TREATMENT

Appointments need to start on time and end on time out of respect for you and other patients who come to the clinic. We invite you to come a few minutes early to each appointment, enjoy the relaxing music in the lobby, and think about your goals for therapy and how you would like to use the session to work towards those goals. At the beginning of our sessions, you will jointly outline the agenda for how time will be spent which means you're expected to collaborate in planning throughout the therapy process.

Although therapy can be difficult at times, there is an expectation that you to make a good faith effort towards your own progress in treatment. If you are given assignments between sessions, it will be important that you complete these prior to the following appointment. There is an expectation that you will be honest with your clinician throughout the therapeutic process. This is especially true if you ever experience thoughts about hurting yourself or someone else. If you are taking medications under the direction of a health provider, you are expected to be compliant with such direction and if you choose to discontinue use of medications it should be under medical direction.

Psychotherapy has both benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. You are expected to be willing to take risks and try new things in therapy as part of the process of change. This may require you to share feelings or thoughts that are uncomfortable or unpleasant for you to express. On the other hand, psychotherapy also has many benefits. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. Although there are not guarantees, your experience is likely to be proportionate to the amount of energy and effort you put forth during the therapeutic process.

Research has shown therapy to be beneficial for those that seek help. In general, those in therapy do better then 80% of those not engaged in some sort of therapeutic process. There are some individuals who show signs of improvement, approximately 43%, without involvement in any therapy process. In some rare occasions, approximately 5% of patients regress following treatment into a more severe condition. In general, most people report that the odds of being helped by therapy far out weigh the potential risks. There are however, alternatives such as self-help books and various community support groups facilitated by non-professionals. If these options are of interest to you, we are willing to make some recommendations based on what others have found helpful.

The first few sessions will focus on evaluating and assessing your needs. It is an information gathering process and it is likely that you will not feel much different after these first few sessions as the assessment process doesn't involve therapy. During this period, you may complete several psychological tests to help us understand your issues. At the end of this initial evaluation period, your clinician will offer some initial impressions about what has been observed, thoughts about what might be creating distress for you, and possible solutions about how to resolve such issues. With your therapist, you will discuss a rough draft of what a treatment plan might look like if you choose to continue therapy. You too, will be conducting your own evaluation of how you experience your therapist, the information you are given, and your feelings about a goodness of fit. There are several questions you are encouraged to answer as you consider whether you want to continue seeing your therapist. These questions may include:

1. Do I feel like my therapist is authentic, genuine, and sincere?
2. Does my therapist seem personable? Are they the type of person I feel comfortable interacting with?
3. Do they communicate their ideas well?
4. Are they competent? For example, does their work suggest they are keeping current with what the mental health field promotes as best practices?
5. Do they incorporate findings from the social science research into their work?
6. Can they engage me? Although clients must co-create what happens in therapy, can the therapist interact with me in a manner that keeps me involved in the session?
7. Did they give me helpful feedback? Do they provide feedback that is tangible and useful for me? Can they give me harsh feedback gently?
8. Can they move beyond my defenses and take me places I really want to go but might be afraid to explore? Do they respect where I am at and yet encourage me to do some risk taking?
9. Are they empathic and can they validate my fears and concerns?
10. Can they move beyond surface issues and understand the core dynamics of presenting problems? Do they deeply understand human nature?
11. Are they willing to disclose how they experience me as a person and also be willing to listen to how I experience them?
12. Will they use some psychological testing or other objective measures as part of our work together? For example, do they use any objective measure in assessment or monitoring outcomes?
13. How will they monitor our relationship throughout treatment? How will they address problems that may arise between how we see things differently?
14. Does my therapist seem committed to confidentiality and keeping the content and details of our sessions private, with the exceptions of limits to confidentiality mandated by law?

Because therapy involves a large commitment of your time and energy, you should consider these questions carefully. If you feel like your therapists style isn't working for you, we encourage you to talk to them about your concerns or any of the procedures used that might be confusing to you. If, after discussing your concerns you feel there isn't a good fit, we are willing to make recommendations to other mental health professionals that we believe do good work but differ from the style of your current therapists. We can also transfer a summary of any evaluations or assessments conducted at our clinic so this information will be available to them.

If you choose to work with me, we will outline a treatment plan with goals and objectives that incorporate changes you would like to make. If a mental health diagnosis is warranted, this will be discussed with you and the implications of such a diagnosis. For example, if you met the criteria for depression, you and your therapist would talk about what that means and how such labels are helpful or potentially harmful. Therapy sessions are usually scheduled at the conclusion of appointments with the secretary, and on average, clients are seen once a week for 50 minutes for individual psychotherapy and 75 minutes for couples therapy. Some cases may require sessions to be longer or more frequent.

As part of treatment, the clinic routinely administer questionnaires that help us track your progress and offer us some feedback on how you are doing. In order to make sure we have the time we need for our session, please come a few minutes early to complete these questionnaires. The secretary will give you a palm-pilot when you arrive and you can take a few minutes to fill it out. At the conclusion of sessions, you will receive an email later that day asking for feedback on your session with a link to our web site that lets you respond. This feedback is helpful in guiding interactions between you and your therapist and making sure that the relationship is operating the way it needs to so you can increase the likelihood of a positive outcome in treatment.

A common question that is often asked is "how long will I be in therapy?" This is a difficult question to answer as there are many factors that influence your ability to have a successful outcome. Some people start therapy will multiple issues (e.g. anxiety, depression, martial problems) which take longer to resolve. Some problems such as addictions generally take longer to treat. Subsequently, without knowing the specific details of your situation it is a hard to answer. However, you can ask your therapist at the time they have completed the evaluation and they will be better able to provide you with an idea of what your course of treatment might look like.

You participation in treatment is voluntary and you can withdraw at any time if you do not feel satisfied with the services you are receiving. Additionally, if you require services we cannot offer, we am willing to refer you to another provider who can. A common situation where this occurs is when an individual might also need couples counseling. It is usually not wise for client's individual therapist to also be their marriage counselor. As a result, in such cases, your therapist will either be the marriage counselor or the individual therapist and have another mental health professional help offer the additional counseling. This does not preclude therapists from periodically having individual sessions with a couple with whom they are working or a couple session with an individual they are treating. However, these sessions are periodic, not long term arrangements.

I offers several services you might like to be aware of including individual, couples, and family therapy. I provide some group therapy with some clinics, but not with others. I hope you will find this web site a rich resource that has articles, helpful readings, and videos you can watch online.