Therapy FAQ

What is therapy?

Therapy (also called “psychotherapy or “counseling”) can mean a number of things, and includes everything from drug rehabilitation to in-patient treatment to career counseling. Private therapy is a relationship between a therapist and an individual, couple, family, or group that entails regular meetings in a private office, like the kind you see on television (Sopranos, In Treatment). During these meetings, a therapist helps people learn how to talk about problems, feelings, or thoughts in a way that helps them deal with whatever is going on at that time. Sometimes people want to come to therapy to deal with something that has happened in the past, even a really small thing. The therapist can help that person fully understand what happened and also learn how it has had an impact on that person’s daily life. Sometimes people want to come to therapy to get some help making a big decision. Sometimes people want to come to therapy for no specific reason at all, just to talk about things they can’t really talk about with other people in their lives. Other times, people might come to therapy not because they want to, but because someone important in their lives told them to, and that’s okay too.

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Does therapy mean I’m crazy?

A lot of people think you have to be crazy to go to therapy, but this is a common misconception. Some people go to therapy to work through serious and specific problems like divorce, death, substance abuse, suicide, or domestic violence. Some people go to therapy to talk about other kinds of problems like depression, anxiety, work stress, family trouble, money problems, or school issues. It doesn’t matter why you come to therapy, or what you decide to talk about. It doesn’t mean you are doing anything wrong, it doesn’t necessarily mean you can’t handle your life, and it certainly doesn’t mean you’re crazy. In fact, a lot of people would be crazy not to come to therapy!

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Who is eligible for therapy?

Everyone is eligible for therapy regardless of age, sex, religion, race, ethnicity, sexual orientation, citizenship, previous convictions, or addiction. You don’t even have to have health insurance. 

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What about my privacy?

One of the biggest reasons people don’t come to therapy is that they are afraid someone will find out what they are talking about. A lot of people don’t know about something called “confidentiality” which is a legal concept that restricts therapists from revealing anything about their clients. It’s good news for anyone worried about their privacy. Because of confidentiality, a therapist can only reveal things said in therapy in very rare situations. For example, a therapist has to call the police if a client is going to be harmful to someone else. Another example is the state mandate to call Child or Adult Protective Services if there is any suspicion that someone is hurting a child, elder, or dependent. Therapists ARE NOT investigators or reporters. They cannot tell ANYONE about things like “socially deviant” behavior, drug use, or marital infidelity unless you give your written permission. And if you've committed a crime in the past and gotten away with it (as long as it's not harm to a child, elder, or dependent), therapists can't say a word! You should have your therapist explain to you all the limits of confidentiality during your first session.

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How long does therapy take?

This is perhaps the most common question therapists get asked, and probably the most impossible one to answer. Since therapy covers such a broad spectrum of problems, each person’s experience is different. Sometimes therapy can be short-term, and resolve very immediate and specific issues in, say, 6-8 weeks. For example, a person might want to talk to a therapist about the best way to tell his boss that he is quitting. Other times therapy can take longer, sometimes a year or two or three, to resolve more deeply-rooted issues. Some people stay in therapy for as long as they can—even up to ten years!—because they love having someone help them with past issues as well as other issues that come up during the course of life. How long therapy takes depends on two things: You and your therapist.

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How much does therapy cost?

This is another difficult question to answer because it depends on you, your current financial situation, your personal preferences, and your health insurance. Generally speaking, private therapy is a costly endeavor. Most cities have several options for low-cost therapy at clinics, counseling centers, and psychology schools. At places like these your fee is typically based on something called a “sliding scale,” which simply means that your fee will be determined based on what you can afford. For example, a counseling center may have a scale ranging from $4 to $90. During your first session, you will work with a therapist to determine where your income level places you on the scale. If this seems like something that would work for you, ask around or research on the internet what options might be available in your community.

For private therapy, each therapist sets his or her own rate. (In order to protect my clients’ privacy, I do not publish my rate online. Please call me for this information.) Most rates are based on the “50-minute hour” which means that you will be charged for the 50 minutes that you meet with your therapist every week.

Some therapists accept insurance, others don’t. The way I work with insurance is by using something called a "superbill." Certain health plans (mainly PPOs) allow for patients to receive care from an "out-of-network provider" which is what I am.  Depending on the plan, a percentage of the visit will be covered (anywhere from 25-90%), or a certain number of visits will be covered.  You should call your plan to find out what your coverage includes. The way it works is simple: My clients pay me out of pocket, I give them a superbill showing that they paid in full for their sessions, they submit the superbill to the insurance company, and they are subsequently reimbursed according to their plan.

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Can a therapist give me medication?

Nope. Only medical professionals, particularly psychiatrists, are qualified to prescribe medication. Marriage and Family Therapists, Licensed Clinical Social Workers, Clinical Psychologists, Licensed Professional Counselors, and Drug Counselors are all mental health professionals who CANNOT write prescriptions. Instead, we work with psychiatrists who can.

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What if I don’t like my therapist?

Great question! Happens more than people realize. The bottom line is that you have your personality just like therapists have theirs. It doesn’t matter how much training therapists may have, or how skilled they are at what they do, sometimes people just don’t jive. You’ll probably know within the first few sessions whether or not you and your therapist are a good match. If you sense a mismatch, bring it up. Your therapist is trained to handle conversations like these. The worst thing you can do for yourself is worry about hurting your therapist’s feelings. Instead, trust that your therapist will be better equipped to help you find another therapist if he or she knows what you are looking for in your therapy experience.

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What if I don’t like therapy?

It is important to remember that as the client, you hold the power to end the relationship at any time. Keep in mind, however, that therapy doesn’t always feel good. Talking about painful feelings, traumatic experiences, or difficult relationships is most certainly going to make you feel sad, depressed, fearful or even angry sometimes. These are important feelings, and it doesn’t mean that therapy isn’t working! Almost everyone feels these feelings at some point in therapy, and being able to work through them with a professional in a healthy way is the whole point. If, however, you find that these feelings are just too overwhelming and distracting, talk with your therapist. The two of you will be able to work out a new arrangement that will make therapy as beneficial as possible for you.

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What if someone I care about needs therapy?

First of all, if you have loved ones who are suffering, they are lucky to have your concern and compassion. If they are over 18, you can urge them to call a therapist to set up an appointment, but ultimately the choice to begin therapy is theirs and theirs alone. For people under 18, parents or guardians can call a therapist to set up an appointment.

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How do I know if therapy will work?

You don’t. Unfortunately, there is no guarantee. There is a lot of research and anectodal evidence that supports therapy, though, and you can ask friends and loved ones what their experiences have been. I’ve been doing this for a while, and I’ve never heard anyone say they were worse off than when they started. Most people find that their lives are entirely different as a result of therapy, and many others have even become therapists themselves!

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When is it time to start therapy?

Anytime. Just call.

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