What is therapy?
When I offer therapy to people, I often start out by just explaining what therapy is. When people come to my office, they see a couch much like they have in their living room. I point out that, yes, there is a couch. However, I don’t sit behind them out of sight and ask them to tell me about their dreams, their mother, or the first things that flow across their minds.
Instead, I explain that my relationship with them is one that is similar to a coach. In the first couple of sessions, I do a comprehensive evaluation, and I note your strengths and weaknesses, and together we come up with a plan of action for how to shine as you deal with the issues that bring you to therapy. Just like a coach, I stand, walk, or run beside you as we walk through the path together to wholeness. I point out your areas of resistance, while respecting your right to decide how to deal with them, and I also praise your successes. I teach new skills and check their development over time, all in the service of helping you succeed.
Is therapy right for me?
Fundamentally, choosing to receive therapy is a personal choice. Usually people come to therapy because they are experiencing pain in some area of their lives. The pain could be from long-standing psychological issues, or it could be from situational problems such as a change in a relationship or a job that have arisen recently, or both. They could have social, spiritual, health, occupational, or relationship-related consequences. In addition, some people seek therapy for personal exploration and growth. Oftentimes when I work with someone and the original crisis is addressed, and when the underlying issues are addressed, people stay on to take what feels good as a result of therapy and make it even better through coaching on my part.
Therapy is just right for anyone who wants to gain ownership of their life, create a better relationship with themselves and others, and move towards goals they have for their life.
Do I really need therapy? I can usually handle my problems.
If things are already working in your life, I will not get in the way of them. The goal is to see you feeling better and coping better, and if it isn’t broken, I’m not going to fix it.
However, there are situations that are very difficult to manage in life. Everyone has at least one in life. Superman is only found in the comics. It is helpful to have an educated, skilled, and compassionate human being available who is not caught up in what is going on to help with looking at difficult situations from different angles with you, applying proven techniques to help address them, and monitoring and encouraging you to follow through on an agreed-upon course of action towards feeling better.
How can therapy help me?
Therapy can be very helpful! A therapist can provide another perspective, support and problem solving skills. We can also help with specific skills geared for such issues as:
- relationship issues
- memories that won’t go away
- spiritual issues that affect you and others
- stress management
- creative blocks
- communication problems
- and many, many more.
Benefits and Risks of Therapy
There are many benefits, but they do depend on how well you use the therapy process and put into practice what you are learning. Benefits of therapy include improvement is:
- Your general mood. If you often feel sad you may feel more hopeful and positive; If often nervous or “on edge,” you may feel more relaxed; if often angry, you may feel less irritable or frustrated.
- Your self-esteem and self-confidence. You may feel better able to accept personal limitations without stress and recognize your strengths.
- Your ability to set realistic goals and accomplish them.
- Your ability to manage stressful life circumstances.
- Your ability to manage strong emotional reactions such as anger, fear, or sadness.
- Your ability to trust, feel close to, and communicate your feelings, thoughts, and needs more openly to others.
- Your ability to stop “problem behaviors” such as excessive drinking, eating, using drugs, unsafe sexual behavior, aggressive behavior, or other behaviors with which you may have had difficulty.
- Your ability to engage in healthier behaviors (changes you have wanted to make but felt unmotivated or unable to begin or continue) such as exercising regularly, following a more balanced diet, spending more time with family and friends, exploring healthy social networks, and just relaxing a bit more.
- If you decide to take part in pastoral counseling, your spiritual life will be more consistent and balanced and you will feel closer to God or your higher power.
There are some risks involved with participating in therapy. Other therapists will not discuss these when they are inviting you to consider doing psychotherapy with them, but I believe it is important that you consider these as well, so you can make an informed decision. These include:
- You might not experience improvement or movement toward achieving your goals. You and I will check your progress closely. If you do not feel that progress is being made, you and/or I may decide to change your treatment, discontinue treatment, or refer you to a different type of therapist, specialist, or program.
- In the beginning some feelings or behaviors may get worse. For example, if you are trying to stop or reduce a certain behavior that you feel is “unhealthy” (e.g., excessive alcohol use), your desire to engage in the behavior may actually increase in the first 2-4 weeks. If you talk about a very upsetting life event (e.g., loss of a loved one, physical or sexual assault, a serious car accident, etc.) you may experience strong negative thoughts and emotions such as sadness, fear, anger, a sense of helplessness, or a belief that things will never get better. The intensity of these thoughts and feelings is usually temporary. You and I can discuss the likelihood that these types of reactions will occur and help you find ways of handling them. Learning how to best cope with such reactions is often an important part of therapy.
- Important people in your life may not support your decision to be in therapy. Some people still have the belief that when someone is in therapy it means that he or she is “crazy” or “weak.” Sometimes these individuals will tease or argue with the client. In more extreme circumstances, someone may stop associating with the person because they found out the he or she is in therapy. If you are concerned about others’ reactions, tell me. You can then discuss how and to whom you wish to disclose that you are in therapy.
- If you expect to use your health insurance benefits to pay for therapy at some point in the future, you may want to find out if your insurance has a pre-existing condition clause. Some health insurance companies deny coverage in the future for the treatment of what they consider to be “pre-existing conditions“.
- If you apply for a job that requires a security clearance, an in-depth background check may be conducted. You and/or I will probably be asked to give information about your therapy. Your psychological treatment history may be cited as grounds for denying you employment.
- You may develop strong positive feelings for me as your therapist and feel sad or distressed when therapy ends. Strong positive feelings for a therapist are normal and usually helpful in developing a trusting therapeutic relationship (it’s difficult to trust someone you don’t like or enjoy talking to). These feelings are usually temporary and make sense. You will be discussing personal thoughts, feelings, and experiences with me. This type of discussion often creates a feeling of closeness. So, when therapy is ending, it’s natural that clients experience a sense of loss and sadness. Once again, such feelings are usually short-lived, especially when excited about feeling better and meeting goals for change.
I encourage you to discuss any fears, concerns, or doubts you have with me, including specific risks and benefits not listed that may be associated with your situation.
What is therapy like?
It is common to schedule a series of weekly sessions, where each session lasts around forty-five minutes. Sessions may involve talking, writing, or doing other activities together with me that are related to your goals. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues or ongoing personal growth. There will be times when you are asked to take certain actions outside of the therapy sessions, such as reading a relevant book or keeping records to track certain behaviors, or trying out new behaviors that have been learned. It is important to process what has been discussed and integrate it into your life between every session for maximum benefit. For therapy to be most effective you must be an active participant, both during and between the sessions.
I like to say that when you come to see me, you see two therapists for the price of one. One is me, the other is Time. You see me for 45 minutes, but Time works with you 24/7, rewarding you for hard work on your part, and pointing out your barriers that need to be addressed in therapy.
I strongly disbelieve in the idea that people should be in therapy for the rest of their lives. Everyone’s situation is different, so I can’t predict how long you may need therapy, but, rest assured, I will be checking in regularly with you to see where you are in terms of your need for therapy. Freud said that “the unexamined life is not worth living.” That is very true, and I believe it. However, I also believe that the overexamined life is not life.
Is medication a substitute for therapy?
I like to say that medication, when it is warranted, is a good aid in stabilizing things or keeping things stabilized so that the change worked on in therapy can happen. Some people believe that by only taking medication, they can be fine. I would argue that they may feel calmer, but nothing else in their life will change. That is why psychotherapy is critically important, and in some ways more important than medication. In some cases a combination of medication and therapy is the best practice, but not always. It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses coping with underlying issues and then brings the underlying issues out when the person in therapy is ready. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness.
As a point of practice, I am conservative in making psychiatric referrals and only refer when it is clear that the person in therapy may benefit, and when the person in therapy is in agreement, unless it is a situation involving a clear and present risk to themselves or others.
Do you accept insurance? How does insurance work?
To determine if you have mental health coverage, the first thing you should do is check with your insurance carrier. Check your coverage carefully and find the answers to the following questions:
- 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 provider?
- Is approval required from my primary care physician?
You can get your answers to these questions by calling the number on the back of your insurance card for “behavioral health” or “mental health/substance abuse” services.
Is therapy confidential?
In general, the law protects the confidentiality of all communications between a person receiving psychotherapy and a psychotherapist. No information is disclosed without prior written permission from the client.
However, there are some exceptions required by law to this rule. Exceptions include:
- Suspected child abuse or dependant adult or elder abuse. The therapist is required to report this to the appropriate authorities immediately.
- If a client is threatening serious bodily harm to another person. The therapist is required to notify the police.
- If a client intends to harm himself or herself. The therapist will make every effort to work with the individual to ensure their safety. However, if an individual does not cooperate, additional measures may need to be taken.
- In Pennsylvania, your medical records can be subpoenaed by a court. In my near 30 years of experience, I have only seen this happen a couple of times, and I would let you know ahead of time that it is happening.
I have a question not answered here!
Feel free to ask me when you contact us! I strongly value your input (I insist on it, in fact!) and want you to be fully informed and in control of your own therapy while we work together.