- Individual Therapy for Adults
Sometimes it is very helpful to have someone to talk to, someone who is not involved in your life. Talking with a therapist is different from discussing things with friends or family members. A therapist has only your best interests in mind, and does not have a vested interest in what you do, or what you decide.
After trust is built (sometimes this by itself can be a slow process), you can feel free to talk about things you wouldn't ordinarily share with others. This opening-up can be healing in itself. Then by exploring the issues and relationships of concern to you, I may be able to offer you some new perspectives and feedback. Sometimes talking is difficult, and we can use other modalities, such as artwork or music, in order to work with important issues and concerns.
Perhaps the most powerful aspect of psychotherapy is the ability to use the therapeutic relationship to experience and examine the patterns in your life, and to start to make changes within the safety of the therapy sessions.
- Individual Therapy for Adolescents
Many adolescents, especially older ones, use therapy much the way that adults do. Talking is the main tool, and the opening-up process is essential. It is often harder to build trust with an adolescent, so sometimes this process may take longer than with an adult. In addition, teens still have some child in them too, and they may need some opportunity to play during sessions.
Another challenging situation when a teenager comes to therapy is that they sometimes don't want to be here. That's okay, even normal!! An adolescent is at a stage of their life when they are trying to stake out their differences with the adults in their lives. If you want them to come to therapy then, by golly, they are not going to agree with you!! But they can still be brought in, and I can still work with them, and kids who don't want to come can still benefit greatly from therapy.
Confidentiality is an important concern when I work with teens. It is critically important that the adolescent feels safe and free to talk about whatever they want, without fearing that their parents will find out. So I always make an agreement with the teen and their parents or guardians that the sessions are confidential, and that I will only convey general information to the adults about what is said in the sessions. However, any instance when safety concerns surface (suicidal thoughts, drug use, child abuse, etc.), I may need to let the parents know. I tell the teenager this, but always strive to let them know beforehand if I am going to disclose something to their parent or guardian.
- Individual Therapy for Children
Children (from age seven and up*) can also greatly benefit from therapy. But they usually cannot talk about things the way that an adult would. Instead, children often express themselves and work out issues by playing. My office is stocked with games and toys (see pictures) so that by using these fun tools, a child can "open up" issues that are troubling him or her. And as these concerns come up in the play, I can work with them, also within the symbolism of the play. It may surprise you how effective this process can be, since on the surface it looks so different from what an adult's therapy would look like. However, if you consider the underlying process, trust still needs to be built, the therapist still has the interests of the child in the fore, and new behaviors can be "tried out" in the safety of the therapist's office.
When I work with children in individual therapy, I want to meet periodically with the parents or guardians. This can be helpful both as a way for you to provide me with important information about your child, and also for me to give you feedback on ways to help your child at home. After all, I only see them for an hour at a time, while you are with them all the other hours in the week.
A special note about confidentiality when a child is in therapy: I strive to keep parents informed about what is happening in their child's sessions. It is important for you to know how things are going. However, it is also important for your child to have the freedom to talk about things without the feeling that everything they say will be transmitted to their parents. They also need some privacy. Therapy cannot work unless the child feels safe and trusts the therapist to talk or express through play about things that they might not feel comfortable telling their parents.
Having said that, any time that there is a question of safety (suicidal thoughts, child abuse, etc.), I will of course inform you right away. Keeping your child safe is always the first priority.
* Children younger than seven usually need a full playroom setting. If your child is younger than seven years old, contact me and I'd be glad to refer you to a good local therapist with such facilities.
- Group Therapy
Please see this video I've made about my therapy groups.
Group therapy can be particularly helpful for many people, providing a safe setting to work on relationship issues. Many times friends avoid telling you how they really feel when they are with you, or relatives will tell you, but their feedback can sting with all that baggage you have with them, making it too painful to hear. In a therapy group, members do not have outside contact, so they can feel freer about being “straight” with one another, giving participants the unique opportunity to get honest, yet gentle feedback. It is also a powerful experience to be helpful to others. Even though you may be dealing with your own difficult issues, you have a lot to offer others, based on your experience and perceptions.
My role in the therapy group is to insure that it remains safe for everyone. It is critically important that no one feels scapegoated or singled out for negative feedback. Everyone has something very important to offer, even if they don't agree with the others.
When someone joins my therapy group, I always meet with them individually for several sessions first. This provides a chance for us to get to know one another, and for you to feel comfortable and safe with me, before you start what is naturally a bit nerve-wracking at first. When you are in a group of people you don't yet know, it really helps to have at least one person you are familiar with. Since we meet individually first, I can be that "anchor" person for you. After just a few sessions (sometimes even after just one session), most people start to feel comfortable in the group.
Whenever a new person joins the group, we discuss confidentiality. The general rule is that “what's said in the room, stay's in the room”. Just as in any other form of therapy, people need to feel safe in opening up, and knowing that others won't “blab” to outsiders about your personal issues is necessary to feel you can share with the group.
- Couples Therapy
Whether you are married or not, straight or gay, your relationship is a central part of your life. When it is not going well, seeking outside help can make a big difference. Some people seek couples therapy before making a commitment to one another, to help them be more sure they want to take this important step. Others seek therapy with their spouse or partner to heal a break in trust or to help them get along better. Still others are thinking that they need to break up, but want to be sure this is the right choice for them. Finally, some couples who have already decided to end their relationship use couples therapy to help them disengage peacefully. This can be especially important when children are involved. Caring parents understand that separating in a calm civil way profoundly helps their children weather the change in the family much easier.
Couples therapy consists mostly of sessions with both partners. However, it may be helpful at times for me to meet with one or both of you individually, to focus more on your individual issues, or to work out an issue alone. In the course of Couples Therapy, I may suggest that one or both partners seek individual therapy. In such instances, I usually refer you to another therapist for this, so that I can continue as your Couples Therapist without any conflict of interest.
Confidentiality is sometimes a concern for people in couples therapy. This is especially true when there is a secret that one partner is keeping from the other. If I meet individually with the person holding the secret, they may wonder whether I will keep the information confidential if they tell me the secret.
My policy in such situations is to discuss the destructive nature of secrets, and to encourage the secret-holder to break their silence in the interest of the health of the relationship. We cannot be productive in couples therapy if both parties don't feel trust in me, and secrets erode that trust. Therefore, I cannot hold such information, but it is much better for the person holding the secret to share it themselves. This can be done in a joint session, if desired, so that I can help the couple deal with the disclosure.
- Family Therapy
Sometimes an issue may arise that is best discussed and worked out with several family members present. This can be true even if it seems that the problem is with one family member. When this is the case, I meet with the family all at once. I may also ask that different combinations of family members come in for sessions. For example, I may want to meet with only the parents, or one parent and one child, or just the children, etc. The aim in Family Therapy is to improve the family's ability to get along and help one another. In addition, Family Therapy can also help individual family members with their individual issues.
In the course of Family Therapy, I may suggest that one or more family members pursue individual therapy. Most often, I will provide some names of other therapist to refer you to in this case. This way, I can continue to act as the Family Therapist, without any conflict of interest that would arise if I was also seeing an individual family member.