Get answers to your questions about what therapy is, how it works, and how to choose a therapist.

What is psychotherapy?
The American Heritage Dictionary of the English Language defines psychotherapy as “the treatment of mental and emotional disorders through the use of psychological techniques designed to encourage communication of conflicts and insight into problems, with the goal being relief of symptoms, changes in behavior leading to improved social and vocational functioning, and personality growth.

What are some of the benefits of psychotherapy?
Psychotherapy can reduce your level of stress, alleviate your symptoms of depression and help you to develop better coping skills. As you work toward overcoming fears of intimacy, you will be able to choose healthier relationships and/or improve your marriage. As the therapy progresses, you will begin to find fulfillment in your work or career and increase your self- confidence.

By resolving old traumas you will better understand yourself, become more relaxed and at peace and will develop a more hopeful outlook.

Basically, anyone who needs help making a difficult decision, who wants to change some aspect of him/herself or who is seeking insight or peace regarding some past incident, can benefit from psychotherapy.

What is the difference between psychotherapy and counseling?
Psychotherapy is frequently viewed as deeper work, as opposed to counseling, which is often provided to address specific issues such as bereavement or marital discord. Mental health counselors can and do provide psychotherapy, however, and psychotherapists can and do assist with career decisions.

There are many kinds of psychotherapy. How do you know which to choose?
There are a variety of psychotherapeutic disciplines. Behavioral treatment, cognitive treatment, counseling, hypnotherapy, psychotherapy, psychoanalysis, psychiatry and social work are some of the more familiar ones. They are similar in that they provide a therapeutic environment that facilitates development and change in the person seeking treatment.

You can find a great deal of useful information on the Web but, the best way to decide what kind of treatment would be helpful for you is to have an assessment by an experienced psychotherapist who can help you decide which approach can best meet your needs.

How is therapy different than talking to a good friend?
Therapists are trained to listen and focus in ways which are different from how a friend will hear you. A therapist's function is to simply to understand what the client is stating in comparison to a friend who's motivations are often more complex and personal. The therapeutic relationship has boundaries which have allow a deeper exploration of meanings and feelings to take place. Knowing a session will end and begin at certain times, that all material is held strictly confidential, and that the therapist's interests are only are only in the therapeutic process allow for a unique setting.

How much does it cost?
If you do not have insurance which covers psychotherapy, I will negotiate a sliding scale fee. I will do this individually depending on financial circumstances. In general, I arrive at a fee based on income, number of dependents, and any special circumstances.

Can I use my insurance?
It depends. In general, I are able to work with most fee for service plans and PPOs and those HMOs which allow out of Network providers. I may be willing to apply to become panel providers of your HMO. Depending on your insurance program, you may be asked to pay upfront and then seek reimbursement from your insurance company.

Can I pay by credit card?
Yes. I accept most major credit cards. A 3% fee is charged for creditcard payments.

Can a psychiatrist also be a psychotherapist?
Psychiatry is a medical discipline with emphasis on the diagnosis and treatment of severe mental disorders.

For analytic work, to address long-standing issues, a psychotherapist is the best choice. Someone who has had psychoanalytical training, is preferable.

If a psychotic disorder (i.e., schizophrenia) is suspected by the therapist, however, then diagnosis by a psychiatrist who specializes in this field should take place first, before a treatment plan is developed. A condition requiring medication, such as bipolar disorder, may also require the services of a psychiatrist.

I want to address a particular issue. Should I see a specialist?
You may feel more comfortable when you begin if you choose a therapist who has experience with your issue. But, you need someone who is experienced enough to work with whatever issues arise. Therapists often develop a specialty after they have worked successfully in treating patients with similar issues such as eating disorders or depression.

Should a gay person consult a gay therapist?
Treatment with a gay or lesbian role model can be helpful for those who feel this is important to them. But gay and lesbian clients can also benefit from working with a gay/lesbian affirmative therapist who can help them address issues of trust and acceptance of their sexual orientation by the straight majority.

Are you taking too much of a chance when you pick a therapist from the Web?
While it can help to have a recommendation from a friend or coworker, it is not always possible to get one and many people prefer to keep their treatment confidential. Choosing a therapist from the Web is certainly a valid option. You should be able to feel, after one or two sessions, whether the therapist is right for you. Make sure to ask about training, experience and credentials.

What about hypnosis?
Freud stopped using hypnosis after he noticed relief from symptoms was short-lived. He realized hypnosis by-passed the resistance to recalling the trauma which resulted in the formation of symptoms. Hypnosis, or the induction of trance-like states, is still being used, however, in relaxation and guided imagery exercises, for example, in help with quitting smoking and for relief for those with serious pain or medical problems.

What is False Memory Syndrome?
False memory syndrome is a much-debated, emotional issue with each side having its advocates and opponents. This is especially true in cases of suspected child abuse. Hypnosis may be able to help patients gain access to unconscious material but no one can say whether this material is objective truth, only that it is what the patient believes. In this sense, the memory is not a fabrication. At the very least, it is more material with which to work in treatment, more grist for the mill.

While it is unlikely people who have been traumatized in childhood fabricate such memories, the actual traumatic events are often distorted by the mind. The use of hypnosis to recover repressed memories of abuse will not necessarily help the patient gain access to the associated emotional states sufficiently to resolve the trauma.

What can I expect from psychotherapy?
Whatever your reasons for seeking psychotherapy, whether to address a specific issue, for treatment for a chronic condition such as depression, to get assistance in changing the way you relate to others, or to find help in negotiating a life transition, you can expect to feel somewhat anxious at first. As you become accustomed to meeting with your therapist, you should become more comfortable.

The first few sessions of treatment are generally devoted to addressing your presenting problems. Many therapists like to hear some details about your family history during this phase and may take notes during these sessions. If you seek treatment at a clinic you may be asked to complete a questionnaire, have an intake interview and/or a psychiatric evaluation before being assigned to a therapist. During this beginning phase you will probably discuss you current circumstances and functioning and any symptoms related to your presenting problem, such as changes in appetite or insomnia.

Does short term treatment work or must I seek long term therapy?
Short term treatment (the number varies but is somewhere in the area of 12 to 20 sessions) is often sought by people who want to address a specific problem or clarify an issue they thought they had already resolved. Many people are able to accomplish what they want in only a few sessions. For others, however, the issue(s) may be so deeply ingrained that short term work simply would not be sufficient, for example those suffering from chronic anxiety or depression. For still others, the initial problem may be clarified in a few sessions but they decide to spend additional time to resolve other issues that emerged in the course of the short term treatment.

I can't manage my life. Will the therapist give me advice?
While counseling can sometimes involve advice and suggestions, psychotherapists generally avoid offering them. A greater sense of mastery occurs when the therapist helps the patient to make his own decisions.

Can depression be treated without medication?
Depending on the severity of symptoms, medication is not mandatory. It may reduce suffering, however, and can speed the progress of treatment. Severe manic or vegetative symptoms can prevent someone from doing psychotherapy without medication and in cases of bipolar disorder it is usually recommended.

Depressive symptoms can develop as side effects of some medications and from certain illnesses. It is a good idea to speak with your physician as well as your therapist if you have medical issues.

What is the DSM-IV?
The Diagnostic and Statistical Manual of Mental Disorders, a publication created by the American Psychiatric Association, “is the standard classification of mental disorders used by mental health professionals in the United States.”