Does coming to therapy mean I’m mentally ill?

It’s a natural and important need to connect with other people when you’re experiencing distress. Just as human beings share the things that make us joyful, we need to have support for our difficult times. Beginning therapy means you’ve taken stock of the fact that you’re struggling and are actively seeking help in feeling better. Most people who come to therapy with me do not have major psychiatric illnesses. I am well-trained in diagnosing and treating mental illness, and certainly I can speak that language if the need arises, but want to remind you to that struggling is normal and addressing it is a move toward health.

What ages do you work with?

I see adolescents over 14 and adults of all ages.

What is Gottman-method couples therapy?

The Gottman Method is the only couples therapy approach based decades of relationship research. It includes specific interventions to help couples repair and rebuild their relationships, and teaches new techniques for communication and conflict resolution. The goal of Gottman methodology is to teach you and your partner skills and techniques that you can use outside of the therapy space, so that you can make changes in your daily lives.

Do I need medication and will you prescribe it?

Many people in therapy can and do make significant progress without medication, and studies have shown that therapy can be more effective at reducing the symptoms of depression than medication alone. I will not push you to consider medication if you want to avoid it, and will support you in connecting with a psychiatrist if medication is something you’d like to consider. As a licensed psychologist in Massachusetts, I don’t prescribe medication, but I do collaborate closely with psychiatrists and psychiatric nurse-practitioners, and I can refer you if you need or want that kind of support.

Why don’t you accept insurance?

Insurance policies require a mental illness diagnosis for payment to be rendered. Although of course there are sometimes important clinical diagnoses that apply, often when people come to therapy, they are just struggling and seeking to feel better. I am concerned about a system that is profit-driven both requiring evidence of a psychiatric disorder while also frequently restricting care. Because of these and other practical constraints, I do not bill insurance in my practice. This protects your privacy and enables us to work on a range of issues that are important to you with out the interference or restrictions of a third party.

Many insurance companies do reimburse members for out-of-network care. If yours does and you’d like to seek reimbursement, I am happy to provide you a detailed receipt to submit.

Is what I tell you in therapy confidential?

Protection of what you reveal in your therapy sessions is one of the most essential components of our work together. There are a few very specific legal and ethical limits to confidentiality, which we will also discuss in our first appointment:

• If there is a clear risk that you will harm yourself or someone else, I will take steps to keep you and others safe. This may include speaking to someone close to you as well as potentially to emergency services personnel.

• If you tell me about the abuse or neglect of a child, an elderly person, or someone who is disabled, I am mandated to report that abuse or neglect.

• If you are involved in a legal proceeding, a judge can order the release of information related to your therapy.

• If you were sent to me for treatment by your employer or by a court, I will probably need to provide some information about whether you are participating in that treatment.

Other than those specific instances, I will protect the confidentiality of what you tell me in therapy unless I have your explicit authorization to do otherwise.

How long will I need to be in therapy?

This is a question best answered after we have some time to sit down together and assess your needs. Different life experiences and presenting concerns lend themselves to varying treatment duration. After we have met, I can make some recommendations, but ultimately, how long you remain in therapy is up to you. We’ll work on the things that are most important to you at the pace that is most comfortable for you. Some people stay in therapy for short durations of six to ten sessions, and some remain considerably longer. You will have my support in remaining in a useful therapy, and you will have my support in ending when you feel ready to do that.