- What is the difference between a psychiatrist and a psychologist?
Psychiatrists and psychologists are both doctors. A psychiatrist has gone to medical school and has either an M.D. (Doctor of Medicine) or a D.O. (Doctor of Osteopathic Medicine) degree. A psychologist has gone to graduate school and has either a Psy.D. (Doctor of Psychology), a Ph.D. (Doctor of Philosophy) or an Ed.D. (Doctor of Education) degree.
A psychiatrist treats patients with medication, while a psychologist treats patients via talk therapy. Rarely, you will find a psychiatrist who has a practice built around both medication management and therapy. Psychologists and social work professionals may also be called counselors or therapists.
- Who should get therapy?
Everyone! I’m only a little biased. ; ) In all seriousness…God is the only perfect being, so that leaves room for improvement in the rest of us! We all have issues, baggage, luggage, cargo, freight, a U-Haul…whatever you choose to call it. I believe that when we stop growing and changing, we die–spiritually, emotionally, psychologically, intellectually. So, it behooves us to keep at it until God calls us home. Specifically, therapy can help with things such as mood or anxiety disorders, personality disorders, relationship issues, self-esteem issues and trauma, among other things.
- If I have family friends to talk to, do I need therapy?
Friends and family can be great sources of support and advice, and social support is one of the best mediators of stress and other psychological issues that we know of currently. But these individuals can be biased in our favor (in fact, we like for them to be!) and, therefore, less able to help us see different perspectives, different solutions and so forth. They may not want or be able to tell us how we are contributing to a particular problem or issue or how our baggage or history is getting in our way. Therapy, also known as counseling, is a way to get guidance from someone who is more objective, someone who can help us see additional viewpoints. Therapists are skilled in problem-solving, so they can help you in ways non-professionals cannot.
- How does therapy work?
In my approach to therapy, the first few sessions are exploratory, information-gathering, history-taking sessions. I often refer to this phase as an interrogation because I ask a great many questions during this phase. As a patient in this process, you are evaluating me just as much as I’m evaluating you. There must be a good doctor-patient fit in order for you to succeed in your treatment. The relationship is what heals.
As we are working in this phase, we are forming up treatment goals, exploring the things you want to work on and in what order you wish to work on them. Most people are driven to therapy for a relatively specific reason, so this is a great place to start. But we are working together here, so don’t feel like you have to know exactly what you want to work on when you come to your first appointment. Some people come to therapy with a general feeling of depression, anxiety or being out of control but aren’t sure exactly why or what to do about it. With history-gathering and a look at current issues, we can discern the origins of the feelings and thoughts and work together to tackle them.
Beyond this, therapy can become much less directive if you like. I will maintain a list of things that I think may be important to address, but we will often see what each session holds rather than strictly sticking to my agenda. I will be honest with you about what issues I think need to be addressed and if you are avoiding anything, but sometimes life throws us curve balls and we need to address those issues in the week’s session first. Otherwise, I can’t expect to have your attention.
Success in therapy is built upon determination, a good therapeutic relationship, awareness, motivation and change. Success comes in many forms. For some issues, it takes talking things through, maybe obtaining a third-party perspective. For others, it comes down to working on forgiveness. For many, it’s about improving self-esteem, being assertive and setting boundaries in your life. The list goes on, but two main goals of therapy, in my opinion, are (1) changing your perception and (2) learning to do things differently in your life.
- With what age groups or populations do you work?
I only work with adults. Having been in the military, there’s a special place in my heart for military service members, veterans and their families.
- What conditions do you treat?
I treat an array of conditions. I particularly enjoy working with couples and personality disorders. If you have questions about my experience with or willingness to treat a specific condition or disorder, feel free to call my office. You will be asked for some basic information, and I will review your case and make a decision regarding treatment. A follow-up call will then be made to schedule your intake appointment or give you referral information if I think another provider may be better able to serve you.
- What makes for a good therapeutic relationship?
There are many opinions on this, but I believe your therapist should be firm yet compassionate, not unlike a parent. There should be a mutual respect and understanding between the two of you. Your therapist should validate you yet hold you accountable. She should encourage you while being honest and direct. Your therapist should be intelligent, reliable, trustworthy and real.
- What is your approach to therapy?
I am a big fan of psychodynamic therapy, what I consider a less intense form of Freud’s psychoanalytic therapy or psychoanalysis. I choose this approach because I like to begin at the beginning. I strongly believe in patterns, so I go back to childhood and start looking for these early on in my work with any patient.
Next, I use psychodynamic theory to conceptualize your case and explain this to you in workable terms, with as little jargon as possible. Case conceptualization is an ongoing and dynamic process, but I generally start with a description of your case in terms of how you came to be the way you are–the good, the bad and the ugly that we all have.
Then, we get to work understanding, dissecting, exploring and changing. At this stage of our work together, I often use principles of cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). Both CBT and DBT are skills-based approaches that lend themselves to homework very well. CBT is about changing thoughts to change feelings and behavior, and DBT is helpful for learning to regulate emotions in distressing situations, as well as being more effective in social and interpersonal interactions.
In an effort to avoid wasting your time and money, my overall approach is pretty direct, and I like to call things out as soon as I see them. Besides, life’s too short to spend all of it in therapy! Metaphors and analogies often make things clearer to me, so I frequently use these with patients as well. I like using role-play in my work with patients, as this helps them prepare for what they will be doing as homework, including various possible contingencies if things don’t go according to plan. I am a big fan of homework, too, as I believe the bulk of your progress occurs outside the four walls of my office. We work diligently in our appointments, but I need you to be working the rest of your week as well.
- How long are your appointments?
Sessions are just under 60 minutes long. I use the last few minutes of the hour after you’ve left to document the session. Extended sessions, generally not covered by insurance, are 75-80 minutes.
If you are late for your appointment, of course, you will not be given your full session time, as doing so makes me late for the next patient. There may be times when I run late due to urgent or emergent matters that require my attention. At those times, I will do my best to give you the full length of your session, but the nature of the work I do doesn’t always permit that. If you ever have any questions or concerns about the time we spend together, please do not hesitate to ask.
- What can I expect at my first appointment?
Your first appointment will be an opportunity for us to get to know each other, to see if we can work together therapeutically. I will review your reason(s) for presenting to therapy and ask you various questions about all aspects of your life to create a better understanding of who you are, top to bottom and past to present.
Along those lines, my approach involves a look into your past, your family of origin and upbringing, as I believe that everything that has happened up until the point at which we sit in front of each other has affected who you are. This is not to say that we dwell on the past–that is a waste of time. We do, however, need to understand from whence we come in order to (1) not feel completely insane in some of our behaviors and (2) to fully commit to making changes we understand.
- How often should I schedule an appointment?
When we are first getting started, I most often recommend weekly appointments. This works for most people because it’s a long enough time to work on homework assignments but not too long that they feel disconnected, lose momentum or motivation or forget what we were doing. Some people start out with less frequent appointments, and we can still accomplish a lot if we meet every other week instead of every week. Some patients come in multiple times a week, as they are highly motivated, often due to a high level of distress, are not overwhelmed by the intensity of such frequent treatment and are adept at accomplishing homework assignments relatively quickly.
As you make progress and feel comfortable, we will start stretching sessions out to once every two to three weeks, then once a month and so on. If I don’t hear from you for about a month and we haven’t previously discussed a longer gap, I will close your chart. You are welcome to return for therapy at any time; chart closure simply means that a patient is no longer actively seeing me for treatment.
- What are your cash rates?
An in-person intake evaluation is $200. A follow-up session is $175. An extended follow-up session is $250.
- What insurances do you accept?
As of 1 Jun 24, I will no longer accept any insurance. For now, I accept a number of insurances, but my relationship with various insurance companies is ever-changing. A few of the insurances I accept include BCBS, Aetna, Cigna, Tricare and Medicare. You can always call the office for more information about insurance. Also, be aware that your insurance plan may have a carve out for mental health that is managed by another company. It is that other company with whom I have to be credentialed, not the main company named on your insurance card. If I am not in-network with your insurance company, you may wish to check with them to inquire about out-of-network benefits that can help offset the cost of your treatment.
- What forms of payment do you accept?
I prefer cash due to the costs associated with other forms of payment but will also accept Visa and MasterCard credit and debit cards. You can obtain a receipt to document whatever form of payment you choose.
- What if my insurance doesn’t cover multiple sessions per week but I want them?
Some insurance companies will cover multiple sessions per week based on medical necessity. You may pay out-of-pocket for any sessions outside of what your insurance covers.
- Do you conduct sessions via phone or video?
Yes. At this time, I’m only doing teletherapy. Simply let my staff know your preference for phone or video when you book your appointment.
- What if I have concerns about mental health treatment?
I am happy to discuss any concerns you may have about your treatment with me at any point in our work together. Many people have concerns about mental health treatment, and the myths about this treatment abound in our world. For a detailed description of various myths and truths about mental health treatment, please check out the Mental Health Myths article under the Publications tab.
- What if we don’t connect therapeutically, I don’t think you can help me or I want a second opinion?
At any point in your treatment with me, you may ask for a referral to another mental health provider. You can also click on the Referrals tab here on my website for a list of other mental health providers. Research has repeatedly shown that the relationship is what heals, not the techniques or approach, per se. For this reason, you should feel very comfortable with your therapist. If you’re not, keep searching until you are.
- Do you conduct hypnosis?
Yes, but this answer comes with several caveats. First, I am not an expert in this area, nor am I specially certified in it. Also, I will only do hypnosis in the context of an established relationship, which means not during the first few sessions while I’m still getting to know you and understand your history. You have to trust me for hypnosis to work well, and I also have to know you well enough to rule out any clinical contraindications to using hypnosis. This takes multiple sessions over weeks or even months.
I will NOT use hypnosis to do repressed memory work. This can be very dangerous and, in my opinion, cannot be relied upon to be entirely accurate, particularly if events occurred decades ago. I figure that if your brain is repressing something, there may be a reason for that and you may not yet be emotionally equipped to deal with it. We can investigate possible repressed feelings and thoughts in other ways, and they will surface when they need to.
Next, I see the hypnotic state as simply a heightened state of relaxation wherein a person’s mind can be cleared some so that attention can be focused in a specific area. For example, I have typically done hypnosis for pain management, and this involves relaxation and visualization of pain-free situations. Therefore, a person’s attention is focused on the images we are creating and not distracted by other things.
And finally, because you are simply relaxed and not entranced, I cannot make you do anything you would not normally do in a waking state with me in front of you. Other therapists feel differently about hypnosis, so be sure to do your research before embarking on this path.
- How long does therapy take?
A course of therapy can vary from a few sessions to several years of sessions. Couples work and personality work take longer, in general, than dealing with a transition or loss, for example. Since my approach is psychodynamic, I tend to see patients for a longer time than many of my colleagues. This is because I seek to understand the underpinnings of existing behavior in an effort to get to the root of the issues first. This awareness–the why of a person’s behavior–tends to make overcoming the past and changing the behavior a lot easier. This is particularly true of personality disorders. Many people want to change, but they want to understand why they behave the way they do first. To me, my approach is more like surgery to repair an injury vs. putting a bandaid on it for the short term. You will be given coping skills to use along the way, however.
If your question is not answered here, feel free to contact me. I will do my best to provide you with the appropriate information for you to make an informed decision about initiating therapy with me.
