Psychotherapy
What is it for, who is it for?
Psychotherapy, as I define it to my patients and students, is the collaborative inquiry between patient and therapist into the patient's pain, patterns of interaction and patterns of expectation. This kind of mutual inquiry or study leads to greater personal and interpersonal freedom, which allows for the reduction or the elimination of symptoms. Psychotherapy can be of brief duration or an extended enterprise focusing on long-term difficulties. The decision on which form of psychotherapy to undertake is usually based on an evaluation of 1 to 3 sessions, where a treatment plan is developed. Psychotherapy is used for the treatment of psychological illness, the treatment of symptoms and for personal growth.
How does psychotherapy work?
Psychotherapy has been shown to be an effective treatment for many psychological incapacities. Outcome studies have consistently shown a significant improvement in people’s lives (see Consumer Reports study of patient satisfaction and outcome and the Journal of Consulting and Clinical Psychology, (1996) Volume 64 for some of the research). While psychotherapy is often the central pillar of psychological treatment, it is also clear that for some people a combination of psychotherapy and medication is what is optimally called for. I have a referral network of psychopharmacologically oriented physicians, who include many nationally recognized experts in the field with whom I work very closely in the treatment of my patients.
If you find yourself anxious, lonely, sad, having difficulties in love, play, and work, or generally having trouble regulating your emotions, psychotherapy may be a useful strategy to pursue. If these experiences have been going on for over six months, a consultation would be in order. If you find yourself having some of these experiences, as well as trouble with your sleeping and eating, feelings of terror or disorganization, and serious interpersonal difficulty than a meeting with a mental health professional is necessary.
When finding a mental health professional, it is important to find someone qualified, technically and ethically. Referrals from physicians or friends you trust are a good place to start. Contacting the professional organizations of psychologists, psychiatrists, social workers, or nurse practitioners in your state is also a good way to begin. Contacting me for a referral might be useful, but my referral network is limited to the northeast and those psychologists and psychiatrists I have trained who live in various parts of the country. In any event I would be happy to help you find someone. Finding a person to work with, with whom you feel safe and respected, where the "chemistry" is right, is an essential part of finding your therapist. Most research into the process of psychotherapy suggests that the nature of the relationship between patient and therapist is a critical variable in the psychotherapeutic endeavor and a major predictor of positive outcome.
Once you begin psychotherapy, a schedule of weekly sessions is set up. People most often meet once per week, but there is significant variability based upon severity of symptoms, intensiveness of the therapy, resources available (e.g., time and money) and the length of the treatment planned. Most of my patients meet once per week with me, some meet twice per week, a few meet three times per week, patients in distress might meet daily to avoid hospitalization. I have several patients with whom I meet monthly and even bi-annually. As you can see, my practice has a good deal of variability in the number of sessions per week that are used to bring about therapeutic results.
What are your procedures of practice?
There are two areas of procedure that I think will be helpful to discuss:
Billing and Payment
Payment is due at the time services are rendered, unless other arrangements have been made. Patients who are subscribers to indemnity policies can have their insurance companies billed by my office. Any copayments or charges that are refused by the insurance company remain the responsibility of the patient and are due upon receipt of statement. Appointments that are missed or canceled without 48 hours prior notice will be the responsibility of the patient and may not be billed to the insurance company.
Emergency Coverage
I can be reached during the day at (781) 237-6550 ext. 2. Usually I will return your call within a matter of hours. The call will be answered within 24 hours. If the matter you wish to discuss is urgent my voicemail gives you directions to access me through my emergency call system. When I receive your call, I will be back to you as soon as is possible (most often within 2 hours). I am accessible in this manner 24 hours per day. When I am out of town, a clinician colleague always provides emergency coverage. You should be aware that here too, confidentiality is somewhat compromised, as it is necessary to discuss with colleagues who provide emergency coverage some minimal information, so that they might be of help to you. Please understand that every effort will be made to limit the amount of information that will be shared with a covering or consulting clinician.