INFORMATION FOR PROSPECTIVE CLIENTS
Psychotherapy is essentially a cooperative exploration of the client’s life concerns and problems, conducted with the help of a trained and experienced guide. It is not a “fix-it” procedure in which a psychological expert manipulates the client into feeling or behaving differently. The healing and growth process set in motion by psychotherapy arises from the innate capacity of humans to understand, learn, grow and change. Our capacity for personal change operates through, and is guided by our subjective awareness, which is typically experienced as a unitary combination of thoughts, emotions, bodily sensations, and intuition or spiritual understanding. Subjective awareness is inherently personal, based on an inner knowing of what is truly important to the self. The process of depth psychotherapy seeks to enhance the client’s ability to utilize their subjective awareness for self-understanding and decision-making. However, not everyone who comes to therapy will have interest in, or feel a need for, an in-depth psychotherapy experience.
The emotional and behavioral problems that bring clients to therapy typically present as anxiety or depression, or a combination of both. Such psychological distress may affect only one area of a person’s life or be limited in time or place (e.g., fear of public speaking or the experience of panic attacks in traffic) and may be well addressed through brief and direct therapeutic interventions. Many problems that produce episodes of anxiety and depression, particularly those that have arisen in relation to a specific incident (i.e., loss of employment, divorce, illness), can be addressed through focused interventions such as Cognitive-Behavioral Therapy, or Interpersonal Psychotherapy of Depression. But, when symptoms of psychological distress are wide-ranging and recurring, an in-depth psychotherapeutic approach may be more appropriate and more effective in promoting meaningful life-change.
An open and trusting relationship between the client and therapist is one of the most essential ingredients in successful psychotherapy. Because psychotherapy is a working partnership, a cooperative process, the client-therapist relationship is of paramount importance. This relationship develops over time, and deepens as the psychotherapeutic process continues. Although this relationship requires time, client and therapist should both have an initial “good feeling” about working together. If they do not mutually experience a sense of having “connected” with each other after two or three sessions, then it is recommended that the client interview other therapists until a good interpersonal “fit” is found.
Please feel free to discuss with me any issues arising during the course of therapy, no subject is taboo for discussion (although some issues may impact confidentiality). Clients often find it particularly difficult to broach issues regarding their feelings about their therapist, whether positive or negative. Usually clients are reluctant to suggest that therapy has not been productive, or useful, or that they feel “stuck”. Discussions of such feelings are very 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 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 often leads to better relationships, solutions to specific problems, and significant reduction in feelings of distress. There are no guarantees of what your results will be, however, those clients who invest their time and energies in the therapeutic process tend to be those who report positive, even life changing results.
Confidentiality is limited, not absolute: the information that you convey to your therapist (written or verbal) is confidential – meaning that it will not be divulged to anyone without your written permission. However, there are legal and ethical limits to confidentiality in the therapeutic relationship, and you should be aware of those limits. Those limits will be covered during the initial session of therapy and revisited during the course of therapy when issues arise that might cross the boundaries of confidentiality.
Remember that: Information you convey to your therapist is considered to be confidential, except in the following special circumstances:
(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.”
Psychiatric medications (i.e., Xanax, Zoloft, Risperdal, etc.) can be seen as “emotional pain medications” for psychological distress – they reduce troubling symptoms, but rarely address the underlying problem fully. In some cases they do provide relatively effective relief of distressing symptoms, all with a minimal expenditure of effort on the part of the patient and the physician. Psychiatric medications are often an essential part of proper mental health care, particularly when symptoms are so severe that normal mental functions are disrupted and daily living tasks become difficult or impossible. I will readily recommend that my clients see a psychiatrist, or an experienced physician, if they have a real need for psychiatric medications. But, I do not advocate the use of medications to relieve minor to moderate symptoms of distress. Medications do not typically address the root causes of psychological distress – unless the problem is primarily neurochemical in nature. Detrimentally, effective medications may even remove the motivation needed to make life changes that could significantly reduce or eliminate the actual sources of distress. I will gladly help you consider the need for a psychiatric evaluation in the case of serious emotional distress or behavioral problems, and may be able to provide referrals to local psychiatrists, if needed.
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 process that adjusts as you change in reaction to treatment, or as situational factors change or 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 in psychotherapy. I will share my understanding of our therapeutic progress and discuss alterations in our goals and methods as we progress.
Specific Information about my psychotherapy practice:
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 an appointment you may leave a message on my office answering service at 512-329-0017, or send an email to tgkphd@gmail.com .