Frequently Asked
Questions

Generally speaking, about two out of three clients report that, because of their counseling, they feel better about themselves, and are more confident that they can handle their problems.  Some factors that may contribute to the effectiveness of counseling include: the expectations and desires of each client; the therapeutic relationship with the therapist; the competence of the therapist; the strategies learned; the investment of the client in applying therapeutic principles; the experience of making healthy decisions and positive changes;  and the length of therapy.

In couple's therapy, the additional components in the determination of effectiveness are whether both partners become aligned in their expectations and desires, and that they work together to create an improved relationship.  This process usually includes each partner becoming accountable for the participation in the relationship, becoming more considerate and wise in the interactions, managing reactivity, learning constructive strategies to resolve differences, and collaborating with each other to create the changes necessary to achieve the desired outcome.

Whether individual or couple's counseling, my aim is usually to: collaborate with the clients to help them identify and set realistic goals; guide clients in improving their communication; help clients resolve issues and differences with others; teach effective coping strategies,  support clients in making healthy decisions; and encourage clients to stay focused on taking the positive action to achieve their goals.

Therapy lasts as long as the client chooses. Some individuals feel satisfied after a few sessions. More commonly clients remain in therapy for about 15 to 20 sessions. Sometimes clients require more therapy to reach their desired goals. The major factors that contribute to the length of time in therapy include the severity of the current problems; the client's personality, history and current coping strategies; and the client's willingness to learn new skills and sustain the desirable changes.

Some individuals think that therapy is only for those who are severely disturbed, and therefore think that therapy might not be helpful to them. Others had difficulty admitting that they have problems. Some people think that no one will be able to help them solve their problems. Some people are concerned that they wouldn't be themselves if they made changes. And other individuals think that they can't afford therapy.

The most frequent request presented to therapists is wanting help to improve a relationship.  Anxiety, frustration, irritation, and depression are also common complaints. Alcohol and drug problems are also frequently discussed.

Although there are many different types of therapy, the primary three theoretical approaches are psychodynamic, humanistic-existential, and cognitive-behavioral approaches.

Psychodynamic therapy draws on psychoanalytic (or Freudian) principles and techniques. This includes examining and resolving unconscious conflicts. The client's early history is seen as extremely important in the formation of the character structure of the person. There is an assumption that the client will be able to make desired changes only after the underlying causes are resolved.

Humanist-Existential psychotherapy considers the whole person (mind, body, and spirit) and focuses on helping the client to heal themselves and work toward a more authentic self. It aims at enabling a client to find constructive ways to better deal with the challenges of life, and focuses on the client's individual experience of distress and leads to exploring and clarifying beliefs and values.  It examines core issues including death, freedom vs. responsibility, isolation, and meaninglessness. It respects the importance of past, present, and future.

Cognitive-behavioral therapy focuses on helping clients identify and examine faulty beliefs, distressing emotions, and ineffective behaviors. The client then learns to think more realistically, which will lead to feeling better, and then chooses more effective actions.  In this system, the present and the future is more important than the past.

Since no one therapy approach works for all people and for all problems, I borrow from the different approaches to help clients.

A psychologist has received a Ph.D. or a PsyD from a university (after completing about 6 to 9 years of post-graduate training and an internship). A psychiatrist has received an M.D. from medical school (after completing about 8 to 10 years of post-graduate training and residency).  A social worker, a licensed professional counselor, or a licensed marriage and family therapist have received a Master’s degree (MA, MS or MSW) from a graduate school (after completing about 3 to 5 years of post-graduate training and internship).  Although they all do therapy, a psychologist is additionally trained in assessment and a psychiatrist can prescribe medication. I am a clinical psychologist.