Does therapy really work?
The American Psychological Association reports that research findings indicate psychotherapy effectively decreases patients’ depression and anxiety, as well as related symptoms such as pain, fatigue, and nausea. Therapy has also been found to increase survival times for heart surgery and cancer patients, and it can have a positive effect on the body’s immune system. The APA also reports research suggests emotional and physical health are very closely linked and talk therapy can improve an individual’s overall health. There is convincing evidence that most people who have at least several sessions of talk therapy are far better off than those with emotional difficulties who choose to forego therapy. According to one major study, 50% of patients noticeably improved after eight sessions while 75% of therapy patients improved after six months.
How does therapy work?
Clinical psychologists use an assortment of evidence-based treatments to help people improve their lives. Most commonly, therapy (often called psychotherapy or talk therapy) is used. There are various forms and styles of therapy and a clinical psychologist will choose the type that best addresses the person’s characteristics, preferences, and goals. Therapy isn’t easy but patients who are willing to work in a close partnership with their therapist often find relief from their emotional distress and begin to lead more productive and fulfilling lives. Taking periodic stock of your emotional well-being can help identify warning signs of common ailments like depression or anxiety. Such illnesses are highly treatable, especially when they are identified in their early stages, before they get so severe that they precipitate some sort of personal—and perhaps financial—crisis. For some, psychotherapy could prove lifesaving; a recent study reported that depression, anxiety, and loneliness can shorten the life span.
How do I chose a therapist?
Psychologists and their patients work together. The right match is vital. Most psychologists agree that an important factor in determining whether or not to work with a particular psychologist, once that psychologist's credentials and competence are established, is your level of personal comfort with that psychologist. A good rapport with your psychologist is critical. Choose a one with whom you feel comfortable and at ease.
How will I know if therapy is working?
As you begin therapy, you should establish clear goals with your psychologist. You might be trying to overcome feelings of hopelessness associated with depression or control a fear that is disrupting your daily life. Remember, certain goals require more time to reach than others. You and your psychologist should decide at what point you may expect to begin to see progress. It’s a good sign if you begin to feel a sense of relief, and a sense of hope. People often feel a wide variety of emotions during therapy. Some qualms about therapy that people may have result from their having difficulty discussing painful and troubling experiences. When you begin to feel relief or hope, it can be a positive sign indicating that you are starting to explore your thoughts and behavior—for some, this can occur within the first few sessions.
I'm an older adult (over age 55), how could therapy help me at my age?
Anxiety and depression can increase the risk of a stroke. On the positive side, a recent study reported that being in a good mood can increase an aging adult’s brain power. Contrary to a popular myth, older adults can change their habits. Research indicates aging does not bring mandatory depression; most older adults are able to thrive despite the expected changes brought by aging. The aging phase of the life span often brings a number of expected, and unexpected, losses. Many are grappling with mental health issues unaddressed for decades, as well as contemporary concerns about new living arrangements, finances, chronic health problems, the loss of loved ones and their own mortality. Psychotherapy can equip an aging adult with new coping strategies in the face of new losses. The concept of retirement is evolving; experts now suggest a key component is emotional readiness. It is imperative that an aging adult work with a psychotherapist who has specialized training with older patients. Most older adults grew up in a generation where mental health issues were not freely discussed and there was shame associated with seeking treatment; studies indicate the stigma is fading.
How is therapy different for men than women?
Women and men are socialized differently in our culture. Women are typically more comfortable expressing their emotions. Many men suffer from the restrictions of their male gender role—the unwritten rules they learn on what it means to be a man. For some men, those restrictions, such as always being in control and never seeking help from anyone, can lead to emotional turmoil. For some men, the result is seeking self-medication such as alcohol or drugs, which can lead to more serious life problems. Gender aware therapy focuses on a man’s strengths and understands the sometime health-threatening proscriptions of the male gender role. Experts say men are expected to be strong, deny pain and vulnerability, and conceal any emotional fragility. Because of these societal expectations, men typically appear to have poorer understanding of mental health and aren’t as good at detecting symptoms of depression compared with women. Often, men who enter a supportive, non-judgmental, safe and confidential environment where they are encouraged to express painful emotions, can feel a tremendous burden lifted and begin to see improvements in many areas of their lives.
What does a therapy session cost? How is payment made?
A typical individual therapy session is 50 minutes long and costs $150. Longer sessions are billed at a higher rate. A sliding fee scale is available to a limited number of patients. Cash or check is required for payment at the time of each therapy session. There is no monthly billing. Fee arrangements should be discussed with your therapist in the initial telephone consultation or no later than the end of the first therapy session.
Do you accept insurance?
Medicare (and supplemental plans) is accepted for aging adults. Insurance companies will not be billed directly. If a patient has insurance, he or she may request a monthly bill they may submit to their insurance company for reimbursement. Many insurance companies will reimburse a percentage of the fee for an out-of-network provider; many PPO plans reimburse from 40% to 60% of psychotherapy fees. It is recommended for patients with insurance to contact their carrier prior to the start of therapy to learn the details of reimbursement for their company.
What if I don't want anyone to know I'm seeing a therapist?
Therapy is conducted in a private, confidential environment. Extremely limited bits of personal information are released from the patient/therapist relationship and typically those occur only for the purpose of consultation with other professionals-- and only after the patient has signed a release of information form. Ethics codes and state laws require that psychologists remain silent about what is discussed or shared during psychotherapy, unless you or someone else’s life is in danger. In the therapeutic relationship, confidentiality is sacred. In the initial session, the therapist will outline the stringent limits of confidentiality. It is vital that the patient feel safe and secure in the therapeutic relationship.
How long will it take until I'm feeling better?
Each patient is different in myriad ways. Some people enter therapy with relatively straightforward issues that can be improved in a brief number of sessions. Other patients bring a lifetime of emotional burdens that need to be untangled. The answer is the length of treatment varies; some achieve their specific, fairly narrow therapeutic goals in six to eight weeks of weekly scheduled sessions, others find reward in a more lengthy period of personal analysis. Patients diagnosed with mild to moderate depression often begin feeling better in just a few sessions. Psychotherapy takes time and work, but as you progress, you learn more effective ways to tackle problems and solve challenging situations. And in the end, you’ve developed skills and acquired tools such as different ways of thinking, more effective coping mechanisms, and improved problem-solving.
Do you prescribe medications?
No. That is the job of a physician, or in the case of psychotropic medications, a psychiatrist is recommended. If a patient is in therapy and the option of medication is considered, a clinical psychologist will refer the patient to a nearby psychiatrist for a medication evaluation. Often, older adults are seeing a number of medical specialists from whom they receive various prescription medications. A clinical psychologist will often arrange a referral for a psychiatrist to allow the patient a medication evaluation to prevent unnecessary, and possibly harmful, drug interactions or accumulation of unwanted side effects.
Isn’t medication enough to cure my problem?
In the short term, therapy is about as effective as medications in reducing symptoms of clinical depression or anxiety disorders. Talk therapy can also produce better long-term results for patients and their family members, in that they often improve functioning in social and work contexts and prevent relapse better than medications. Compared to the use of medication alone, which may seem like a more cost-effective option in the short term, research has shown that the benefits of psychotherapy extend to one’s physical health as well, often resulting in better physical health and lowering of your overall health costs over time. In many cases, medication can be a helpful supplement to patient’s work in therapy; studies indicate therapy can enhance the effectiveness of medications. Talk therapy, it should be noted, has no side effects. If entering therapy is a financial consideration, for many there is no better investment than on one’s self and future.
What if I’m afraid of feeling I’m being judged by the therapist?
During psychotherapy, the psychologist listens to what you say without judgment, no matter how embarrassing, shameful or frightening your thoughts or feelings are to you. People often reveal things during psychotherapy that are scary and very personal, and the fear of how others will respond or react is normal. The role of the psychologist is to remain neutral and supportive, to help you cope better with the troubling situation, and to work with you to find a good solution for your concerns.
I’ve seen therapy on TV and in the movies—is it really like that?
In reality, while there's often a couch or a comfy chair, therapists are not detached, distracted listeners who charge an outrageous sum for an hour of their time. And just because you receive counseling doesn't automatically mean that something is wrong with you. Many people believe they must have an intense issue to enter therapy but often people can benefit for something as simple as reaching a specific goal.
I have a full-time job; does that mean I can’t have therapy?
Many people who work full-time during the week find a way to fit in their psychotherapy session if it’s important to them. Some people schedule an appointment during their lunch hour, others make arrangements with their employer to allow them to leave early one day a week. Others find a therapist who offers after-hours sessions. At Encino Psychotherapy, there is a waiting list for those who want to schedule an evening session.