How much do you charge?
What is your philosophy of treatment?
How many sessions will treatment require?
What do you think of psychiatric medication?
What is meant by cognitive-behavioral therapy?
What is direct therapeutic exposure?
What is EMDR?
How much do you charge?
My typical fee is $160-200 per 50-minute psychotherapy hour depending upon the complexity of your problems. I can typically conduct a brief screening with you over the telephone to determine if I can help you. This is a fee-for-service practice which means clients/patients are directly responsible for paying on a weekly basis. For those who are insured, I provide a monthly (or more frequent if needed) summary statement identifying diagnosis and session payments so that you can seek reimbursement of your therapy costs. Most insurance plans will cover between 60 and 80% of your bill and will often limit the total number of sessions to between 10 and 20. You can consult a representative of your plan to find out exactly what your mental health benefit is.
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What is your philosophy of treatment?
I believe that the core of healing that happens in psychotherapy occurs as a result of safe disclosures in the context of a trusting relationship. Sometimes changing the ways you think about your experiences can be effective; sometimes understanding the patterns of problems that keep happening in relationships leads to change; and sometimes simply being more mindful, more compassionate, and more in-the-moment brings relief from suffering and yields new meaning and purpose to a person's life. Often the increasing respect for and trust in yourself provides a way of guiding change on your own.
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How many sessions will treatment require?
The length of treatment will vary according to the severity of the problem. My practice relies heavily on the use of cognitive-behavioral therapy (CBT) (see below) which is among the most rapid approaches to successful treatment. Some problems if caught early--certain phobias of flying, heights or driving--can be treated in fewer than 8 sessions. Problems with depression or anxiety which have arisen in response to work stress or family conflict, may require fewer than 15 sessions. The majority of clients I serve have more serious problems--longstanding anxiety or depression, bipolar disorder, alcohol or drug problems, survivors of childhood abuse, a car accident involving serious injuries or fatalities, or being victimized by violent crime; these problems typically require 6 months or more of treatment. In our initial meetings, I can provide you with a realistic estimate of what the length of treatment I believe would be best for you.
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What do you think of psychiatric medication?
I am a Ph.D. clinical psychologist not a medical doctor (M.D.) therefore cannot by California State law prescribe medication. Nevertheless, I am regularly asked my opinion on the issue. I am happy to discuss medication questions and issues on an individual case-by-case basis. In general, research has shown that moderate to severe depression or PTSD are most effectively treated with a combination of cognitive behavior therapy and drug therapy. When appropriate, we can work with your personal physician or make a referral to one of our collaborating doctors to arrange for receiving medication.
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What is meant by cognitive-behavioral therapy?
Cognitive behavioral therapy (CBT) refers to an approach to psychotherapy which is evidence-based and solution-oriented. Instead of focusing on early history or problems related to a person's upbringing, CBT emphasizes teaching skills and strategies to clients which directly address current problems in living. When I see clients who have survived severe or even catastrophic stressors, managing overwhelming feelings of fear, tension and irritability are usually a high-priority for therapy. CBT immediately addresses this problem through relaxation, soothing imagery, and meditative techniques. These strategies are immediately helpful but not sufficient. Panic disorder, major depression, and PTSD require further work using techniques such as direct therapeutic exposure, eye movement desensitization and reprocessing (EMDR) (see below), and cognitive techniques (for example, learning methods to challenge irrational thoughts). CBT also involves setting clear and achievable goals for clients to increase their self-confidence through consistent changes in their lives
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What is direct therapeutic exposure?
Direct therapeutic exposure (DTE) is probably the best researched and most effective technique for the treatment of PTSD in survivors of many different types of trauma including combat, rape and domestic violence, crime vicitimization, and motor vehicle accidents. DTE involves helping the client, in a safe and gradual way, talk about and imagine the most upsetting parts of the traumatic event. Although the experience in the short-term can be painful and upsetting, clients regularly report rapid shifts into feelings of being released or unburdened. Working with a therapist experienced in these methods is absolutely critical however because the unexpected emergence of memories or reflections of different aspects of the traumas is common. A proportion of clients will remember earlier life traumas. Successful therapy will address these different, newly discovered memories in a similarly sytematic approach to exposure.
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What is EMDR?
EMDR stands for eye movement desensitization and reprocessing and is considered by most researchers and practitioners as one type of therapeutic exposure. Although highly controversial during its experimental phase about 15 years ago, it has become much more mainstream and has even shown to be as beneficial as DTE (see above) in some well controlled outcome research with trauma survivors. The procedure involves the practitioner helping the client imagine the traumatic experience while systematically asking her to move her eyes from left to right numerous times (or listen to a tone played in alternation to the left and right ear). Although we still do not completely understand why or how this is effective, at the very least we suspect that the distraction from the usual ways we process bad memories helps retrain our emotional experiencing. Some practitioners believe that the eye movements help introduce "inter-hemispheric"processing--that is, engaging each hemisphere of the brain in quick alternation--which helps in faster processing of painful memories.
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