Why do therapy in the first place?
While there are many routes to improving one’s life, psychotherapy offers the opportunity to have a safe-yet-intimate relationship with a trained professional who neither over-reacts to nor ignores or minimizes one’s struggles and concerns. I like to make a distinction between offering clinical judgment (which is what I’m trained to do) and moral judgment (which most people find unhelpful). Therapy also allows people to use the relationship and interactions with their therapist to test out beliefs about relationships more generally and to develop and practice skills which they can then use in the wider world.
What form of therapy do you provide?
I am a disciplined eclectic therapist, which means that I utilize a spectrum of techniques which are informed by psychodynamic, existential-humanistic, control-mastery, and cognitive-behavioral theories (among others) over the course of treatment. I believe that every individual deserves their own, individually tailored therapy; often, it evolves considerably over time. What is effective for a given individual at a given time may not be equally effective at a different time, or for a different person.
DO YOU ACCEPT INSURANCE?
While l do not take insurance, I frequently help the people I work with obtain reimbursement for my services as an out-of-network provider. Some people find it helpful to use a Health Savings Account to reduce the cost of psychotherapy.
How FREQUENT ARE APPOINTMENTS?
In general, I find that weekly appointments offer the best structure for treatment, and the expectation when someone is new to my practice is that we will meet on a weekly basis. Under rare circumstances, such as in a crisis situation, I meet with people more than once per week. Conversely, some people find that biweekly sessions are frequent enough once the therapeutic relationship is well-established and the focus has shifted to maintenance of the progress already made.
How long does it take?
The length of time people spend in therapy varies widely. For some individuals who have a single issue they are addressing, or whose concerns are time-sensitive, a few months may be enough. Some people find therapy so helpful, both for addressing crises and for supporting introspection, that they choose to continue for years.
How will I know if it’s working?
Therapeutic efficacy can be assessed using both subjective and objective tools, both of which I support. Subjectively, treatment progress may be gauged by a greater sense of well-being, improved self-worth, more effective coping skills, reduced conflict and improved communication in relationships, as well as decreases in symptoms such as depression and anxiety. It can also be helpful to use objective tools such as periodically administered screeners or assessment tests to have a more measurable picture of changes over time.
How will I know when it’s time to end therapy?
Sometimes it’s obvious when a course of therapy has reached its conclusion…and everyone involved knows it. At other times, however, it is less clear, and more assertive action must be taken to end therapy when appropriate. Psychologists are ethically bound to discontinue treatment when the patient is no longer benefitting from the work. People also can find it helpful to take breaks during a course of therapy for many reasons, including a desire to go out and practice some of the skills they’ve developed in the outside world without the benefit of regular therapeutic support.
WHAT ABOUT MEDICATION?
As a psychologist, I cannot prescribe medications; however, some of the people I work with find that they benefit from a period of using antidepressants, anxiolytics, ADHD medications, etc. Once I have their written consent, I work collaboratively with their physician or psychiatrist to offer insight into the patient’s unique strengths and challenges, with the goal of helping to inform not only the selection of medication but also to offer an objective assessment of both its efficacy and any side-effect issues that may arise during the course of treatment.
WHAT ABOUT MEETING IN PERSON?
For many of the people I work with, there is no substitute for a face-to-face interaction. I am conducting masked, in-person sessions with fully vaccinated individuals in my well-ventilated San Francisco office when desired. I also meet with people by secure video conference or phone call, assuming that there is not a good clinical or legal reason why doing so is inadvisable. I have been offering therapy by video and phone for over seven years, and feel confident that I am able to deliver the same high-quality care in this manner as I do in person.