Question 1

How is psychotherapy different from talking to a close friend?

Accepted Answer

Because successful psychotherapy starts with a trusting relationship with a psychotherapist, you should feel comfortable with your psychotherapist – similar to how you might feel talking to a close friend or trusted loved one – but psychotherapy is distinctly different from talking to a friend. Unlike a friendship, psychotherapy is a relationship with a trained professional who agrees to keep your discussions completely confidential (except in certain circumstances that will be explained before treatment starts), understands your unique history, background, strengths, challenges, needs, wishes and goals, then uses her clinical training and knowledge to help you to reach those goals.   A psychotherapist has years of education and clinical experience in the art and science of psychology, including, but not limited to, the emotional and biochemical (ie., your unique brain chemistry) bases of behavior, the science of relationships and how they influence us, information from decades of research into what causes various problems (ie., depression, anxiety, trauma), and years of training in scientifically-proven specific treatments to help people overcome their problems.   Even our most insightful and supportive friends simply don’t have the kind of background it takes to help with many problems.  In addition, unlike friendships which should involve a healthy give-and-take (ie., sometimes your friend is there for you, sometimes you are there for them) and typically involve some negotiation (ie., who does what for whom and when they will do it), psychotherapy is a relationship in which the therapist and client have clear roles and boundaries. Psychotherapists typically meet with their clients in their professional office at specific appointment times, usually for 45-55 minutes, at a specified interval (ie., weekly, bi-weekly, monthly) chosen to meet the client’s treatment needs.   It is the psychotherapist’s job to listen objectively, focus specifically on you and your needs, create a scientifically-supported treatment plan or road map to help you achieve your goals, and then help you use what you have learned in treatment to be your best self, typically without the support of the therapist at some point. Unlike a friendship, psychotherapy is a relationship focused just on you, and it has a beginning, middle and an end.   As a client, you also have a specific role that is explained at the beginning of the psychotherapy relationship – you agree to keep your appointments consistently, pay for your treatment timely, share your concerns and observations of how you are feeling and behaving between sessions as honestly as possible, try as best you can to use the suggestions you and your therapist agree you will work on between sessions (ie., try a new skill), let your psychotherapist know what aspects of treatment are working for you and which ones might not be, and follow any office policies (ie., we have a fragrance free policy) that will be explained at the start of treatment.   Overall, psychotherapy is a special kind of relationship in which a trained, licensed, professional psychotherapist focuses objectively on your specific problems and concerns to help you achieve your goals so that you can be your best self.

Question 2

I'm nervous about talking to a stranger about my problems. What happens in psychotherapy

Accepted Answer

Many people hesitate to call a psychologist for help, either because they tell themselves their problems aren’t big enough for psychotherapy, or because they don’t know what to expect in treatment. The unknown can be scary, and it can be helpful to know what to expect – from the first call and appointment, through the treatment process, to completion of care.

Question 3

What should I expect from our first conversation?

Accepted Answer

If I can’t answer your call immediately because I am seeing clients, I will get back to you as quickly as possible to briefly talk about what concerns you and how I might be able to help you. If you would like, I will take your insurance information and help you figure out your insurance benefits – no one appreciates financial surprises from their health care!   We will agree on an appointment time for you to come in for your first appointment, and you will be asked to read, complete and sign forms you will find on this website so I can review them before your appointment, instead of using time during your appointment on paperwork.

Question 4

What should I expect from my first appointment?

Accepted Answer

First things first – take a few deep breaths and settle in. For some people, meeting with a psychologist to talk about their concerns isn’t a big deal, but most people feel nervous talking about their personal issues with someone they have never met before – that is completely understandable!   By listening to you objectively, with respect and without judgement, I will do my best to help you to feel comfortable talking about what concerns you now, difficulties you may have had in the past, and what you would like to see different in your life in the future. It is also important that you ask any questions that you have, or express any concerns that come up about psychotherapy.   We might discuss if I’m going to be the best therapist to meet your needs; if I don’t think I am, I’ll let you know and I’ll give you referrals to other therapists who might meet your needs better – it’s important that we both decide that we’re going to work well together. I’ll also ask you how you learn best (for example, do you like to read books that will give you information and ideas about how to make positive changes in your life, or would you rather get information and ideas from me in our discussions at your appointments), and we might even have time to talk about some of the possible treatment approaches that will help you achieve your treatment goals.   At the end of the visit (45-55 minutes), if we have both decided we might work well together, I’ll ask you to make a written list, sometime before your next visit, of what you would like to have different in your life when treatment ends. I’ll schedule your next appointment (typically in one week, though this can vary)… That’s it!

Question 5

How frequent will my appointments be and how does the scheduling work?

Accepted Answer

At our next meeting, I will ask how you felt after your first visit and answer any questions that might have come up in the week since we last met. We’ll review your “wish list” for therapy, and we’ll talk in more detail about how best to meet your goals using scientifically researched, effective and efficient treatment strategies.   At the end of the visit (45-55 minutes), we’ll decide approximately how often to meet, and will schedule your next appointment (usually every 1-2 weeks in the beginning, less frequently as you start to feel better). I will also remind you of the importance of committing to keeping your appointments, because successful psychotherapy depends on maintaining the momentum of treatment. In subsequent appointments, we will work on the problems that concern you. A typical appointment starts with a check-in to see how things have been going since the last visit and a discussion of how to best to use your treatment time. Depending on your treatment needs and goals, session time is typically spent gaining a better understanding of the problem (ie., learning what is happening in the brain when you have a panic attack and how you can use that information to reduce panic and anxiety), learning new skills (ie., meditation to reduce stress levels, specific breathing patterns to reduce anxiety, assertiveness strategies for making your needs and wishes known in relationships), getting new perspectives on a problem by considering different ways of understanding the issue, or using a highly specialized form of treatment (EMDR) to reprocess traumatic memories.

Question 6

What is the best way to reduce or end my psychotherapy sessions?

Accepted Answer

As your problems resolve, sessions are scheduled less frequently. Treatment is typically focused on maintaining your improvements and learning how to best take care of yourself after psychotherapy ends.

Question 7

Can I have a relationship with my therapist outside of my psychotherapy treatment?

Accepted Answer

No. Because the psychotherapy relationship is focused specifically on you and your treatment needs, psychotherapists don’t have relationships (ie., friendships, dating relationships) with their clients outside of treatment – both during treatment, and after treatment ends. This allows you to get the best possible care by preventing confusion and keeping the focus on you and your needs (ie., if you’re friends outside of treatment, you need to be a friend in return, turning what should be a one-way street into a two-way street. Just imagine how confusing it would be if the rules kept changing when you were driving! It would be just as stressful and confusing if therapeutic relationship rules kept changing).

Question 8

What happens if I see my psychotherapist when I'm out in public, like at a restaurant or the gym?"

Accepted Answer

Maintaining your privacy and confidentiality should be one of your psychotherapist’s top priorities. Typically, psychotherapists discuss this issue at the start of treatment and explain that if you see one another in public, the psychotherapist will not acknowledge, greet, or approach you – nor will the psychotherapist expect you to acknowledge, greet, or approach him or her. If you decide that you want to greet or approach your psychotherapist in public you certainly can – it’s your privacy and confidentiality, and you can choose if you want to disclose your relationship if you want to. If you do decide to say hello, it is best to keep conversation brief and general. Specific discussion about your difficulties or treatment should be reserved for the confidential space of the psychotherapist’s office, or telephone contact.

Question 9

How long does pyschotherapy last?

Accepted Answer

Many people are afraid to start psychotherapy because they think psychotherapy lasts for years. While some difficulties take longer to treat than others, studies suggest that many clients feel some benefit within the first 8 sessions of treatment. While the earliest form of psychotherapy, psychoanalysis, did involve multiple weekly sessions and lasted for years, many modern, scientifically-researched treatment methods are targeted (ie., developed to treat specific issues like depression, anxiety, life stress or trauma) and designed to be effective and efficient (ie., work as quickly as possible). It’s always a good idea to discuss expected length of treatment with your psychotherapist. While he or she won’t be able to give you an exact timeframe, he or she should be able to give you an idea of how long treatment will last.

Question 10

Which is better, psychotherapy or medication? Do psychotherapists prescribe medication?"

Accepted Answer

Depending on the problem, psychotherapy is often as effective, or more effective than medication. In some cases, though, medication is more effective or absolutely necessary to treat a problem. Often, a combination of both psychotherapy and medication gets the best results. With the exception of a few states in the US, psychologists are not licensed to prescribe medication, though they are educated about medications for psychological problems, can assess if medication would be helpful, and can make some recommendations about the types of medications that might be helpful. Because psychotherapists do not have prescription privileges in Pennsylvania, if your psychotherapist suggests medication, or if you want to try medication, your psychotherapist will refer you either to your primary care physician or a psychiatrist (a medical doctor licensed to prescribe medication) for further evaluation.

Question 11

Do you take my insurance? If you don't do you have a sliding fee scale?

Accepted Answer

We accept many major insurances, and we are happy to find out before you start treatment if we participate with your insurance. You are still responsible for any co-pays, co-insurances, or deductibles. We accept all major credit cards, many FSA / HRA cards, checks and cash (for further details, please see our financial policy). We do not offer a sliding fee scale, and payment for treatment is expected at the time of the session.

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