Is therapy right for me?

Seeking out therapy is an individual choice. There are many reasons why people come to therapy. Sometimes it is to deal with long-standing psychological issues, or problems with anxiety or depression. Other times it is in response to unexpected changes in life such as a divorce or work transition. Many seek the advice of a counselor as they pursue their own personal exploration and growth. Working with a therapist can help provide insight, support and new strategies for all types of life challenges. Therapy can help address many types of issues including depression, anxiety, conflict, grief, stress management, body-image issues and general life transitions. Therapy is right for anyone who is interested in getting the most out of their life by taking responsibility, creating greater self-awareness, and working toward change in their lives.

Do I really need therapy? I can usually handle my problems.

Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you are in life, and by making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.

Knowing, feeling, doing—these are different aspects of our being. They are interrelated and of equal importance. Our schools often train us to believe that if we know something, we have mastered it. Our lives, however, get complicated and beg us to reconsider, because such thinking seems way too simplistic. Knowing something is not enough. Often clients know what they are doing that they don't want to do anymore; they just can't manage to figure out a way to make the changes they think they need to make. Thoughts, feelings and behaviors are inseparably integrated. We need to take all three into account when we approach our concerns. To do so, we need to be able to identify underlying feelings, a skill often undervalued in our society, which typically considers our thoughts to be more important.

A talented therapist can help you bring what you know and what you feel into line with what you do. You can come to understand why aspects of your life are a certain way; you can learn to identify the feelings that go along with certain kinds of thoughts, and you can begin to understand yourself and make changes, if changes are appropriate.

I will support you as you go, and work to help you from falling into negative judgments about things you have done, or decisions you have made, in the past. I will help you come to begin to understand that at earlier points in your life, you did the best you were able to do at the time. You are different now, because your life experience is broader, and your choices about your behavior will also be different.

How can therapy help me?

A number of benefits are available from participating in therapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body-image issues and creative blocks. Many people also find that counselors can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:

• Attaining a better understanding of yourself, your goals and values
• Developing skills for improving your relationships
• Finding resolution to the issues or concerns that led you to seek therapy
• Learning new ways to cope with stress and anxiety
• Managing anger, grief, depression and other emotional pressures
• Improving communications and listening skills
• Changing old behavior patterns and developing new ones
• Discovering new ways to solve problems in your family or marriage
• Improving your self-esteem and boosting self-confidence

What brings people into therapy?

Most people come in to seek perspective and to share the burden of something that is bothering them. Often their concerns include:

• Feeling sad, anxious, or depressed, for reasons clear or unclear
• Fears about the future
• Feelings of worthlessness or low self-esteem
• "Impostor syndrome" that sometimes accompanies success
• Workaholism or perfectionism that interferes with daily life
• A sense of spiritual crisis
• Coping with a chronic illness (such as diabetes or asthma) in themselves or loved ones, or coming to terms with a new diagnosis
• Dealing with changes such as separation and divorce, or family problems such as alcoholism or addiction
• Trying to cope with a traumatic event, death of a loved one, or world events
• Smoking, spending too much money, or other habits they would like to break
• Wanting to learn to understand and manage their anger
• Changes in life stage, such as getting married or experiencing empty nest syndrome
• History of abuse, whether sexual, physical, emotional or psychological
• Social adjustment in a new environment, such as a new school or new job
• Relationship issues, such as break-ups or infidelities
• Confusing priorities: too many interests, not enough time

What should I be looking for in a therapist?

All licensed therapists in Washington have met the criteria required in order to practice in our state. They have academic and clinical preparation, as well as additional personal and professional experience, which they bring to bear on their work. Theoretical perspectives and techniques vary from therapist to therapist.

You will want to discuss the therapist's basic orientation to therapy, and make sure it fits with your ideas about mental health. Your therapist will be able to explain what she does and how she does it in language that makes sense to you. She will also be able to tell you about her expectations.

When you walk into a therapist's office, however, the first thing you encounter is the personality and temperament of the therapist.

This is where compatibility comes into the picture. Can you see yourself getting along with the therapist? Is this someone you sense you can trust? Is their manner comfortable for you? Do you feel welcome in their presence?

As with any relationship, your relationship with your therapist is an interplay of two personalities. Once you decide you would like to work with a particular therapist, the building of trust can begin. From the strength of that initial foundation your story will flow to them, and guidance and support will flow from them to you. When you feel safe and secure in the relationship, you will be able to open up and receive the help that is offered.

Trust your instinct. Let your feelings guide your decision about which therapist you select.

What is therapy like?

Every therapy session is unique and caters to each individual and their specific goals. It is standard for therapists to discuss the primary issues and concerns in your life during therapy sessions. It is common to schedule a series of weekly sessions, where each session lasts around 50 minutes. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues or ongoing personal growth. There may be times when you are asked to take certain actions outside of the therapy sessions, such as reading a relevant book or keeping records to track certain behaviors. It is important to process what has been discussed and integrate it into your life between sessions. For therapy to be most effective, you must be an active participant, both during and between the sessions. People seeking therapy are willing to take responsibility for their actions, work toward self-change, and create greater awareness in their lives. Here are some things you can expect out of therapy:

• Compassion, respect and understanding
• Perspectives to illuminate persistent patterns and negative feelings
• Real strategies for enacting positive change
• Effective and proven techniques along with practical guidance

How long will it take me to feel better?

Often, clients report a feeling of relief with the initial experience of being heard, of sensing that someone understands their concerns, and of making a commitment to work with a therapist until things in their lives start to make better sense to them. As you can imagine, some matters are simple and some are more complex. Human concerns exist on a spectrum. It can take time to resolve long-standing issues. There is no instant fix in therapy, but the process itself is healing and leads to greater understanding and peace.

Your therapist will create a plan that pertains specifically to you and your needs. Besides the nature of your concerns, this plan will also take into consideration such factors as how long you are able to commit to therapy, your budget, and your broader goals.  I cannot tell you with certainty when you will feel better; I can, however, make a commitment to working with you for as long as the counseling relationship is beneficial.

Is medication a substitute for therapy?

In some cases, a combination of medication and therapy is the right course of action. Working with your medical doctor, you can determine what's best for you. It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be reached solely by medication. Instead of just treating the symptom, therapy addresses the cause of distress and the behavior patterns that curb progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness.

I'm afraid people will think there's something wrong with me if I seek therapy.

To the contrary, it is a sign of a compassionate sense of self that you want to talk to someone skilled and empathetic for guidance and support as you unravel a knot in your life. These days, most people see the indisputable value of therapy, both short- and longer-term. You're in good company in choosing to seek help. Remember that it is completely confidential, and it is entirely up to you to decide whether to tell anyone about your decision to see a therapist.

Perhaps if you were to think of therapy as mentoring or coaching, it would help you reframe this concern. We all know how valuable mentors are in our business lives, and we understand the key role coaches play in inspiring their teams. Think of a therapist as a person squarely in your corner, who can have your back and share professional insights. The counseling relationship is a sacred space in which you can relax and look into your heart and soul without fear of being judged, criticized, or in any other way minimized.

I can see how these answers apply to adults. What about children and adolescents?

As you know, there are developmental stages along the maturation process of the human being. Erik Erikson (psychoanalyst, humanitarian, 1902-1994) describes this in his biopsychosocial theory of life cycles. To reduce his thinking to a single focus, it is fair to say that Erikson believed that life is a series of experiences and lessons through which we grow. We learn, and move on to the next phase. The direction and pace of this progression is unique to the individual, which means no two eight-year-olds, for example, will be in the same place in all areas along the spectrum simply because they are chronologically matched. The same goes for adolescents, who move through the process of growing up at their own speeds.

When I work with children, I also work with their parents, with a goal of helping the parents see the context in which their children are developing. Parents often want to know whether their children are normal. It is my practice to help parents understand the theoretical concept of normalcy, and how it pertains to any particular child's development.

Often with children who are considered intellectually gifted, asynchronous development occurs. This means, for example, that a child may be several years beyond her peers in her musical or language skills, right in the middle of the pack with her athletic abilities, and socially awkward. The delightful challenge with these children is to help them see themselves as more than their various parts, and to assist them in coming to grips with the nature and implications of high intelligence.

Do you accept insurance?

To determine if you have mental health coverage, the first thing you should do is check with your insurance carrier. Check your coverage carefully and find the answers to the following questions:

• What are my mental health benefits?
• What is the coverage amount per therapy session?
• What length of session does my plan cover?
• How many therapy sessions does my plan cover?
• How much does my insurance pay for an out-of-network provider?
• Is approval required from my primary care physician?

I will provide you with a billing statement identifying the date, amount you paid, and the service provided, which you may submit for reimbursement to your insurance carrier, if this is covered by your policy.

Is therapy confidential?

In general, the law protects the confidentiality of all communications between a client and therapist. No information is disclosed without prior written permission from the client. However, there are some exceptions required by law to this rule. Exceptions include:

• Suspected child abuse or dependent adult or elder abuse. The therapist is required to report this to the appropriate authorities immediately.
• If a client is threatening serious bodily harm to another person. The therapist is required to notify the police.
• If a client intends to harm himself or herself. The therapist will make every effort to work with the individual to ensure their safety. However, if an individual does not cooperate, additional measures may need to be taken.