What is psychotherapy?

Psychotherapy is a commitment to and an investment in yourself. Therapy is a process in which you talk, openly and honestly, to a professional who has been extensively trained in human behavior and change. Through therapy, people come to understand their feelings, thoughts and behaviors. Through this exploration, people gain insight into the origins of their problems and can learn to develop better ways of dealing with these problems and interacting with others. Many people think that therapists will tell them what to do and how to do it. OUR approach is a little different. We help you see yourself more clearly and understand your feelings and needs at a deeper level. Only then can you make your own informed choices about where you want to go, when and how. Of course, we will offer suggestions that we think may improve your situation, but the ultimate decisions are always yours.

How do I know if I (or someone I love) should see a psychologist?

Psychotherapy is recommended if a person is experiencing psychological distress that negatively affects his or her life in any of the following areas: relationships, work, school, health, sleep or appetite. Some examples of psychological distress include:

• feeling sad
• unhappy
• depressed
• anxious
• nervous
• tense
• stressed
• angry
• out of control
• overwhelmed by life and by decisions

A person in need of therapy may notice changes in mood or behaviors and may feel dissatisfied with life. You may have tried to deal with these problems on your own, but found that you or your loved one were not improving. If this is the case, psychotherapy may be helpful.

Who comes to therapy?

Most of our clients are ordinary, sane individuals in pain or turmoil, trying to understand and cope with personal, family, and societal issues.

A person may seek therapy for themselves or a loved one because:

• It has become difficult to cope with one of life’s changes, for example, a divorce, a move, a health crisis, a new school or job, a new marriage, or having a child.
• A child is having difficulty managing his or her behavior at home, or school, or both. The child may be angry or aggressive, or just not do what adults tell him or her to do.
• A marriage is in crisis, or just not as close as it used to be.
• A child isn’t living up to his or her academic potential in school. Or, an adult isn’t performing as well in life as he or she should be.
• A child or adult feels depressed and can’t seem to “snap out of it.”
• A child or adult is feeling nervous or anxious too often, either about something specific or just in general.
• A person can’t shake a particular addiction, whether it be drugs or food or exercise, or a particular habit such as hair pulling or hand washing.
• Parents may want advice and suggestions about handling a difficult or “different” child.

Individuals seeking therapy have different kinds and degrees of psychological discomfort. What they have in common is that they often feel like what they’re doing now isn’t working. New perspectives, tools and strategies are needed to produce different outcomes.

What are therapy sessions like?

The psychotherapy session provides a safe, confidential, non-judgmental environment where a person can identify and come to terms with emotions and needs. The process of psychotherapy will help:

• Define problems and underlying issues
• Learn what is “normal,” “natural,” or expectable in current circumstances
• Discover misconceptions or conflicts that may be blocking action or change
• Change self-defeating behavior and dysfunctional patterns of interaction
• Gain tools, along with hope or courage to take charge of life.

There is nothing mystical or “weird” about a therapy session. We simply sit and talk. My clients tell me that while they may arrive at their first session feeling a little nervous, they are comfortable with the process moments after we have begun talking.

Are sessions confidential?

Yes! One important point to make about communication with any psychologist is that psychologists are bound both by law and, for American Psychological Association members like myself, by a code of ethical conduct for the profession to keep information that is shared confidential. On a personal level, most psychologists take this responsibility very seriously.

There are a few exceptions where law does require psychologists to share some information from therapy. One of the most important is that, if a client makes statements that present a credible threat either to harm him/herself or to harm another person, the psychologist is of course bound to take necessary steps to ensure safety. In most cases related to harming oneself, the psychologist is going to work with the client to find a way to ensure safety without breaking confidentiality. While psychologists of course do want to keep people safe and alive, it is also true that we want the client to feel in control of that process as much as is possible.

Another exception is that psychologists are “mandated reporters.” This means that, if a person shares information about child abuse or about the abuse of an elder or dependent adult, the psychologist does have to report that information to appropriate authorities.

In addition, there also are a few cases where a judge might order a psychologist to share some confidential information. The psychologist will “claim privilege” and not provide information in these cases until the judge orders him or her to do so.

What are the benefits of psychotherapy?

Many people find therapy to be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, and the hassles of daily life. Specifically, psychotherapy can help you or your loved one.

• Find new ways to cope with stress and anxiety
• Manage anger, depression, and other emotional pressures
• Improve communications skills–learn how to listen to others, and have others listen to you
• Get “unstuck” from past relationships and family issues–break old patterns and develop new ways of dealing with old issues
• Heal old psychological wounds–repair damage from the past
• Discover creative ways to problem-solve
• Reach full potential in life
• Improve self-esteem and boost self-confidence
• Increase ability to love oneself and love others–enrich relationships with a greater capacity for respect, compassion, and joy.

How are psychologists trained?

On average, psychologists have more than seven years of training in addition to their bachelor’s degree, and 3,000 hours of supervised practice in psychology. A year of supervised post-doctoral psychological training must be completed before psychologists take their national test and a state-administered oral exam.

Psychologists licensed to practice in the state of Texas have degrees in the following: Doctor of Philosophy in Psychology (Ph.D.), Doctor of Psychology (Psy.D.), or Doctor of Education (Ed.D.). Psychologists are further required to take continuing education courses each year to keep their licenses current.

How long are the sessions?

Sessions are generally 45 to 60 minutes long and are usually scheduled once a week at a regular time. The length of therapy depends on your particular circumstances or problems and on the goals that we set.

Will insurance cover my psychotherapy sessions?

Most insurance policies do provide mental health coverage, and we accept insurance payment from many different plans. We will be happy to discuss the specifics of your insurance coverage with you either before or during your first visit, depending on your preference.

How do I choose a psychologist?

Therapy involves a large commitment of time, money, and energy, so you should be very careful about the therapist you select. Although credentials, training, and experience are important, by far the most important factor is whether you feel you can connect with that person.

• Here are some questions you should answer when considering a particular therapist:
• Is the therapist licensed?
• Does the therapist have training and experience in the issues of interest to me?
• Does the therapist show an interest in and understanding of my concerns?
• Is the therapist able to talk to me in language I can understand?
• Is the therapist accessible and responsive?
• Does this therapist feel “right” to me-do I feel understood and safe.

RESOURCES

Victims of abuse and trauma in all its forms – verbal, emotional, physical, and sexual often suffer profound emotional effects. They require not only therapy to heal their emotional wounds, but also practical guidance and topical education. Helping the survivor regain control of his or her life is the over-riding goal of the entire therapeutic process.

Addictions

Addictions are treatable diseases that affect your brain and your behavior. People can become addicted to many different things including: drugs, alcohol, smoking, food, exercise, gambling, sex, pornography, shopping, and/or work. Someone who is addicted to these things often acts without thinking of the consequences, such as problems with health, money, relationships, and performance at work or at school. Addictions can often be effectively treated with cognitive-behavioral therapy by learning to replace inappropriate ways of thinking and behaving with ways that function better.

ADHD and Hyperactivity

Attention Deficit Hyperactivity Disorder (ADHD) is a condition that becomes apparent in some children in the preschool and early school years. It is hard for these children to control their behavior and/or pay attention. The principal characteristics of ADHD are inattention, hyperactivity, and impulsivity. Because many normal children may have these symptoms, but at a low level, or the symptoms may be caused by another disorder, it is important that the child receive a thorough examination and appropriate diagnosis by a well-qualified professional. ADHD responds well to medications, behavioral therapy for the child, and/or special parenting techniques.

Anger Management

Anger is a normal emotion that signals us we don’t like something that is happening in our environment. While there is nothing at all wrong with anger itself, many people express their angry feelings inappropriately. A hot temper can lead to relationship difficulties, work problems, and even legal troubles. However, effective techniques can be learned to manage anger appropriately. People can be taught to vent their anger in productive ways leading to effective communication with others and more satisfying life relationships.

Anxiety

Anxiety is a normal reaction to stress. It helps one deal with a tense situation in the office, study harder for an exam, or keep focused on an important speech. In general, it helps one cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder. Left untreated, anxiety disorders can worsen, but with treatment, most show dramatic improvements.

Bipolar Disorder

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. Different from the normal ups and downs that everyone goes through, the symptoms of bipolar disorder are severe. They can result in damaged relationships, poor job or school performance, and even suicide. But there is good news: bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Blended Family Issues

Approximately 1 in 3 Americans is currently involved in a stepfamily, either as a stepparent or a stepchild. These blended families often present special challenges and can benefit from psychotherapy to address their unique issues. Parenting and discipline differences, finances, and emotional baggage from past relationships can all combine to create stress within the family. But by dedicating the necessary time to develop their own rules and traditions and form loving relationships, stepfamilies can create lasting and rewarding bonds with one another.

Childhood Behavioral Problems

Children misbehave for many various reasons. They may be suffering from a psychological disorder (such as ADHD or depression), experiencing a difficult life change, or they may simply be challenging children requiring unique discipline approaches. Careful testing involving observation and discussions with parents and children can determine the reasons for a child’s misbehavior. And psychotherapy can then address these issues and improve a child’s functioning at home, at school, and with peers.

Chronic Illness

Adjusting to a chronic illness can be difficult for both the affected person and the entire family. Learning to cope with physical and emotional pain in addition to the daily stresses of doctors’ visits and dealing with medications and treatments can all be extremely stressful. Psychotherapy to address the emotional issues and teach coping strategies can be very beneficial for all involved.

Depression

A depressive disorder is an illness that involves the body, mood and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely “get over it”.

Divorce Adjustment

Divorce can be a difficult experience for everyone involved in this dramatic life change. Both adults and children often react with depression, anger, and anxiety. Parents may find that these emotional difficulties make it challenging to cope with the daily struggles of being a parent, whereas children may develop behavior and academic problems in school. Psychotherapy can help each member adjust to the changes that divorce brings and help minimize any negative impact.

Eating Disorders

Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Eating disorders are not due to a failure of will or behavior; rather, they are real, treatable medical illnesses in which certain maladaptive patterns of eating take on a life of their own.

Grief

Grief differs based on who we are, whom we have lost, and how much our daily life is affected by the death or loss. Grief is a normal reaction to loss, and while we typically think of the emotional reactions, people can also experience grief through physical and behavioral symptoms. Some typical grief responses include feelings of shock, depression, guilt, loneliness, and anger; physical reactions including headaches, fatigue, and sleeplessness; and behaviors including excessive crying and withdrawal. Talking with a caring professional can help you process these emotions and develop effective strategies to cope with the realities of a painful loss.

Low Self-Esteem

As humans grow and develop socially, mentally and physically, we are profoundly affected and shaped by people’s opinions of us. The words and actions of parents, teachers, and peers will either give us confidence to believe we can do anything or convince us we are worthless. It is important to build up a child’s self-esteem: providing a safe, loving, accepting environment will reassure children and teach them that, with support, he or she can be or do anything. Similarly, if an adult was not taught to value him or herself, these issues must be processed and resolved to facilitate a successful life.

Marital Communication

Effective communication within a relationship is a skill that takes both practice and considerable effort. Yet few of us have been trained to clearly express our needs or to actively listen to our partners. Without successful communication, it is difficult to solve problems and develop emotional intimacy with your spouse. Learning communication skills can help a troubled marriage or can simply improve an already good marriage.

Neuropsychological Assessments

Neuropsychological assessment is an evaluation of how one’s brain is functioning. A neuropsychologist administers various tests to examine skills such as:

• Intelligence (IQ)
• Academic Achievement
• Language Skills
• Attention
• Executive Functioning
• Short- and Long-Term Memory
• Fine Motor Skills
• Social/Emotional/Behavioral Functioning
• Adaptive Skills (life skills for taking care of oneself & getting along with others)

Children, adolescents, and young adults who are having difficulties with learning and overall functioning may benefit from a neuropsychological evaluation. In addition, individuals with neurological/medical diagnoses or general developmental concerns would benefit from a neuropsychological evaluation.

Obsessive-Compulsive Disorder

People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items. These thoughts and rituals are not pleasant, and they can become all consuming. However, OCD responds well to psychotherapy and most people can be treated effectively.

Panic Attacks

Panic disorder is a real illness that can be successfully treated. It is characterized by sudden attacks of terror, usually accompanied by a pounding heart, sweatiness, weakness, faintness, or dizziness. During these attacks, people with panic disorder may flush or feel chilled; their hands may tingle or feel numb; and they may experience nausea, chest pain, or smothering sensations. Panic attacks usually produce a sense of unreality, a fear of impending doom, or a fear of losing control. People who have full-blown, repeated panic attacks can become very disabled by their condition and should seek treatment before they start to avoid places or situations where panic attacks have occurred.

Personality Disorders

Personality disorders are pervasive chronic psychological disorders, which can negatively affect a person’s life in many ways including one’s work, one’s family, and one’s social life. While most people can live pretty normal lives with mild personality disorders (or more simply, personality traits), during times of increased stress, the symptoms of the personality disorder will gain strength and begin to seriously interfere with their emotional and psychological functioning. Those with a personality disorder possess several distinct psychological features including disturbances in their ability to have successful relationships; inappropriate emotions, disturbances in ways of perceiving themselves, others, and the world; and difficulties with impulse control. These symptoms come together to create a pervasive pattern of behavior and inner experience that is quite different from the norm and that often tend to be expressed in behaviors that appear more dramatic than what society considers usual. There are ten different types of personality disorders that exist, which all have various emphases. Successful treatment typically focuses on increasing one’s coping mechanisms and interpersonal skills.

Phobias

A specific phobia is an intense fear of something that poses little or no actual danger. Some of the more common specific phobias are centered around closed-in places, heights, escalators, tunnels, highway driving, water, flying, dogs, and injuries involving blood. Such phobias aren’t just extreme fear; they are irrational fear of a particular thing. You may be able to ski the world’s tallest mountains with ease but be unable to go above the 5th floor of an office building. While adults with phobias realize that these fears are irrational, they often find that facing, or even thinking about facing, the feared object or situation brings on a panic attack or severe anxiety. Luckily, phobias are highly treatable and a return to full functioning is expected.

Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers. PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or hurricanes. People with PTSD may startle easily, become emotionally numb, lose interest in things they used to enjoy, have trouble feeling affectionate, be irritable, become more aggressive, or even become violent. They avoid situations that remind them of the original incident, and anniversaries of the incident are often very difficult. These symptoms of PTSD usually respond very well to psychotherapy.

Social Anxiety

Social phobia, also called social anxiety disorder, is diagnosed when people become overwhelmingly anxious and excessively self-conscious in everyday social situations. People with social phobia have an intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends. Nonetheless, the symptoms of social anxiety are highly treatable.

Stress Management

Stress is the “wear and tear” our bodies experience as we adjust to our continually changing environment. Stress has both physical and emotional effects that can be either positive or negative. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of anxiety, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, and insomnia. With any life change (positive or negative), we experience stress as we readjust our lives. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it. The goal of effective treatment is not to eliminate stress, but to better manage it.