You may have questions about therapy. Please browse the questions and answers below, or click on a question to jump to the answer.
If you are considering therapy, and have any other question, feel free to contact me here. I would be glad to help.
How does psychotherapy work?
Psychotherapy includes a number of different types of therapy. Each one uses techniques intended to help you become more aware of your thoughts and feelings, and some focus on making changes in behavior. And each psychotherapy has a theory for how those changes take place.
Cognitive Behavior Therapy (CBT) helps people become aware of their feelings and thoughts in order to change their behaviors. Specifically, cognitive behavior therapists use techniques and give clients tools to decrease self-defeating behaviors like procrastination, social isolation, avoidance, smoking, overeating, alcohol abuse, passive-aggressive behaviors, aggressive behavior, substance abuse, reassurance seeking, and many other behaviors that get in the way of living a more satisfying, meaningful, and happy life. CBT therapists also help clients learn new adaptive behaviors or increase their frequency. Those behaviors may include effective communication, greater productivity, increased physical activity, relaxation exercises, reading social cues, assertively asking for what you want, dating skills, etc.
Cognitive Behavior Therapy (CBT) is really about setting goals and helping people to decrease unhelpful, self-sabotaging behaviors, while increasing effective skills so that individuals can reach their goals now, and have the skills to do that again and again on their own in the future. Of course, when people behave better and achieve their goals more frequently, they often times reduce the intensity and even the number of times they experience negative emotions like guilt, anxiety, embarrassment, and shame.
Goal setting and therefore the behaviors that help get you to those goals are set based on your values, morals, philosophies, religious beliefs, principles, or any other kind of guiding beliefs that are central to how you want to live your life. So CBT therapists will often help you explore and clarify those bigger principles too.
How does psychotherapy help you?
Psychotherapy at its best, reduces suffering as efficiently as possible, enhances existing strengths, and teaches you skills you don’t have yet that you need to build the life you want.
So the goal is really to help the client reduce suffering and increase vitality currently in psychotherapy in session with therapeutic techniques and with suggested exercises in between sessions. Work in between session is done to speed up the healing process and to cultivate self-confidence, real world practice, and greater independence. With enough practice clients learn how to use the skills to take care of themselves so they can leave therapy confident they can use the tools themselves as needed, while always knowing if additional support is needed they can return. But independence and autonomy are stressed. We don’t want therapy to decrease a client’s abilities or foster dependency.
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What is the role of a therapist?
Effective therapists function as both experts; conducting therapeutic techniques in session, educating clients about mental health issues and the scientific and research that supports the treatment of these issues, and as collaborative equal partners who recognize we are all in this together; empathizing and humanizing the experience of suffering and the path to healing and growth.
What is the difference between psychotherapy and counseling?
Psychotherapy and counseling are often used interchangeably. Historically counseling was often taught in departments of education and may have focused on working with students and/or dealing with career development. Many counseling programs focused on strengths and were client focused. But there has always been a great variety of approaches within counseling.
More important than whether someone says they are providing psychotherapy or counseling is the specific theoretical approach, technical skills, and styles they use. For instance a counselor and a psychotherapist may both practice the same kind of therapy, while two psychotherapists could have two very different theories for how therapy works, use different techniques, and differ greatly in their personal style.
So if you are considering seeing a professional counselor or psychotherapist, it is important to ask him or her to tell you what their theoretical approach is, what kinds of techniques they use, if those techniques are supported with scientific research, and what their style is like.
Professionals or staff in their office should be happy to answer those questions or point you to information on their website that address those questions.
What is the difference between a therapist and a psychologist?
Psychologists in New York State can be licensed professionals with doctoral degrees. This typically involves at least five years of graduate work, a clinical internship, passing of a licensure exam, and completing a number of supervised clinical hours. The requirements vary by state.
Anyone can call themselves a “therapist.” That doesn’t mean that someone referring to themselves as a therapist is not a licensed professional, it just doesn’t mean that they are. Licensing is done by the state, so different states license different kinds of professionals. If someone refers to him or herself as a therapist, it is a good idea to ask if he or she is licensed, and if so as what kind of a professional and what kind of training have they had.
Should you see a therapist or psychiatrist?
This question differs depending on the person, symptoms, diagnosis, etc. The important thing if you are experiencing symptoms is to see a qualified professional who can accurately assess what you are experiencing and then recommend the appropriate kind of treatment.
As explained above, the word, “therapist” is a general term that could refer to anyone. Someone without any mental health education or training can call themselves a “therapist” in New York, but some very well trained social workers, psychologists, and other licensed professional therapists use the term as well.
In addition a psychiatrist, who is a medical doctor, can provide psychotherapy and/or prescribe medication to treat mental health disorders. So if it is determined you need medication, a psychiatrist or nurse practitioner (NP) is necessary in New York. If various kinds of therapy are required a psychiatrist if trained in effective therapy may be a good choice, or a psychologist, social worker, or mental health counselor could be effective as well.
Again, the important first step is to have a well qualified professional assess what you are experiencing to determine who will be best able to help you.
What disorders can be treated with psychotherapy?
Fortunately, there are many mental health disorders that can be effectively treated. There is scientific evidence that Obsessive Compulsive Disorder (OCD), Depression (Major Depressive Disorder), phobias, Post-traumatic Stress Disorder (PTSD), Bulimia Nervosa, Binge Eating Disorder, and many other disorders can be effectively treated with certain kinds of therapy.
Unfortunately, there do remain some disorders that we have not yet demonstrated we can effectively treat and even for the disorders above, there are some people who do not improve as much as we would hope.
What is also critically important to know is that not all kinds of psychotherapy have been shown to effectively treat the disorders listed above or others. Some forms of psychotherapy have not been shown to help these or other disorders and there is evidence in some cases, particular kinds of therapy can even make problems worse. So it is incredibly important to find professionals who are able to provide scientifically supported treatments for the specific issues you are experiencing.
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What do you do in psychotherapy?
What takes place in psychotherapy will vary greatly depending on the kind of therapy and the particular psychotherapist. But it will often involve questions and exercises that help you become more aware of your values, goals, feelings, beliefs, behaviors, sensations, relationships and how all of these interact to produce your overall sense of satisfaction, meaning, and vitality (or when things aren’t going well dissatisfaction and unhappiness).
Then in Cognitive Behavior Therapy (CBT) it would involve the therapist using techniques and exercises in session and teaching the client to use tools outside of the therapy sessions to change behaviors and change or accept feelings and thoughts with the larger goal of enhancing satisfaction with life.
What happens during psychotherapy?
What occurs during psychotherapy, as noted above, varies greatly by the type of therapy and the personal style of the therapist. Different therapists can be more or less active and directive in session. Some may do a lot more listening than speaking. Some may be very active and directive, asking very specific questions, conducting many exercises in session, while others may be more passive and give more space for the client to share as he or she thinks is important.
Effective therapy, in my opinion, typically requires ongoing assessment of what is needed in the moment with a particular client. Therefore while my sessions may have common elements to provide familiar structure, the content, pace, and style will be very different for different clients, and even for one client depending on the current mood and situation. Humor, the amount I speak or direct, question, or challenge depend on what would be most effective for that client in that session.
How long is a session with a therapist?
Individual therapy sessions typically run from 30-55 minutes. There are clients and kinds of therapy where 80-90 minute sessions are also conducted.
Group therapy sessions can run from 45 minutes to two hours depending on the kind of group and the number of group members.
How often should you see a therapist?
The most common frequency is once a week .
But there are times when two or more times per week could be appropriate, especially if the issue is acute and serious, or if the goal is to provide therapy in a condensed format for a reason like someone is preparing to go away to college, etc.
There are also times, when going every other week or once a month could make sense. I often taper clients to this kind of schedule after symptoms have been significantly reduced and the client has learned the skills to cope better on his or her own.
Is therapy expensive?
Unfortunately, therapy can be very expensive.
With that said, there is very good therapy available on sliding scales at many universities.
And there are therapists that take insurance, where you may only be responsible for a co-payment and deductible.
You may also have out-of-network coverage with your insurance plan where you may be reimbursed for some portion of the payment to a psychotherapist who doesn’t take insurance.
How much is a therapy session in nyc?
Psychotherapy in NYC can range from $125 to $450 per session. You will want to call the psychotherapist and ask what their rate is.
Is therapy covered under insurance?
Therapy is frequently covered by insurance. Depending on your insurance plan you may have to see an in-network provider or you may have out-of-network coverage where you could see someone who isn’t in-network, but your insurance company will pay for a portion of the cost. You can call your insurance company and ask them if you have out-of-network coverage for individual psychotherapy.
That way you can know in advance what you can expect to pay. The last thing you want is to find out after finding a great therapist is that you are stressed by the cost, that defeats the whole purpose.
How do I find out if a therapist takes my insurance?
You can call your insurance company and ask with a specific name or ask them to direct you to their website, where most insurance companies list the psychologists, social workers, and psychiatrists who are on their insurance panels and accept in-network insurance.
How do you know when it is time to stop therapy?
Ongoing assessment of your symptoms and your goals is a good idea for effective therapy. Together with your psychotherapist you want to discuss when stopping therapy or gradually tapering makes sense.
While some clients can continue to benefit from ongoing therapy, you never want to become dependent in a way that is countertherapeutic, i.e., decreasing self-reliance, confidence, or independence. Likewise therapy takes time and money, so those are resources to consider as well. No one should ever feel they can’t leave therapy. Therapists should happily have clients complete therapy when the client is ready. This should be a very open dialogue. At the same time, if the client is continuing to benefit, dependency isn’t being fostered, and has the resources, a client doesn’t necessarily have to discontinue therapy either. While suffering may have decreased, some clients continue to identify areas for growth and can build on that, as long as it is beneficial to the client and therapy isn’t continuing because the client feels guilty or the therapist can’t let go for some reason. Therapists should work as efficiently and effectively as possible to help clients achieve their goals as expediently as possible.
Can therapy help? If I can talk to a smart, compassionate friend, why would I pay for therapy?
Therapy is not for everyone and it is not for every problem. Certainly good advice can come from a number of sources, including friends and family members. There are problems that require scientific and clinical expertise. There are also issues that may require careful assessment to determine what the actual problem is. And finally there may be issues that are so private in nature, revealing them to someone in a personal capacity may not be an option yet. There may also be chronic problems or unfulfilled dreams that people have been trying unsuccessfully to help you with. That is when effective therapy with an expertise in the area may be appropriate.
Some therapies are supportive and non-directive in nature. Therapy practiced in this office is active and directive. Concrete goals are set, barriers are identified, and interventions target removing barriers or giving clients the tools to navigate around them so they can achieve goals and live a happier, more satisfying, and meaningful life.
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What kinds of problems might be addressed in therapy?
Emotional problems, such as anger, anxiety, embarrassment, depression, and shame can be targeted. Therapy can help to reduce how often you experience these feelings and how intense they are. As you learn to change your feelings you will become more confident as you feel a sense of control. You will also learn how to behavior towards your goals even if you are experiencing an emotion. Once you are confident you are in more control of your life, you can continue to revise your life goals and get back to embracing the changes you want to make at work, with friends and family, and any other area of your life.
What happens in a therapy session?
Therapy sessions will begin by going over how successful you were since the previous session in hitting your targets and what difficulties you had. We will then set an agenda, so we can efficiently use our time. We will be sure to take stock of why things went well, so it is clear how to ensure things can continue to go well. We will also utilize interventions to eliminate the existing problems by carefully analyzing them, and develop existing or new skills in order to better manage them in the coming week.
The goal is to effectively treat emotional and behavioral problems. We do this so clients can begin to live the kind of vital life that represents what is most important or valuable in their lives, not one that is dominated by escaping negative emotions or old behavioral patterns. Often times clients are not even conscious of the patterns of avoidance in their lives. Once you have the tools you can begin to clarify what is most important and move towards that, rather than fleeing from negative emotions and distressing thoughts.
How long are the therapy sessions?
Individual therapy sessions are 45 minutes. Although there is a clear agenda and structure, there is still time to explore what is necessary to be sure that the client is really understood. Given the nature of emotional and behavioral problems, it is critical that the work doesn’t stop after 45 minutes. Assignments are given to be done in between sessions. Bad habits have typically been ingrained over years, and so the more practice that takes place outside of session, the sooner the problems can be resolved. In addition, often times the work required involves situations at work, home, and with people that are not going to be in the therapy session. So the sessions are 45 minutes, but we will use time outside of session to do the work as well.
What can I discuss in therapy?
Anything can be discussed in therapy. There is great flexibility about topics and existential questions can be the main focus for a particular client. With that said, we will be goal focused. If the goal is to come to a greater understanding or acceptance of existential issues, then we will spend the appropriate time on that. Without being overly rigid, we will navigate back to the goals and the agenda when we go off course. If something new comes up though, we will simply add it to the agenda in order to incorporate it into the longer-term goals.
Who can I see for therapy?
I am a clinical psychologist and I practice forms of cognitive behavioral therapy (CBT) and behavioral therapy. These kinds of therapy include Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Rational Emotive Behavior Therapy (REBT), Traditional Behavior Therapy, etc. You could also speak to a mental health counselor or a social worker. In fact, anyone can call themselves a therapist. Therefore it is critical to inquire about professional licensure and the extent of expertise in terms of trainings, publications, etc.
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What if I don’t feel comfortable with the therapist?
At my practice there are a number of therapists. I always let potential clients know that we want to be sure they are incredibly comfortable with the fit. So if they are not very satisfied after three or four sessions, I encourage them to call me directly and I will arrange for them to see someone else. Honestly this has only occurred a few times in the years I have been doing this, and in those cases it had to do with a client realizing they would be more comfortable with a therapist of a different age or sex.
Insurance and Filing Options
As a courtesy, we electronically submit clients’ insurance claims monthly. This means clients typically don’t have to deal with very much paperwork, which we know can be stressful and overwhelming.
So if you are entitled to any out-of-network reimbursement, the checks would be mailed directly to you from your insurance provider. But you would provide payment for therapy at the time of service.
It is always a good idea to call your insurance company in advance to be sure there are not any surprises regarding reimbursement.
The lowest amount I have seen for someone with out-of-network coverage is 50%, and some plans are significantly higher. We are not an in-network provider for any insurance.
We would be happy to speak with you to answer any questions you may have or schedule an appointment. Please feel free to call our office at (212) 551-1184.
What is CBT?
Cognitive Behavior Therapy (CBT) is an active directive form of therapy. Expert CBT therapists perform a careful assessment of thoughts, feelings, behaviors, relationships, etc. Goals are established based on what is valuable to the client. Wherever negative symptoms exist, CBT therapy specifically assesses what is maintaining the symptom and intervenes to alleviate symptoms.
The general model proposes that we frequently behave in ways that are self-defeating when we are experiencing intense negative emotions. For example, we may greatly value a relationship. In fact because we value it so much, we become incredibly scared, hurt, and then angry when our partner says something that indicates his or her dissatisfaction with us. In a fit of anger we may say something in response that makes the situation worse. Over time, this pattern can put the relationship we value so much at risk.
CBT helps clients to become much better at recognizing situations and thinking patterns (distortions and faulty reasoning) that intensify negative emotions, putting people at greater risk of behaving against their own goals. With practice clients learn these and other skills to regulate their emotions and at times even more importantly change their behaviors. This enables clients to initiate and develop healthy relationships, be more productive at work, and enjoy recreational pursuits. The overall goal is to reduce distress and to enhance well being.