A GUIDE TO COUNSELING AND PSYCHOTHERAPY

James J. Crist, Ph.D.

Licensed Clinical Psychologist

Child and Family Counseling Center

The decision to begin psychotherapy is one which may have important consequences for the rest of your life. Research shows that when people enter therapy with a good understanding of what they are about to undertake, they are likely to achieve more favorable results. This sheet provides you with information about what therapy is about.

In psychotherapy, you and a trained mental health professional will work out ways to handle psychological problems, as well as those of daily living. These may include anxieties and fears, interpersonal problems, depression, low self-esteem, substance abuse and other addictions, parent-child problems, and academic problems. Your therapist will help you to get to know yourself better in order to understand the nature of your difficulties. Together, you and your therapist can come up with more constructive ways of dealing with your problems. Therapy may include individual, couples, or family sessions.

The type of therapy will also depend on the theoretical orientation and background of your therapist. Such types may include cognitive-behavioral, insight-oriented, psychodynamic, experiential, and family systems. You may wish to ask your therapist about his orientation at the start of therapy. Therapy is more likely to be successful if you spend time between sessions thinking about what was discussed or trying out suggestions made by your therapist. Specific books for you to read may be recommended. Ask your therapist if this is something that you would find useful.

The length of your treatment will vary, depending upon the nature of your presenting concerns and your level of motivation to change. Therapy can last 3-5 sessions for short-term crisis intervention, and 10-12 sessions for relatively specific or situational problems. For problems which are severe, affect many areas of your life, or have been present for a long time, therapy may take much longer. You may wish to periodically review your progress and goals with your therapist. If you are considering stopping therapy, this should be discussed with your therapist ahead of time. It is very important that a final session be scheduled so you and your therapist can review your progress and final recommendations can be made.

Generally, sessions are held once a week and last for 45-50 minutes. This gives your therapist the rest of the hour to make notes which will aid in planning further treatment and assessing your progress. With the advent of managed care, additional time is often needed to complete insurance forms and requests for additional sessions. Sometimes, twice weekly sessions may be needed. Extra sessions may also be scheduled. On occasion, your therapist may not be able to start on time. If this happens, your time will usually be extended to make sure you receive a full session. If your therapist is on vacation, another therapist will be available should an emergency arise.

If you and your therapist conclude that medication might be helpful as part of your treatment, a referral for a psychiatric consultation will be made. Generally, your therapist will continue to see you for therapy, while the psychiatrist will prescribe and monitor the medication.

The therapy relationship is confidential. No information about you or your treatment will be released without your consent. However, in some cases there are legal limits to confidentiality. If child abuse or neglect is suspected, your therapist is legally required to make a report to child protective services personnel. If you are in danger of hurting yourself or another person, your therapist will act to prevent harm from occurring, including arranging for you to be hospitalized if needed. In criminal cases and certain civil cases, your confidentiality is not guaranteed and records may be subpoenaed by a court of law or by other interested parties. If you are using your health insurance, you will be asked to authorize releasing certain specific information to the company. Some insurance companies will release specific information to your employer without your consent; however, it is illegal for your employer to use this information in any legal or supervisory proceedings which might involve you. Periodically, your therapist may consult with another professional about your case in order to improve the quality of the treatment provided. In such cases, no identifying information will be revealed. Ask your therapist if you have questions regarding confidentiality.

As therapists, we are committed to helping individuals grow toward their fullest potential on a physical, emotional, social, and spiritual level. Our goal is to help you resolve problem areas that are keeping you from achieving your goals. Your responsibility is to help us understand your life situation, thoughts, and feelings to the best of your ability. This includes thoughts and feelings about your therapy and your therapist, which can be relevant.  Your therapist is a member of various professional organizations and has agreed to abide by their ethical principles. A copy of these principles is available upon request.

(6-98, Updated 9-02)