Questions About Therapy
How Confidential is Therapy?
In general, therapy is confidential; I do not speak with anyone else about you or anything we discuss, and all records and email communications are secured. Telehealth sessions are never recorded.
There are exceptions to confidentiality which are explained in detail in the “Information and Consent” form on the “How to Begin” page. If you or a child or an elderly person is in danger or being harmed, or if you threaten someone else with harm, I have legal as well as moral obligations to notify appropriate authorities to prevent that harm. Other exceptions include legal mandates, insurance company requirements if you want reimbursement, or communications to other treating clinicians for which you give me permission. Please feel free to ask any questions about confidentiality at any time.
What if I haven’t done telehealth before?
The telehealth platform I use, doxy.me, is simple to join; you write in a website in your address bar, and you are in my virtual waiting room. A computer is preferable, but a smartphone will work as well. If technical problems get in the way, we can consider working through Facetime or in a telephone call.
How Long Will Therapy Take?
Therapy can happen in a few sessions, a few weeks, a few months, or off and on over many years. How long it will take to reach your goals depends on many factors—what the goals are, how established the problems have been, what kind of treatment is helpful, how much work you do in between sessions, your supports, and complicating life stressors. In early sessions, though, we can make a prediction or set a limit on the time or number of sessions you want or feel able to manage. It is usually a good idea to work at least weekly for a few weeks to establish our relationship, be clear about goals, and get some “traction” in the work. Most often, people work for a few months to resolve a problem, and then return after a while for a “booster” session or to handle a new issue. Unless I think more frequent sessions are necessary to do the work, or there is a risk of some kind I think requires more intensive treatment, so long as my schedule permits it, I am flexible about the length and frequency of treatment. I welcome patients to return when they feel it would be helpful.
What About Medication and Other Treatments?
Many psychological problems are benefitted by the use of psychiatric medications as well as therapy; sometimes therapy can go much faster with medication help. I frequently coordinate care with psychiatrists and internists who are prescribing medication for my patients, and refer when I think that is indicated.
Psychologists are not licensed in California to prescribe medications. As I did minor in psychopharmacology in graduate school and do work with many patients who use medications, while I do not recommend any particular medications, I am knowledgeable about them and do help monitor their effects as well as side effects. If I believe a medication consultation or reevaluation would be helpful to you, I will discuss this with you, and if you decide to go forward, if needed I will refer you to an appropriate physician.
There are other kinds of treatment that can be helpful as well–neurofeedback for anxiety, ADD, TBI and other brain dysregulation; Transcranial Magnetic Stimulation (TMS) and ketamine infusions for depression; there are even devices for brain wave regulation that can be used at home to help with depression, anxiety, and sleep problems. I discuss these with patients as options or adjunctive treatments whenever they are relevant, and keep abreast of new treatment options becoming available.
When do you have appointments? How long are appointments?
I schedule clinical appointments on Mondays, Tuesdays, and Thursdays between 10 a.m. and 7 p.m. Appointments are typically 50 or 60 minutes. Sometimes, once we are well established, we may work out briefer sessions.
Can I speak with you before making an appointment?
Yes–let’s have a brief (20 minute) phone call so that you can tell me a little about what you’re needing help with, and ask any questions you may have. Please email me at firstname.lastname@example.org and let me know your number and good times for us to talk. I will call you as soon as I am able.