FAQS

What should I expect from the first appointment?

The first appointment is actually a consultation, not a psychotherapy session. A thorough psychological evaluation will take place by way of interview. I will ask the prospective patient a lot of questions, ranging from the "presenting problem" to a developmental history. The purposes will be to determine the problem areas and attempt to understand the underlying reasons for the problems, get a sense of what the "big picture" looks like and, for both the patient and the therapist, to decide whether they feel comfortable working with each other. Feedback will also be given at the end, and the prospective patient will be given an opportunity to ask questions. The initial consultation sometimes takes a little longer than actual psychotherapy sessions.

How long are the sessions?

A standard psychotherapy session is 45 minutes, though an additional 5 minutes or so may be added if it is awkward to stop the session exactly at the end of the 45 minute period.

What is the nature of your practice?

My experience is quite diverse as I have been in private practice for 28 years and have done a great deal of community health work and supervision of clinical psychology and psychoanalytic candidates. Most of my patients are adults, usually ranging in age from early 20's to late 50's. The types of problems that I help patients with run the entire range of the diagnostic spectrum. However, most people seek treatment for a combination of anxiety, depression and/or relationship problems.

What is your style and orientation?

My style is rather informal, collaborative and geared toward providing a safe, therapeutic environment and relationship for my patients. My orientation is psychodynamic/psychoanalytic which by definition, means that it is based loosely on the ideas of Sigmund Freud. This is not to say that I embrace all of Freud's ideas and some of his theories are no longer credited.

More importantly, my approach is geared toward the unique problem(s), circumstances and life history of each patient. Patients come to me with a way of dealing with the world which was, at one time, adaptive or at least seemed adaptive. However, they have reached a point where their modus operandi is now working against them rather than for them. The work we do together is designed to give patients the freedom to find new ways of dealing with old or new problems. It is geared toward giving them the freedom to change, should they decide that they want to.

How often should I come to therapy?

Most people start psychotherapy at one session per week. Some individuals who are in acute distress find it necessary to start at two sessions per week. Still, others start at once a week and over time, decide that they want to increase the frequency of their sessions in order to receive more in depth treatment. These treatment decisions are made together, between the patient and me. The bottom line is that it really depends on what the individual seeks to get out of the psychotherapy experience.

How long should I expect to be in therapy?

Psychotherapy is a process. Many patients experience some level of relief from symptoms, such as anxiety or depression rather quickly and can accomplish their goals over the course of say, 6 months or a year. At the same time, many patients choose to remain in therapy longer in order to deal with more deep-seated issues. It really depends on what the individual seeks to get out of psychotherapy, along with the pace that the patient chooses and is psychologically able to proceed with treatment. The therapist has to go at the patient's pace.

What is your philosophy on medication?

Most of my patients are not currently on any psychotropic medication. However, many of them find that medication works very well in conjunction with ongoing psychotherapy. If I think that a patient can benefit from medication, then this is certainly something I will bring up for discussion. I do not (and am not licensed to) prescribe medication. However, I refer patients to a few different psychiatrists with whom I have a working relationship. They are experts on medication and enjoy the role of working together with the patient and the therapist in their role as the one who prescribes the medication.

If I use insurance how much is my co-pay?

Patients have different insurance benefits and this may be the case even where their insurance is provided by the same insurance carrier as other patients. Therefore, I have no way of knowing what any patient's co-pay is until his or her benefits are checked with the insurance carrier. The co-pay, along with the benefits package is determined by the insurance company, not by me.

What are my rights regarding privacy and confidentiality?

Every patient has the right to privacy as outlined by HIPAA guidelines, along with the code of ethics of the American Psychological Association and the "doctor-patient relationship." Confidentiality is really the essence of the psychotherapeutic relationship. Everything that a patient tells me is 100% confidential with 3 very, very specific exceptions. If someone tells me that when they leave the session they are going to hurt themselves, then I have to do something. If someone tells me when they leave the session they are going to hurt someone else, then I have to do something. If someone tells me about a case involving child abuse/neglect, then I have to do something. These are very, very specific circumstances. I am not an alarmist by nature, and in 28 years of private practice I have never had to violate anyone's confidentiality. There may be times when the patient wants me to consult with another doctor in which case the patient will need to sign a waiver to permit that other doctor to speak with me. It is important for you to know that the confidentiality "belongs" to the patient, not the doctor.