I have never been in therapy before - what can I expect?

Making the decision to begin therapy is often filled with anxiety about the unexpected, which is a normal reaction. To begin therapy takes a great deal of courage, and it often takes people a long time to make the initial phone call. When you call to make an appointment with me, I will do a brief initial screening over the phone to determine if I can be helpful with your concerns, and if our schedules will allow us to make an appointment. We will also briefly discuss insurance coverage and payment. You are also free at that time to ask any questions you might have regarding my approach, training, etc.

It is important to remember that therapy often takes hard work on both our parts, is most likely not a quick fix, and may sometimes feel uncomfortable. Sometimes feelings such as anger or grief will arise, and clients often feel that these feelings have no place in therapy. Quite the contrary! To change patterns and feel in charge of your life, you may need to experience a variety of feelings in our work together. I will serve as a support for you during those difficult periods, as well as welcome your accomplishments.

What can I expect at the first session?

When you come in for your appointment, I will try and make it as comfortable for you as possible. I will most likely want to know what brings you to therapy at this time, and what you hope to gain from therapy. I will also review my policies and give you information on the Health Information Privacy laws. I will let you know if I feel I can be helpful.

What do I do if I feel that change isn’t happening quickly enough?

When someone is in distress, it is a normal reaction to want immediate relief from that distress. More often than not, individuals report some slight symptom relief after 5-6 sessions, but longer-lasting change often takes a longer period of work together. Along the course of therapy I will check in with you to see how you feel things are going, and if we need to make any adjustments to what we are doing. It is important that we have an open on-going dialogue regarding these issues, even if at times it feels uncomfortable.

How do I end therapy?

This question often arises for those beginning therapy. Ending therapy, or “termination”, is as important a part of therapy as the beginning. It is a time when we can both review the changes you have made , prepare you for future challenges, and say good-bye to each other. It is not unusual for people to want to end therapy when they are feeling angry or frustrated, or feel that change is not happening quickly enough. While each person has the right to end things in the way they like, it would be most beneficial to you if we could have that discussion together and terminate over a few sessions. It is most likely time for termination when you feel that your original goals have been met, that any other additional issues might have been considered, other people in your life have noticed the changes, and that your life is in a place that feels good. I will be honest with you and offer my opinion as to whether or not I think the time is right for termination, but the ultimate decision is up to you.

I want to bring my teenager in for therapy - how does that work?

While some teenagers are eager to speak with a therapist and may even approach their parents about beginning therapy, others are not. It is often very difficult for parents to make the decision to bring their teenager to therapy. You may be at the end of a long road of failed attempts at improvement, and your teenager may not be interested in talking to a therapist. In those cases, I often use the analogy of a "broken leg" – if your teenager’s leg was broken, you would not negotiate whether or not they were going to go to the hospital and have their leg set; it is the same if you as a parent believe that your child is at psychological risk. If a teenager refuses to come to the initial session, I will see the parent(s) alone.

Because adolescence is such a unique developmental time, it is important that the teenager feel that their sessions are places in which they can discuss and work things out with an objective outsider. Confidentiality often becomes an issue, particularly if the teen is 16 years of age or older. My policy regarding confidentiality with teenagers is that everything is confidential except under the following conditions: (a) I have concerns that the teenager is going to hurt him/herself or someone else or (b) If there is a suspicion of child abuse. In those cases, I will immediately contact the parents, and if indicated, the proper authorities. There are other situations that may fall into more of a "gray" area; in those cases, I may make the professional determination that the parents should be informed of a certain situation/issue. In those cases, I will work with the teenager to find a way for us to tell the parents together.

For adolescent therapy, I will usually see the teen for 3-4 sessions, at which time I will then schedule a parent conference with you to review any changes you see in your teen since beginning therapy; the direction for the treatment; and how we can work together as a team to provide the best supports for your child. After that, parent conferences are scheduled as needed or at your request. Family sessions, with both you and your teen, will also be scheduled when/if needed.