About Therapy

How do I know if I need counseling?

Sometimes, the need for counseling is an individual choice: A person might recognize that he or she is not coping with normal stresses the way he or she once did. Or perhaps there has been a significant loss or trauma that “just won’t go away.” Maybe a relationship is in jeopardy, but the parties wish to save it. At times, one cannot get a new perspective on a problem, such as with a child’s behavior or a situation at work, and an outside, objective view is needed. In other words, counseling can be appropriate whenever one feels “stuck” or out of ideas. Other times, the need for counseling is made apparent by others. Sometimes, for example, a partner will insist that one seek help or the relationship will end. Perhaps an employer will insist on counseling because of deteriorating work performance or because of substance use. There may be legal difficulties that warrant some help, as with anger management. While counseling (and at times psychopharmacology) is available for severe mental illness, such as schizophrenia or bipolar disorder, or for mood disorders such as depression, panic, or anxiety, it may also be appropriate for less profound conditions. As a general rule, anytime a problem or concern begins to have a “spillover effect” that interferes with other aspects of one’s life or prevents appreciation of normally satisfying experiences, counseling can be helpful.

What is counseling? How does it help?

Counseling is an interactive and interpersonal process in which an individual, a couple, or family members explore concerns, problems, issues, fears, and so forth with a professional who is trained in helping to find solutions or resolutions that feel “right.” Good counselors seldom tell someone what to do or what path to take. We do listen carefully; develop an understanding of the situation, not just on the surface, but in terms of underlying dynamics and influences as well. We help people to consider new perspectives on the past and the present. We help people to change thought and behavior patterns, but not their basic personalities. Counseling works on many levels. First, the relationship is important. We are impartial and objective listeners who do not pass judgment, or like friends or family, have a stake in liking or being liked. Just knowing that their thoughts and feelings are understood and appreciated sometimes helps people. Talking itself is also helpful. Often verbalizing one’s thoughts and feelings to another person helps provide more objectivity and a different view than merely thinking something to oneself. Feeling accepted “as is” provides another resource. Second, counselors offer a “bird’s eye view” of what is occurring in a person’s life. Whereas a person seeking help tends to approach a situation in typical and habitual ways, the therapist can help by changing the perspective, whether about something that is happening in the present or in understanding the significance of past experiences. Often, it is not what has happened, but what meaning we give to what has happened that determines how we will be affected. Third, there are instances in which we can provide specific tips or ideas for dealing with things better. For example, in couples’ counseling we often focus on improving communication, or in family counseling on responding more productively to particular behaviors.

How do I choose a counselor?

There are several factors in choosing a counselor/therapist. One, certainly, is their credentials. It is generally a good idea to select a therapist who has specialized education and is licensed by a professional licensing board. In Pennsylvania, there are licensed psychologists, social workers, marriage and family counselors, and counselors. Some individuals are certified but not licensed (certification usually is a lesser credential, but may apply to a specific area of expertise), such as Certified Addictions Counselors and Certified Marriage and Family Therapists. Another is membership in a professional organization at either the state or national level, such as the American Association for Marriage and Family Therapy, the National Association of Social Workers or the American Psychological Association. Such membership ensures that the practitioner subscribes to a specific ethical code. Membership in the American Association for Marriage and Family requires several years of additional education and supervision in marriage and family therapy. It is important to note; simply because a therapist advertises that he or she does marriage and family therapy does not mean that they have been specifically trained to do so or that they continue to meet continuing educational requirements for that specialty. To be safe, when seeking therapy, always ask the therapist specifically about their training and experience.

Therapy word of mouth is also an effective way to locate a good therapist. If you know someone who has had and has benefited from counseling, that person may be able to direct you. Similarly, and probably more reliable, is to ask another professional (such as your family doctor or your attorney) if he or she can recommend someone. These people are often in a position to make a more objective evaluation of someone else’s effectiveness and qualifications. Ask questions. Don’t be afraid to interview a prospective counselor over the phone. Be certain of confidentiality. Ask about education, background, experience, and credentials. Ask about his or her approach to therapy and problem solving. A good counselor is usually happy to answer your questions, forthcoming with responses, able to explain his or her approach, and conveys a sense of ease. If you come away with a fairly good feeling, schedule an appointment and get a sense of how the two of you interact. If you find that you are uncomfortable for some reason, bring this up to the therapist, and depending on how your concerns are addressed, either continue or ask for a referral to someone else. Remember, counselors are there for you and there should be a good fit between you. Don’t worry about hurting the counselor’s feelings as a result of your questions. If he or she is experienced they will understand that you are being a careful and informed consumer.

What services do you offer?

We are an outpatient practice, meaning that we see people at our offices, not in their homes or in an institutional setting. We provide counseling to individuals, couples, parents and children, and families for a wide variety of concerns. We can help with such difficulties as depression, anxiety, panic disorders, obsessive compulsive disorders, bipolar disorder, addictions, relationship conflicts, behavioral problems, ADD/ADHD, sexual concerns, trauma, grieving, divorce, child rearing, among others. We always make an initial assessment on which a treatment approach and strategy is determined. We will screen for some possible underlying medical problems. If we suspect any, or if we think that medication may be helpful (and you agree), we will refer you to your physician or to a specialist for the appropriate medications. In addition to the counseling we provide, we also conduct psychological and/or substance use evaluations for custody disputes or other circumstances. We can, in some instances, provide expert testimony in court. We provide mediation for divorce and custody settlements, or for business or other conflicts. We do a limited amount of psychological testing. We are available for consulting on psychological and related matters to attorneys, doctors, or other professionals. And, we also provide trainings and public speaking.

How long does thereapy last?

Therapy is an individualized process. The length of therapy depends upon the nature of the problem, its severity and its duration. Some situations may require only a single session, although this is rare, while some require several months. Many cases run between 6-12 visits, and most are completed within 25. Typically, sessions are scheduled once a week, and last 50 minutes (an hour), or in some cases 90 minutes. As therapy progresses your therapist might move to seeing you twice a month or less.