How can therapy help me?
A number of benefits are available from participating in therapy. Therapists can provide support, problem-solving skills, useful perspective, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues, and creative blocks. Many people also find that therapists can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, couples issues, and daily hassles that grind you down.
Therapists can help you to come to a fresh and more useful understanding of a difficult problem, teach you skills to apply in your life outside the office, or point you in the direction of a solution.
The benefits you obtain from therapy depend on how honest you are with yourself and your therapist, how regularly you come and how well you use the time we spend together, and how much you put into practice what you learn in the outside world when we're not meeting. The more you do practice the skills and perspectives we discuss and learn in therapy, the more the benefits generalize to your ongoing life because you'll develop greater comfort and expertise in them.
Some of the benefits commonly available from therapy include the following:
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
Do I really need therapy? I can usually handle my problems.
You probably are handling a great deal of your problems well. However, everyone goes through challenging situations in life sometimes, and while you may have successfully navigated through other difficulties you've faced, you're also smart to seek extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, which is something to be admired. We will certainly learn from and build upon your current strengths and past achievements. We're just going to be adding to these strengths by giving you more tools in the form of new perspectives and skills to work with your issues and problems more effectively and probably with less effort than you are currently expending.
You are already taking responsibility by accepting where you may be stuck or spinning your wheels in life and making a commitment to change things by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to more effectively handle triggers, stay away from past damaging patterns and cycles, and overcome whatever challenges you face.
Why do people go to therapy and how do I know if it is right for me?
People have many different motivations for coming to psychotherapy. Some may be going through a major life transition (unemployment, divorce, new job, new relationship, etc.), or are not handling stressful circumstances well. Some people need assistance managing a range of other issues such as low self-esteem, depression, anxiety, addictions, relationship problems, spiritual conflicts and creative blocks. Therapy can help provide some much needed encouragement or perspective and help with skills to get them through these touch periods. Others may be at a point where they are ready to learn more about themselves or want to be more effective with their goals in life. In short, people seeking psychotherapy are ready to meet the challenges in their lives and ready to make changes in their lives to cope with these challenges in new ways.
What is therapy like?
Because each person has different issues and goals for therapy, therapy and therapy length will be somewhat different depending on the individual. In general, you can expect to discuss the current events happening in your life, your personal history relevant to your issue, and report progress (or any new insights gained) from the previous therapy session. Depending on your specific needs, therapy can be short-term, for a specific issue, or longer-term, to deal with more difficult, entrenched, or complicated patterns, or to further your desire for more personal development. Either way, it is most common to schedule regular sessions with your therapist (usually weekly) so you don't lose momentum or commitment to this change process.
It is important to understand that therapy will only work well and long-term if you actively participate in the process. The ultimate purpose of therapy is to help you bring what you learn in session back into your life and learn to be your own therapist increasingly. It's therefore key that we work to establish more healthy patterns until they become more firmly established and you increase your confidence in them and yourself. Therefore, beyond the work you do in therapy sessions, your therapist each week will work with you to name some activities and behaviors you can do outside of therapy to support your process. This might involve such things as reading a relevant book, journaling on specific topics, testing your thoughts/beliefs for how accurate or helpful they are, noting and practicing particular behaviors, or taking action on your goals. People seeking psychotherapy are ready to make positive changes in their lives, are open to new perspectives, and willing to take responsibility for their lives, so these outside-session behaviors build on that readiness.
What about medication vs. psychotherapy?
Psychiatric medication can certainly be helpful for certain problems and at certain times. Research, however, shows that the long-term solution to mental and emotional problems and the pain they cause isn't just medication. As a psychiatrist colleague of mine once wisely said, "Pills don't teach skills." Instead of just treating the symptom, therapy addresses the causes of our distress and both the unhelpful cognitive and behavior patterns that interfere with your progress. My philosophy is that you can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness. In many cases a psychiatrist can help you determine what's best for you, and in some cases a combination of medication and therapy is the right course of action. Depending on the problems you present with and the medications you're on, medications can help with, interfere with, or have no effect on therapy progress. This is why it's good to consult with a well-trained professional on these issues. I have a list of several very good psychiatrists whom I trust and refer clients to (and who refer their clients to me) if you want to explore these issues alongside of psychotherapy.
It's important to appreciate that many clients are prescribed anti-anxiety or anti-depressant medications by their primary care physicians, who unfortunately do not have as much extra training and experience in understanding and treating mental disorders that psychiatrists have. Therefore if you are currently being prescribed psychiatric meds just by a primary care or other physician, I will strongly encourage you to have a consult with a psychiatrist I know and respect to make sure you get the best and most up to date treatment.
Do you take insurance, and how does that work?
I'm afraid that I no longer accept insurance as a result of losing many thousands of dollars of unpaid bills by insurance companies. I can, however, provide certain clients who are not on Medicare with receipts that they may then submit to their insurance company for partial reimbursement of my fees. Given the complexities of insurance, you would need to find out whether your medical insurance plan provides such reimbursement, however.
I can and do see clients who are on Medicare, but completely outside of the Medicare payment system (there is a form that these clients must sign prior to our working together clarifying the nature of the limitations). Medicare regulations permit me to see such clients, given that I clarify these limitations.
To determine if you have this type of "out of network" mental health coverage through your insurance carrier that can help defray the costs of seeing me, 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 are these:.
What are my mental health benefits?
What is the coverage amount per therapy session?
How many therapy sessions does my plan cover?
How much does my insurance pay for an out-of-network licensed psychologist?
Is approval required from my primary care physician?
Medicare clients are not legally permitted to submit receipts for treatment by me for reimbursement, so I will not provide receipts for clients who are on Medicare
Does what we talk about in therapy remain confidential?
Confidentiality is one of the most important aspects of the relationship between a client and psychotherapist. Successful therapy requires a high degree of trust due to the discussion of highly sensitive subject matter that is usually not talked about anywhere but in 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, naturopath, attorney), but by law your therapist cannot release this information without obtaining your written permission (see rare exceptions below).
State law and professional ethics require therapists to maintain confidentiality except for the following situations:
A therapist must break confidentiality under these circumstances:
* Suspected past or present abuse or neglect of children, adults, and elders. This must be reported 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.