Answers to common questions

What services do you provide?

I offer individual, couples/marriage and family therapy.


What benefits can I expect from working with a therapist?

People in therapy tend to have lower levels of anxiety and stress, decreased conflict, and improved quality of life. Therapy can provide an education, clarity and perspective into life's challenges. It can help create solutions to difficult problems and offer unbiased support. . Many people find that working with a therapist can enhance personal development, improve relationships and family dynamics, and can ease the challenges of daily life. Sometimes, client’s report just having someone there to listen, is very helpful.

What other benefits are there?

• Developing new skills for handling stress and anxiety.
• Modifying unhealthy behavior and long-standing patterns.
• Attaining insight into personal patterns and behavior.
• Increasing confidence, peace, vitality, and well-being.
• Improving ways to manage anger, depression and moods.
• Discovering new ways to solve problems.
• Improving listening and communication skills.
• Enhancing the overall quality of life.

What will happen after I call or email you?

I will return your email or phone call and answer any questions you have - if you decide to go forward, we will schedule an appointment.

How do I know if I need therapy?

Therapy is right for anyone who is interested in getting unstuck, creating greater self-awareness, and working towards change. Therapy is different from talking with friends or family members about your concerns.  A well-trained therapist can provide insight, support, and new strategies for all types of life challenges. A therapist can help you clearly define the issue and then teach and guide you to a better place in your life and relationships.  If you are considering therapy, you are probably a good candidate. If you aren't sure, you might try out one session and go from there

What can I expect in the first session?
 
It is normal to feel nervous, but once we get started, most people quickly relax.  You can expect to talk about the most recent issue that’s bringing you into counseling / therapy and the outcomes you would like to experience.

How long does therapy last?
 
Therapy can be short-term, focusing on a specific issue or longer-term, addressing more complex issues. However the length of treatment varies significantly depending on your goals and the nature of your concerns. The amount of time it takes depends on many factors.  Some of these include: your readiness for counseling, the presence of a secondary issues (i.e.: addiction personality disorder or history of trauma).

Marriage and family therapists regularly practice short-term therapy; 12 sessions on average. Nearly 65.6% of the cases are completed within 20 sessions, Marital/couples therapy (11.5 sessions) and family therapy (9 sessions) both require less time than the average individuated treatment. About half of the treatment provided by marriage and family therapists is one-on-one with the other half divided between marital/couple and family therapy, or a combination of treatments. (Adapted from www.AAMFT.org)


How long is each session and how often do I attend?

Individual sessions are between 50 – 60 minutes.  Couples / Family sessions are 90 minutes for the initial appointment and then 50 – 60 minutes thereafter. Longer sessions can be requested and are recommended for crisis and trauma work. In order to obtain the most effective results, weekly visits are recommended.  Between sessions it is important to process what has been discussed and integrate it into your life. After some traction is established, counseling quickly moves to bi-weekly and then some clients wish to attend monthly to maintain or reinforce their changes.


Is therapy confidential?
 
Yes. The law protects the confidentiality of all communications between a client and a psychotherapist. Information is not disclosed without written permission. However, there are number of exceptions to this rule. Exceptions include:

• Suspected child abuse, elder abuse, or the abuse of a dependent adult. The therapist is required by law to immediately report this to the appropriate authorities.
• If a client is threatening serious bodily harm to another person/s or them self. The therapist must notify the police and inform the intended victim. The therapist will make every effort to enlist their cooperation in insuring their safety. If they do not cooperate, further measures may be taken to ensure safety.
• If a court orders the records.

How long is your wait list?

It varies; however a one to two week wait time is common. If you require immediate care, please let me know upon contact.  If you are in a serious medical or emotional crisis, I advise you to seek help at your nearest hospital emergency room where they can best assess your short-term treatment needs.


How do I pay?

Cash, check or all major credit cards are accepted for payment.


What if I have to reschedule / cancel?

Please contact me at least 24 hours in advance of your session. If less than 24 hours notice is given then you will be charged 75% of the regular session rate.


Do you treat other issues?

Although I specialize in anxiety, couple’s issues & trauma, I also work with depression, bi-polar, grief, abuse and parenting.


What is Marriage and Family Therapy?
 
A family's patterns of behavior influences the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn't just the person - even if only a single person is interviewed - it is the set of relationships in which the person is imbedded. Marriage and family therapy is:

• brief
• solution-focused
• specific, with attainable therapeutic goals
• designed with the "end in mind."

Research indicates that marriage and family therapy is as effective, and in some cases more effective than standard and/or individual treatments for many mental health problems such as: adult schizophrenia, affective (mood) disorders, adult alcoholism and drug abuse, children's conduct disorders, adolescent drug abuse, anorexia in young adult women, childhood autism, chronic physical illness in adults and children, and marital distress and conflict. (Adapted from www.AAMFT.org)


What is a Marriage and Family Therapist?
 
Marriage and Family Therapists (MFTs) are mental health professionals specifically trained in psychotherapy and family systems. They are trained to diagnose and treat mental and emotional disorders and address a wide array of relationship issues within the context of marriage, couples and family systems.  Marriage and Family Therapists broaden the traditional emphasis on the individual and attend to the role of individual in primary relationship networks such as marriage and the family.  MFTs take a holistic perspective to health care; they are concerned with the overall, long-term well-being of individuals and their families. MFTs have graduate training (a Master's or Doctoral degree) in marriage and family therapy and are recognized as a "core" mental health profession, along with psychiatry, psychology, social work and psychiatric nursing. (Adapted from www.AAMFT.org)


What are the qualifications to be a Marriage and Family Therapist?

Marriage and family therapy is a distinct professional discipline with graduate and post graduate programs. Three options are available for those interested in becoming a marriage and family therapist: master's degree (2-3 years), doctoral program (3-5 years), or post-graduate clinical training programs (3-4 years). The Federal government has designated marriage and family therapy as a core mental health profession along with psychiatry, psychology, social work and psychiatric nursing. The regulatory requirements in most states are substantially equivalent to the American Association of Marriage and Family Therapists Clinical Membership standards. After graduation from an accredited program, a period - usually two years - of post-degree supervised clinical experience is necessary before licensure or certification. When the supervision period is completed, the therapist can take a state licensing exam, or the national examination for marriage and family therapists conducted by the AAMFT Regulatory Boards. This exam is used as a licensure requirement in most states. (Adapted from www.AAMFT.org)


Why use a Marriage and Family Therapist?

Research studies repeatedly demonstrate the effectiveness of marriage and family therapy in treating the full range of mental and emotional disorders and health problems. Adolescent drug abuse, depression, alcoholism, obesity and dementia in the elderly -- as well as marital distress and conflict -- are just some of the conditions Marriage and Family Therapists effectively treat. Studies also show that clients are highly satisfied with services of Marriage and Family Therapists. Clients report marked improvement in work productivity, co-worker relationships, family relationships, partner relationships, emotional health, overall health, social life, and community involvement. In a recent study, consumers report that marriage and family therapists are the mental health professionals they would most likely recommend to friends. Over 98 percent of clients of marriage and family therapists report therapy services as good or excellent.

After receiving treatment, almost 90% of clients report an improvement in their emotional health, and nearly two-thirds report an improvement in their overall physical health. A majority of clients report an improvement in their functioning at work, and over three-fourths of those receiving marital/couples or family therapy reports an improvement in the couple relationship. When a child is the identified patient, parents report that their child's behavior improved in 73.7% of the cases, their ability to get along with other children significantly improved and there was improved performance in school. Marriage and family therapy's prominence in the mental health field has increased due to its brief, solution-focused treatment, its family-centered approach, and its demonstrated effectiveness. Marriage and family therapists are licensed in 46 states and are recognized by the federal government as members of a distinct mental health discipline.
Today more than 50,000 marriage and family therapists treat individuals, couples, and families nationwide. Membership in the American Association for Marriage and Family Therapy (AAMFT) has grown from 237 members in 1960 to more than 23,000 in 1996. This growth is a result, in part, of renewed public awareness of the value of family life and concern about the increased stresses on families in a rapidly changing world.  (Adapted from www.AAMFT.org)

Can anyone call themselves a Marriage and Family Therapist?

No. Someone must hold a specific license with their state board of Marriage and Family Therapy to advertise themselves as a Marriage and Family Therapist. AAMFT Clinical Members meet stringent training and education requirements that qualify them for the independent practice of marriage and family therapy (MFT).  AAMFT requires Clinical Members to abide by the AAMFT Code of Ethics, the most stringent ethical code in the marriage and family therapy profession. This code delineates specific ethical behavior and guidelines for members to follow to ensure the ethical treatment of clients. Clinical Membership in the AAMFT signifies an MFT's dedication to his or her ongoing professional development. Each month, AAMFT Clinical Members receive important updates on current clinical and research developments in the field, as well as numerous opportunities throughout the year to attend professional development conferences. (Adapted from www.AAMFT.org)


What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories (Shapiro, 1989a, 1989b). Shapiro’s (2001) Adaptive Information Processing model posits that EMDR facilitates the accessing and processing of traumatic memories to bring these to an adaptive resolution. After successful treatment with EMDR, affective distress is relieved, negative beliefs are reformulated, and physiological arousal is reduced. During EMDR the client attends to emotionally disturbing material in brief sequential doses while simultaneously focusing on an external stimulus. Therapist directed lateral eye movements are the most commonly used external stimulus but a variety of other stimuli including hand-tapping and audio stimulation are often used (Shapiro, 1991). Shapiro (1995) hypothesizes that EMDR facilitates the accessing of the traumatic memory network, so that information processing is enhanced, with new associations forged between the traumatic memory and more adaptive memories or information. These new associations are thought to result in complete information processing, new learning, elimination of emotional distress, and development of cognitive insights. EMDR uses a three pronged protocol: (1) the past events that have laid the groundwork for dysfunction are processed, forging new associative links with adaptive information; (2) the current circumstances that elicit distress are targeted, and internal and external triggers are desensitized; (3) imaginal templates of future events are incorporated, to assist the client in acquiring the skills needed for adaptive functioning. (Adapted from www.EMDR.com)

Is EMDR a one-session cure?

No. When Shapiro (1989a) first introduced EMDR into the professional literature, she included the following caveat: “It must be emphasized that the EMD procedure, as presented here, serves to desensitize the anxiety related to traumatic memories, not to eliminate all PTSD-symptomology and complications, nor to provide coping strategies to victims” (p 221). In this first study, the focus was on one memory, with effects measured by changes in the Subjective Units of Disturbance (SUD) scale. The literature consistently reports similar effects for EMDR with SUD measures of in-session anxiety. Since that time, EMDR has evolved into an integrative approach that addresses the full clinical picture. Two studies (Lee, Gavriel, Drummond, Richards, & Greenwald, 2002; Rothbaum, 1997) have indicated an elimination of diagnosis of posttraumatic stress disorder (PTSD) in 83-90% of civilian participants after four to seven sessions. Other studies using participants with PTSD (e.g. Ironson, Freund, Strauss, & Williams, 2002; Scheck, Schaeffer, & Gillette, 1998; S. A. Wilson, Becker, & Tinker, 1995) have found significant decreases in a wide range of symptoms after three-four sessions. The only study (Carlson, Chemtob, Rusnak, Hedlund, & Muraoka, 1998) of combat veterans to address the multiple traumas of this population reported that 12 sessions of treatment resulted in a 77% elimination of PTSD. Clients with multiple traumas and/or complex histories of childhood abuse, neglect, and poor attachment may require more extensive therapy, including substantial preparatory work in phase two of EMDR (Korn & Leeds, 2002; Maxfield & Hyer, 2002; Shapiro, 2001).  . (Adapted from www.EMDR.com)


Is EMDR an efficacious treatment for PTSD?

Yes. EMDR is the most researched psychotherapeutic treatment for PTSD. Twenty controlled outcome studies have investigated the efficacy of EMDR in PTSD treatment. Sixteen of these have been published, and the preliminary findings of four have been presented at conferences. Seven randomized clinical trials have compared EMDR to exposure therapies (Ironson et al., 2002; McFarlane, 2000; Rothbaum, 2001; Thordarson et al., 2001; Vaughan et al., 1994) and to cognitive therapies plus exposure (Lee et al., 2002; Power et al., 2002). These studies have found EMDR and the cognitive/behavioral (CBT) control to be relatively equivalent, with a superiority in two studies for EMDR on measures of PTSD intrusive symptoms, and for CBT in the study by Taylor and colleagues Taylor, Thordarson, and Maxfield (2002) on PTSD symptoms of intrusion and avoidance.
The efficacy of EMDR in the treatment of PTSD is now well recognized. In 1998, independent reviewers (Chambless et al., 1998) for the APA Division of Clinical Psychology placed EMDR, exposure therapy, and stress inoculation therapy on a list of empirically supported treatments, as “probably efficacious” ; no other therapies for any form of PTSD were judged to be empirically supported by controlled research. In 2000, after the examination of additional published controlled studies, the treatment guidelines of the International Society for Traumatic Stress Studies gave EMDR an A/B rating (Chemtob, Tolin, van der Kolk, & Pitman, 2000) and EMDR was found efficacious for PTSD. The United Kingdom Department of Health (2001) has also listed EMDR as an efficacious treatment for PTSD.
Foa, Riggs, Massie, and Yarczower (1995) suggested that exposure therapy may not be very effective with clients whose prominent affect is anger, guilt, or shame. Reports by clinicians treating combat veterans (e.g., Lipke,1999; Silver & Rogers, 2002) indicate that EMDR may be effective with such PTSD presentations. A preliminary study found that EMDR reduced symptoms of guilt in combat-related PTSD (Cerone, 2000). Taylor et al. (2002) reported equivalent and significant effects for exposure therapy and EMDR on reducing symptoms of anger and guilt. (Adapted from www.EMDR.com)


What can I expect with EMDR?

Each case is unique, but there is a standard eight phase approach that each clinician should follow. This includes taking a complete history, preparing the client, identifying targets and their components, actively processing the past, present and future aspects, and on-going evaluation. The processing of a target includes the use of dual stimulation (eye movements, taps, tones) while the client concentrates on various aspects. After each set of movements the client briefly describes to the clinician what s/he experienced. At the end of each session, the client should use the techniques s/he has been taught by the clinician in order to leave the session feeling in control and empowered. At the end of EMDR therapy, previously disturbing memories and present situations should no longer be problematic, and new healthy responses should be the norm. A full description of multiple cases is available in the book "EMDR The Breakthrough Therapy for Overcoming Anxiety, Stress and Trauma" by Shapiro & Forrest. (Adapted from www.EMDR.com)


How many sessions will it take?

The number of sessions depends upon the specific problem and client history. However, repeated controlled studies have shown that a single trauma can be processed within 3 sessions in 80-90% of the participants. While every disturbing event need not be processed, the amount of therapy will depend upon the complexity of the history. In a controlled study, 80% of multiple civilian trauma victims no longer had PTSD after approximately 6 hours of treatment. A study of combat veterans reported that after 12 sessions 77% no longer had post traumatic stress disorder. (Adapted from www.EMDR.com)


How many sessions with the therapist before (s)he begins EMDR?

This depends upon the client's ability to "self-soothe" and use a variety of self-control techniques to decrease potential disturbance. The clinician should teach the client these techniques during the preparation phase. The amount of preparation needed will vary from client to client. In the majority of instances the active processing of memories should begin after one or two sessions. (Adapted from www.EMDR.com)



OTP provides adult, adolescent and teen psychotherapy, therapy, counseling, EMDR and parenting support for treatment of anxiety, PTSD, trauma, panic, and depression.  OTP is within driving distance of Longwood, Lake Mary, Oviedo, Winter Springs, Apopka, Sanford, Altamonte Springs, Maitland, Winter Park, College Park, Orlando, Windermere, Dr. Philips, Baldwin Park.