Common Questions
How can therapy help me?
That depends!
There are two best predictors of success for clients. First, are you ready to change? The old adage, “you can lead a horse to water” very much applies. No matter the skill or theoretical orientation of a therapist, therapy cannot happen TO you. Therapy with me will be work. When the emotional system and brain have been doing things the same way for years, one has to essentially rewire the operating system. This takes time, practice, and… work.
The second most important indicator of success is the goodness of fit between the therapist and client. That is why the initial sessions of the therapy relationship should be an interview of the therapist, not the other way around. Therapy isn’t free. You wouldn’t hire a plumber with no experience in fixing your particular leak that did not engender your trust or that annoyed you, right? Why would you ever do that with a therapist, even if they were covered by your insurance carrier? Unlike with a physician who is meant to diagnose and fix, a therapist is in the business of working with clients in a collaborative way.
Do I really need therapy? I can usually handle my problems.
Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you’ve faced, wouldn’t it make sense to seek out extra support when you need it? If your roof had a leak and you didn’t know how to fix it, what sense would it make to climb a ladder and scratch your head wondering where to begin? I believe seeking therapy is a sign of strength and courage. You are taking responsibility by accepting where you are in life and making a commitment to change the situation by seeking therapy. Decades of research have shown the long-lasting benefits that therapeutic support provides – ideally giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.
What is therapy like?
After the initial intake, I almost always begin sessions with the same two questions:
First, “Tell me where you are” is a purposely vague question intending to help me get my finger on the pulse of what is happening for you since the previous session. This might be details of what has transpired, or simply a gauge of how you are feeling. “Second, tell me about your last session.” If we are doing things right, each session should build on the last. With me, we will stay focused on addressing the challenges that you presented in the first session.
My goal is to have you happily fire me because your issues are resolved!
How often should I come?
I have an online scheduling software. It is your job to schedule yourself as often as you wish. Generally, people start with weekly appointments, then taper to twice per month, once per month, and as-needed.
Many therapists are trained to schedule once per week to make sure you don’t have unconscious resistance and to secure the relationship. That makes sense on a certain level, but I’ve changed my mind about that over the years. There are so many people who genuinely are hurting that are eager to work and show up, that I could have three full-time jobs if I wanted to. I have chosen to work with those that are ready to do the work, and thrilled to get the support. I also admire those that have the clarity to show up when they need it.
What about medication vs. psychotherapy?
First, therapists cannot prescribe medication. Only psychiatrists and other medical doctors can do so. I do believe that medication can be helpful, but will only recommend that course of action if we have explored all of the other options first!
Do you take insurance, and how does that work?
To determine if you have mental health coverage through your insurance carrier, 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:
- What are my mental health benefits?
- What is the coverage amount per therapy session?
- What is the “allowable amount” for an LCSW, and what percent of that amount will they cover?
- Is approval required from my primary care physician?
See Rates & Insurance for more information.
Does what we talk about in therapy remain confidential?
Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but 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.
However, state law and professional ethics require therapists to maintain confidentiality except for the following situations:
* Suspected past or present abuse or neglect of children, adults, and elders 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 threatened to harm another person