Why do people seek therapy?

People come into relationship counseling, marriage counseling or individual counseling for many reasons. Some need to respond to unexpected changes in their lives, while others seek self-exploration and personal growth. 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 kind of people do you tend to work with?

Most of my clients are intelligent, successful people who are experiencing some trouble in their life (relationship difficulties, life transitions, depression, anxiety) or feel ready to move beyond some past issue or limitation to create a more fulfilling life. I counsel men, women, couples, married, cohabitating, gay, lesbian, straight, or transgendered,and children, from school age to those in their eighties. I specialize in relationship counseling, marriage counseling, couples counseing, and individual counseling.

Do you accept insurance?

I do not accept insurance. See the next section to understand why I choose to offer only fee-for-service psychotherapy.

What are the advantages and disadvantages of using insurance to pay for counseling sessions?

Comparison of Issues It is important for people to know the difference between using insurance versus paying for therapy on their own. Why would you pay for your psychotherapy rather than use your insurance? The issues are outlined below.

Issue Self-Payment Using Insurance Privacy Clients’ personal information is kept strictly confidential unless a specific release of information is signed by the client (except in cases of danger to self or others). Therapists are not allowed to share information about a client’s treatment with anyone unless they have prior written consent. The insurance company requires information about a client’s most dysfunctional behavior in order to justify treatment. The therapist may be required to provide not only a diagnosis, but also a treatment plan and progress notes. The information goes into a database, and the insurance company does not inform the client about who has access to this information, how it is protected, and how the information may limit the client’s future insurability. Choice of Therapist Clients choose and contract with their own therapist. A client is free to choose a therapist based on his/her own preferences and needs. If a client is not satisfied with one therapist, he/she may choose another therapist or seek a second opinion at any time. Most insurance companies limit the choice of therapist. Clients are required to go to a therapist that is part of their network of providers, and the insurance company has a contract with that therapist. With HMO’s, no other providers are covered. If a client is not satisfied with one therapist, he/she must usually get authorization to seek a second opinion from another therapist on the insurance company’s list. Choice of  Length And Type of Treatment  The client and therapist together determine the length and type of treatment. Clients discuss the appropriate treatment with their therapist and are active participants in the decision-making process. Clients are free to go to therapy as long as they and the therapist deem it necessary without outside interference. The insurance company determines the length and type of treatment. They tend to limit sessions to 3-8 in order to reduce costs. Even if there is a maximum number of sessions allowed, they may not authorize use of the maximum. They encourage very brief psychotherapy lasting only a few sessions. With some PPO's, a client is usually allowed to use a maximum number of visits or a maximum dollar amount for the year.

What can I expect in a therapy session?

During counseling sessions, you are expected to talk about the primary concerns and issues in your life. A counseling session lasts 45-55 minutes, but some people request longer sessions. Usually weekly sessions are best. Some people who are in crisis or extreme distress need more than one session per week, at least until the crisis passes. During the time between sessions it is beneficial to think about and process what was discussed. At times, you may be asked to take certain actions outside of the therapy sessions, such as researching and collecting facts of functioning in your family of origin, contacting and developing enhanced relationships with family members with whom you previously had little contact, reading a relevant book or keeping records. For therapy to "work," you must be an active participant, both inside 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 developing new ones
• Discovering new ways to solve problems
• Improved ability to manage personal boundaries
• Improved parenting skills
• New ways to make positive meaning out of your experiences
• 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 counseling experience.

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 dependent 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.

Any recording of sessions is grounds for immediate termination.