Frequently Asked Questions
What is your fee ?
My fee for counselling is $110 an hour and $40 for an additional half-hour (in couples and family therapy it is sometimes helpful to meet for longer than an hour). I do not usually provide monthly billing. If you have financial concerns do not hesitate to discuss them with me.
If you would like to submit a bill to your insurance company to see if they will reimburse you, I will complete the insurance form you give me at the end of each month. Note that this may mean that you will not have the same extent of confidentiality you would otherwise expect.
When insurance is utilized for psychotherapy services, patients should be aware of the limits of confidentiality. Typically, insurance companies require the following information: length of illness, psychiatric diagnosis, dates of service, and the names of persons being treated. However, more and more companies require additional information such as family abuse history, alcohol and drug history, treatment goals/interventions, and details of treatment sessions. In addition, some require the right to audit client records. What this means is, if you utilize your insurance benefits for psychotherapy services, you may not have the extent of confidentiality you would otherwise expect.
What about confidentiality?
What you talk about with me is confidential. Generally, no information will be shared with anyone without your written permission. However, you need to know that there are some exceptions to this confidentiality policy:
1) In certain circumstances I may be ordered by the court to testify or release records;
2) If you are a victim or perpetrator of child abuse, I am required by law to report this to the appropriate authorities;
3) If you are a victim or perpetrator of elder or dependent adult abuse, I am required by law to report this to the appropriate authorities; or
4) If you threaten to harm yourself or someone else, I may need to inform the relevant authorities (e.g., emergency services or the police) or take other reasonable steps to prevent the threatened harm.
I sometimes meet with an AAMFT clinical supervisor (who is bound by the same confidentiality policy as I am) to review my work as a therapist. On these occasions, I may talk about details of therapy in progress. In these circumstances the identity of the client remains anonymous.
What can psychotherapy do for me?
It depends on what you are looking for. If you believe that psychotherapy is like a visit to the doctor, where you get a diagnosis, followed by a prescription that is supposed to lead to a cure, you will probably be disappointed. There is frequently no “cure” for the life experiences that prompt people to seek psychotherapy. That is not to say there is no hope: “Hope is justified”.
We are sometimes able to help ourselves. There are those who come to terms with difficult experiences through solitude, meditation or prayer. Others write about what is haunting them in journals, poems, songs and stories, or express themselves in other art forms. These can all be ways of attempting to come to terms with life experiences that we find difficult to address.
We are sometimes able to help ourselves address the difficulties life hands us, with help from our friends and family. However, often the very friends and family to whom we turn for support are caught up in similar life experiences, and are unable to guide us towards new possibilities. And those to whom we might choose to turn find it difficult to help because there are strong emotional bonds that complicate what they can ask and tell us. They are too close to us, and too much part of our lives, to be able to stand back and clearly tell us what they see, what they think, and what they feel.
Often, when we finally turn to psychotherapy, it is in moments of crisis (i.e., a turning point that signals risk and/or opportunity ). There is frequently a sense of urgency. In such circumstances, we may feel strongly but be unable to process what we are feeling. At these times, it is difficult for those close to us to help.
Psychotherapy can be helpful in bringing you to a place where you see new possibilities and new directions. It can help to lead you to an attitude of curiosity, to a process of recollection, to a view of alternative futures, and to an awareness of the potential of self-healing in relation with others.
Psychotherapy can be helpful to you if you are able to find a therapist who you believe has the background and experience to help you to address your concerns, a therapist with whom you feel you have some affinity. A therapist can help you in various ways: by attending to you closely, by providing a setting in which to explore unsettling aspects of your life, by assisting you to view what is happening in your life in new ways, and by encouraging and supporting you to adopt different ways of addressing aspects of your life that you have found difficult to negotiate.
It is not so much what psychotherapy can do for you, as what a psychotherapist can assist you to do for yourself, in relation to other people and in relation to various aspects of your life.
What is the difference between family therapy, psychiatry, psychology and psychotherapy?
Family therapy is an approach that is grounded in the belief that individuals and their problems are best seen in context, and that the most important and accessible context is the family. Individuals, couples and families benefit from the unique perspective and skills of family therapists, whether the presenting concern is related to couple or marital relationship, to children, to blended or step families, or to a specific problem or disorder (e.g., substance abuse, depression or an eating disorder). An increasing number of studies demonstrate the effectiveness of marriage and family therapy in treating a full range of mental and emotional disorders.
Psychiatry is the medical specialty concerned with mental disorders, maladjustment, and abnormal behaviour. Some psychiatrists adhere strictly to the medical model (e.g., diagnose and prescribe medication), while others engage in psychotherapy and may use an eclectic approach. Psychiatrists have trained and qualified as medical doctors and have then gone on to specialize in psychiatry.
Psychology is the science of behavior and mental processes. Clinical psychology focuses on helping clients cope with their environment through testing and the diagnosis of problems, and with follow-up counselling or group work. Counselling psychology focuses on the follow-up counselling or group work.
Psychotherapy is a general term used to refer to many approaches of therapy to help people in psychosocial distress. It refers to a specialized, formal interaction between a psychotherapist and a client in which a therapeutic relationship is established to help to resolve symptoms of mental disorder, psychosocial stress, relationship problems and difficulties in coping in the social environment. Some specific types of psychotherapy include, but are not limited to; family therapy, behavioral therapy, cognitive therapy, psychoanalysis, psycho-dynamic therapy, group psychotherapy, supportive counselling, gestalt therapy, experiential therapy, psychosocial therapy and psychodrama.
In short, psychotherapy is what family therapists, psychologists and psychiatrists do when they meet people and talk with them to help them address the difficulties they are experiencing in their lives.
What is special about couples and family therapy?
Family therapy and couples therapy are approaches to helping people who are experiencing difficulties in their lives, and providing this help in relationship with others. Until family therapists began to see families and couples about fifty years ago, psychotherapy was a process for one person and his or her therapist (e.g., as in psychoanalysis). The process usually took a long time and was therefore expensive and out of reach for all but the wealthy. Family therapy began as a result of a search for a more effective, less costly, and less time consuming approach to psychotherapy.
Because many difficulties are related to our relationships with those close to us, it makes good sense to meet with all those involved in the difficulty. Each individual in a couple or family unit will have their own interpretation of what is going on, their own idea about what they would like to change, and their own belief about how this change should occur.
It is often helpful to have all these opinions out in the open without the arguments that often accompany these different opinions about who is right and who is wrong. Family therapists, in talking with family members, are able to recognize the relational dynamics in which individual behaviour takes place. As family members become aware of these dynamics, they are better equipped to be able to change their own behaviour so that the same old difficulties are less likely to keep on happening. Not only can they help themselves, they can also help each other to make the changes they have agreed upon as helpful goals.
Even when a difficulty seems to be a very personal matter (e.g., a phobia), it is often helpful to have the support of your family to share their impressions of similar experiences (everyone has experienced fear at some level), and for them to be aware of how you want them to relate to you in relation to your fear. Is it something you would like them to ignore? Is it something to be talked about? Or is it something that you want them to help you overcome in particular ways?
When one person in a family is having difficulties, everyone in the family is affected. When one person in a family is having difficulties, everyone in the family can be a part of resolving these difficulties.
How long will it take?
It will probably not surprise you to know that there is no simple answer to this question.
In terms of my own practice, there are individuals, couples and families I see just once and learn later that the one meeting was enough to enable them to make the necessary changes to overcome a particular difficulty. More often, family therapy is a process that extends over several meetings because the issues are complex and, by the time people decide to ask for professional help, the concerns are severe or have become entrenched.
If you want to limit therapy to a certain number of visits (for example, because of financial considerations), let me know and I will plan therapy accordingly. Brief therapy (6 -12 meetings) focuses on the immediate issues and on pragmatic solutions. Longer-term therapy (12 or more sessions) addresses your concerns in more depth and explores these concerns in relation to other aspects of your life, with a view to helping you understand how difficulties have arisen. With such understanding, it may be possible to avoid similar difficulties in future.
What if therapy stirs up things I don’t want to remember?
It is possible that participating in therapy will prompt you to address uncomfortable topics or uncover painful memories. This is a beneficial part of the therapeutic process, as long as you are ready to do this and the process is gentle.
Are their any risks in participating in psychotherapy?
Psychotherapy is not helpful for everyone. Research suggests that a small but significant percentage of people do not benefit from psychotherapy. For some, the problems seem to get worse. It is not clear whether those who “get worse” just get worse and drop out of therapy, or whether things seem worse (which sometimes happens at the start of therapy) and they drop out of therapy too soon and never deal with the issues.
If you feel that you are not benefiting from therapy, it is important to talk about it with your therapist.