Frequently Asked Questions About Therapy

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therapy faqsCAN 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 ). People who benefit the most are frequently putting the most into their therapy, as well.   The process is a combined and mutual effort on the part of the you and your therapist.

HOW OFTEN DO I NEED TO COME IN FOR 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. There are studies on couple work that indicate couples make the most changes in the first 4-6 weeks of the counseling process.  Later, when an individual or a couple feels improvement, moving to less frequent sessions can be a consideration.

HOW LONG IS A SESSION? Sessions are 45 minutes in length fo individuals and 75 minutes for couples.  First sessions for individuals can be 75 minutes, as well.

HOW LONG DOES IT 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 get help 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 satisfied with your progress, it is a good idea to talk with your therapist about your financial situation and see if arrangements can be made so you can continue.

However, the short answer to this question is that “it depends”. Sometimes a short term problem can be resolved rather quickly. Other times, people come in for deeper or more chronic issues, and they can take months or longer. Sometimes therapy lasts a shorter time or longer time than people expected. The decision to stop is best discussed with your therapist, and ideally both of you come to an agreement. It is ultimately your decision. (See “How do you know when therapy is finished below)

HOW DO YOU KNOW WHEN THERAPY IS FINISHED? Probably the best determinants are how you are feeling in your daily life about yourself and your relationships, and whether you have met the goals for which you first sought help. However, it’s also true that sometimes we can have immediate changes more related to the lifting of hopelessness rather than internal changes that will sustain for very long.  I believe it is your decision about whether you are ready to stop therapy. I will tell you 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 sessions are 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? Short answer is YES! 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 extremely 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.

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 treatment 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 and fruitful time in therapy as we learn to trust ourselves in where we are in the present moment.

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.

HOW SHOULD I HANDLE IT IF I HAVE A PROBLEM IN THERAPY OR NEED SOMETHING ELSE? In reality, because therapy is a relationship, it is a good idea to do something different than you might do in other relationships and talk to your therapist about your problem. Hopefully, you feel safe enough to talk with her/him, and talking out what you are feeling, and what you may be needing that you aren’t getting is a step in a healthier direction to begin to work out relationships in a more productive way. Therapy can be a good practice place for healthier relationships in that way. Also, I like to remind people, therapists do not all work the same way and cannot know what everyone is needing. Sometimes, people tell me they are wanting goals and solutions, and sometimes people tell me they want to discuss something about their history or their family relationships. A therapist does not necessarily know these things if you don’t tell them. However, if you do communicate your needs and they are not responded to, perhaps you do not have a good therapeutic match for you.

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 first. I will understand it 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 anumber of situations. Research demonstrates that therapy and medication in combination is moreeffective 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.

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 COUPLES WORK, 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.

HOW LONG HAVE YOU BEEN DOING MARRIAGE COUNSELING? DO COUPLES YOU TREAT GET BETTER? This is an excellent question. I think what clients may really want to know is how good a marriage therapist are you? To be effective, a marriage therapist must be different in approach than an individual therapist. See When is Marital/Couple Therapy Best.  However, I work with my team members, and if you don’t show up for practice, or do your preparatory homework, we cannot get our show off the road. In that way, I am as good as my players. If you are motivated and want to fight for your relationship, I am very effective. I have helped couples who have been hopeless to feel hopeful and loving again. If you have told yourself there is no hope and are not going to be helped, then your wish will come true. I am ready and willing to collaborate with you to succeed at finding a way to make your marriage work, if that is what you want.  By the way, I have been a therapist for 25 years.