What to expect in therapy
Once we have scheduled a session, depending on your insurance or payment method and residency, you will receive some emails requesting that you set up an account and sign necessary consent documents. You will then be sent a link for the virtual video session via doxy.me. The first session is called an intake, and at this session we primarily focus on collecting background and setting expectations and goals for the therapy. Many people enter therapy for one problem and find that they wish to continue it to resolve others; this is normal and a natural consequence of the kind of ‘life-auditing’ that therapy facilitates. Session frequency ranges but usually clients start out with weekly appointments, going 4 to 5 times and then tapering to once every other week as skills and insights build. This means that for clients with practical, easily identifiable concerns, treatment may last anywhere from 3 to 6 months. For some people, treatment may be as short as a few weeks, while for those engaged in trauma-focused or psychoanalytic work, treatment may last for well beyond a year.
As a therapist, I am practical, solution-oriented, and straightforward with clients. In my experience, I am capable of engaging with clients in deep, meaningful work and insight-building in much shorter periods of time than most therapists. The more information I am given and the more collaboration I receive, the more I can facilitate the self-improvement a client is looking for. While some people will need more time in therapy than others, no one should seek to spend a lifetime in it. The therapy I offer provides solutions, not crutches, and the best results are reified in those who are committed to self-sufficiency. This does not mean you will be rushed to meet your goals; instead, you will be appropriately challenged to do so. Keep in mind that goals are set by the client and can always change depending on need.
The two techniques I most often use include cognitive behavioral therapy (CBT) and psychoanalysis. My work with clients will draw on elements from both of these strategies.
CBT
Cognitive behavioral therapy is an evidence-based practice that focuses on the relationship between thoughts, feelings, and behaviors in the present. In other words, how a person thinks about the world and situations influences how he or she feels about them and, in its turn, conduces to action or inaction. For example, if I tell myself that roller-coasters are dangerous, I will be afraid of them and, as a result, avoid them. If I tell myself roller-coasters are a great time, then I will enjoy them and seek them out for thrills. CBT seeks to build meaningful connections between a client’s thoughts, feelings, and behaviors and to renegotiate them in a way that leads to better outcomes and interactions with the world.
Psychoanalysis
Psychoanalysis or psychodynamic therapy is significantly less structured than CBT and, unlike CBT which is focused primarily on the present, psychodynamic techniques seek to understand the present through an examination of the client’s past. Psychoanalysis works to locate the meaningful connections between one’s upbringing and early experiences and his or her current thought patterns, feelings, and behaviors. Psychoanalysis is particularly useful for understanding how we might be unconsciously sabotaging our efforts at self-improvement or protecting ourselves from fears deeply rooted in our past. Where CBT assists clients in building skills and tools to increase their self-sufficiency, psychodynamic techniques arm clients with heightened self-awareness and actionable behavioral insights.
Solution-Focused Therapy
Some people have issues that simply do not require much more than a few sessions. I have even treated people successfully in as few as two. In short-term solution-focused therapy, the goal is quick, practical insights, solutions, and outcomes for individuals who have either limited time or funds, and most importantly, problems that can be practically resolved. Clients benefiting from this approach are typically struggling with an important decision or are looking for a readily implementable strategy regarding a conflict or relationship issue. At times, it is as simple as seeking a little confidence boost with some normalization of concerns and strengths-based encouragement. It is important to remember that it is still ultimately the responsibility of the client to implement whatever insights or solutions are generated; when clients are already prepared to act and have a good idea of what outcome they would like, resolution can occur in four or fewer sessions, or just several weeks.