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's important to process what's been discussed and integrate it into your life. After some traction is established, counseling quickly moves to bi-weekly and then some clients like to attend monthly to maintain or reinforce their changes.
Yes. The law protects the confidentiality of all communications between a client and a licensed psychotherapist/therapist/counselor. Information about you can not be disclosed (to anyone) without written permission. HOWEVER, (this is that HIPPA stuff) there are a number of exceptions to this rule. Exceptions include:
1. 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.
2. If a client is threatening serious bodily harm to another person/s or themself. The therapist must notify the police and inform the intended victim.3. If a court orders the records.
Yes. A late cancellation is considered anything under 24 hours from you appointment time. If less than 24 hours notice is given, then you're charged for the time you've booked. So PLEASE, please contact me at least 24 hours in advance of your session. You can call, text or email me.
If you have an appointment on a Monday, you have to contact me by noon on the prior Friday to avoid the late cancellation charge. This is so I can try and fill your appointment slot.
No-show fees are the same.
COMMON MARRIAGE COUNSELING QUESTIONS
No, not usually.
I have a client who calls me her Sigman - in this context: When her husband says he wants to come in and see me too, she says "No. She's MY SIGMAN."
It's important that both people feel like they are on equal ground with their therapist. If I saw you first, we've already built a relationship and this puts your significant other at a disadvantage, even if they want to come and see me. In good couple's counseling, I have an equal opportunity to build a relationship with both people.
My client's husband learned that he has to get his own SIGMAN.
But don't fret. I have great colleagues that I'll refer you both to for couple's work.
No. Well, kinda.
When I do couple's work I see my couple together for the first visit (which is 90 minutes). The second and third sessions are individual session for you (that's the kinda part) and then your significant other. Every session after that is always the 3 of us.
This helps to create an even playing field for the therapy work we'll do together.
Yes. All the time.
FYI: Not all therapists have experience in this area. I'd recommend only a therapist who does.
COMMON TRAUMA / EMDR QUESTIONS
A trauma is any event that when you recall it, you begin to bubble up some emotion. You may feel the emotion in your body as stomach flutters, tightness in your chest or back, racing heart, lump in your throat, shortness of breath or tears.
Actually, we all experience traumas (T's) in our life. Some obvious and big, some subtle (and no one would know). Lots of times the (T) settles out and just becomes a story for us. However, sometimes our brain can't make sense of it and it keeps resurfacing. At least the emotions keep resurfacing and getting in our way of having the life we want to have, both personally and professionally.
Examples: Natural disasters, sudden/tragic loss, terminal health diagnosis, accidents, violence (physical & emotional), divorce, date rape, war. childhood events, etc.
No. One is the event and the other is the outcome. A traumatic event can lead to Post Traumatic Stress Disorder (PTSD) but not the other was around.
FYI - a traumatic event doesn't always lead to PTSD.
This is dry but hang in there:
Eye Movement Desensitization and Reprocessing (EMDR) is a therapy treatment that was originally designed to alleviate the distress associated with traumatic memories. EMDR facilitates the accessing and processing of traumatic memories to bring these to resolution. After successful treatment with EMDR, distress is relieved, negative beliefs are reformulated and physiological arousal is reduced.
Interpretation: It makes you feel so much better!
During EMDR the client attends to the emotionally material in brief sequences. 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.
I use a little gadget called a Theratapper that's wonderful. It uses your senses of hearing, seeing and touching. My clients love it.
It's thought that EMDR facilitates the accessing of the traumatic memory network, so that 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.
No. But it works faster then other conventional methods of therapy.
Here's some boring stuff:
When Francine Shapiro (1989a) first introduced EMDR into the professional literature, she included the following caveat: “It must be emphasized that the EMDR 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).
Yes, Yes, Yes! EMDR is the most researched psychotherapeutic treatment for PTSD.
More boring stuff:
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.
Yes! I use abbreviated EMDR processing daily with my clients for issues of anxiety, grief, anger, depression, worry and more.
It's amazing to see the insights they have and the resolution they experience during our sessions.
OTHER COMMON QUESTIONS
A Marriage and Family Therapists (MFT) is a mental health professional specifically trained in psychotherapy, relationship and family systems. They are trained to address a wide array of relationship issues within the context of marriage, couples and families.
MFTs take a holistic perspective, they are concerned with the overall, long-term well-being of individuals and their relationships.
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 mental health counseling. (Adapted from www.AAMFT.org).