Frequently Asked Questions

How long do I have to stay in therapy to get results?

Therapy involves personal growth. Since we all have fairly limitless capacity to grow, it's sometimes difficult to measure exactly when therapy is complete--since in some ways, there's always more work to do. Clients who come to therapy on a regular basis and make a concerted effort to work on their problems can notice changes within a few months, though normal therapeutic relationships last for at least a year. Often they last for multiple years if the chemistry between client and therapist works well.

How frequently do I need to come in?

I encourage clients to come for one hour every week. In rare cases, I will suggest more regular meetings. And, in some cases, I will permit meeting every other week. But, to adequately make progress in working on an issue, the rhythm of weekly meetings makes an important contribution.

How do we know when we're done?

This is always a very difficult question, since there always remains things that people can potentially work on in therapy. To monitor our progress, I will ask my clients to keep in mind the situations and questions that caused them to look for a therapist in the first place. Evaluating whether you feel that you have made progress against these goals will help us to assess whether it makes sense to wrap up our therapy work. You always have the right to decide to terminate our relationship. And in some cases, you may even get therapeutic value from making a good choice to fire me, or to decide that you have gotten what you need in working together. Where appropriate, I will challenge that decision based on the things that you have told me you want to get out of therapy. But, I will also respect that therapy is not a life-long commitment. It has a beginning and an end, and you will get to participate in deciding when we should move on.

How much does therapy cost?

I have information on my fees published online. To see this information, click here.

Are my sessions confidential?

In general, everything that you tell me during therapy remains confidential between you and me. You may, in writing, permit me to talk to other people about your case. Also, in two specific circumstances, I will need to break confidentiality: if you express to me plans to harm yourself or if you express plans to harm somebody else, I will need to protect you from such actions.

I have close friends. Why do I need a therapist to talk to?

The support that we receive from friends remains a critical part of our mental health. However, our friends--because they know us and because they adhere to common social norms--often will reinforce the very traits in ourselves that we want to change. The dynamics of a friendship frequently depend on our staying the same. Especially when we find ourselves in a vulnerable position, we look to our friends for support and caring. While therapy certainly depends on support and caring, it also has a clear objective of allowing for change. I have received specific training to allow you to explore areas of your life without taking on the social roles of a friendship. In this way, therapy differs quite markedly from a friendship. Each has its place in our solving problems in our life, and clearly there exists overlaps in how they each serve us.

I'm having relationship issues. Do I want individual therapy or couples counseling?

In general, I encourage clients to meet with me as a couple if they have relationship issues. Couples counseling allows the couple to grow together and to accommodate the changes that take place in therapy in an equal way. Couples counseling also allows the two members of the couple (and the therapist) to see a more complete picture. That said, sometimes a partner will not want therapy when you do. Also, you may have issues that you want to address that you don't initially feel comfortable sharing with your partner. In these cases, individual counseling can prove quite helpful, especially if that therapy can maintain focus on you as the client rather than on the faults of your partner.

Do you believe in using prescription medication like Prozac or Paxil in conjunction with therapy?

In short, yes. While I do not prescribe medications (only medical doctors can), I do believe that medications can have a valid place in the therapy that I do with my patients. A lot of research points to the combination of talk therapy with medications as a very effective approach to you in your mental health issues. At the same time, I have a bias against using medications unless they seem absolutely necessary. Please feel free to talk with me if you think that medications might be right for you.

Will you do individual therapy with one member of a couple you work with?

If I do work with a couple, I will see the members of the couple only when they are together. As a neutral party to both members of the couple, I do not want to find myself in a position of having to keep confidential  the things that I learn in individual work. If you choose to do couples work with me, I can gladly recommend other therapists for individual work, if you also want such counseling. There may be times where I ask to meet with the members of a couple separately if I have a specific reason to do so.

Is it okay to ask you, as the therapist, personal questions about your life?

Quite commonly, patients find themselves curious about me and my life. After all, I have learned a lot about you and it seems unfair that you don't know much about me. I have a bias against sharing too much information about my personal life with you for a number of reasons. First, the more you know about me, the more you might assume that you need to present yourself to me in a particular way in order to fit in with me. Second, I find the curiosity (and assumptions) that you may impose on me offer very valuable insights into how you see the world and view other people and I want to share those insights with you. Finally, sharing information about me can blur the line between a professional relationship and a friendship and I work hard to maintain that distinction, regardless of the care and friendliness that I bring to my professional work.

That said, I believe that you will learn a lot about me in our interaction. You will pick up very specific details about how I think about the world and how I view people and relationships. You will occasionally sense my biases and values through my reactions, the things that I remember, or even the jokes I find funny. And, you will learn a great deal about how I interact with others and how I present myself to the world (through my dress, my choice of words, my curiosities and my questions). I believe that these details--not the specifics of my personal life--constitute the important things that you will want to know about me as we work together.

Do you practice a particular form of therapy?

I do. I take a lot of influence in my therapeutic style from Murray Bowen's Differentiation Theory, as well as David Schnarch's Sexual Crucible model (which, itself, is very consistent with Bowen's work). It is quite common that therapists say that they practice an ecletic form of therapy, drawing from many different approaches. At some level, all therapists are different people, so nobody practices a model strictly. But, on a much more important level, it is NOT the case that therapy models get better when you mix them all together. Each model possesses important basic ideas that don't overlap with other models. My sense is that combining models compromises the effectiveness of all of the models rather than netting something better than the parts (in fact, this principle is often true when people "compromise" in any aspect of life or relationship). If you would like to read more about David Schnarch or the Crucible approach, I highly recommend his book, Passionate Marriage.

How should I behave if we run into each other in public?

During the course of our work together, I may run into you as we go about our everyday lives. Since we typically have gotten to know each other in a very specific context, these chance meetings will often feel awkward for both of us. In the event that we do meet in public, I will wait for you to initiate any interactions and I will understand completely if you choose to ignore me. If you do decide to say hello, I recommend that we keep our interactions to a brief and cordial interaction. I do not expect that you will introduce me to the people that you are with (and I will not introduce you to the people I am with either). Most important to me, I want to make sure that we respect each others' privacy and don't raise questions among the people around us that put either of us in a difficult position of explaining.

What should I talk about if nothing interesting has happened during the course of the week since we last met?

Some of the best sessions of therapy occur when we don't have to solve an immediate problem or crisis from the week that has passed. In those sessions, I encourage you to tell me a story from some other time in your life. You can choose any story that you remember: a time that elicited some reaction--embarrassment, anger, happiness, fear. There really is no "correct" topic to discuss in therapy. I find that almost any story that comes to mind leads to us to an interesting attribute about you and the narrative of your life. In these cases, you don't need to know the reason that you choose to share a particular experience (though frequently you will have a reason that we will discover together).

Why do you accept Bitcoins? How does it work?

Bitcoins strike me as a particularly cool innovation in how we pay for things and how we think about money. I want to support its adoption and welcome clients who share my enthusiasm for new paradigms of transacting our lives. After all, much of what we do in therapy involves changing paradigms in our life. Because of exchange rate issues, I cannot offer Bitcoins as a payment option for clients who use insurance to pay me. If you want to pay me in bitcoins, you may access my payment page at Coinbase.

Other questions?

You may request more information online, or to set up an initial session, call me at my office.