People enter therapy for many different reasons. Some of them include:

• If you would like to improve your work life or your relationships, therapy can help.
•  If you find yourself acting in unproductive or self sabotaging ways
• If you would like to have more meaning and satisfaction in your life.
• If you are having difficulty communicating with your partner.
• If you feel stuck in your career.
• If you are an artist and have reached a creative plateau, or are “blocked”
• If you have recently experienced a loss, or a major life event, therapy can help you to put words to your feelings.
•  If there are painful events in your past that you have not shared or processed fully.

You might have other reasons that I have not mentioned. We can speak more about this when we begin working together.

While all therapies differ, generally our first  sessions are structured. I will ask questions and we will explore the reasons for your considering therapy at this time. I will ask what your expectations for the process are, and to know what your previous experiences in therapy, if any have been like. Then, it is helpful to get your family, work and relationship history. This way, we have a context for your present life and hopefully can help you see some events that are familiar to you in a new light.

After this is accomplished, the sessions may become more free form. You may speak about whatever is on your mind. I might ask you to bring in dreams, to keep a journal, or to recall an emotional moment from the previous week.  Eventually you will gain insight into how your history is impacting on your present life. You will learn to recognize destructive patterns and how to take healthy risks to improve your life.

Therapy can sometimes slow down or briefly feel like nothing is happening. This is not unusual, and can actually be helpful. If you are feeling bored or stuck it is important that we explore it together, and not to get discouraged by this temporary occurrence.

The human being is the most complex organism known. Our gestation period and our childhood development is the longest of all mammals. Our problems and our character (which leads to how we respond to our environment and to how we make decisions) are years in the making. It is unreasonable to assume that such longstanding issues can be resolved in a few weeks or a few months of once a week therapy. One should be very skeptical of practitioners promising quick, easy solutions to life’s problems. While therapy can take years, the results are longstanding and meaningful.

Common sense tells us that we would be most comfortable with someone who we think shares our perspective or life experience. However the therapeutic relationship is different than the social relationships we are accustomed to. Experienced psychotherapists and psychoanalysts are trained to work with a wide range of people and to understand their emotional and psychological issues regardless of individual history.

New clients often ask me if I share their sexual orientation, if I’m been in recovery, if I am a parent, and many other similar questions. Even if I share one or more of these traits with you what is most important is your personal experience, how I can help you to understand yourself and how to help you make better choices in your own life. When we first meet, one of our first tasks will be to safely explore if we are a good therapeutic fit. If not, I may be able to direct you to the right therapist. In any case, beginning to understand how we are the same or different can be a powerful learning experience and an opportunity for therapeutic growth.

It is common today to look for a therapist based on inclusion in an insurance plan or geographical convenience. Deciding to engage in psychotherapy is one of the most important decisions that a person can make. It should not be taken lightly, or with solely financial concerns in mind.

A comparison is appropriate here; If you needed medical advice for a life changing illness, would you choose a surgeon or a specialist based on price only?  On where their office was located? Of course not. Just as one skilled surgeon is not interchangeable with another, your relationship with your therapist is a unique one that should be undertaken with great care.

It’s understandable that having paid for insurance, that you would want to get the most use out of it. Unfortunately, in today’s economic climate, insurance HMO panels do not usually compensate in network mental health treatment adequately. As third parties they can ask for confidential information and may attempt to guide your therapy in a certain direction. They may decide to stop payment after a small number of sessions.

In order to avoid these situations, it is preferable make an investment in yourself and to pay  a little more “out of pocket”. If your insurance company reimburses “out of network” therapy, you may submit the charges to them and they may pay a percentage.

When we first meet, we will see what the financial options are. I will work with you to set a fee that you can pay on a regular basis that we can both be comfortable with.

Therapists belong to insurance panels for any number of reasons. They may be new to the field and might belong to panels to build up their “numbers”. They may be on panels to fill hours that are logistically hard to fill, like an hour in the mid morning or early afternoon…

Whatever the reasons, it is hardly for financial compensation. In return for sending referrals to the therapist, insurance companies pay a very low fee. Most experienced therapists are affiliated with very few insurance panels, if any at all.

When we first meet we will discuss your current insurance plan. Some companies will only pay if the service provider is “in network” meaning that the provider has signed a contract with the insurance company to accept a fixed rate.

Many experienced therapists are not “in network” because the reimbursement rates are low. Most therapists do accept the form of insurance known as “Out of Network”. This means that you pay the therapist the full fee for each visit and then the insurance company may then reimburse you later for some percentage of the cost. Some

Questions to ask your insurance provider before your first session:

• What is my deductible per year for outpatient mental health services?
• Is that deductible for physical and mental health services combined or solely for mental health?
• After my deductible is met, at what percentage will services be reimbursed?
• How many sessions at this percentage do I receive per calendar year?
• Do these percentages vary during the calendar year?