Is therapy right for me?

Seeking out therapy is an individual choice. There are many reasons why people come to therapy. Sometimes it is to deal with long-standing psychological issues, or problems with anxiety or depression. Other times it is in response to unexpected changes in one's life such as a divorce or work transition. Many seek the advice of counsel as they pursue their own personal exploration and growth. Working with a therapist can help provide insight, support, and new strategies for all types of life challenges. Therapy can help address many types of issues including depression, anxiety, conflict, grief, stress management, body-image issues, and general life transitions. Therapy is right for anyone who is interested in getting the most out of their life by taking responsibility, creating greater self-awareness, and working towards change in their lives.

Do I really need therapy?  I can usually handle my problems.

Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you're at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.

How can therapy help me?

A number of benefits are available from participating in psychotherapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that counselors can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:

• Attaining a better understanding of yourself, your goals and values
• Developing skills for improving your relationships
• Finding resolution to the issues or concerns that led you to seek therapy
• Learning new ways to cope with stress and anxiety
• Managing anger, grief, depression, and other emotional pressures
• Improving communications and listening skills
• Changing old behavior patterns and developing new ones
• Discovering new ways to solve problems in your family or marriage
• Improving your self-esteem and boosting self-confidence

What is therapy like? 

Every therapy session is unique and caters to each individual and their specific goals. It is standard for therapists to discuss the primary issues and concerns in your life during therapy sessions. It is common to schedule a series of weekly sessions, where each session lasts around fifty minutes. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues or ongoing personal growth. There may be times when you are asked to take certain actions outside of the therapy sessions, such as reading a relevant book or keeping records to track certain behaviors. It is important to process what has been discussed and integrate it into your life between sessions. For therapy to be most effective you must be an active participant, both during and between the sessions. People seeking psychotherapy are willing to take responsibility for their actions, work towards self-change and create greater awareness in their lives. Here are some things you can expect out of therapy:

• Compassion, respect and understanding
• Perspectives to illuminate persistent patterns and negative feelings
• Real strategies for enacting positive change
• Effective and proven techniques along with practical guidance
  

Is medication a substitute for therapy?

In some cases a combination of medication and therapy is the right course of action. Working with your medical doctor you can determine what's best for you. It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness.

Do you accept insurance? How does insurance work?

To determine if you have mental health coverage, the first thing you should do is check with your insurance carrier. Check your coverage carefully and find the answers to the following questions:

• What are my mental health benefits?
• What is the coverage amount per therapy session?
• How many therapy sessions does my plan cover?
• How much does my insurance pay for an out-of-network provider?
• Is approval required from my primary care physician?

Is therapy confidential?

In general, the law protects the confidentiality of all communications between a client and psychotherapist. No information is disclosed without prior written permission from the client.

However, there are some exceptions required by law to this rule. Exceptions include:

• Suspected child abuse or dependant adult or elder abuse. The therapist is required to report this to the appropriate authorities immediately.
• If a client is threatening serious bodily harm to another person. The therapist is required to notify the police.
• If a client intends to harm himself or herself. The therapist will make every effort to work with the individual to ensure their safety. However, if an individual does not cooperate, additional measures may need to be taken.

Psychological Services:

Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychologist and patient, and the particular problems you bring forward. There are many different methods we may use to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home.

Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On the other hand, psychotherapy has also been shown to have benefits for people who go through it. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress. But there are no guarantees of what you will experience.

Our first few sessions will involve an evaluation of your needs. By the end of the evaluation, we will be able to offer you some first impressions of what our work will include and a treatment plan to follow, if you decide to continue with therapy. You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Therapy involves a large commitment of time, money, and energy, so you should be very careful about the therapist you select. If you have questions about our procedures, we should discuss them whenever they arise. If your doubts persist, we will be happy to help you set up a meeting with another mental health professional for a second opinion.

Meetings:

We normally conduct an evaluation that will last from 2 to 4 sessions. During this time, you can decide if your therapist is the best person to provide the services you need in order to meet your treatment goals. If psychotherapy is begun, we will usually schedule one 45-minute session (one appointment hour of 45 minutes duration) per week at a time we agree on, although some sessions may be longer or more frequent if there is a need. Once an appointment hour is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation unless we both agree that you were unable to attend due to circumstances beyond your control such as illness, inclement weather, etc. If it is possible, we will try to find another time to reschedule the appointment.

Professional Fees:

Our fee per session hour (45 Minutes) is based upon what is reasonable and customary for northern NJ. In addition to weekly appointments, we charge this amount for other professional services you may need, though we will break down the hourly cost if we work for periods of less than one hour. Other services include psychological assessment/testing, report writing, telephone conversations lasting longer than 15 minutes, preparation of records or treatment summaries, and the time spent performing any other service you may request of me. If you become involved in legal proceedings that require our participation, you will be expected to pay for our professional time even if we are called to testify by another party. [Because of the difficulty of legal involvement, we charge $200.00 per hour for preparation and attendance at any legal proceeding.

Billing and Payments:

You will be expected to pay for each session at the time it is held, unless we agree otherwise or unless you have insurance coverage which requires another arrangement. In cases where we submit bills for you and the check is mailed to your home, you will be expected to pay me our agreed upon fee immediately upon receipt of the insurance reimbursement. Payment schedules for other professional services will be agreed to when they are requested. In circumstances of unusual financial hardship, we may be willing to negotiate a fee adjustment or payment installment plan.

Insurance Reimbursement:

In order for us to set realistic treatment goals and priorities, it is important to evaluate what resources you have available to pay for your treatment. If you have a health insurance policy, it will usually provide some coverage for mental health treatment. We will fill out forms and provide you with whatever assistance we can in helping you receive the benefits to which you are entitled; however, you (not your insurance company) are responsible for full payment of our fees. It is very important that you find out exactly what mental health services your insurance policy covers.

You should carefully read the section in your insurance coverage booklet that describes mental health services. If you have questions about the coverage, call your plan administrator. Of course we will provide you with whatever information we can based on our experience and will be happy to help you in understanding the information you receive from your insurance company. If it is necessary to clear confusion, we will be willing to call the company on your behalf.

Due to the rising costs of health care, insurance benefits have increasingly become more complex. It is sometimes difficult to determine exactly how much mental health coverage is available. "Managed Health Care" plans such as HMOs and PPOs often require, authorization before they provide reimbursement for mental health services. These plans are often limited to short-term treatment approaches designed to work out specific problems that interfere with a person's usual level of functioning. It may be necessary to seek approval for more therapy after a certain number of sessions. While a lot can be accomplished in short-term therapy, some patients feel that they need more services after insurance benefits end.

You should also be aware that most insurance companies require you to authorize us to provide them with a clinical diagnosis. This information will become part of the insurance company files and will probably be stored in a computer. Though all insurance companies claim to keep such information confidential, we have no control over what they do with it once it is in their hands. In some cases, they may share the information with a national medical information databank.

Once we have all of the information about your insurance coverage, we will discuss what we can expect to accomplish with the benefits that are available and what will happen if they run out before you feel ready to end our sessions. It is important to remember that you always have the right to pay for our services yourself to avoid the problems described above.

Contacting Us:

While someone is in the office most week days and Saturdays, we are often not immediately available by telephone. We will not answer the phone when we are with a patient. When we are unavailable, our telephone is answered by voice mail, that we monitor at least 2 times per day. We will make every effort to return your call on the same day you make it, with the exception of weekends and holidays. If you are difficult to reach, please inform us of some times when you will be available. If you are unable to reach us and feel that you can't wait for your therapist to return your call, contact your family physician or the nearest emergency room and ask for the psychologist, social worker or psychiatrist on call. If your therapist will be unavailable for an extended time, we will provide you with the name of a colleague to contact, if necessary.

Professional Records:

The laws and standards of our profession require that we keep treatment records. You are entitled to receive a copy of your records, or we will prepare a summary for you instead or with your approval send them to another mental health professional. Because these are professional records, they can be misinterpreted or upsetting to untrained readers. If you wish to see your records, we recommend that you review them in our presence so that we can discuss the contents. Patients will be charged an appropriate fee for any professional time spent in responding to information requests.

Minors:

If you are under eighteen years of age, please be aware that the law may provide your parents the right to examine your treatment records. It is our policy to request an agreement from parents that they agree to give up access to your records. If they agree, we will provide them only with general information about our work together, unless we feel there is a high risk that you will seriously harm yourself or someone else. In this case, we will notify them of our concern. We will also provide them with a verbal summary of your treatment when it is complete. Before giving them any information, we will discuss the matter with you, if possible, and do our best to handle any objections you may have with what your therapist is prepared to discuss.

Confidentiality:

In general, the privacy of all communications between a patient and a psychologist is protected by law, and we can only release information about our work to others with your written permission. But there are a few exceptions.

In most legal proceedings, you have the right to prevent a psychologist from providing any information about your treatment. In some proceedings involving child custody and those in which your emotional condition is an important issue, a judge may order our testimony if he/she determines that the issues demand it.

There are some situations in which we are legally obligated to take action to protect others from harm, even if we have to reveal some information about a patient's treatment. For example, if we believe that a child is being abused, we must file a report with the Division of Youth and Family services (DYFS).

If we believe that a patient is threatening serious bodily harm to another, we are required to take protective actions. These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the patient. If the patient threatens to harm himself/herself, we are obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection.

These situations have rarely occurred in our practice. If a similar situation occurs, we will make every effort to fully discuss it with you before taking any action.

While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have at our next meeting.