Common Questions

Is psychotherapy right for me?

Engaging in psychotherapy is an individual choice. Some come to psychotherapy to deal with long-standing psychological issues, or problems with anxiety, depression, disorganization or impulsivity. These issues may be new or longstanding, or both (chronic with recent exaccerbation). Other times it is in response to unexpected changes in one's life such as a divorce or a work transition. Many seek the guidance and support of a psychotherapist 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, body-image issues, and general life transitions. Therapy is right for anyone with enough insight and self reflective capacity who is ready to invest in enhancing self-awareness, and working toward change.

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

Everyone goes through challenging situations in life.
While you may have successfully navigated through other difficult times in the past, choosing to "tough it out" or "suck it up" is sometimes neither healthy nor responsible. Avoidance can itself be a symptom of mental illness, and sometimes prevents recovery. If your symptoms or concerns keep you from thriving in your work, love, and play endeavors, seeking professional assistance may be an important step toward confronting your own avoidance, regaining control of your life, and steering your own ship in more fulfilling directions.

Psychiatrists help millions of adults move beyond personal barriers.

Asking for help is often a true sign of strength. Sometimes people fear that seeing a psychiatrist or taking a psychiatric medication means reliquishing self control or admitting defeat but many are surprised to see that psychiatric treatment helps them regain a sense of control over their lives. Engaging in treatment for your mental health is often an important part of taking better care of yourself. Accepting where you are in life and making a commitment to change the situation requires more strength of character than denial. Therapy provides support and long-lasting benefits, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.

How can therapy help me?

A number of benefits are available from participating in psychotherapy. 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 use psychotherapy to enhance their quality of life by creating more adaptive thinking and behavior patterns. Psychotherapy may help you learn and use more adaptive ways to think about and react to major stressors or minor setbacks in daily life. Psychotherapy may offer you a fresh perspective on a difficult problem or point you in the direction of a solution.

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 self-esteem and boosting self-confidence

What is therapy like?

Psychotherapy sessions are tailored to your specific concerns, needs, and goals, and often provide an opportunity to address, confront, or shift concerns, patterns, or thoughts that keep you stuck in a place you do not really want to be.

It is common to schedule a series of weekly sessions, where each session lasts around forty-five minutes. Therapy can be short-term, focusing on a specific issue, or longer-term, addressing more complex issues or ongoing personal growth. Although I have been trained in a number of psychotherapeutic approaches and often integrate skills from other areas in my work, my strengths as a therapist are in brief psychodynamic psychotherapy, and I often integrate cognitive behavioral therapy techniques in the process. (Brief in psychotherapy terms is often around 30-40 weekly sessions.) In my experience, CBT exercises can often greatly enhance psychodynamic work by helping people reframe issues in their lives. Sometimes when psychotherapy begins as a goal directed focused process, more complicated underlying issues are brought to light that may be more amenable to longer term work with different goals and/or techniques. If you have a specific idea about the type of therapy you think would be best for you and your situation, I encourage you to discuss this with me before we meet, or during your evaluation.

For psychotherapy to be most effective, I believe that patients must be active participants, both during and between the sessions. It is important to process what has been discussed and integrate it into your life between sessions. 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. The people I have seen benefit most from psychotherapy have been those willing to take responsibility for their actions, work towards self-change and create greater awareness in their lives. I cannot change the world you live in, but perhaps together, we can find ways to help you navigate your world in a healthier way for a more fulfilling life.

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

The benefits you obtain from therapy depend on many things, but I believe that one of the most important is how ready you are to reevaluate your old patterns and replace them with more adaptive ones. So, like many things in life, timing and motivation are very important. There may be a time in your life when the prospect of pattern change becomes more appealing to you than it is now. That may be a better time for you to engage in therapy.

Is medication a good substitute for therapy?

It is well established that the long-term solutions to mental and emotional problems and the pain they cause often require more than just medication. Instead of just treating the symptom, psychotherapy addresses the cause of a patient's distress and the behavior patterns that get in the way of progress. That said, sometimes medication makes it easier to address these issues, and is often a helpful complement to psychotherapy.

Medications and psychotherapy are both reasonable evidence-based treatments for many of the problems that bring people to see psychiatrists. Some problems respond better to medications and others better to therapy, and often both work better or more quickly together than either alone. This is one of the reasons many people choose to see a psychiatrist for psychotherapy even if they are not taking medication: it keeps your options open. Every time I see a patient for psychotherapy, I bring all those years of medical training with me, and sometimes when psychotherapy becomes frustrating because it is not effective enough quickly enough, they decide to try a medication. For people who are ambivalent about trying medication, it can be helpful to be able to work closely with a therapist who understands how medication may be helpful, who can integrate discussions about medications into the therapy.

Do you accept insurance? How does insurance work?

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 psychotherapy session?
  • How many psychotherapy 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 am an in-network provider for Stanford University students with Cardinal Care insurance. If you have insurance with another carrier, I would be happy to provide diagnostic codes, and billing statements that you can use for requesting reimbursement from any insurance carrier that covers out-of-network outpatient psychiatry and psychotherapy.

Is therapy confidential?

In general, the law protects the confidentiality of communications between a client and psychotherapist. However, there are some exceptions required by law which are important for you to understand. Exceptions include:

  • Suspected child abuse or dependant adult or elder abuse. The therapist is required to report such suspicions to the appropriate authorities immediately.
  • If a patient is threatening serious bodily harm to another person. The therapist is required to notify the police and/or take other measures to protect the potential victim.
  • If a patient 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.
  • Current laws enable current providers involved in your care to exchange information relevant to your care, but a client may revoke this implicit consent. For example, if you do not want your psychiatrist to discuss your recent laboratory results with your current primary care provider, you have the right to request that this information not be shared.

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