1. I am not sure I need psychotherapy. What should I do?
Come in for the first therapy session, which is also an assessment. Remember: at the end of the assessment, I may agree that you do not need psychotherapy. And if I do think you need psychotherapy, you will have a chance to talk about your doubts or worries and to make a choice. You can always decide against entering therapy.
In my experience, this question sometimes comes from people who are afraid of the cost or are afraid of the emotional risks. If cost is the issue, look at my statement on my Sliding Scale on the Fee, Insurance, Sliding Scale page. If the fear is about the emotional risks or pains, remember that I have 25 years of experience, enough to say with confidence that I will help you past such fears in our first meeting
2. What is your approach to therapy? And how can I know if you are the right therapist for me?
Read my essay Thoughts On Choosing a Therapist and read the page in Experience section titled My Approach. But come to a session; you can judge and experience for yourself. You will ultimately decide if you want to begin the therapy process with me. In my experience, the answer is almost always yes, but if the answer is no, I will actively work to find you a suitable therapist. There are many good therapists in the region where I work and the most important outcome from the assessment process is that you begin to receive the help you need.
3. How do I begin? What happens in the first sessions?
You begin by calling for an appointment and coming to it.
Our first two to four therapy sessions are also an assessment time so I have a clear understanding of the issues and you have a chance to meet me and decide if you are comfortable working with me. The very first session is mostly about why you are seeking therapy now, though we may wander on to other topics. You will have time to ask me questions. I also need to obtain certain information at the end– address, phone number, etc.– and there are a few forms to complete, so I schedule the first session for an hour instead of the usual 45 minutes.
If I think I can be of help, I will offer to continue psychotherapy with you beyond these assessment sessions. I will share my initial thoughts about the issues you raised. I offer both long-term and short-term therapy, and I will discuss the frequency and possible duration of therapy.
In general, everyone can benefit from a safe confidential talk with a trained therapist they trust who strives to understand them. But on rare occasions, the therapy help you need is not work that I do. I would then explain what kind of therapeutic help you need and where you might get it. I would offer to assist you track down the proper treatment and offer to stay in touch by telephone or in person until you had successfully made the transition to the new treatment. Since most people who see me already know they need psychotherapy, this outcome is uncommon.
4. What happens in a psychotherapy session?
You talk about what is on your mind and I make comments. That may sound pretty bland, or even boring, but actually it should become deeply meaningful and very intense. After all, you are talking about your life.
5. How long will this process last?
I will a have better idea after the assessment sessions and I will discuss it then. Long-term intensive psychotherapy may last a year to several years. Short-term work will last at least several months.
6. Why come to long-term therapy twice a week, or three times?
Many people choose long-term psychotherapy to understand themselves in depth and to attempt more fundamental change. In addition, when problems are persistent or severe, long-term psychotherapy is essential. Once a week long-term therapy is a very intense experience but patients who can manage coming more often have a more powerful experience. Considerable energy in once a week therapy goes in to working through the events of the past week; this is important of course, as it is your life. But coming more often enables us to work on the deeper patterns.
7. Most therapists bill for missed sessions—do you? Why do therapists do this?
I do; indeed, every therapist I know does. The reason is simple: when we set up a regular appointment with you, we are giving you exclusive access to that time slot, which is not how other professionals work. Physicians usually work with a waiting room filled with people so if one person is late they just see the next person. Other professionals, such as lawyers or accountants, can fill the cancellation time with other billable work such as work on briefs or tax returns.
The only billable work most therapists do is their time seeing patients and the time we schedule with you is exclusively yours, not available for anyone else. With enough advance notice we can do something productive with the time created by a cancellation but with little or no notice we literally sit in our office waiting for you. Of course I do know that emergencies happen, so I have struggled to come up with a policy that is fair to all. I describe my policy on the page titled Information for My Current Patients and I remain open to suggestions for a fairer policy.
8. Do you provide medication? Do you work with people on medication?
I do not provide medication; a psychiatrist would do this. I am very comfortable working with patients on medication, perhaps because I was Director of a hospital-based program for many years (see My Work Experience page). I occasionally refer a patient to a psychiatrist for a medication review.
But medication does not replace psychotherapy; it should just provide enough relief that the work of psychotherapy continues. I have had many patients who either rejected my suggestion that they see a psychiatrist for a medication review or who did go and then refused medication, and in all these cases, they continued to do very successful work in psychotherapy.
9. You were Director of both an Adult and an Adolescent Partial Hospitalization program: what are these programs?
The State of Michigan licenses Partial Hospital Programs (PHP) to provide a level of care between twenty-four hour in-patient care and once a week outpatient care. Day Hospital patients live at home and attend each weekday, receiving five hours of intensive programming daily. My Adult PHP staff consisted of two PhD psychologists, two clinical social workers, a nurse, an art therapist, an activities therapist and two activity assistants; in the smaller Youth PHP program I supervised a separate staff of a teacher, a social worker, a clinical psychologist, a nurse, an occupational therapist and a treatment assistant.
10. What insurance do you accept?
I am again a Blue Cross provider (March 2010) after a two year absence from Blue Cross and I am now on the Blue Cross PPO panel. I do not take any Blue HMO or any other insurance at this time.