The very first session will be an Evaluation, for both of us. You will be asked some questions, including what prompted you to call us, and your counselor will present if/how he can help you. Afterwards, you will decide if you wish to go forward. If you do, our standard practice would be to complete an Assessment.
The next 2-3 weeks would be an in-depth Assessment of the problem and its development. At the end, your counselor will present his findings and, together, you would develop goals along with a plan-of-action to move forward. The assessment would provide recommendations that might (but do not usually) include a full psychiatric, psychological or medical examination. At the end of the Assessment, both you and your counselor would have the opportunity to discuss/reframe/develop our findings into a plan-of-action, including how often you meet (e.g., weekly, bi-weekly, monthly, etc.) from then on.
Certainly, this is our normal practice. If you come to us in a crisis, the flow may be different at first but we would eventually want to slow down and get back to the in-depth Assessment when things calm down.
Overall, our major mission will be to improve how you feel and/or function in your world. To that end, we will start by identifying and building upon your strengths (which you may not fully appreciate right now) rather than focusing on a diagnosis. We look to incorporate an understanding of systemic pressures as well as the depth and range of your personal experience. The definition of a disorder is clear (dysfunction and/or dysphoria**) but with little meaning when it is someone else's perception of the problem framed as an individual's issue (not systemic). At their best, diagnoses are a communication tool between professionals and necessary only for insurance/disability coding. It is pretty clear to (and found throughout the research) that everyone can be diagnosed with something.
If you do not want to use insurance or do not have insurance, we will not need to present a diagnosis. However, we will work from themes which may be akin to diagnoses. If you have insurance and will be using it as payment or seeking reimbursement, whether in-network or out-of-network, we will need to present a diagnosis to the insurance company. We will always be clear with you about your ongoing diagnosis (it can change) and hope you will help in defining it via the Assessment. If there is not a diagnosis that meets the criteria of your insurance (meaning, your counselor believes you are okay), we will tell you and we will not be able to go further with the insurance company paying. If you have a diagnosis already (e.g., bipolar disorder), then we will begin from that framework.
**Dysfunction: Client is not functioning properly in their system (e.g., can't keep a job, consistent relationship issues, etc.) Dysphoria: Feels bad, depressed, confused, anxious or worried/afraid.
I have heard about Cognitive-Behavior Therapy (CBT), is that what you do? If not, could you please tell me about your "therapeutic style?"
Our counselors have been trained to provide many different types of therapy, but we have always found the CBT model to be helpful, but incomplete.
For most people, we believe problems are in systems, not individuals. That is, a person's mental health (or dysfunction) represents the interactions with the people around them, their system. Systems create and/or maintain positive or negative mental health within individuals. While we cannot always adjust our systems, we may be able to redefine, create boundaries or learn to accept their dynamics. If there are official-sounding words for the style of our counselors, they would be: applied-developmental, eco-systemic, structural, relational, insight-oriented and client-centered.
If you have insurance but not one we accept, call them and ask if you have "out-of-network benefits" for mental healthcare. If so, there will probably be a deductible and then they will reimburse a percentage after the deductible is met. (They will tell you, write it down.) We possess all of the necessary information (license & NPI #s, procedure codes, etc.) on our receipts specifically intended for insurance companies.
For example, one of our clients has out-of-network benefits that include a $400 deductible. After the $400 is met, the insurance company reimburses 70%; that is, you must pay the first $400, then they pay you back 70% of what you spend for the rest of the contract year.
If you do not have insurance and are serious about finding help, we can work something out based on your financial situation. We can discuss this in our first contact by phone, before we meet.
It is important to understand that you will get more results from therapy if you actively participate in the process. The ultimate purpose of therapy is to help you bring what you learn in session back into your life. Therefore, beyond the work you do in therapy sessions, your therapist may suggest some things you can do outside of therapy to support your process - such as reading a pertinent book, journaling on specific topics, noting particular behaviors or taking action on your goals. People seeking psychotherapy are ready to make positive changes in their lives, and are open to new perspectives and take responsibility for their lives.
Can you fix my kid?
We will do our best, but prepare yourself to do some work. While our counselor will meet with your child and seek to help them resolve their inner turmoil, increase motivation or aid in successfully navigating a healthy childhood/adolescence, he knows that we can only get so far without support from their system. We see things systemically; we believe problems are in systems and are expressed through individuals.
After getting to know your child, it will be highly likely that your counselor will be inviting you (and any other parents/care-givers) into individual sessions and/or family sessions. We will review the tenets of eco-systemic structural family therapy and attachment-relational therapy. Be very clear: we are not a behavioralists, although some behavioral constructs may serve as foundations to our discussions.