Working with a Therapist

I often receive phone calls from individuals who are either interested in starting therapy or have been told they should. First time callers usually ask “How does this work? How do I start?”
Let me start from the beginning to explain.

Obviously the first step is to contact a few therapists by phone or email. If a therapist does not respond to you in a timely manner, cross them off your list. If they are slow to respond now, you cannot be sure they will be responsive in a time of crisis or emergency (everyone I work with has my cell phone number for that very reason-you need to be able to reach your therapist in times of trouble).

Studies show that the most important element of positive therapeutic outcome is the therapeutic alliance or how comfortable you feel with your therapist. Believe it or not, it matters more than the therapist’s specific theoretical orientation (i.e., cognitive behavioral). If you do not feel comfortable with the therapist during your first phone contact or in the first session do not feel you are a good fit, find another therapist. Psychotherapy is too important to waste time and money with a therapist you are not comfortable with.

The initial consultation is one hour (60 minutes). Sessions after that can be 45 or 60 minutes and that is up to you. Sessions may be scheduled weekly, biweekly, monthly, or as needed. I will make a recommendation but it is purely the patient’s decision.

I am often asked to estimate how long treatment will take. While that is difficult to say, I will say that for some issues like eating disorders, treatment is going to take a lot of time and work. An anxiety disorder will take fewer sessions. Behavioral problems with children might only take a few sessions. Infidelity-no quick fix, but we aren’t looking at years of therapy. It all depends upon the severity of the problem and how committed you are to working on it. I give 100 percent and will do all I can to assist you. I do not ever try to keep people in therapy when they do not need to be there or do not want to be there.

I utilize what I call the Dentist Model of treatment. Initially, you come to me with a presenting problem. I learn about you, your relevant history, and your world. During the course of therapy, we resolve the issues that brought you to treatment and therapy concludes. Thereafter, you make an appointment when there is a problem, just as you would would with the dentist when you have a toothache or cavity. This works quite well because even if I do not see you for a few years, I do remember you, your history, and our work together. You will not have to start from the beginning. We can jump right in and work on your presenting problem without having to go over your history.

Life is messy-if it took time for the presenting problem to develop, it may take some time to resolve it. Having patience with the process is very important, and understanding that progress with long standing issues can be a slow climb to the top that is sometimes riddled with ups and downs. My role as psychotherapist is to keep you on the right track heading in a positive direction while getting you off the volatile emotional roller coaster. I view it as a collaborative effort.

Some therapists are less talkative than others. I will adjust myself to whatever your needs are, However, especially in the first session, I will not just sit there and wait for you or your child to talk. If you don’t talk, I will. This is not a chess match and I take very seriously the importance of helping you resolve whatever has brought you to therapy.

Scheduling therapy sessions is flexible and open ended. I understand that finances, work, and other things play a part in how often you may come to therapy. There is no pressure from me on how frequent you have appointments. I will make my recommendation and work with what ever you choose.

I will work with you to develop a therapeutic work box of tools to help you cope and to ensure a more rapid and lasting recovery from your presenting problem.
Immediate relief in the first session is not always possible but I will do my utmost to ensure you leave the first session with some relief as well as a plan for long term success.