What is therapy?
Realistically, therapy isn’t easily described in general statements. Some believe it’s both a science and an art. Furthermore, it varies depending on the personalities of the therapist and patient, and, the particular problems which the patient brings to the therapeutic situation. Typically, in order to maximize therapeutic success, it is recommended you will have to work both during our sessions – and sometimes at home or in-between your sessions as well.
While it may not be easy to seek help from a mental health professional, it’s often the best way to be better able to understand your situation, thoughts, feelings and behaviors while moving toward resolving your difficulties. By using my knowledge, training and experience regarding human development and behavior, I will make observations about situations as well as offer suggestions for new ways to approach them. Furthermore, with your consent, it will be important for you try new approaches in order for change to occur. You’re always free to bring others (e.g., spouse, significant others, family members, or friends) to a therapy session if you feel it would be helpful – or if I may recommend it.
How long is a session?
Unlike the 60-minute hour that we’re all used to, a therapy “hour” is typically 45-50 minutes long. Needless to say, there may be occasional situations when flexibility is needed and we can extend the session time. Other appointment length arrangements can be made on a case-by-case basis and/or an as-needed basis.
How often should I come to therapy?
This varies somewhat depending on the person. The majority of my patients come once per week – at least initially. Occasionally, it may be helpful to attend therapy twice a week. It may be requested by you or suggested by me. Of course, we would discuss the therapeutic reasons for this (e.g., successfully getting through a crisis) as well as for how long. I don’t recommend coming less than once a week (especially at the beginning of treatment) because it's difficult to maintain consistency and the momentum of your progress. Over time, the frequency of sessions may vary, depending on your needs.
How do I know I’ll be comfortable working with you?
Making a decision to begin therapy is significant. Committing to a particular therapist during an initial phone call or during the first session can add additional stress to whatever you may be experiencing. It’s very important to ensure you are comfortable with our therapeutic relationship, and, feel I can help with achieving your desired results (i.e., treatment goals, indicators of improvement/success.)
In order to lessen any sense of initial pressure or anxiety, I suggest meeting for a couple of appointments so you can experience what it’s like to work together. Most importantly, you can then decide whether I have something to offer which would be helpful and useful to you.
Can therapy really help me?
Yes, in most cases. Therapy helps basically healthy people who experience the difficulties of a major life event such as the loss of a loved one, a job or home, the end of a relationship or news of serious illness. Working through these challenges can return a person to functioning more fully and with greater peace of mind. Therapy also helps people who experience depression, anxiety, bipolar illness and personality difficulties to learn how to maintain greater stability and manage their lives more effectively.
Therapy is not always about “trauma and drama” – sometimes a person can be surprised (or shocked and confused) by the challenges in adjusting to positive life events such as a new job, a promotion, getting engaged or married, purchasing a “big ticket item” or something long yearned for, getting pregnant or starting a family, graduating schooling and/or training, or some other kind of hard earned success. Just as “stress” is associated with negative events or situations, there is something called “eustress” (which is a kind of positive stress or challenge to one’s resources in response to something good or desirable.) Yes, “quality problems” such as an achievement and success may require sorting out thoughts and feelings in order to fully enjoy and settle into the “sweet spots” of life and our efforts. It’s not all about “sour patches.” Ideally, therapy can help with both.
When you need to talk to someone, an experienced, licensed psychologist can help you get through the struggles attached to what is overwhelming, so you can move to a place in your life which is less painful and has more opportunity for vitality.
So, how hard do you have to work? Therapy is not like a visit to your medical doctor. It is collaboration between patient and therapist. This calls for an active effort on your part for a successful and satisfying outcome. Self-reflection and thoughtful consideration about what we talk about during our meetings is the “active effort.”
We all have what we need within us: the feelings, talents, sensibilities and ethics to live our lives well. Our work is to find them, trust them and learn how to use them constructively and creatively.
What helps an adult to grow and mature? Few arrive at adulthood in one unblemished piece. For various reasons, parts of ourselves get “stuck” as we develop while other parts grow to maturity without difficulty. This “stuck-ness” may become a central reason many people have gaps in their maturity or discrepancies between their chronological age and their emotional or developmental age. In effect, many grown-ups need to “grow up” (or move forward) in some areas of their life as life eventually requires the use of all parts of the person, even those that are waiting to be developed. Therapy helps emotional and chronological maturity get in sync so people can grow out of their “stuck-ness” and into a place of greater well-being, sense of ease, relational improvement, and more self-confidence.
Although people often enter therapy in some sort of crisis, it is usually longer-term, underlying issues that concerns or nags at them. One of my goals is to work as quickly as possible, trying to make the most of each session. The people I work with don't expect miracles, but they usually are in significant distress when we first meet, and want relief as soon as possible. As therapy progresses, goals may expand or broaden, so we are not just working to get rid of pain and suffering, but also to create richer, deeper relationships, more satisfying and creative work, be at more peace with themselves, and more engagement in life. Helping others achieve these goals is deeply meaningful to me.
Therapy is different for everyone, obviously, depending on your goals. Together we can tailor your sessions to work best for you. For example, you may want highly structured sessions with homework, or you may want sessions to be mainly insight-oriented with little structure and greater freedom to explore your inner and outer world. The first few sessions will be part of an informal assessment phase where we are building rapport and trust, creating a safe psychological “space” in which to set goals and determine what works. After that, the ongoing work of therapy begins; therapy isn’t a quick fix but needs diligent effort for best results. When you feel comfortable moving into the final stages of therapy, we will mutually assess your progress, ensure your goals are satisfied, and begin the termination phase of treatment, which can last a few sessions.
What are the benefits and risks of therapy?
“Therapy” is the Greek word for change. Change happens when you become more of who you are. This is different than trying to make yourself something or someone you're not. Finding our own path, our own individual way more often than not leads to satisfaction, insight and a more balanced and fulfilling life. Things don’t change overnight, but even small gains work to balance and reshape our lives. Major upheavals are not always necessary. Change comes in its own time and sometimes step-by-step.
Psychotherapy (“therapy”) has both benefits and risks. You may learn things about yourself you don’t like or may feel uncomfortable with. At times, therapy requires recalling unpleasant aspects of your life history at times. However, therapy has also been shown to have benefits for people who seriously engage in the therapeutic process. That is, it can lead to significant reductions in feelings of distress, better relationships and/or resolutions to specific (or long-standing) problems. However, there are no guarantees about what will happen.
Therapy may involve a large commitment of time, money and energy so you should be very careful about the psychologist (“therapist”) you select to work with. If you have any questions about my approach, we can discuss them whenever they arise. If your doubts or concerns persist, I’m willing to help you find an appropriate consultation with another mental health professional if necessary and/or requested.
Often, growth can’t occur until you experience and address issues which create sadness, sorrow, anxiety or emotional pain. The success of the therapeutic collaboration depends on the quality of the efforts on both the part of the patient and therapist, and, the realization that ultimately, you are responsible for the lifestyle choices/changes which may result from therapy. For example, one risk of exploring painful and/or difficult relationships is the possibility of exercising the option of ending a relationship.
As mentioned above, while there is no guaranteed outcome from being in therapy, there are several things you can do that may increase the chances of successfully reaching your treatment goals. For example, it is highly recommended you:
- make a commitment to your treatment;
- consistently keep your appointments;
- spend time thinking about your session before and/or after the appointment;
- if so inclined, write down or journal your thoughts, feelings, reactions, dreams or memories between and/or during appointments; and,
- attempt to do any mutually agreed upon “homework,” “experiments” or “suggestions” (e.g., consult with a physician and/or psychiatrist, participate in marriage/family therapy and/or consult with another mental health professional) between therapy appointments.
Also, to the best of your ability, you want to be as open, honest and willing during your sessions. If necessary, I encouraged you to share with me any thoughts or feelings of dissatisfaction and/or discomfort with your therapy.
The above are suggestions with regard to making your therapeutic experience as successful, meaningful and productive an experience as possible. Therapy is, ideally, a life-changing endeavor – why not give it your best?
Do you prescribe medications?
As a licensed clinical psychologist, I do not prescribe drugs. But I will provide you with referral sources for psychiatrists (i.e., medical doctors) who do, especially if you (or I) think a medication evaluation would be helpful.
Is it necessary to take medicine?
I work with people who are taking medication and those who are not. Medication is not a barrier to therapy nor is it a substitute for therapy. For some the combination of medication and "talk" therapy is what facilitates change and wellness. For others, therapy alone meets their needs. This is something we can explore together if/when the situation arises.
What should I do for my first visit?
Even if you’ve been in therapy before, going to your first session can be a bit nerve-racking. Of course, you’re coming with the hope of feeling better and improving a situation or relationship – ideally, sooner than later. However, you are meeting a stranger (me) to talk about your problems, some of which may be very personal. Simply put, you are not sure what to expect from a new therapist and embarking on a new experience can be challenging. Don’t forget, just like the first day of anything (e.g., school, work), you never have to repeat it again and subsequent sessions after the initial appointment should be less anxiety-provoking.
Below are a few suggestions to help you alleviate some stress and feel reasonably prepared for your first appointment.
Paperwork: Download and complete the Intake and Informed Consent forms and bring them to your appointment. This way you don’t have to hassle with filling them out in the waiting room; rather, you can complete them at home at your leisure.
If you’re using insurance, bring a copy of your insurance card or the card itself. Whether you are paying privately or using your benefits, please be prepared to settle up either at the beginning or end of the session (whichever you prefer) with cash, check or credit card.
Make sure to take time to think about what you want me to help you with. Either form a mental list or make a note of the issues/problems you want to discuss. Consider what would be a desirable outcome or what you are striving to achieve. For some, it’s as simple as asking yourself, “What’s bothering me so much I feel a need to talk to a therapist?” and/or “What do I hope to get out of therapy?” Hopefully, thinking along these lines prior to your first session will assist in beginning your journey to a happier, healthier life.
For those who’ve been in therapy in the past, you might want to compile a short summation of what you found most helpful or not useful (e.g., techniques, style of communicating, the use of homework assignments or therapeutic exercises, etc.). Naturally, I don’t want to repeat someone’s mistakes but rather build on proven workable methods for you. If for some reason you don’t think I’m able to be helpful or that I am not a good fit for you, you always have the right to discontinue treatment at any time. Hopefully, given the opportunity, we can discuss what changes can be made, or I can provide you with referrals.
And finally, not only is motivation to change a critical ingredient toward creating positive outcomes, so is keeping an open mind. This may be difficult at first when feeling hopeless, helpless, stuck, anxious, or too "down in the dumps" to try new ideas or new ways of at looking at your thoughts, feelings and actions. While I’m not a miracle worker and certain life problems/situations can be monumental and overwhelming, it’s important to remember that “very difficult” isn't always impossible.
Are my therapy sessions confidential?
Yes - although there are some exceptions. It’s important to consider that any communication between us once you have begun therapy is private and confidential. I am bound by law and the code of ethics of The American Psychological Association to do so. Information about your therapy can be released to a third party only after you have given me written consent. However, there are certain requirements which mandate disclosing otherwise confidential information. Below are exceptions to confidentiality.
- If I have reasonable cause to believe you are in such a mental or emotional condition as to be in danger of harming yourself and/or others, I will work to find a way to ensure the safety of you and others without breaking confidentiality (if possible.)
- I will work to keep you in as much in control of the process as possible. I may be obliged to take protective action, including seeking hospitalization or contacting family members and/or others who can help provide protection.
- If I have knowledge, reasonable suspicion or have observed a child under 18 who has been the victim of child abuse, neglect or abandonment, the law requires I file a report with the proper authorities. The above also pertains to the elderly and dependent adults.
- If you communicate a threat of physical violence against an identifiable victim, I must take protective actions, including notifying the potential victim and contacting the police. I will work to keep both the intended victim and you safe.
- A judge can subpoena records in a court case.
These situations are very unusual in my practice. However, should they arise, I will make every effort to fully discuss them with you before taking any action; and, I will limit my disclosure to only what is absolutely necessary.
While this summary of exceptions to confidentiality should prove helpful in informing you about potential situations, you may also wish further information by contacting the Pennsylvania Board of Psychology. It's always important for us to discuss any question or concern you may have now or in the future regarding confidentiality.
What do I do in an emergency?
A true emergency is something of a serious or severe nature requiring immediate attention. There are many examples of this. The most extreme is when you are at risk of harming yourself or another. We can discuss situations that are specific to you (and/or your circumstances) and develop response plans on what to do if this occurs. However, your first course of action is to ALWAYS call 9-1-1 or go to your nearest hospital’s emergency room.