COVID 19 & Teletherapy
Seeing a therapist used to imply being in the same room with them, but not any longer. Teleconferencing has made it possible to see a mental health professional from a distance.
With recent requirements for social distancing, many therapists and clients have had to either pause their work or make other arrangements, including meeting by video conference.
I've been providing teletherapy services for a few years now. Here are some common questions and issues that come up when thinking about making the transition.
Will My Therapist Agree to Online Sessions?
Some therapists (myself included) are enthusiastic about using teletherapy, some won't use it at all, and a large number of therapists approach it with some reservations. I've been surprised how many therapists are now moving to it with the COVID-19 outbreak and resulting social distancing. Most therapists generally seem to find that it's a very beneficial approach.
Even among therapists I know who were skeptical about online sessions in the past, the majority have opened to the idea. They seem to recognize it as a good option to avoid an untimely break in the therapy relationship, and to provide continuity of care.
Will It Be Weird?
If you're generally comfortable with communicating through a screen (e.g., Skype, FaceTime), you'll probably be comfortable moving to online therapy. If you can't stand this form of communication, you'll likely have a harder time with it. Of the dozens of clients I've treated through teletherapy, most seem to find the transition to be smoother than they expected. Therapy tends to be intense, and quickly enough you're likely to forget about the medium and focus on the work.
That said, expect some differences with teletherapy. It's different when you're not in the same room with someone, and you're experiencing them in two spatial dimensions instead of three. It can also be harder to pick up on body language through a video. And while most of my clients seemed to be comfortable with making the switch, a few were not, or found the transition to be quite challenging. Occasional tech issues come up (like a delay in the audio and video), but typically can be handled with a little patience and humor.
Is It Effective?
Research suggests that therapy by video conference can be very effective, which has also been my clinical experience. It depends on you and your therapist, of course, but in general you should expect it to be helpful if you were finding in-person therapy helpful.
Personally, some of the most powerful clinical experiences I've witnessed have occurred through teletherapy. In my own practice, I've seen it work for people dealing with things like depression, anxiety, obsessive-compulsive disorder, insomnia, relationship issues, grief, and trauma.
Will Insurance Reimburse Me?
A growing number of insurance providers seem to be willing to cover online therapy sessions. They'll probably require the standard things for reimbursement: your identifying information, the provider's license and so forth, a diagnostic code, and a session (CPT) code. Check with your insurance provider before starting your sessions if you'll depend on reimbursement to cover the sessions.
How Does It Work?
You and your therapist will agree on a platform to use (or in some cases may decide to forego video and simply speak by phone). Some rely on Skype or FaceTime, although those options are not HIPAA compliant. More secure platforms include VSee, Zoom, and Doxy, among others. There may be a fee for your therapist to use the technology depending on the service, but it should be free for you (aside from your therapist's session fee, of course).
How Should I Prepare for My Sessions?
Some important and finer points about the logistics of teletherapy:
Do a test of the software beforehand for your own peace of mind and to be sure it will work, and verify that you have your therapist's contact information (e.g., VSee username).
Find a place in your home where you'll have as much privacy as possible. This could be a challenge if kids are out of school or other family members are always home (or work from home).
Along those lines, I recommend ear buds for privacy and also better sound quality. That way your therapist's voice won't feed back into your microphone and out their speakers.
Make sure you're sitting somewhere you'll be comfortable for the length of your session.
Have your screen on a stable surface, since excessive movement can create a feeling of seasickness for your therapist. If they're new to teletherapy and their screen is bouncing around, ask them to do the same.
A finer point: try to have the top of your head near the top of your video screen, rather than in the bottom half of the screen. That way when they're looking at your face they'll be looking more or less into their camera (assuming it's at the top of their computer), so it will feel like they're looking at you.
Be sure to close email and turn off notifications that could be distracting and dilute the experience for you. You'll want to have your full attention focused on your session.
Also close programs that could slow down your computer's processing ability and interfere with the quality of the video.
You may also need to work out payment arrangements with your therapist if you generally pay in person. Some therapists will keep a credit card on file for you; others will ask that you mail a check. Find out what they prefer.
Are There Other Advantages to Online Therapy?
One plus of online therapy you'll notice right away is that there's no travel time involved, so your sessions will probably take up much less of your day. With that in mind, you may want to build in some transition time into and out of therapy, since travel time often provides a buffer before and after your session. It might be challenging, for example, to return directly to childcare after an emotional session. Even a 10-minute break to process and digest the session can make a big difference.
You'll also never have to cancel for weather (assuming you have electricity and Internet), and there are no concerns about whether you could pass along a sickness to your therapist (or vice versa) if you're well enough to meet but possibly contagious. It's also possible to see your therapist when you're traveling, just as I've been able to see clients when I've been on the road.
What If My Therapist Won't Do Online Sessions?
If your current therapist isn't open to doing teletherapy, you might consider speaking with a new therapist who does offer online sessions. Obviously it's not ideal to have to start over with someone new, especially if you've been seeing your therapist for a while. But it may be your only option if you're committed to continuing therapy with as little interruption as possible.
If you don't want to start with a new person, consider other resources during the hiatus from seeing your therapist (and work with them on the plan, if possible). For example, there may be books, brief online courses, or other resources that will help you to continue the work. Your therapist might be open to having brief phone check-ins during this time.
Seek out additional support from loved ones, as well, and be sure to take care of your basic needs like sleep, nutrition, and movement to keep your body and mind healthy. You might find journaling to be helpful during this time, as it's been shown to be an effective way to process thoughts and emotions.
Keep in mind that there could be unexpected benefits to taking a therapy vacation. While it may not be ideal, an unplanned break from therapy can lead to surprising growth, as the work you've done settles in and takes hold.
The Bottom Line
If you're considering teletherapy, talk it over with your therapist and see if it's worth giving a try. You don't have to know in advance if it's the right decision for you—you can always plan to do a limited number of sessions to see how it goes. If it works well, it could be a convenient and time-saving way to continue the important work of therapy.
Find the fill article here.
If you're looking for a therapist who provides online sessions, I invite you to contact me to schedule your free phone consultation today! Contact Me Here
Accepting Unwanted Emotions
Emotions: according to the dictionary, the definition of an emotion is, “a conscious mental reaction (such as anger or fear) subjectively experienced as strong feeling usually directed toward a specific object and typically accompanied by physiological and behavioral changes in the body”.
But emotions serve us in a variety of ways. For example, they give us valuable messages (e.g., fear in an unsafe situation), reveal how important something is to us (e.g., you have stronger emotions in your romantic relationship than you do when you’re shopping for cereal or having a casual conversation with a stranger), and prompt us to act (e.g., you stroke a partner’s face with love or turn away from spoiled food in disgust).
But the story of emotions is a bit more delicate and complex, as it isn’t simply about what we feel in response to what happens around us. We tirelessly size up our inner world and place value judgments on it. Depending on the circumstances we’re in and the messages we’ve received along the way about what we’re allowed to feel, emotions (or at least certain ones) may get tagged as acceptable, healthy, or reasonable, or they might get labeled as wrong, crazy, or threatening. For instance, researchers at the University of Oxford highlighted the following categories of disapproving beliefs when it comes to painful emotions:
Emotions are too powerful and can’t be managed.
Emotions are bad and/or ridiculous.
Emotions are defective and make no sense.
Emotions are unproductive.
My emotions could sabotage me or other people.
My emotions might spread to other people and I can’t let that happen.
What’s thorny about this is that if we have a negative outlook on our emotions, we’ve got a whole new load to carry—we’re more likely to have another negative emotion layered on top of the one we’re already experiencing. The emotions we have about how we feel are known as meta-emotions. For example, let’s say we see sadness as a sign of personal weakness and inadequacy. Because of this viewpoint, we might feel shame or fear in response to our sadness. And it’s not just uncomfortable emotions that get a bad rap. People can feel nervous about pleasant emotions too.
Our ideas about our emotional life don’t just impact how we feel about our emotions, but the steps we take to respond to them as well. To illustrate, let’s stay with our example of sadness. We regard it as a signal that we’re weak and defective in some way, and this idea stirs up intense shame. The big question now: What do we do with all of this? Considering that we’re treating sadness as intolerable and we feel ashamed of it, we’re relatively unlikely to talk about it with someone else, to be kind to ourselves in the face of it, or to allow ourselves to feel sad and see what happens. No, instead we’re probably going to be more inclined to react to sadness in other ways, such as:
Mentally beating ourselves up for feeling it
Racking our brains over why we feel this way and why we can’t get over it and feel happy like everyone seems to feel
Trying to cover it up when we’re around other people
Self-medicating with alcohol or other substances
How we choose to respond to our emotions also has an impact on how we feel and on our quality of life. If we criticize ourselves all the time, that harsh voice gets stronger and we’ll continue unintentionally manufacturing more shame. We could mull over why we feel the way we do and question why we can’t make it go away, but this approach is more likely to leave us feeling even worse. If we try to hide our sadness and mask what feels so unspeakable, we’re liable to bear the cost of this strategy, experiencing more distress, less comfort, and more detached relationships. And although we can try to escape through alcohol and other substances, this opens the door to use disorders and other problems.
There are a variety of other ways in which rejecting what we feel sets the stage for giving us more of the very thing we don’t want. For instance, when people are scared of emotions, this forecasts difficulty managing anger, feeling more upset, drawing from pleasant memories to feel better, and symptoms of posttraumatic stress disorder (PTSD). Moreover, people who view uncomfortable emotions as bad are also less likely to be empathic toward themselves. And the idea that painful emotions are hazardous is related to lower odds of naming such emotions for one’s children, a valuable step in emotional skill-building.
So if it doesn’t serve us to treat our emotions as off-limits, what’s the alternative? When we accept distressing emotions as being a universal, natural part of life, it’s ironically linked to experiencing them less and, in the long run, having better emotional health.
But why might this be? Why would accepting the emotions we don’t want generally be connected with them dwindling rather than growing? Researchers have proposed several possible explanations:
Rumination can make people feel worse, and individuals who accept upsetting emotions don’t tend to ruminate over them as much.
Efforts to avoid what a person feels can go awry and have a boomerang effect, furnishing them with more of what they tried to push away.
Individuals who accept their emotions may be spared an extra layer of emotional pain by not having to feel upset about feeling upset.
Disquieting emotions that we meet with acceptance are less likely to have as much staying power.
Acceptance is a mindset, an approach of giving ourselves permission to experience our emotions and taking the perspective that they’re human rather than silly, weak, crazy, wrong, dangerous, or beyond our power to ever be able to manage. It’s about challenging that self-critical inner voice that says we can’t feel what we do, or that an emotion will harm us or be a badge of our inherent fault or shame. Acceptance is about giving ourselves the space to listen to ourselves in a nonjudgmental way.
Read the full article on Psychology Today.
If you live in the Los Angeles or Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Check out my services to see which one might fit your needs. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
Feeling Blue? It could be Seasonal Affective Disorder...
Seasonal affective disorder (SAD) is one of the few ailments that is on a clock: It usually begins in October, and people who suffer from it usually feel the full effects in January and February. We also know that it’s more common for people living in places that get less sunlight during the winter and it’s more common in women than men, according to psychologists and researchers.
Traditionally, SAD is treated with antidepressant medication or light therapy, but there has been recent piloting towards a new approach using cognitive behavioral therapy (CBT), looking at the effects of CBT method on reducing negative thought patterns for people with SAD, using the Socratic method to interrupt negative thought patterns and make way for more mood-neutral thoughts, while simultaneously focusing on behavior and helping people to make slight shifts in their habits.
Here are a few questions to consider.
Q
What is seasonal affective disorder?
A
Seasonal affective disorder is a type of clinical depression that commonly occurs in the fall and winter months and typically resolves in the spring and summer. While it can take any seasonal pattern, the fall/winter type is overwhelmingly the most common. The only thing that makes it different from garden-variety depression is the seasonal pattern that it follows.
Because of their similarities, SAD is often misdiagnosed as depression. It sometimes takes a few years for people who have this pattern to recognize that it’s a pattern, and that it’s tied to the seasons.
Q
What are the most common symptoms?
A
Because we’re diagnosing depression when diagnosing SAD, we look for at least five of the nine diagnostic symptoms of depression. We’re diagnosing a depression that follows a seasonal pattern, meaning we’re looking for depressive symptoms that are present much of the day, almost every day, for at least two weeks. The hallmark symptoms of depression are:
Feeling consistently down for most of the day or nearly every day.
A loss of interest in the things that would have otherwise been enjoyable, such as social activities that previously would have brought a sense of enjoyment or pleasure.
Feeling overwhelmingly tired or experiencing low energy.
Inability to hold attention and focus or experiencing difficulty in concentrating.
Feeling worthless or hopeless.
Issues with sleep. Either too little or too much. In winter depression, we tend to see hypersomnia or sleeping too much. In most cases, the individual sleeps for at least an extra hour a day compared to the spring or summer. Some patients may sleep ten to even fourteen hours a day and are still tired. It’s not restorative sleep that we’re seeing. A minority of patients, on the other hand, experience insomnia.
Changes in appetite or weight. This could be either wanting to eat a lot more or a lot less than usual. In winter depression, it’s usually wanting to eat more, and it’s usually carbohydrate-rich foods. Either sugars, starches, or both. With this, we typically see weight gain with an increased appetite or weight loss with a decreased appetite.
Agitation often accompanied by feelings of guilt and shame.
In extreme cases, thoughts of death or suicide.
Individuals can be diagnosed with SAD when they’re experiencing five of these symptoms, which need to include the first and/or second symptom.
These are not momentary symptoms; rather, they are pervasive for at least a couple of weeks. On average, it’s estimated to be five months of the year in a major depressive episode. It’s a lot of time to spend in depression, in terms of the cumulative toll that it could take on a person’s life.
Q
Whom does it affect most?
A
Similar to depression, there is a pronounced gender difference for those affected by SAD. Depression in general is two times more common in women than in men, and data suggests seasonal depression is even more common in women than in men. When we look at its prevalence, we’re looking at a single snapshot in time. And we’ve found that most cases occur in young adults, typically in their twenties to thirties. We’re not entirely sure why it occurs in this age range, though, since these studies don’t follow people over time. One theory is that SAD becomes less prevalent as people age, because they learn how to cope with it or possibly move to places that don’t have winters that are as harsh.
Q
How does SAD differ from depression? For individuals who have been previously diagnosed with depression, does that put them at an increased risk of developing SAD?
A
It’s estimated that up to 10 to 20 percent of recurrent depression cases follow a seasonal pattern. This is generally the course of depression, in which a depressive episode tends to return over time, with periods of time without depression between the episodes.
For SAD patients, there are unfortunately very few studies that have tried to look at the long-term trajectory of the disorder. So we don’t have a coherent idea of its outlook. We’ve tried contacting people we knew who had SAD in the past to learn about their experience and see where they’re at today, and we’ve found mixed long-term courses. A lot of them continue to experience SAD episodes every winter. Others become more subclinical, where they used to have full-threshold SAD, and now they may just have the winter blues. Some develop a completely nonseasonal course where they still have depressive episodes but it’s not tied to the seasons. And others fully remit, where they don’t have depression, seasonal or otherwise, moving forward.
In terms of how SAD differs from depression, there is a strong correlation of SAD with latitude in the United States. The farther you are from the equator, the more cases you’ll find. It is estimated that 9 percent of those people who live in Alaska suffer from SAD, compared with 1 percent of those who live in Florida. For most people—at least in the northern United States—SAD slowly begins in October. People often report an increase in their symptoms after the end of daylight saving time and experience their symptoms in full effect in January and February. It is in these two months that we find the largest proportion of SAD patients in a full major depressive episode.
Another strong link is photo period, or length of daylight. Photo period is the strongest predictor of when symptoms start in any given year for someone who has seasonal affective disorder, as well as how severe the symptoms are on a given day. The number of hours from dawn to dusk determines your photo period. We believe that photo period is what explains the onset of this disorder and can determine how bad symptoms may be on any particular day.
Q
What is the traditional approach to treating SAD?
A
Light therapy was the first line of treatment developed specifically for SAD patients. It was developed at the National Institute of Mental Health under Norman Rosenthal. He was a psychiatrist who moved from South Africa to Bethesda, Maryland, to work at the National Institute of Mental Health, and he experienced SAD symptoms. He was interested in learning more about it, and seeing if others experienced similar symptoms. He put an ad in The Washington Post, asking whether anyone experienced depression in the fall and the winter, and the lab phone rang constantly for weeks at a time. They had a huge response from people who thought they had the symptoms. They brought them they seemed to follow. From this, they developed light therapy as a form of treatment.
With light therapy, the goal is to give people a very bright dose of light, first thing in the morning, to simulate an early dawn. In theory, we’re trying to jump-start a sluggish biological clock, so that circadian rhythms go back to a normal phase as if they’re in the summer, when these people are feeling good. The devices tested in clinical trials are 10,000 LUX, which is the same intensity of light from the sky at sunrise. We block out the UV rays since they’re not necessary for an antidepressant response. We’ve found that prescribing patients to sit in front of 10,000 LUX for at least thirty minutes a day is what it takes for the treatment to be effective in people who have SAD. That said, similar to finding the right antidepressant, it can be a bit of a trial-and-error process. We try to find that sweet spot of exactly how many minutes a day and at what time or times of the day it’s most effective for the patient. The optimal benefit from light therapy must be determined on an individual basis so we can balance any side effects they may experience in response to the light.
The same drugs that are effective in treating nonseasonal depression—particularly SSRIs like fluoxetine/Prozac—have been tested for SAD with a good outcome in placebo-controlled studies. There is one drug that’s FDA-approved specifically to prevent SAD, which is Wellbutrin Extended Release. There was a large multisite study—with the GlaxoSmithKlein drug—completed a few years ago with over 1,000 SAD patients. The study compared putting people on the Wellbutrin Extended Release versus a placebo, and the participants started the treatment early in the fall when they weren’t yet having their symptoms, and the study followed them into the winter. The researchers found fewer relapses on the drug than with the placebo, which led to the FDA approval of the medication. Either bright-light therapy or antidepressant medication are typically used in treating SAD.
Q
How can cognitive behavioral therapy be used to treat SAD?
A
There is an extensive body of research demonstrating that CBT is an effective talk therapy for people with depression. There have also been a lot of clinical trials showing that it worked as well as antidepressant medications for improving depression. Additionally, when you follow people over time, after they’re treated to remission using CBT versus treated to remission using antidepressant medications, there are fewer relapses and recurrences among those treated with CBT than those treated with antidepressant medication.
Q
Recommendations?
A
Resist the urge to self-diagnose and self-treat. Seek evaluation from a qualified person who can figure out once and for all if it’s SAD or if it might be something else, including a depression that’s not following a seasonal course. And know that there are treatment options out there that are effective, including light therapy, antidepressant medications, and cognitive behavioral therapy. So there are reasons to be optimistic that one of these interventions will be helpful in terms of improving your experience.
This article is for informational purposes only, even if and to the extent that it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. View the full article here: https://goop.com/wellness/how-to-treat-seasonal-affective-disorder/
If you live in the Los Angeles/Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
Attachment Styles & The Effects on our Relationships
Many psychotherapists (including myself) believe that our adult personalities are unconsciously planted in our childhood experiences. And the way we relate to others, too, seems to be established in our very first relationships—typically with our parents. From the way our caregivers meet our emotional needs in early life, we develop social coping habits that collect into something called an “attachment style”—a pattern in the way we relate to others. A healthy attachment style might serve us well, fostering solid self-esteem and positive relationships, but an unstable one might hold us back from forming functional relationships.
Attachment theory isn’t talked about as often today. However, we all have something to learn from knowing our attachment style: The first step is knowing if you have an insecure attachment style, and, if so, what kind. The second—and this is the tough part—is changing it. Stepping into the unconscious mind isn’t intuitive or easy, but it’s not impossible—and it can reform the way you approach relationships going forward.
Here are a few examples:
You may have been single for some time and wonder why. Or you may be a serial dater who enters relationships falling hard in the first few months—only to cool down and lose interest. You may yearn for love but find yourself staying home binge-watching Game of Thrones. You may have found the perfect partner but get so in your head that it’s impossible to enjoy dinner with them. Perhaps you have been in a long-term relationship but feel unfulfilled, and no matter what they do, you can’t seem to trust your partner. If any of these scenarios apply to you, you may be mimicking feelings that were established when you were in diapers.
Do any of those sound familiar? Many of the fears, beliefs, and behavioral patterns you present as an adult are derived from how you felt in the first few years of life. Our thoughts and actions are shaped by the way you were attached to your primary caregivers.
Attachment theory is useful and relevant especially in identifying insecurities and detachments that affect our general well-being. There are three main types: anxious, avoidant, and secure. Of course, there’s a lot of individual variability, but most people tend to identify with one of these types.
Anxious
Anxiously attached people require a lot of attention. They never seem to be satisfied with the amount they are receiving and consistently want more, a need driven by the devastating fear that they are not good enough. They often compare themselves with others and strive for perfection.
It is almost impossible for an anxiously attached person to fully trust anyone, and so they make a mess of romance and friendships. They are often suspicious, scared of being betrayed, and predisposed to meddling in the affairs of others. If you don’t text them back within an hour or two, they tend to take it personally; they believe that something is wrong, feel annoyed, or worry they have offended you in some way.
People that are anxiously attached are waiting for the other shoe to drop. They may constantly be on the verge of breaking up with their partner or friends, but they don’t go through with it because they don’t want to be left alone. Does it remind you of anyone?
Avoidant
These people often seem indifferent and unaffected by even the most turbulent of relationships. They keep their emotions closed off and don’t engage too deeply in love.
It feels unsafe for avoidants to show who they are; they’re often dealing with self-doubt and uncertainty. They busy themselves with a wide array of useless tasks in order to place distance between themselves and others. They are often workaholics who have little time to socialize with friends, and they even have a tendency to neglect their spouses and children. Avoidants are masters of self-soothing, which often leads to reliance on unhealthy obsessive patterns around substances, exercise, and food.
People who are avoidant may yearn for a loving connection but find themselves running from scenarios where they are asked to commit—in the face of real intimacy, they become uncomfortable and tend to slip away when things get serious.
Avoidants are encased by an unconscious fear that they will be abandoned and rejected and therefore they do not allow themselves to get too close. Unfortunately, this can lead to loneliness, a sense of disconnection, and pessimism.
Secure
Those who are securely attached find the joy in friendships and intimate partners and are not afraid to let it all hang out. They have a balanced and healthy ego—for the most part—and believe in themselves and the vitality of companionship. They seek partners who are also healthy and have a low, well-balanced center of gravity, which allows them to take risks without the fear of failure.
When a securely attached person is paired with an anxious or avoidantly attached person, he/she can tell right away that something is amiss. This does not mean that relationships do not exist between these groups, but if they do, they are often short-lived and unfulfilled. Securely attached people sometimes have a blind spot that prevents them from understanding what people with insecure attachments are coping with. They are the fortunate ones who had parents who showed the correct amount of love for them. This is the primary difference: Avoidants and anxious types did not receive what they needed to feel fully safe.
What next?
We can’t go back and change the details of the first years of life, but there are a few things that can be done to heal these wounds. I encourage you to seek out the help of a therapist. Therapy can be immensely helpful in healing old wounds, shifting your perception of yourself and the people around you, and allowing you to feel safe.
If you live in the Los Angeles/Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Contact me now to see if we might be a good fit to work together! Or book your appointment now!
Made The Brave Decision To Go To Therapy...Now What?
I’ve made the brave decision to go to therapy…now what?
We’ve all been there - feeling overwhelmed, confused, thinking we could benefit from seeing a therapist. But only some of us make it through the door and get the help we need. Why is that? Looking for a therapist can be a grueling process.
Searching for a therapist can feel extremely impersonal, leading you from profile to profile on the web only to find yourself lost. The whole process can feel like a massive load - that’s why breaking it down into smaller manageable parts can be a great way to maximize your search. Here are a few tips to consider:
Check in with yourself. I always ask my new clients what they’re looking for out of therapy - what are your goals? What do you want to work on? Is there a specific type of therapy you want to try: individuals, couples, family, etc.? Are there certain qualities you want your therapist to have?
Pro Tip: I suggest taking time to imagine the kind of therapist you want to work with. Write down the traits that feel important to you, and traits that are deal breakers. Ideally what you are looking for is finding a therapist that puts you at ease.
Consider your therapy budget: Therapy is expensive. While I believe it is one of the best investments we can make in our self, there are real financial barriers that can make it hard to do so. Depending on the community you live in, therapy can range from $80-$200 per session.
One option is to consider using your insurance for therapy; it is important to first find out what type of reimbursement, if any, your insurance company offers. If it is a requirement to see someone “in network,” ask for a list of providers and begin looking them up online. Some insurance companies will provide reimbursement for therapy that is '‘out of network'‘ and your therapist can provide you with a “superbill” each month to submit to your insurance.
Pro Tip: Look at your overall spending and see where you can make adjustments. Saving could be as simple as bringing lunches to work and making coffee at home. It is a choice, like everything else, and you must weigh the financial commitment you are willing to make.
Ask people you trust for recommendations: Asking people you trust for recommendations is a great place to start. This could be a friend, family member, colleague or other health professional.
Pro Tip: If you have a friend or family member who is a therapist, they would also be a good person to ask as well. Therapists tend to have reputable colleagues who they can refer you too.
Use the web: The Internet is a great resource for reading about and finding local therapists. Psychology Today and Good Therapy have a comprehensive listing of therapists and allows you to search based on several different factors. All therapists listed in those databases must prove that they have an advanced degree and an up-to-date professional license. You can read profiles or click through to individual therapist websites. Yelp is another great way to search for local therapists.
Interview therapists: Once you narrowed down your list of potentials, it’s time to start making calls. I offer all new clients a free 20 minute consultation to see if we might be a good fit to work together. Pay attention to how you feel on the phone. Do you feel comfortable talking with him or her? Do they sound clear and confident while answering your questions? Is their style of communication relatable? If yes, go ahead and book an intake session at the end of your phone call. Feel free to do this with more than one therapist if you like the idea of “shopping around.”
Pro Tip: Have a few questions prepared before calling, such as:
How would you describe your style of therapy?
What do you charge per session?
What insurance plans do you take?
Do you provide a sliding pay scale?
How often will we meet?
How does therapy work?
Found the right person…now what? Your first session with your therapist will cover a lot of material. You will be asked to share what brought you into therapy, parts of your personal and family history, and the current symptoms you are experiencing. Your therapist will ask you personal questions and, depending on your relationship to vulnerability, this may feel challenging. This is normal and to be expected. Your therapist should never rush your process. Your pace and comfort level must be respected.
“A person’s relationship with their therapist frequently mirrors their relationships outside the therapy office. We often unconsciously recreate dynamics from other relationships with our therapist giving us the opportunity to process negative feelings and work through maladaptive patterns in a safe space. A good therapeutic relationship can be a corrective experience: We are accepted for who we are, encouraged to look inward and connect with our true natures, and supported in growing into our real selves.”
If you live in the Westlake Village Area and are interested in individual or couples therapy I invite you to contact me via email at: tanyasamuelianmft@yahoo.com
major credit to The Every Girl for the guideline to this very important post!