are for therapy, your first task is to figure that out. It may take several sessions before a direction is clarified. During the course of therapy your goals may change. However, establishing a direction for therapy will help you get the most out of the experience.
Do you accept insurance? How does insurance work?
There is a confusing array of insurance arrangements. The first thing you should do is check with your insurance carrier. Check your coverage carefully and find the answers to the following questions:
- Do I have mental health benefits?
- What is my deductible and has it been met?
- How many sessions per calendar year does my plan cover?
- How much do you pay for an out-of-network provider?
- Is there a limitation on how much you will pay per session?
- Is primary care physician approval required?
Is therapy confidential?
In general, the law protects the confidentiality of all communications between a client and a psychotherapist. Information is not disclosed without written permission. However, there are number of exceptions to this rule. Exceptions include:
- Suspected child abuse or dependant adult or elder abuse. The therapist is required by law to report this to the appropriate authorities immediately.
- If a client is threatening serious bodily harm to another person/s. The therapist must notify the police and inform the intended victim.
- If a client intends to harm himself or herself. The therapist will make every effort to enlist their cooperation in insuring their safety. If they do not cooperate, further measures may be taken without their permission in order to ensure their safety.