Frequently Asked Questions
Does everyone need therapy?
Not everyone needs therapy, however, most people can benefit from therapy. It can be incredibly useful for folks who are motivated to change, are ready to see different possibilities for their life and are willing to face the patterns that keep them stuck. Other people seek therapy to cope with long-standing psychological conditions, unexpected changes in life, and to manage issues such as self-esteem, body image, stress, infertility, relationship conflict, etc. You are a good candidate for therapy if you are interested in getting the most out of life by creating greater self-awareness, improving your coping skills and if you are willing to take responsibility for the direction of your life.
Am I a weak or damaged person because I want therapy?
It’s normal to feel apprehensive and weak when you are swimming in a sea of uncertainty, confusion, and disillusionment about life circumstances however, suffering in silence or isolation is not helpful. While talking to friends, family, and people in the community are all meaningful ways to connect, it may also limit the amount of information we divulge and limit the objective nature of the feedback we receive. Therapy is a place where you can share your deepest worries, strangest thoughts, and behaviors with a professional who is trained in many areas that can help you. Be careful about falling prey to the judgment of others and the stigma about therapy. As I round out over 28,000 hours of therapy with people from all over the country and the world, my professional opinion is, as Harry Stack Sullivan eloquently stated, “We are all much more simply human than otherwise…”
What should a person look for in a therapist?
Everyone has different needs. The single most important factor despite your unique circumstances is that you feel understood, that you felt comfortable talking to the therapist, and that they are authentic.
What about just taking medication?
It is well established that psychotropic medication alone is not a long term solution for emotional issues. Nevertheless, medication may alleviate symptoms for some time. To better ascertain if you will need medication, please consult with a prescriber such as a psychiatrist or psychiatric nurse practitioner. While we do not prescribe medications at Partners In Resiliency, we collaborate with several prescribers both in our office and in the community. For example, we make referrals for medication management when a client requests it or when we arrive at a place in treatment when we feel it is appropriate. Our goal in therapy is to address core issues employing evidence-based interventions that have fewer risks and side effects than medication. Our philosophy is that people can achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness that includes all aspects of living such as regular exercise, healthy nutrition, etc.
How frequent are sessions and how long will therapy last?
The duration of therapy depends on many factors. Most commonly, people come to therapy once a week for a 45-50-minute session. During the first stage of psychotherapy, it is important to come weekly and consistently to build therapeutic rapport and for the therapist to gather information about all the ways the issue(s) are affecting you. There may be times when you can’t imagine staying in therapy a minute longer; there may be other times when you can’t imagine ending. Both feelings are normal, and both feelings can help us gauge where you are in the process.
What are the first steps?
Out of Pocket Versus Insurance– First you will need to decide if you will use insurance or if you will pay out of pocket. Confidentiality is compromised when a person uses insurance to pay for therapy. Additionally, insurance carriers require a psychiatric diagnosis and they will only cover certain psychiatric diagnosis. The therapist will have to report the diagnosis to the insurance company and they can request to see information associated with the services they cover.
Verify benefits- If you choose insurance, you will need to verify your benefits because ultimately you are responsible for the bill. It is common practice for private practitioners to ask you what the copay is and then submit the bill. If you do not check, you may be left with a hefty bill if you have underpaid. Ultimately you will sign a standard agreement indicating that you will take responsibility for whatever your insurance does not cover. It is better to be prepared.
Search- You have perused some profiles on psychology today, good therapy, google or another search engine and found someone who seems to be what you are looking for. Hopefully, they indicate they have a license to practice therapy (PsyD, Ph.D., LCSW, LPC). You may want someone who is provisionally licensed (not fully licensed yet) because they may have a discounted rate if you are paying out of pocket. Usually, the profile will indicate if they require supervision.
Contact- You will contact the private practice to find out if they have availability. Most therapists see about 20-30 clients per week which means that they usually only have around 40 active clients. A good therapist tends to fill up quickly. They will take down the information needed to send you paperwork and schedule an appointment.
Paperwork- If the therapist has availability, you will receive paperwork which will include demographic information, Privacy Practices, and Consent to Treat. This paperwork will be reviewed during your first session. They will let you know if you need to arrive early. Usually, if you have completed the paperwork it will not be necessary.
Your first appointment- You’ve got your paperwork completed, you know where the office is and you are scheduled to get there before the scheduled appointment time. You are in the parking lot and you think- Sh*&, is this really where my life is that I need to talk to someone about it? Yes and no. Most people don’t need therapy, they want therapy. They have a general desire for things to be different and have recognized that doing the same thing over and over again expecting a different outcome is ridiculous. This is normal. It’s okay and even normal to have those thoughts. Most people say that the first step into therapy is the hardest because there are so many unknowns. It’s overwhelming but remember, on the other side of that door is someone who has made it their life mission to hear your story and walk through this process with you. They have listened to at least 3,000 hours of personal struggles. You can do this.
Your therapist will greet you in the waiting room and you will follow them back to their office. They will ask general questions to start the session. Usually, these questions are about where you were raised, your current work situation, etc. As the interview progresses, the questions will revolve around the reason you are in treatment. Always remember that if you don’t feel comfortable, you can decline to answer. Not only are you the client but you are also the customer. At some point during the process, the therapist will explore goals, treatments, risks, and benefits. Feel free to ask any questions you need and if there is something that you want to discuss that wasn’t covered, you may also tell them about that before the session ends.
What is therapy like?
Relationship- Excellent question and probably the most difficult to answer. All therapists seem to be unique in their approach but we all have one commonality. At some point in our training hopefully, we learned about the “common factors theory,” which is backed by substantial evidence that indicates that the most influential factor during the therapy hour is the quality of the therapeutic relationship. Ah Ha! Now you understand why therapists are always harping on the relationship qualities they bring into the session. Therefore, it is in your best interest to find a therapist that you are comfortable with.
Breakthrough- Movies have greatly influenced how people view the therapeutic process. For example, the breakthrough moment in Good Will Hunting wherein Robin Williams hugs his client and says “it’s not your fault.” Thereafter, the client leaves from that session forever changed. I would say that is not an accurate depiction of what transpires regularly. Therapy is comprised of a series of small breakthroughs with occasional eureka moments that may leave you speechless. Change doesn’t happen overnight but when it does, it is an amazing feeling.
The couch- Not all of us have couches and if we do, we won’t ask you to lay on it. Some people will choose to lay back during an EMDR session or a meditation/visualization exercise but for the most part, people are sitting upright. Usually, an office will have a few places to sit and a kleenex box.
How does that make you feel- Guilty as charged. At some point, most therapists will ask you to reflect on your emotional reaction to an event. The reason why we do this is that we want to bring a level of awareness to encourage insight and our understanding of your situation. Most integrative therapist will also ask where you feel an emotion in your body. No doubt, it’s an odd question but there is an overwhelming body of literature that suggests that mental health is tied to our ability to be present in our body- fully.
Talking into the abyss- Silence is an important function for a therapist but it should not be the only function. Therapy is an interactive process yet the level of interaction is dependent on the circumstances and the theoretical underpinnings of the therapist. Many of the evidence-based interventions require some level of interactive feedback from the therapist. Know what your preferences and questions are and express them during the first few sessions. For instance, if I were the client, I would not appreciate a lot of self-disclosure from the therapist. That may take away from the space and freedom I need to share my story. It may also influence what I choose to disclose.
Just tell me what to do- Therapy and coaching are two different beasts. Most therapists will not tell you what to do however they may help you sort through the pros and cons. Therapists generally help you discover your own solutions. That being said, I have heard that some therapists intermingle coaching into their therapy sessions. This is not a practice that we engage in at Partners In Resiliency.
Teletherapy- In some cases, teletherapy is an appropriate alternative to in-person therapy. Most teletherapists have an office wherein teletherapy is an additional service they provide. It is not suitable for children, people in crisis, or when using hypnotherapy. Many of our teletherapy clients have busy work schedules, live in rural areas, or complicated situations such as domestic violence, agoraphobia, etc. If you are interested in teletherapy, please contact us to discuss your options.
Does therapy work differently for children? What about for adolescents?
The guiding principles of therapy are the same regardless of the client’s age. There are two elements that modify the therapeutic work with children. First, the language of children is play. Play is how children relate and communicate and it is the place where we must meet them. Therapists usually observe the child at play, working with them in a play therapy setting. This could entail sand-tray therapy, play therapy with dolls, or therapeutic games. THe second element that is crucial to our work is the time spent with the family. It is essential to support the system in which the child interacts to strengthen the skills and progress made during the therapy sessions.
With adolescent clients, I am sensitive to the formidable developmental task of separation that they are undertaking. This life stage can be challenging for both parent and child, and I can serve as a safe space for all parties navigating these waters. Healthy development does not mean that children “outgrow” their parents as they pass through adolescence; rather, it means that parents and children find new ways of relating as children move toward adulthood. I work with adolescents and their families to facilitate these new ways.