Does coming to therapy mean that I’m mentally ill?

It’s a natural and important need to connect with other people when you’re experiencing distress. Just as human beings share the things that make us feel joyful, we need to have support for our difficult times. Beginning therapy means that you’ve taken stock of the fact that you’re struggling and are actively seeking help in feeling better. Most people who come to therapy do not have major psychiatric illnesses.

I am well trained in diagnosing and treating mental illness, and certainly I can speak that language if the need arises. Struggling, though, is a normal human phenomenon, and seeking help for it is a move toward health, not a reflection of illness. The fact that you make an appointment with me will not cause me to think that you have a mental illness, and I encourage you to be gentle in how you think of yourself.

What ages do you work with?

I see children, adolescents, and adults of all ages in my practice. I work with individuals and couples for both short- and long-term therapy.


What is Gottman-Method Couples Therapy?

The Gottman Method is the only couples therapy approach based on thirty years of relationship research. It includes specific interventions to help couples repair and rebuild their relationships, and teaches new techniques for communication and conflict resolution. The goal of Gottman methodology is to teach you and your partner skills and techniques that you can use outside of the therapy office, so that you can begin to quickly make changes in your home and on your own time.


What is the Emotional Freedom Technique (EFT)?

EFT is an energy practice that combines the ancient Chinese principles of acupressure with modern psychology. It is well-researched and validated and is accepted by the American Psychological Association as an effective treatment strategy. There are no needles. I teach clients of all ages to tap lightly on specific meridian points in order to release emotional difficulties and to achieve a greater sense of peace and joy in their lives. Children love EFT, and clients of all ages see fast results.


Do I need medication if I am depressed?

Many people with depression can and do make tremendous improvement without the use of medication. In fact, studies have shown that psychotherapy is often more effective at reducing symptoms of depression than medication alone. I will facilitate a referral to a psychiatrist for a medication consult if one is indicated or if medication for depression is something you want to consider. Sometimes, medication and psychotherapy in combination are more effective than either one alone in treating major depression. However, being depressed does not automatically mean that you will need medication to get better, and in fact, statistics suggest that you’re very likely to get well without it. This is true not just for depression, but also for a range of presenting concerns.


Will you prescribe medication if I feel I need it?

No. As a licensed psychologist in Massachusetts, I am not a prescriber. I do collaborate with psychiatrists, though, and I can refer you if necessary and help to coordinate your treatment.


Why don’t you accept insurance?

Insurance policies require a diagnosis from the Diagnostic and Statistical Manual of Mental Disorders for payment to be rendered. Although there are of course sometimes important clinical diagnoses that apply, often when people come to therapy, they are not mentally ill; they’re just struggling and seeking to feel better. I am concerned about a system that is profit-driven both requiring evidence of a psychiatric disorder and, frequently, penalizing patients for using their benefits. I have also too often seen treatment improperly restricted because of the corporate concerns of insurance companies. Because of these and other practical constraints, my practice does not accept insurance. This protects your privacy and enables us to work on the issues that are important to you without the interference or restrictions of a third party. It also protects you from having a psychiatric diagnosis on your record, which can affect your options when you seek additional health insurance or life insurance down the road.

Many insurance companies do reimburse members for out-of-network care. I will provide you with the paperwork necessary to seek reimbursement if your carrier provides that option and you wish to pursue it. If you are facing financial hardship, let me know and we can discuss options to help you get the care you need.


Is what I tell you in therapy confidential?

Protection of what you reveal in your therapy sessions is one of the most essential components of our work together. There are a few very specific legal and ethical limits to confidentiality, which we will discuss in your first appointment:

  • If there is a clear risk that you will harm yourself or someone else, I will need to take steps to keep you and others safe. This will include speaking with people close to you and potentially to the police and medical personnel.
  • If you tell me about the abuse or neglect of a child, an elderly person, or a person with a disability, I am mandated to report that abuse or neglect.
  • If you are involved in a legal proceeding, a judge can order the release of information related to your therapy.
  • If you were sent to me for treatment by your employer or by a court, I will probably need to provide some information about whether you are participating in the mandated treatment.

Other than those specific instances, I will protect the confidentiality of what you tell me in therapy unless I have explicit written authorization from you to do otherwise.


How long will I need to be in therapy?

This is a question that is best answered after we have some time to sit down together and assess your needs. Different life experiences and presenting concerns lend themselves to varying treatment durations. After we have met, I can make some recommendations to you. Ultimately, how long you remain in treatment is up to you. We’ll work on the things that are most important to you at the pace that is most comfortable for you. Some people use therapy in short durations of six to ten sessions, and others stay considerably longer. You will have my support in remaining in a useful therapy, and you will have my support in ending when you feel ready to do that.


What is your code of ethics?

I follow the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. This code of ethics has been written specifically to guide psychologists in the United States, and the Board of Registration of Psychologists in Massachusetts also requires me to uphold its principles. As a licensed psychologist, I have also passed state and national exams that assess my knowledge of ethics as well as federal and state laws that apply to the practice of psychology.


Are you willing to meet with my other practitioners as necessary?

Yes. With your permission, I can be in contact with whoever else is participating in your care, and in fact it is often helpful to coordinate treatment.


What do I do in the event of an emergency?

If you are having a life-threatening psychological emergency, you should dial 911 or go immediately to your nearest emergency room. If you are a current patient, I will also provide you a contact number where you can reach me in an urgent situation. If you cannot reach me and need immediate assistance, the psychiatrist on call at your nearest hospital will assist you.


I’m worried that the way I’m living my life might be different than the way you’re living yours. Will differences such as these affect my treatment?

It’s almost certain that our lives will be different, just by virtue of the fact that we are different people. I work with people with a wide range of backgrounds, priorities, values, family structures, and beliefs, and I am committed to supporting you in your individual life. It is both my professional obligation and my personal commitment to avoid discriminating on the basis of such things as gender, sexual orientation, family structure, race, ethnicity, etc. If, when we meet, either of us feels like I cannot or should not provide therapy to you, then I will be glad to provide you with the names of other clinicians to consider. I will only see you for therapy if I’m confident that I can offer you my full support.


If I take advantage of your complimentary phone consultation, does that mean I’m obligated to schedule an appointment with you?

No, it doesn’t. It’s very important that you feel a sense of safety and ease with your therapist, and I offer the phone consultation as an initial means for us to investigate whether we’re apt to be a good match. If either of us feels that we are not likely to work well together, I will be glad to provide you another referral. If you’re comfortable and would like to make an appointment, you’ll be welcome to do so.

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What are your hours? Can I see you in the evening or on weekends?

I generally see therapy clients on Mondays, Tuesdays, Wednesdays, and Thursdays during the day. I have a limited number of evening hours and provide occasional, structured appointments for psychological testing and assessment. If your work schedule precludes daytime therapy and my evening appointments are full, there are other providers locally who may be able to see you after work. I do maintain some lunch-hour appointment times to offset the burden of having to take time off of work. Although it isn’t easy to take time out for therapy, you will find that as your distress is reduced, your work day is more productive.


Can we communicate by email between sessions?

I am happy to use email to facilitate changes in appointment times or other brief logistical questions. I don’t use email for clinical work. This is both to protect your privacy (since online communications are not always tamper-proof) and to encourage you to use our sessions together effectively.


What ages are best for coming to therapy?

There is no right age for therapy. Distress is something that can affect us all at any time in our lives, and having support in hard times is always a good idea. If you’re at a particular time of transition in your life (such as going to college, having a baby, ending a relationship, changing jobs, etc.) you may be more vulnerable to stress. Change in your life is a particularly good indicator for seeking therapy. Additionally, therapy is worth considering any time you’re feeling unhappy more than you’re feeling happy, or anytime you’re grappling with a hard decision.


The greatest mistake you can make in life is to be continually fearing you will make one. 

– Elbert Hubbard