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Frequently Asked Questions

Q. What is psychotherapy?

Psychotherapy is generally a discussion between a patient/client and a professionally trained and licensed mental health practitioner, such as a psychologist, psychiatrist, social worker and/or marriage and family therapist. The purpose of psychotherapy is to identify specific concerns and problems that a patient has and to develop solutions that would bring satisfactory results. There are many different schools of psychotherapy but, generally, the shared purpose between all of those schools is to help the patient experience less stress and increased control and personal freedom in their life.

Q. How do I know when I should see a therapist?

Often, before entering counseling or therapy, people have tried many different solutions on their own, in order to help them solve a problem. These attempts may include going to a friend, speaking with family, and approaching your priest, minister or rabbi. If these attempts have not seemed to be effective, or if the results obtained are not completely satisfactory to your particular circumstances, this may be a time to seek out professional assistance. One indicator that psychotherapy may be warranted is when you find yourself in a repetitive pattern of behavior that seems to be bringing the same results over and over again, and these results do not make you happy.

Q. How do I know what kind of therapist to see?

There are several different kinds of mental health professionals. Confusion among the various mental health professionals is an often common experience. A brief overview follows:

Psychologists are doctoral level mental health professionals that have attended a 4-year doctoral training program in psychology, in addition to a 1-year pre-doctoral internship, and often a 1 to 2 year post-doctoral residency training program specializing in psychological and psychiatric problems.

Psychiatrists are mental health professionals that have originally attended medical school and then followed their medical training with a 3-year residency program specializing in psychiatry. They are currently the primary providers that are licensed to prescribe medications in order to augment the treatment of psychiatric disorders.

Social workers are most often masters level clinicians who have attended a 2-year masters level graduate program, followed by a 1-year supervised internship.

Marriage and family therapists are most often masters level therapists who have attended a 2-year masters level program that focuses on family therapy.

Licensed professional counselors and licensed drug and alcohol counselors are 2 additional therapists you may see who typically are trained with masters degrees.

There are also nurses who specialize in psychotherapy and, in some cases, can provide medications under supervision. These are usually advanced practice/nurse practitioner masters level nurses.
In actuality, the above explanation is overly simplified. Any therapists are broadly trained and often have specialized expertise in particular areas. It is generally important, when you seek out a therapist, to find out what that particular therapist’s areas of expertise are, in addition to attending 1 or 2 sessions to evaluate for yourself how comfortable you are with that particular therapist’s approach to treatment.

Q. What can I do to help my marriage?

Marital therapy is a very complex form treatment, since it includes the individual psychological makeup of each of the spouses, in addition to the way each of the spouses relates to the other. There appears to be some important elements that significantly contribute to marital satisfaction. Perhaps most important is the way a couple communicates, problem solves, and spends pleasurable time with each other. These 3 factors are pretty much common sense. However, despite that, often when couples come in for treatment, it is observed how these 3 elements are lacking in their marriage. Therefore, marital therapists will often focus on cultivating these 3 characteristics, in order to help a couple enhance their satisfaction and reduce their level of stress. Again, it is very important to recognize that a happy marriage, in large part, is determined by the amount of time each partner puts into caring for their marriage. This sounds overly simplistic but, in reality, it is a very big challenge, as anyone who has been married for a long period of time knows. Therefore, we suggest and recommend that, to improve your marriage, you spend time engaging in pleasurable activities that are couple-enhancing, spend time talking and develop good strategies to problem solve. Going to see a psychologist, or other therapist with training in marriage and family therapy, can help get this process started.

Q. What results that can be expected from psychotherapy?

This is a difficult questions to answer, since the results are often directly dependent upon what a patient’s goals are. Results could be very specific, such as overcoming a specific fear of public speaking. Or they can be much broader, such as increasing one’s self-esteem or improving your marriage. It is especially important that you and your therapist sit down together at the onset of treatment to discuss what it is you would like to receive from therapy and what the therapist’s ideas are, as to how they can help you. Each person’s goals for treatment are unique, as each individual is unique and, therefore, successful treatment will be specific to each individual. One common thing that you should expect, however, is confidentiality between the therapist and yourself. With few exceptions, the information you discuss with your therapist is confidential, unless you sign a written release authorizing them to share information with anyone else. You should expect that the therapist will be attentive and helpful in assisting you to resolve your concerns. You should also expect that you will be satisfied with your interactions with your therapist and feel like you are moving closer to reaching the goals that you have outlined at the onset.

Q. What are the costs of psychotherapy?

The cost of therapy varies widely, based on the therapist’s credentials, their experience, and their geographic location. Often, health insurance will cover a portion of the cost. Again, every state has different legislation governing insurance benefits, and it is very important for you to understand how your particular insurance policy works regarding mental health and substance abuse coverage. It will probably be an important issue in your initial phone conversation with your therapist to discuss the role of your particular insurance coverage in treatment. Many people carry insurance that is managed by a managed care company. This often will mean that a therapist will have to submit a written or telephonic treatment plan to a managed care reviewer, who will then review the treatment plan and make a decision as to whether or not therapy services will be authorized and, therefore, paid for. Again, it is important that you understand how this works and that you speak to your therapist about this at the beginning of treatment.

Q. Does my family have to know about my therapy and do they need to need to know?

This is an important question that often will be decided upon between the therapist and yourself. Many therapists prefer to work within a family therapy model and will often want to see significant family members that may be related to your particular concerns. Not all therapists share this same philosophy and many others will only be interested in talking with you about your views on your problems. It is important for you to realize that, unless you and your therapist agree to bring family members in (or you make such a request at the beginning of treatment), it would be inappropriate and a breach of confidentiality for your therapist to single-handedly decide to contact family members in order to have them become a part of your treatment. Again, this is an area which you and your therapist will want to discuss, so that you can conjointly decide whether or not it would be to your advantage to have family members involved in your therapy. This decision is best made within the context of your particular goals and the issues that you wish to address.

Q. What do I do if my child is having problems?

There are at least 2 schools of thought within the therapeutic community. One school of thought places heavy emphasis on treating the child within the context of the family and their school environment. Often these therapists are actively involved in resolving problems by helping family members to understand their children’s particular behavior problems and developing strategies to solve these problems. The other school of thought focuses on seeing the child as an individual, and the therapist will often have little contact with parents or other family members, preferring to treat the child alone. Most probably, there are a wide variety of therapists who prefer some sort of mixture of these two schools. If you have concerns about your child and whether their behavior is problematic, often consulting with your pediatrician first is a useful first step. Most pediatricians are very well informed about normal developmental processes in children and can help guide you in the right direction. Certainly contacting a psychologist or other licensed mental health professional who specializes in child behavior problems would also be an acceptable alternative. Again, treatment with children usually starts out with an initial assessment and discussion of a treatment plan with the child’s parents or legal guardians and then moves into the treatment process.

Q. How do I know whether I should be on medication?

A decision to take medication or not is a complex decision, which often is dependent on multiple factors. There are several diagnoses that have been demonstrated to be especially responsive to psychopharmacological intervention. Depending on the severity of one’s symptoms, the level of interference of these symptoms in a person’s day-to-day functioning, and the subjective level of distress that a particular person feels, a decision to use medications as an adjunct to psychotherapy is often indicated. At this time, psychiatrists and licensed nurse practitioners are the 2 groups that currently prescribe psychiatric medications. Therefore, if you are in treatment with 1 of these 2 professionals, certainly a discussion of the benefits of psychopharmacological intervention would be appropriate. Additionally, if you are seeing another mental health professional, such as a psychologist, social worker and/or marriage and family therapist, discussion of a medication consultation can also be very useful and indicated. Often, if the patient is not responding to the verbal forms of psychotherapy, it is useful to consider a second opinion from a prescribing mental health practitioner to determine whether or not medication may be of assistance. Typically, your therapist will work with someone who can assist you in obtaining medications if you need them.

Q. What do I do if I am unhappy about my therapy or have questions about it?

Therapy is about communicating. Therefore, if you have concerns or questions about your therapy, it is very important that you discuss this directly and openly with your therapist. Remember, you are employing your therapist and, therefore, your therapist is responsible and accountable to you to answer your questions. If, after discussing your concerns with your therapist, you are not satisfied with the process or procedures, it is always appropriate to ask your therapist for the name of another clinician from whom you can obtain a second opinion. Most therapists will not be hurt or insulted by this process, but rather would be encouraging of your health and growth and for you to be self-determined in your decision-making processes about what is right for you.

 

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