Commonly Asked Questions About Therapy in San Diego
What is the length of therapy sessions?
Standard therapy sessions run anywhere from 45 - 60 minutes depending on the service that’s being provided. Occasionally I will offer a longer session (up to 90 minutes) as appropriate, on a prorated basis.
How often should we meet for therapy?
During the active phase of therapy, I recommend that we meet on a regular, weekly basis. May studies have shown that this weekly “dosage” of therapy contributes to better outcomes in therapy. Depending on your circumstances and the nature of your issues or distress, I may recommend more frequent sessions such as twice a week until you’re feeling more stable. I don’t offer every other week or once a month appointments unless we’re in the very end phase of therapy if needed or appropriate as it’s been my experience that client’s tend not to make as much progress when they’re not consistent in their attendance. Additionally, it can be difficult to go long stretches to time between sessions when you’re processing more emotional or traumatic material.
How can I utilize my insurance for therapy?
In order to utilize your insurance, you must receive a mental health diagnosis after the first session. If your symptoms don’t fit the level of severity to meet criteria for a mental health diagnosis, unfortunately insurance plans won’t consider therapy “medically necessary” (their words) and services aren’t eligible for coverage for out-of-pocket reimbursement.
Insurance companies also have a right to review your therapy documentation such as the assessment, treatment plan and progress notes periodically, and may place restrictions on the amount of sessions they’re willing to cover or require a prior authorization to begin services.
How long will I need to come to therapy?
There are a lot of factors that contribute to how long it will take for you to feel like you’re ready to discontinue your therapy, thus it’s difficult to say until we meet and begin working together. The average length of therapy that my clients typically commit to is around 4-6 months, although I have had some clients who see me for 10-12 weeks or for longer periods such as 1-2 years depending on their needs and goals. I regularly check in with clients to ensure that we’re on track and working toward the goals that we initially established at the beginning of therapy and whether we need to make any adjustments along the way.
What happens during the first session?
The first appointment is called the “intake assessment” and it’s an opportunity for me to gather more background and history regarding the issue that you’d like to work on in therapy. Prior to your appointment, you will receive a link to my client portal with some intake paperwork for you to review, complete, and sign. This includes my informed consent for therapy and a couple of questionnaires to help me get to know you and your circumstances better. It’s helpful to have those completed before our appointment so that way we can make the best use of our time.
How do I know if I really need counseling?
All of us go through struggles and difficulties and can benefit from the support of an objective and unbiased professional who can guide us in seeing our issues from a fresh perspective. Seeking therapy is a positive step toward growth and personal well-being. If you find yourself struggling in the following areas, these are good indicators that reaching out for support may be beneficial:
Difficulty managing your emotions/lacking emotional support
Relational conflicts (with family, friends, co-workers, or significant others)
Unresolved past issues or traumatic events
Grieving the loss or someone or something
Dealing with a difficult life transition (divorce, job loss, starting college, moving, etc)
Changes in your health such as a cancer diagnosis or facing a major medical procedure
Struggles with self-esteem/self-worth
Feeling overwhelmed by stress
If any of the above issues resonate with you, or if you simply feel like something’s just not quite right and your day-to-day functioning is suffering, beginning therapy is a valuable option to support you in feeling better. Working with a professional counselor or therapist can provide you with valuable coping skills and tools to boost your mental well-being and personal growth.
Is therapy confidential?
The session content and all relevant materials to your (or your child/family’s) treatment will be held confidential unless you request in writing to have all or portions of such content released to a specifically named person/persons. Some limitations of such client held privilege of confidentiality exist and are itemized below:
If a client threatens or attempts to commit suicide or otherwise conducts him/her self in a manner in which there is a substantial risk of incurring serious bodily harm.
If a client threatens grave bodily harm or death to another person.
If the therapist has a reasonable suspicion that a client or other named victim is the perpetrator, observer of, or actual victim of physical, emotional or sexual abuse of children under the age of 18 years.
Suspicions as stated above in the case of an elderly person or dependent adult who may be subjected to these abuses or neglect.
If a court of law issues a legitimate subpoena for information stated on the subpoena.
CONFIDENTIALITY IN COUPLE AND FAMILY THERAPY
If you have contracted with me for couples or family therapy, family members and couples may be seen at times individually or conjointly. Information shared during these sessions or in related settings (e.g., telephone calls) is considered part of the overall family or couple therapy process and is not confidential from the other participating family members or partners. I will use my discretion in handling these matters. This is referred to as a “no secrets” policy. It is important that you understand this policy before treatment begins. It supports my belief that healthy relationships are built on openness and truth. Additionally, I will not release records to any outside party unless authorized to do so in writing by all adult parties who were part of the family therapy, couple therapy or other treatment that involved more than one adult client. This includes any request for records in divorce proceedings.
CONFIDENTIALITY AND MINORS
Communications between therapists and patients who are minors (under the age of 18) are confidential. However, parents and other guardians who provide authorization for their child’s treatment are often involved in their treatment and technically have a right to know about what’s happening. Consequently, your therapist, in the exercise of his or her professional judgment, may discuss the treatment progress of a minor patient with the parent or caretaker but will ask parents/caregivers to respect their child’s privacy and trust your therapist’s professional judgement and discretion. Patients who are minors and their parents are urged to discuss any questions or concerns that they have on this topic with their therapist.
CONFIDENTIALITY AND CONSULTATION WITH OTHER PROFESSIONALS
Multidisciplinary treatment teams in residential or hospital settings frequently consult with one-another in order to review and discuss the treatment plans and progress, etc. of the agency’s patients. Such communication is permitted under California law. Section 56.10(c) of the California Civil Code permits health care providers to discuss and exchange information about the patient, if it is for the purpose of diagnosis or treatment of the patient. In general, HIPAA also permits such activity under the category of “health care operations.”
Occasionally I may need to consult with other professionals in their areas of expertise in order to provide the best treatment for you. Information about you may be shared in this context without using your identifying information.
What’s the difference between in-person and online therapy? And which one is better?
The main difference between online and in-person therapy is missing out on what we clinicians refer to as “in the room” experiences. There’s something powerful about being “in the room” with someone else in the midst of their pain and holding space for that person. Additionally, therapists are able to pick up on subtleties in mannerisms and body language which can be clues into a person’s inner angst (eg. shaking the knee, wringing of the hands, changes in muscle tone, etc). Some of these subtleties can be lost in translations through online communication. Additionally, there can be glitches and technical difficulties which can be frustrating and serve to distract from an online session. On the flip side, online therapy offers many new conveniences such as greater flexibility with scheduling. Clients can make progress through either modality. It comes down to preference and comfort level.
What happens if counseling isn’t working?
If you feel like you’re counseling isn’t working, I want you to feel comfortable having an open, honest conversation with me. The last thing I want is for you to feel like you’re spending valuable time and money and not meeting your goals. We may decide that there needs to be adjustments made in your goals/treatment plan. Or, we may find that I’m not the best therapist for your needs, and that’s okay. Either way, I’m happy to provide referrals to other resources and help you find a therapist that is best suited to help you accomplish your goals.
Is medication a substitute for therapy?
While medication can be an important component in managing mental health conditions, it is not a substitute for therapy. Medication can help alleviate symptoms such as anxiety, depression, and mood swings, providing much-needed relief and stability. However, therapy addresses the underlying issues, thought patterns, and behaviors contributing to these symptoms. Through therapy, individuals gain insight, develop coping strategies, and work towards long-term healing and personal growth. A combined approach, where medication and therapy are used together, often yields the most effective results, offering comprehensive support for mental health challenges. If you're considering treatment options, consulting with both a therapist and a psychiatrist can help you create a well-rounded plan tailored to your needs.
How do I choose a therapist?
Choosing a therapist can be a difficult decision. Therapy is a vulnerable process and it’s important to find a therapist that is a good match for your needs. Knowing where to start can be half the battle. I wrote a blog post about this question which you can find here.
Ready to get started with therapy in Chula Vista?
Schedule a free, 15-minute phone consultation where we can assess whether I may be the best fit for your needs and schedule your initial appointment. I look forward to hearing from you!
