Frequently Asked Questions
What is psychotherapy?
Does psychotherpy work?
How do I know if I need psychotherapy?
If I’m in therapy, does it mean something is wrong with me?
How do I find a therapist?
How much does therapy cost? What if I can’t afford it?
What is psychotherapy?
At its most basic level, psychotherapy is a contracted interpersonal relationship between a trained, licensed therapist and a person who needs help in healing psychological wounds or in solving life problems. There are multiple types of therapeutic orientations a therapist may work from. Some, coming out of the psychoanalytic or psychodynamic schools, focus more on early experiences in life—analyzing how we have made meaning out of what we learned very early about the world and ourselves, and the focus is healing from old wounds. Others, especially in the cognitive and behavioral schools, focus much more on the here-and-now of behaviors and thoughts, with therapy focused on giving concrete tools for change right now without paying much attention to the past. Many therapists today, including myself, use a combination of these approaches, mixing interventions to help you cope with anxiety, depression, stress, etc. in the here-and-now while also paying attention to how earlier experiences inform your current reality.
Does psychotherapy work?
There is a lot of conflicting information and opinions out there about the effectiveness of therapy. In finding the answer to this question, it is important to first settle on a definition of what it means for therapy to “work.” We need to define what outcomes of therapy would constitute success. A study may show that a certain type of therapy doesn’t work based on one definition of success, but based on another definition it definitely does work. Or vice versa!
Some types of therapy are more effective than others at treating specific conditions. For example, EMDR typically yields successful results in the treatment of PTSD. Clinical depression is most effectively treated by a combination of anti-depressant meds concurrent with talk therapy. But many clients do not have neatly defined problems, or they have multiple problems at once. As it turns out, generally speaking, the relationship between the therapist and the client is the most accurate predictor of success in the therapy. If the client and therapist like one another, and if the client feels respected and safe during therapy, the probability of experiencing success is high.
When deciding whether to pursue therapy, I would advise that you define for yourself what success would look like for you. Identify some specific short-term and long-term goals. When you are interviewing a potential therapist(s), share this information with them and ask them to tell you specifically how they can help you achieve your goals. It is the job of the therapist to explain to you how they work, to demonstrate their qualifications for treating your problem, and to thoroughly answer any questions you have. If you do not feel your questions are answered thoroughly or to your satisfaction, you may want to think carefully about working with that particular therapist.
How do I know if I need psychotherapy?
Just having a problem doesn’t necessarily mean that you need psychotherapy. I am of the belief that the vast majority of individuals can experience greater insight and healing from therapy, but the reality is the time and financial commitment can be significant. So if you are wondering if you need therapy, or if therapy is something you should make a priority in your life right now, I encourage you to ask yourself two questions:
1. Is your problem lasting an inordinate amount of time? An example of this might be that you lost your job or were diagnosed with an illness some time ago, but you are still having difficulty letting go and living into your “new normal.”
2. Is the problem hindering your functioning in any major area of life? This includes work, school, family, spirituality, physical well-being (e.g. somatic symptoms like back pain or teeth clenching), or ability to do basic self-care tasks (trouble sleeping, loss of appetite, difficulty getting out of bed, etc.)
If you answered yes to either one of those questions, then I would encourage you to pursue the possibility of therapy.
If I’m in therapy, does it mean something is wrong with me?
Absolutely not! Experiencing traumas, losses, and difficult emotions is a normal part of human experience. You may need healing. You may need to let go. You may need discernment or to make new meaning out of your life. You may need to adjust to a “new normal.” And you may be able to do these things more effectively with help from a therapist. But whatever is going on in your mind and heart, seeking therapy does not mean something is wrong with you. It means you’ve been through some difficult times, you’ve lived to tell the tale, and now you want to take steps to achieve healing and fuller life.
How do I find a therapist?
Finding a therapist can be a confusing and overwhelming endeavor… even for me, and I’m a therapist! Here are some tips I’ve found useful both in recommending to my clients and also in finding a therapist for myself:
1. Research. Ask people you trust—friends, colleagues, family members, etc.—for recommendations. Do an online search for therapists in your area. Compare their websites to your personality and the issues you are facing.
2. Choose a therapist (or 2 or 3—check out several options if you have a few you think might work!) and make an appointment.
3. Most therapists offer a free consultation session (20-30 min typically). Make use of this; and if the therapist doesn’t explicitly offer it, ask for one!
4. Before going to your appointment(s), make a list of your problems/symptoms/issues, as well as some short-term and long-term goals of therapy. Also make a list of any questions their website didn’t answer, such as their therapeutic philosophy, credentials, experience, etc.
5. At the appointment(s), pay attention to how you feel. Do you feel comfortable and welcome in the space? Does your personality seem to jive well with the therapist’s? Do you feel satisfied with the answers he or she has given you?
6. After you’ve met with the therapist(s), in order to make a decision, go back over the information you received as well as doing a “gut check” with yourself. Did you feel comfortable, respected, and safe in the space? Did you just plain like or not like the therapist? How did you feel while you were with him or her?
7. If you did not feel like the therapist was a good match, you can start back over at 1 or ask that therapist for a referral.
How much does therapy cost? What if I can’t afford it?
The going rate for therapy varies regionally. In the Seattle area it tends to be approximately $90-140 per 50-minute hour. Some therapists accept insurance, and others offer sliding scales based on income. For example, I use a sliding scale up to $100 for individuals and up to $120 for couples.
If you plan to use insurance for therapy, be aware that your records will become part of a file at your insurance company, and the therapist will no longer have control over how that information is used. Also be aware that financially investing in therapy may help you to take your therapy seriously, investing the time and energy that is required for healing. Some therapists don’t accept insurance for this reason.
When I work with clients to negotiate a fee for counseling, we start with my sliding scale and compare that to what they think is reasonable for them. What I tell clients is that the therapy that is going to be optimal for their benefit in getting the work done is one that stretches them slightly—so they feel it as an investment—but is not a hardship.
The cost of therapy will be one of the factors you will need to consider when researching therapists. Rather than view it purely as a hindrance or annoyance, see it as a natural and normal part of the investment required to make therapy successful.