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How do I know if I need professional help or not?

You may be wondering whether therapy is even necessary for the issues your dealing with right now. If so, look at the list below.

My feelings (or thoughts, behaviors) are causing significant distress in my life. For example:

• I’m finding it hard to concentrate or function at work, home or school.
  
• I’m not feeling enthusiastic about anything.
  
• I’m avoiding interactions with people.
  
• I’m just feeling plain overwhelmed.
  
• I’m having thoughts of harming myself.
  
• Nothing I’ve tried (e.g. self-help books, talking to friends, exercise, etc.) seems to alleviate my problems.

My friends or family seem tired of listening to me, or they aren’t able to offer me the help or advice I need.

I’ve started overusing or abusing something to try to alleviate my symptoms. For example:

• Alcohol, cigarettes, or other substances
  
• Food
  
• Gambling

Friends, family or coworkers have noticed something is wrong and have suggested that I talk to somebody.

If you experience any of the issues above, you should consider seeking professional help. Even if you don’t strongly agree any of these statements, you may still seek professional help if you need to.

If you are experiencing a medical emergency or if your emotions or behaviors are putting your safety or the safety of others at risk, you should could call 911 or go to your nearest emergency room immediately.

 

How do I pick the right kind of therapist?

The kind of help you seek out depends on the level of care you need. I offer outpatient psychotherapy. There are many levels of mental healthcare, but here are descriptions of the least intensive and most intensive levels of care on the spectrum:

Outpatient psychotherapy
This is a form of treatment for people who do not need to be hospitalized. Here are three general types of mental health professionals who can help you on out-patient basis:

• Therapists, counselors and clinical social workers. These professionals can help you learn how to manage your issues and teach you ways to cope. They typically have Master’s degrees. My license falls under this category.
  
• Psychologists. These mental health professionals can also help you learn how to manage your issues and teach you ways to cope. However, they are also qualified to provide extensive diagnostic testing and psychological evaluations. Psychologists typically have a doctoral degree.
  
• Psychiatrists. A psychiatrist is a medical doctor who treats mental illnesses. Most psychiatrists only see patients to prescribe medication, though some also provide talk therapy. In most states psychiatrists are typically the only mental health professionals who can prescribe medication.

When appropriate, some clients may seek help from both a psychiatrist for medications,and from a psychotherapist for outpatient therapy.

Inpatient Care
This level of care is for individuals whose condition requires admission to a hospital. Patients may be admitted to a hospital under conditions including, but not limited to:

• They are extremely ill due to a medical condition or physical trauma.
  
• They are at risk for self-harm or suicide or they are at risk of harming someone else.
  
• They are experiencing hallucinations or delusional thinking.
  
• They require detox from alcohol or another substance
  
• Their ability to care for their basic needs is severely impaired.

If you are experiencing a medical emergency or if your emotion or behaviors are putting your safety or the safety of others at risk, you should could call 911 or go to your nearest emergency room immediately.

What is the therapy process generally like?

There are some common features that occur in almost all forms of outpatient therapy. I have outlined them below.

Types of Therapy Sessions

 

Intake Session

This is your first session, which may range from 75-90 minutes. At the intake a therapist will get a thorough history from you. The specific problems and symptoms that have brought you to therapy will be assessed, and other relevant information about your background will be gathered. Based on this information, your therapist will assign a diagnosis and develop a treatment plan. In order for you to make informed choices about your treatment, your therapist should also explain in detail any form of treatment that you agree to participate in. History taking, assessment and treatment planning may sometimes take more than one session and may be updated and revised throughout the course of therapy.

Regular Sessions

Regular sessions following the intake are usually 45-60 minutes. These sessions are the heart of therapy. This is when interventions (actions and techniques used to bring about change) are applied. These are noted in the treatment plan. Interventions may vary depending on your needs and on the orientation of the therapist.

One common intervention used in one form or another by therapists of most orientations is supportive listening. During supportive listening, the client talks about what’s bothering them, and the therapist listens attentively, giving the client as much space as possible to talk. Occasionally the therapist checks in with the client by paraphrasing and offering empathy or feedback to confirm the connection and to encourage the client to continue talking and thinking.

Length of Therapy

Outpatient psychotherapy does not need to be a lengthy, ongoing process. In my experience the typical number of sessions for clients is about 8-10. Therapy usually starts out on a weekly basis and sessions may later be spaced out to every 2-3 weeks on average. However, there are always exceptions. Some clients may only require 2-3 sessions, while others require ongoing therapy for several months or a few years. Some clients, after finishing therapy, may return for an occasional “tuneup.” It all depends on a client's particular needs and circumstances and on the nature of the issues they are faced with. I do believe in empowering my clients, so I often tell them that your main goal in therapy should be to not need me eventually.

 

Therapy Approaches I Use in My Practice

The approaches to therapy that I use can help you to explore your hopes, values and goals. They can also help to promote your natural abilities to heal, adapt and relate to others in meaningful ways. Here are the primary forms of therapy I use:

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is an innovative approach that triggers the brain's natural tendency to heal through sensory stimulation such as eye movements. The process addresses negative beliefs and replaces them with more realistic truths. It can resolve past issues, relieve present symptoms, and provide skills for dealing with the future.

Acceptance and Commitment Therapy (ACT)

ACT is an approach that draws on cognitive behavioral psychology and meditative practices such as mindfulness, (i.e., one's ability to relate to thoughts, emotions and experiences in an objective, accepting way). ACT promotes a client’s freedom to take action that is more consistent with his/her values.

Family Systems Therapy (FST)

FST views problems within a family as the result of a family’s group dynamics rather than the results of a particular member’s behaviors. A Family Systems therapist helps individuals understand how their childhood family operated, their role within that system and how that experience influences current relationships.

A Note About Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a common form of therapy that emphasizes how our thought processes influence our emotions and behaviors. The goal is to identify and correct any so called dysfunctional beliefs that may underly the client’s thinking and then help the client to modify thoughts and behaviors that flow from those beliefs. Many other forms therapy, including the ones I use, have a CBT component in that they also address a client’s underlying thought processes. However, the forms of therapy that I use employ different interventions than standard CBT.