An overview of this page
This is the most essential information that I would want all my patients to know at the beginning of psychotherapy.
What is psychotherapy?
My personal definition of psychotherapy is that it is an ongoing process that involves learning how to think and behave more effectively in the pursuit of valued directions in one’s life. It typically occurs in the context of an ongoing relationship with a qualified professional who can provide a good balance of both support and challenge.
Is psychotherapy effective?
There is strong research support that psychotherapy is effective for a broad range of conditions and issues. Most people who complete an appropriate course of psychotherapy are significantly better off than most people with similar problems who do not complete therapy. The majority of people who complete psychotherapy meaningfully improve, and these effects tend to endure. For many conditions, psychotherapy is at least as effective as medication and its effects tend to be more lasting.
What factors predict successful psychotherapy?
Some factors that predict successful psychotherapy include:
The patient and therapist have a shared agreement about the goals and methods of therapy;
The patient perceives that the therapist understands and respects them;
The patient feels free to communicate to the therapist about what is working and is not working in their therapy;
The patient views therapy as a process of learning to think and behave differently, and understands that this requires active effort both in sessions and between sessions; and
Therapy continues for a sufficient amount of time.
How long should psychotherapy last?
Therapy can be brief (e.g., 1-3 sessions), short-term (e.g., 4-16 sessions), intermediate term (e.g., 17-30 sessions), or longer-term. The recommended length of therapy will depend on how much time is required to help a person achieve their therapeutic goals. Generally speaking, the greater a person’s problems are in number, duration, severity, and impact on quality of life, the longer the duration of therapy. But other factors can influence the length of therapy, such as a persons level of motivation for change. After our first session or two, I most likely will be able to provide you with a general idea about how long I think it may take for you to achieve your goals with therapy.
How frequently should therapy sessions be scheduled?
Psychotherapy tends to work best when sessions are scheduled regularly on a weekly or biweekly (every other week) basis. Most commonly, I tend to see people biweekly. Therapy tends to suffer when there are long gaps between sessions. It can be appropriate to schedule sessions further apart (e.g., monthly) after a person has made significant progress but is not quite ready to end therapy.
How long do psychotherapy sessions last?
Psychotherapy sessions are typically 45 minutes long. Please note that if you are late for a session, I am not always able to provide a full 45 minute session.
How are psychotherapy sessions scheduled?
Our Department's receptionist handles all the scheduling, and they are available Monday to Friday from 8am to 5pm (541-754-1288). My appointments are generally available on Monday to Thursday from 8am to 3:45pm, and on Friday from 8am to 10:45am. I do not have evening or weekend appointments. At any given moment, my schedule tends to be fairly full for about 3 weeks out. Please take this into consideration if you know you would like to schedule appointments on a weekly or biweekly basis. You may want to schedule two or three appointments at a time to be able to obtain a time that works for your schedule.
How do I cancel appointments appropriately?
Missed appointments are costly, and we try to avoid them if at all possible. Please make every effort to cancel or reschedule your appointment with at least 24 hours notice. Late cancellations and no shows typically result in a $50 fee. I make exceptions for serious illnesses, emergencies, and major weather events. I always attempt to discuss the circumstances of missed appointments with my patients prior to assessing the fee. Therapy may be discontinued if a patient has a pattern of excessive missed appointments.
What are the best ways to end psychotherapy?
Ideally, you and I would mutually decide when to end psychotherapy. This would occur when either the you have met your goals for therapy, or when we conclude that another course of action would likely be more beneficial (e.g., a change of therapists). Unfortunately, many people end therapy unilaterally without having this discussion, and many of them likely miss out on what psychotherapy has to offer. If you are having doubts about whether therapy is being helpful, please discuss this with me rather than just ending therapy. Frequently the biggest breakthroughs in therapy come out of this discussion.
What should I expect about the rate of progress early in therapy?
It is important to have realistic expectations about the pace of change in therapy. While people sometimes make rapid progress in therapy, often progress is more gradual. Several sessions are typically needed before one can begin to draw well-informed conclusions about the likelihood that therapy will be helpful. For this reason, I recommend that patients make a commitment to attending a certain number of sessions (e.g., 4 to 6) before beginning to draw any conclusions.
How will I know if therapy is working?
There are several ways that I can help you assess your progress in therapy. First, I help you define your specific goals for the outcome of therapy, and help you establish criteria for measuring your progress toward these goals. Second, I regularly invite your feedback regarding your perceptions of progress. Third, I regularly use symptom measures to track progress.
What should I do if I feel that therapy is not being sufficiently helpful?
Talk to me! Let me know. This will give us the opportunity to have a conversation about what is not working and to address it.
How is a psychotherapy session structured?
I start every session with two things that typically take a few minutes: A check in and setting the agenda. During the check in, I am interested in hearing about how you have been doing, any significant events that may have occurred since last session, and about how you are feeling therapy is going so far. Then, I invite you to collaboratively "set the agenda" for the session (e.g., the topics we will focus on). It is very helpful if you have already put some thought into this. Near the end of the session, I try to allow time to help you reflect what you got out of the session, and to consider what you can do to keep the therapeutic work going between sessions. It also is another good opportunity for you to tell me how you feel therapy is going, and identify any topics you want us to put on the agenda for the next session.
What are the limits of confidentiality?
The information you disclose in psychotherapy is protected by federal and state laws, with only a few exceptions. These include the following:
If you are using insurance, information provided to your insurance company for authorization and billing purposes;
If a clear emergency exists where there may be danger to you or others (e.g., potential suicide or homicide).
If a child or vulnerable adult is being abused or neglected; and
If ordered by a judge pursuant to a valid subpoena.
What are appropriate boundaries in the therapeutic relationship?
For ethical reasons, your therapist's only role in your life should be as your therapist. To maintain appropriate professional boundaries, I do not make personal connections with patients on social media. If I encounter one of my patients outside of therapy, my default position is to allow the person to determine whether they want to acknowledge my presence. If a patient initiates contact with me, I am typically glad to greet them and speak with them briefly.
Will my insurance company cover psychotherapy?
Every plan is different. The best thing you can do is examine your policy and contact your insurance company with any questions. Please note that insurance companies will cover psychotherapy only if it meets criteria for “medical necessity.” This typically means that the person has a diagnosable disorder that is causing a significant impairment in one or more areas of life functioning.
What should I do if I have a mental health crisis?
In the event of a life-threatening emergency, please call 911 or go to the nearest emergency room. If you want an appointment with me sooner than our next scheduled appointment, contact our Department receptionist and request an urgent appointment. If no appointments are available, the receptionist will contact me, and I will contact you. If you have an urgent matter after hours or during a holiday, call 541-754-1288 and press 0 to reach the answering service. If you desire, the answering service will attempt to contact me. However, it is not guaranteed that I will be able to immediately respond. If you cannot reach me in a timely manner, and have an urgent need to consult with a behavioral health counselor, please consider utilizing a community crisis line. Updated phone numbers are published in local phone directories and online. If you have a history of suicidal thoughts and remain vulnerable, please let me know so we can work together to reduce your risk. Also, please see my page on suicide prevention.
Is there anything I can do to get a good start in psychotherapy?
Yes! Here are some actions that may be helpful to complete following your first therapy session:
(1) more fully articulating your goals for therapy;
(2) identifying actions you can begin taking that would help to move you toward your goals;
(3) following up on any recommendations I made during our initial session;
(4) identifying what you want to for us to focus on in your second session;
(5) considering what questions you may have about psychotherapy and how to get the most out of it;
(6) browsing relevant pages on my website; and
(7) scheduling a medical examination if you have not had one in the past year.
There are two relatively brief therapeutic exercises that I encourage you to complete prior to your second session: Therapeutic goal setting and planning and dissecting the problem. These exercises will help you to become more specific about your goals for therapy and to identify factors that may be maintaining or complicating the difficulties that brought you to therapy.
Further questions?
If you have any questions or concerns about the information on this page, please let me know.