You can expect me to treat you with professionalism, respect and compassion as we work together to resolve your concerns. We will take some time to get to know each other and to build a trusting relationship at your pace. While I will do a lot of listening, I like to actively engage by asking questions, making observations, and giving feedback. While this process is going to be hard sometimes, you can also expect us to laugh. I have a gentle sense of humor that I bring into my work because I find it best not to take oneself too seriously.
Since the most important aspect of successful treatment is the therapeutic relationship, the first step is for us to have a conversation on the phone or in person to see whether we might be a good fit. If we decide to work together, treatment begins with an initial evaluation.
The initial evaluation generally takes 60-90 minutes. It is a clinical assessment that will provide me with the information that I need to create a plan for your treatment, and to make a clinical diagnosis if applicable. I will gather information about your history, about your issues of concern, and about any symptoms you are having. I will ask you some standardized questions that may or may not apply to you. You will also have the opportunity to provide me with information that you would like me to know, and to ask me questions.
After the initial evaluation, I will work on developing a plan for your treatment. It may take one or two more sessions to gather enough information to complete the plan. I will ask for your input in terms of what issues you are most concerned about, what you would like to prioritize, and what your expectations are for your treatment. We will discuss an estimated timeframe for treatment based on your expectations, your resources, and my professional judgment. While the progression of treatment can change, being cognizant of a timeframe will help us make the best use of our time. We will need to consider what we can realistically accomplish in the timeframe that we agree upon. Once the treatment plan is completed, I will share it with you and welcome your feedback. Treatment plans are subject to revision in response to your rate of progress and to accommodate any new issues that emerge.
Sessions typically last 45-60 minutes and are preferably scheduled on a weekly basis for new clients, and for clients with more serious concerns or higher level of need. Psychotherapy is most effective when treatment occurs frequently and regularly. During the session we will talk about current events in your life, especially as they are relevant to your issues of concern. We may talk about events from your past that provide insight into your current feelings, your way of thinking, and your behaviors. I will listen to you, provide you with support, and give you honest feedback from my professional perspective. I will implement treatment interventions that are appropriate to your concerns and to your readiness. I will often provide you with reading material to supplement your treatment. Sometimes we may set goals for you to work on between your sessions if you are ready and willing. The process of psychotherapy for each individual is unique, and tailored to your needs and level of readiness.
Length of Treatment
The length of time in psychotherapy varies according to the severity of your concerns, the impact of those issues on your functioning, what your goals are for your treatment, and your readiness to change. I am mindful that people differ in the amount of time and resources that they are able to devote to their treatment, and I will strive to work within your boundaries. I will be respectful of your time frame and I will focus on what we can accomplish. To give you an idea of treatment length parameters, 12 sessions or less may be considered brief therapy, short-term therapy tends to average around 20 sessions, and longer term therapy can be 6 months or more. Research supports greater benefit as treatment length increases, especially for people who have more serious mental health issues. However, most studies also found the majority of psychotherapy clients to report improvement with brief psychotherapy — especially if the focus is on problem solving or working through a temporary life event. This is a significant positive finding that validates the benefit of brief and shorter term treatment. In addition, research has found the benefits gained from psychotherapy to be lasting and to reduce the overall need for health services (American Psychological Association, 2012).
Changing Your Treatment Schedule
Your treatment needs will decrease when you have made progress on your goals, when any symptoms you were having lessen in severity, when you are no longer in distress, and when you have developed a greater ability to manage on your own. Signs of decreased need may include having less to talk about, feeling less urgency to attend your appointments, and even forgetting about your appointments. This is often part of the natural progression of treatment, and a positive indication that you are ready to change the schedule of your sessions. We may decide to increase the length of time between sessions and/or to decrease the duration of sessions. Changing your treatment schedule is a way for us to determine how you do with less support, with the objective of you becoming more confident in your ability to manage on your own. Oftentimes, this is a way of phasing out of treatment that makes the transition easier than abruptly discontinuing weekly sessions.
Termination & Referral
When possible, I strive for a mutual termination of treatment with my clients that is based upon achievement of treatment goals and reduced need. I prefer the decision to discontinue treatment to be something that we openly discuss and agree upon. However, you are of course free to discontinue your treatment at any time and for any reason. Sometimes termination is predetermined by exhaustion of health insurance benefits. Other times, it is determined by a change in your needs such that another professional or another treatment modality would be in your best interests. Regardless of the circumstances, it is preferable for us to work through termination of your treatment together. It is a transition, and I want to ensure that you are emotionally prepared and provided with appropriate resources and referrals to continue your treatment elsewhere if needed. It is also beneficial for you to experience a healthy ending to our therapeutic relationship and to achieve closure.
Please be assured that even after we terminate your treatment you may always access me as a resource. You may also contact me to re-initiate treatment for a relapse of your issues, or for any new concerns that emerge. Setbacks and unforeseen circumstances will happen in life. I hope that you will seek help when you need it.
For more information about what to expect from your treatment, please read Understanding Psychotherapy and How It Works, as published by the American Psychological Association.