Psychotherapy may be seen as a cooperative exploration of the client’s life concerns and goals, a joint problem solving effort undertaken with the assistance of an experienced guide. Therapy is not a “fix-it” procedure in which a psychological expert manipulates the client into feeling or behaving differently. The healing and change process initiated by psychotherapy has its basis in the innate capacity of humans to understand, learn, and grow.
An open and trusting relationship between the client and therapist is the most essential ingredients in successful psychotherapy. Because psychotherapy is an intimate working partnership, the quality of the client-therapist relationship is of paramount importance. Initial rapport should feel positive and therapeutic relationship should grow and deepen as we work together. Please feel free to discuss with me any issues arising during the course of therapy, no subject is off limits for discussion (although some issues may impact confidentiality). Clients may find it difficult to broach issues regarding feelings about their therapist, whether positive or negative, and clients may be reluctant to suggest that therapy has not been productive, or that they feel “stuck”. Discussions of such feelings are important therapeutically and often lead to important treatment gains. When in doubt, talk through it before deciding to walk away from the therapy process.
Psychotherapy can have benefits and risks. Since therapy may involve discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, or helplessness. On the positive side, psychotherapy can produce improved relationships, solutions to specific problems, attainment of personal goals and significant reduction in distress. There are no guarantees of what your results will be, however those clients who invest their time and energy in the therapeutic process tend to report positive, even life changing results.
Confidentiality is limited, not absolute: the information that you convey to your therapist (written or verbal) is confidential - it will not be divulged to anyone without your written permission. However, there are legal and ethical limits to confidentiality in the therapeutic relationship.
Those basic limits are as follows:
(1) If you seriously convey to your therapist that you intend to harm yourself, or that you intend to harm someone else.
(2) If you tell your therapist that you, or someone you know, is abusing, or has abused a child, an elderly person, or a disabled person.
(3) If your therapist receives a valid court order to testify about you, or to provide your therapy records."
Therapy sessions are scheduled as a standard 55 minute session (CPT code 90837), but depending on your requirements for treatment, and available time, may be only 45 minutes (CPT code 90834). Typically clients are seen once per week. However, sessions as often as two or even three times per week, or as little as once every month, are used when therapeutically appropriate. Treatment may be brief, 3-4 sessions, or more lengthy 20-30 sessions, but always it is your requirements and progress that determines the time in treatment.
Payment for therapy is expected at the completion of each session, unless other billing arrangements are made. My standard session fee is $150 for the 55 minute session, and $120 per 45 minute session. Clients with significant financial difficulties that would preclude treatment, may be seen at a reduced rate if prior arrangements are made. Additionally, I participate in Medicare Part B outpatient mental health services for clients so covered. However I do not participate in Medicare Secondary Payer arrangements. All commercial insurers would be on an “out-of-network” basis and you would be directly responsible for my standard fee and all interactions with your insurance company.
Regarding sessions missed without 24 hours advance notice: your first time is on me, the second time is $50, the third time is $100. I do not charge for missed sessions if you are ill or legitimately unable to attend. To cancel a session you may leave a message on my office answering service at 512-329-0017, or send an email to tgkphd@gmail.com .
Plans for your psychotherapeutic treatment: Psychotherapy will be tailored to you and your situation through a combination of empirically validated treatment approaches such as Interpersonal Psychotherapy of Depression, Cognitive-Behavioral Psychotherapy, and Existential-Humanistic Psychotherapy. Our psychotherapeutic process will necessarily be flexible and will be altered to suit your needs and progress in treatment. Psychotherapy is a fluid, living and growing engagement that alters as you change in reaction to treatment, or as your situational factors are altered by your attitudes and behaviors. We will discuss the treatment process and our interpersonal process as an integral part of treatment. Communication of your reactions and expectations is crucial to the process. I will share my understanding of our therapeutic progress and discuss alterations in our goals and methods.