Frequenty Asked Questions
Nuts & Bolts
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A psychologist specializes in treating mental illness, relationship issues, and other psychological problems through psychotherapy. A psychologist does not prescribe medication, but may refer someone to a psychiatrist if they believe that medication is important for successful treatment. Psychologists in private practice usually have a doctorate in psychology, and they have spent years studying how therapy helps people resolve emotional and relationship problems.
A psychiatrist is a physician who specializes in treating mental health diagnoses with medications. Some psychiatrists are also trained to offer psychotherapy, while most psychiatrists focus on medication evaluation and management but do not conduct talk therapy.
Social work programs vary widely, so it’s hard to know what expertise a social worker has without asking them. In general, social workers do not have the extensive training in mental illness and mood disorders that psychologists have, but some social workers have completed graduate training in psychotherapy and have become proficient as psychotherapists.
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When starting therapy for the first time, people often ask how long it will take or how many sessions they will need. Because feelings and relationships are highly individualized and complex, there is no way to know for certain how to answer such questions.
However, a therapist should be able to give you some idea of how treatment for your presenting problem usually works. Once you begin counseling, you and your therapist will periodically talk together about how it’s going so that you’ll understand the time frame and about how many more sessions you will probably need.
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I offer appointments in my office or online. Some people prefer to meet virtually from home, either because they find it more convenient or because they are more relaxed and comfortable when they are in their own home. Other people may not have privacy for sessions at home or feel that connecting through screens feels impersonal so they prefer to meet in person.
Many people use both methods, coming into the office when time permits but using virtual appointments when that isn’t possible. In my experience both formats work well and it’s a matter of personal preference rather than one being better than the other.
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My cancelation policy is that I will not charge for appointments canceled before 7:00 a.m. on the day of the appointment. I know that “life happens” so I also allow everybody one “freebie” late cancelation or missed appointment per calendar year.
After that first missed session with no fee the charge for additional missed appointments depends on whether I can fill the time. I will not bill for time I am able to use for work I can fill in so my fees for appointments canceled at the last minute vary.
Is Therapy Right for You?
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A good psychotherapist can help you determine whether talk therapy alone, or a medication, or a combination of both, would be best. For some people, taking an antidepressant or antianxiety medication is very helpful either short- or long-term because there is a lot of depression or anxiety in their family – they are predisposed to it – and talk therapy isn’t powerful enough to override that. But for many more people the hype that a medication will “fix” or “cure” depression or anxiety is just that – advertising hype.
Antidepressants can reduce depression but they don’t create happiness. Antianxiety medications can reduce anxiety but they don’t eliminate it. Talk therapy provides skills and insights that reduce depression and anxiety, and it often leads to people finding more satisfaction, ease, connection, and joy in life.
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I think there are different reasons people feel this way. Some people are so nervous about talking to a therapist that they tell themselves they can solve their problems on their own to avoid opening up to someone they don’t know. Some people believe they don’t deserve the help, or they’ve grown up with a message that therapy doesn’t work anyway, so they aren’t able to feel comfortable getting the help they do deserve.
But therapists offer expertise based in years of research and training that the average person can’t be expected to know, so even though people do ultimately need to work through their problems themselves, I don’t believe they should have to do that on their own without the knowledge and guidance of someone trained to help them.
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If you are able to make the changes you need without help from a therapist, kudos to you! There are people who can figure something out or read a book that shows them how to change and who don’t need any therapy to make that happen. But most people, even when they know what needs to change, don’t know how to make it change, and that’s where a therapist can help.
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This is a common misunderstanding – that all therapists dig into your past whether it’s relevant or not. A good therapist will only ask you to talk about your early life if they have determined that it’s important and relevant. They might ask a few general questions about your childhood as they get to know you initially, but there won’t be a lot of time spent on that unless you already know you need to deal with it or they explain to you why it will be helpful.
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There are several reasons an earlier attempt at therapy may not have been helpful. Sometimes the therapist, even a good one, just isn’t the right fit personally – it can take trying more than one person to find a good match. Sometimes the therapist didn’t have the kind of training or approach that is most suited to your particular situation or problem.
There are many different styles of doing therapy and finding someone with a different approach than your earlier therapist might set you up with someone who can really help. And sometimes people are more ready to tackle a problem now that they weren’t really ready to face or work through at an earlier time. So the bottom line is that if you’re still wrestling with a problem that wasn’t helped by an earlier therapist it is worth trying again with someone else.