What is psychotherapy all about? Therapy is not easily described in general statements. It can be said that one main goal of therapy is to learn about our habits and patterns of feeling and behavior and how they cause us problems. We can then learn new habits and patterns which will be more successful for us. Although it seems strange to think that we might not know ourselves completely, experience has shown that many of the problem-causing habits and patterns are things we have done all our life and are so automatic that we don't even think about them as learned or optional behavior. Therapy provides a special setting in which we can learn about ourselves. This can help us to be more effective in our relationships with others and with ourselves. It takes time, helpful observations and support to recognize and change our ways of living.
Do normal people need counseling? It is a common misconception to think that only seriously ill or "crazy" people need therapeutic help. Studies show that over eighty percent of people can benefit from therapy at some time in their lives. So, it is normal to need therapy when special concerns or difficult feelings arise. Most people have a problem with anxiety, depression, stress, relationships, etc., at some point.
How do I know I need psychotherapy? Most all people coming for therapy are struggling in a relationship with a spouse, significant other, child, coworker or boss, parent, or friend. Chances are they have tried everything they know to resolve the struggle, with little or no long-lasting results. Many times our efforts result in a band aid being placed on a deep wound, and the problem always returns after a few days or a few weeks. Many times our best efforts make the problem worse! It is usually when things are at a standstill, or are chaotic and intense, or seem hopeless that a person turns to a professional therapist.What I advise people is to come for one session, meet the therapist you have chosen, spend an hour discussing your struggles, and then decide if therapy is right for you. I will offer my recommendations for treatment, if treatment is warranted. Most of the time the issue is not as bad as it seems to you, and treatment in many cases is relatively short-term. Much is dependent on your (and your significant other's) motivation and desire to resolve the problem and your willingness to work hard on the problems in the time between sessions. Therapy is not the same as seeing a medical doctor; it is a collaborative relationship between you and your therapist in which you will find that YOU are the authority and expert on your own life, and YOU have the internal strength, courage, and will to make changes.Who is the best therapist for me?I encourage people to call around and interview several therapists. Much of the power of the therapeutic process occurs in the relationship between you and your therapist. If it is not a good "fit," the overall effectiveness of the therapy will be diminished.Therefore, the most important question is the one you will ask yourself: How do I feel about this person? Does he or she seem comfortable and compatible for me? Does he or she seem empathetic? Naturally, you will feel somewhat anxious with the therapist in the initial session . Pay attention to all your feelings. (Don't ignore your feelings. If you have a creepy or uncomfortable feeling, choose someone else).
Is therapy risky? Psychotherapy has both benefits and risks. The risks sometimes include experiencing uncomfortable levels of feelings, like sadness, guilt, anxiety, anger and frustration, loneliness, and helplessness. Therapy often requires recalling unpleasant aspects of your history. Therapy has also been shown to have benefits for people who undertake it. It often leads to a significant reduction of feelings of distress, better relationships, and resolutions of specific problems. However, there are no guarantees about the outcomes.
What occurs in the first therapy session? Most therapists will conduct an intake assessment session before beginning treatment. The first step in helping you is to determine exactly what kind of counseling you need. Our first session is a "getting acquainted" time and normally lasts 60 minutes. I will ask questions about your presenting problem, about what caused you to seek assistance, about your background, your expectations for therapy, and so forth. Mostly, you will talk and I will listen. By the end of the initial evaluation, I will be able to offer you some initial impressions of what our work will include and an initial treatment plan. You should evaluate this information along with your own assessment about whether I am a person with whom you feel comfortable working. Therapy involves a large commitment of time, money, and energy, so you should be very careful about the therapist you select. I am happy to discuss any of your questions and offer you an appropriate referral if necessary. If counseling is initiated, I will usually schedule one 50-minute session (one 90-minute session in the case of family therapy) per week at a mutually agreed upon time, although sometimes sessions will be longer or more frequent.
How often do I come to therapy? This depends on the type of treatment approach and your condition. More serious or complex problems require more frequent treatment, in general. One meeting per week is the usual minimum frequency of meetings. Two meetings per week are a common recommendation when disturbing symptoms are involved or during a crisis. Your therapist will make a recommendation for you.How much does therapy cost?My hourly fee is $175.00. I am on a number of insurance panels that may pay for most of the cost of my fees. For persons without insurance and needing financial assistance, I can refer you to my Psychological Assistant, Lon Clark, who has a sliding fee scale ranging from $60.00 to $110.00 ($50.00 for university students without insurance).In addition to weekly appointments, it is my practice to charge my full fee on a prorated basis for other professional services you may require, such as report writing, telephone conversations which last longer than 10 minutes, attendance at meetings or consultations with other professionals you have authorized, preparation of records or treatment summaries, or the time required to perform any other service which you may request of me. In unusual circumstances, you may become involved in a lawsuit that may require my participation. You will be expected to pay for the professional time required, even if I am compelled to testify for another party. (Because of the complexity and difficulty of legal involvement, I charge $175.00 per hour for the preparation for and attendance at any legal proceeding.)Is psychotherapy confidential?In general, the confidentiality of all communications between a client and mental health provider is protected by law, and I can only release information about our work to others with your written permission. However, there are some exceptions.Although rare in occurrence, by law I am obligated to inform you of these exceptions.In most judicial proceedings, you have the right to prevent me from providing any information about your treatment. However, in some circumstances, such as child custody proceedings and proceedings in which your emotional condition is an important element, a judge may require my testimony if he/she determines that resolution of the issues before him/her demands it, and my case records may be subpoenaed.There are some situations in which I am legally required to take action to protect others from harm, even though that requires revealing some information about a client's treatment. If I believe that a child, an elderly person, or a disabled person is being abused, I must file a report with the appropriate state agency. (If you reveal information that constitutes physician misconduct, I am required to report the physician to the state medical board; however, I will not reveal your name or give them any information that would allow you to be identified, unless you agree to it).If I believe that a client is threatening serious bodily harm to another, I am required to take protective action, which may include notifying the potential victim, notifying the police, or seeking appropriate hospitalization. If a client threatens to harm him/herself, I may be required to seek hospitalization for the client, including contacting family members or others who can help provide protection.How long does therapy last?That's entirely up to you. Many people gain tremendous benefit from attending therapy once a week. Exploring your own internal mental and emotional processes in relation to how you perceive and relate to yourself, others, and the world is very fascinating and growth enhancing. The bottom line, though, is that you decide when to enter therapy and you decide when you leave therapy.
