ANN PULTZ KRAMER, M.S. | 13800 HEACOCK STREET, SUITE C 212 | MORENO VALLEY, CA 92553 | 951.653.4001 27403 YNEZ RD., SUITE 204,TEMECULA, CA 92591: 951.992.6373

CAN THERAPY HELP ME?
Although psychotherapy is not for everybody, most people benefit from therapy when they feel comfortable in the relationship with their therapist (see www.talkingcure.com ). Even people who came to therapy at the urging of someone else in their family or in their relationship find they are able to work on issues and grow in ways they had not imagined once they are comfortable talking to a therapist.

HOW OFTEN DO I NEED TO COME IN FOR THERAPY SESSIONS?
Usually once a week is helpful, especially if you and/or your relationship are in a lot of distress. Less than that, in my experience, is not helpful for people to feel the benefits. Later, when things are less difficult, moving to less frequent sessions can be a consideration.

HOW LONG IS A SESSION?
Sessions are 45 minutes in length.

HOW LONG DOES THERAPY LAST?
Often, when someone asks this question, there may be two concerns that can interfere with therapy and its eventual progress.

First, this can occur when there is a desire for immediate results. Many people come to therapy wishing to fast forward the process of change, while wanting to avoid it altogether at the same time. This is a common struggle that a therapist can help you to sort out.

Second, financial pressures can create a need for immediate change. If you are experiencing financial concerns that lead you to leave therapy prematurely when you are making progress and satisfied with your therapy, it is a good idea to talk with your therapist about your financial situation and see if arrangements can be made so therapy can continue.

However, the short answer to this question is that "it depends". Sometimes clients come in looking for a resolution to a short term problem. Once that problem is resolved, , the therapy can be completed. Other times, people come in for deeper answers to long term problems, and their therapy can take months or longer. Sometimes therapy lasts a shorter time or longer time than people expected. I do not believe that all problems are solved with long term therapy and that it is my job to decide that you are not done if you want to stop therapy. (See below)

HOW DO YOU KNOW WHEN THERAPY IS FINISHED?
Probably the best determinants of when therapy is finished is how you are feeling in your daily life about yourself and your relationships, and whether you have met the goals for which you sought therapy. Many times clients ask me if they are finished with therapy. I believe it is mostly your decision about whether you are ready to stop therapy, and I will speak up if I have strong feelings about your choice to stop or continue for any reason.

WHAT IF I CAN'T ATTEND A SCHEDULED SESSION?
Because therapy is scheduled hourly, therapists are not able to have other clients in the waiting room to bring in as other professionals might to fill an appointment. An unattended session is an hour for a therapist that will remain unfilled while the therapist is there ready to work. Therefore, the 24 hour requirement to cancel an appointment is more necessary to a therapist than other professionals you have worked with in the past. (All professionals request and appreciate this courtesy, however).

I will discuss my policy with you as you set up your first appointment and on your first appointment. Less than 24 hour notification of a missed appointment will be charged at the full session fee.

IS THERAPY CONFIDENTIAL?
Confidentiality is a critical aspect of therapy. There are some exceptions to your legal rights to have privacy and confidentiality, which I will go over with you in the first session. It is important that you know I consider your privacy and legal right to have confidentiality very important. For that reason, I have never had an inside cleaning service or anyone outside the office have access to my office or my files. My office has a state-of-the-art security alarm system.

I HAVE FRIENDS/FAMILY/MINISTER. WHY DO I NEED TO TALK TO A THERAPIST?

All of our relationships have a place in our life. Your friends have your needs and feelings in mind, if they are caring friends. They often will be reluctant to help you with things that are difficult to discuss or challenge you in areas if they feel it will risk the relationship. Sometimes, they may not want you to change at all and have an interest in your remaining the way you were when they first met you. It is the rarest of friendships in which you can grow and maintain the friendship.

Family members often have the most difficult time seeing us differently than how we were initially defined in the role the family cast us in. The relationship with a therapist is established on your desire to grow and the therapists' willingness and desire to help you to achieve that goal.

ANN PULTZ KRAMER, M.S. | 13800 HEACOCK STREET, SUITE C 212 | MORENO VALLEY, CA 92553 | 951.653.4001

WHAT IS YOUR RELIGION, MARITAL STATUS, ETC.?
Although I do hear these questions from time to time from my clients, I do not answer these questions directly for several reasons. First, many times these questions are being asked with assumptions about the answers that may or may not be accurate. For our purposes, the assumptions you make about the answers, what they mean to you, whether or not they are accurate, and how they effect your relating with others is an important therapeutic issue.

Second, I differentiate myself in my relationship with you as a friend in that, although I will offer my care, my empathy, my support and my willingness to understand (in a way sometimes even a friend or family may not) I am careful to keep your therapy about your needs and not about mine. What that means is that I am not in a "reciprocally sharing relationship" with you, but one in which you and your well-being is the objective and focus of our work. Although you are likely to learn something about me and my thoughts and preferences on issues as we go along, it will not be the direct focus of our relationship.

Sometimes, it can feel a little uncomfortable at first to be in a relationship without the immediate knowledge of what another person thinks about something. Eventually, it can also become a freeing opportunity to examine your own thoughts and feelings without the influence of another person's opinions or beliefs.

WHAT SHOULD I TALK ABOUT IN THERAPY? HOW DO I START A SESSION?
Many times people want to discuss what has happened each week between sessions, and work on problems that have arisen from work, family or relationship situations. Sometimes it is helpful for people to discuss issues from their lives, their childhood, their previous relationships that have been on their mind for reasons they may not understand. Sometimes, people come in not knowing what to discuss. Often, that can be the most interesting time, even though it may initially feel uncomfortable.

I encourage people to take some time in the waiting room to come into awareness of your body and your feelings, and see what comes up for you. I also encourage people to give themselves permission from time to time to come in without a script or an agenda and allow themselves to be present to the moment in the room and feel what they are feeling. That can be very helpful for people in a surprisingly profound way.

IF I SEE YOU IN PUBLIC, WHAT SHOULD I DO?
Because we have discussed so many things that are personal, it may be awkward for you and for me if we meet in public. I will respect your privacy if we do meet. Although I may be happy to see you, I will wait for you to acknowledge me and will not greet you firstI will understand if you do not choose to acknowledge me or introduce me to any others you are with.

DO YOU THINK MEDICATION FOR MY PROBLEM IS A GOOD IDEA?
Medication has been proven to be helpful for a number of problems in a number of situations. Research demonstrates that therapy and medication in combination is more effective than medication without therapy. Much controversy exists around the research of medication which is increasingly conducted by pharmaceutical companies or agents of pharmaceutical companies, and is therefore conducted with an underlying motive toward a particular outcome. That being said, there are times when medication and its' side effects should be weighed against the negative outcome of what would occur if medication was not used. In addition, I do not believe that medication is the only answer to many of the disorders suggested earlier (see individual therapy) and have reservations about resorting to medication unless it is necessary. I do not prescribe medications but I would be happy to refer you to psychiatrists that I have confidence in.

I/WE HAVE BEEN TO OTHER THERAPISTS, IT WAS NOT BENEFICIAL. WHY SHOULD I GO TO YOU?
I have heard that many times from my clients . My response is that therapy is a unique relationship and that therapy is not the same with all therapists. However, I can tell you a few things about how I work that may help you to understand a few differences you may experience in participating in therapy with me. I am active in therapy with clients. I have heard clients occasionally complain about therapists who sit and take notes and look at the clock. I will be an active person in the relationship and ask you to be active in the relationship with your progress. I offer resources to my clients to help them supplement counseling with knowledge, support groups and reading materials. Also, I commit to my clients. I make every effort to show up consistently to our scheduled sessions, be in good health, rested and alert. I continually attempt to grow in my skills and knowledge to better help my clients.

ANN PULTZ KRAMER, M.S. | 13800 HEACOCK STREET, SUITE C 212 | MORENO VALLEY, CA 92553 | 951.653.4001

HOW DO I KNOW WHETHER INDIVIDUAL, COUPLE OR FAMILY THERAPY IS BEST?
This is an excellent question, and often, one type of therapy can be better at a given time for a given problem than at another time or with another problem. For more information on this issue, please go to When is Couple/Marital Therapy Best? and/or When is Individual Therapy Best? And/or When is Family Therapy Best?

CAN I SEE YOU INDIVIDUALLY FOR A WHILE AND THEN BRING IN MY PARTNER FOR COUPLE THERAPY?
It is never a good idea for a therapist to see someone individually and then bring the other partner of their couple or marital relationship in for therapy after they have established a relationship with one individual. For information about this, go to the second paragraph of When Is Couple/Marital Therapy Best?.

IF WE SEE YOU FOR COUPLE THERAPY, CAN YOU SEE ONE/BOTH OF US FOR INDIVIDUAL THERAPY?
It is your relationship that is my focus and my "client" when you come to me for help with your relationship. It is not a good idea for me to work with either of you individually, although I can understand that we may feel comfortable with one another and it would feel easier for you. It can be confusing for you to talk with me if you believe your partner is speaking with me about you, and can erode the trust that is essential for us to have in working together. It also creates a problem regarding the focus of treatment if the therapist is wearing too many hats. I can refer you to other therapists that I feel comfortable with to help you in making a decision about individual therapy for one or both of you.