Below are answers to some common questions about therapy and my practice. For more detailed information, please refer to my Information for Clients Handout.
What is my Approach?
I use a primarily cognitive-behavioral approach to therapy, also known as CBT. This means that we focus on your thoughts and behaviors, how they impact your life, and what changes could be made that may improve your life. Cognitive-behavioral therapy techniques have been shown by research to be helpful for many people in reducing their problems. Cognitive-behavioral therapy often involves assigned “homework,” or practice outside of sessions. This helps you to learn new skills and see how they impact your life. When cognitive-behavioral therapy techniques do not seem like the best approach for a person’s problems, I integrate other therapy approaches into our work together. I will work with you to find the best treatment option for you.
In my work with children, I believe in working collaboratively with parents and other providers (such as school professionals, other caregivers, and psychiatrists or family doctors), as agreed upon by parents, to coordinate services. If you are bringing your child in for therapy, you can expect to be an active part of the treatment process. I may work with you and your child together for all or part of a session, and may even ask to meet with you without your child for some sessions. I will keep you informed of your child’s progress. I will also rely on you to provide updates about your child’s functioning. I may assign activities for your child to do at home and ask you to help or monitor their completion.
Some children, and most adolescents, benefit from increased confidentiality, meaning that less specific information is shared with their parents. Times when younger children may benefit more from increased confidentiality may include cases of divorce or abuse. Parents are often less actively involved in work with adolescents, although their contributions are still very important. Together, we will discuss what level of parent involvement makes the most sense for your child and family. Parents are always notified of safety concerns, regardless of the child or adolescent’s preference.
What is the difference between a psychologist, a psychiatrist, and a psychotherapist (e.g., LPC, LMFT, LCSW)?
Psychologists have a Ph.D., or doctor of philosophy degree, in the area of psychology, and a license to practice as a psychologist. Training to become a psychologist involves attending graduate school for five or more years after college, obtaining a certain number of supervised hours to be licensed, and passing licensing exams. The specific number of hours and required exams varies by state. Psychologists generally meet with individuals every week or two to help them develop strategies for dealing with their problems. Psychologists do not attend medical school. In most states, including Texas, psychologists cannot prescribe medication.
Psychiatrists have a medical degree. They attend four years of medical school after college, after which they receive several years of psychiatric training during internship and residency. General adult psychiatrists receive four years of psychiatric training, while psychiatrists who treat children and adolescents receive three years of general training and an additional two years of training specific to the treatment of children and adolescents. Although psychiatrists can provide therapy as well as prescribing medication, many psychiatrists today focus on medication management and do little if any therapy with patients.
Psychotherapists (e.g., LPC’s, LMFT’s, LCSW’s) earn masters degrees which generally require two or three years of graduate school after college. As with other mental health providers, they must receive a certain number of supervised hours and pass an exam to be licensed.
What can I expect for my first session?
The first therapy session, also called an intake session, is a chance for us to get to know each other and decide whether or not to work together. During this session, we will discuss your reasons for seeking therapy as well as your goals. You will also have the opportunity to ask me questions about therapy. Because there is more information to be discussed during a first session, and paperwork to be reviewed, intake sessions are generally 75 to 90 minutes (up to an hour and a half) instead of the usual 45 minutes, and, as such, have a higher session cost than most sessions. Many therapists require you to fill out extensive paperwork before your first meeting, and have 60 minute first sessions. I prefer to minimize the paperwork you fill out before meeting with me and have longer first sessions where we can discuss your background and reasons for seeking therapy in person.
When working with preadolescent children, I prefer to meet alone with the parents for the first session. This will give you an opportunity to get to know me and make sure you feel comfortable with me before introducing me to your child, and will help you answer your child’s questions about what to expect. It will also allow you to discuss your concerns openly without the child present; listening to parents’ concerns can be unnecessarily uncomfortable for young children. If you are bringing your adolescent in for treatment, please bring them to the first session. We will meet together to discuss treatment and confidentiality. I will then likely meet with each of you individually for a portion of the session to discuss your individual concerns and goals for treatment.
Please note that a parent or legal guardian is required to attend the first session with a minor to consent to their treatment. If you are divorced, you will need to provide documentation verifying your legal authority to seek treatment, or allow me to obtain consent from the other parent as well.
How often are therapy sessions? How long does therapy last?
Therapy sessions are generally once a week for 45 minutes for the first several weeks or months of therapy. Weekly meetings can be particularly important for young children when starting therapy; it helps them to develop a relationship with the therapist and to solidify new skills through consistent practice and repetition. Sessions are sometimes held every other week, and on rare occasions, you may have multiple sessions in a week. We will discuss the best frequency of sessions for you when making a treatment plan.
The length of treatment can vary depending on your needs.
Do you take insurance?
This is a fee-for-service practice. This means that you are expected to pay for services at the time they are provided. I am not an “in-network” provider for any insurance panels, meaning that I do not take insurance. Some insurance plans will pay for “out-of-network” services. This means that they will reimburse you for all or part of the cost of services. At your request, I will provide you a receipt that you can submit to your insurance company for reimbursement. It is your responsibility to verify your insurance coverage for out-of-network services. You may want to use the insurance coverage questions form when calling your insurance company to help you obtain all of the necessary information about your coverage. If you plan to submit for reimbursement, I encourage you to contact your insurance company before our first session If your insurance company does not reimburse you, you are still responsible for paying for your sessions.
There are several reasons that people may not want to use insurance coverage for therapy services. Most insurance companies require personal information about you and your treatment, including a diagnosis and information about your treatment and progress in therapy, in order to approve services. This information then becomes part of your medical record and may be accessible by other agencies in the future, such as health or life insurance agencies, and potentially even employers and lending agencies. It could also impact your ability to serve in the military. Insurance companies have the right to approve or deny services based on your diagnosis and the type of treatment you are receiving. They can limit the number of sessions you are allowed and the type of treatment you can receive.
I believe you should have the right to seek therapy with a provider with whom you feel comfortable and that you should be able to make decisions about the type and length of therapy you or your child receive, in conjunction with that therapist. Everyone experiences difficulties at some time in their lives, and many people find it helpful to meet with a therapist to work on strategies for dealing with those difficulties. Not everyone who seeks therapy has a diagnosable mental health problem. You should be aware that insurance companies generally require a diagnosis to pay for psychological services.
Do you do psychological testing?
At this time, I do not do psychological testing. My practice involves therapy with children, adolescents, and adults. As part of your therapy, I may ask you or your child to complete brief questionnaires to help me provide the best treatment possible. If I believe that additional testing would be helpful, I will refer you to another provider for that testing, or help you to access those services through the school system when appropriate.
Do you prescribe medication?
As a psychologist, I cannot prescribe medication. I will help you to develop your strengths and learn new skills for managing your concerns. If you are already prescribed medication, I will coordinate services with your prescriber, with your written permission. If you are not taking medication and I think it would be helpful, I will discuss this with you and help you find a provider who can evaluate your medication needs and prescribe the appropriate medication for you or your child.
Do children really need therapy? Won’t they just grow out of it?
Many children do experience significant mental health problems, such as depression or anxiety, and the majority of them do not receive the help they need. Even if they do not have a psychological diagnosis, if your child is struggling, they may benefit from therapy. Therapy can help your child learn new skills for dealing with their problems, and can help reduce the risk of more serious problems later on. The earlier your child gets help and learns new skills, the better. Without help, their problems may worsen. If you are not sure how to help your child deal with their problems, or your attempts to help have not been successful, a therapist may be able to help. There is no guarantee that your child will “just grow out of it.”