Question: What is Cognitive Behavioral Therapy (CBT)?

CBT is  based on the theory that thoughts and beliefs shape our behavior and our reality. A CBT therapist will work with clients to change distorted, destructive thought patterns and replace them with healthier, more accurate thoughts. As clients learn to identify patterns that are keeping them “stuck” and build on existing strengths, they begin to make better choices and will see a positive emotional change.  Clients are encouraged to try new behaviors outside of therapy, also. For example, if the primary problem is feeling isolated and depressed, the “homework” might be to learn more about classes or groups that sound interesting, to make a phone call to a friend, etc. The therapist will work with the client to develop “small, attainable goals” and to discuss how these new behaviors worked for them.

 

Question: What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) was developed by Francine Shapiro in 1988 as a new way to treat trauma survivors. Since then it has been used successfully to treat post traumatic stress disorder in combat veterans, survivors of disasters, and people dealing with trauma such as assault, child abuse, etc. One theory as to why it works is that the side to side eye movement (or other bilateral stimulation) is similar to REM sleep in the way it processes blocked information and allows memories to be integrated. The person will still remember the incident, but it will not have the overwhelming, debilitating feelings attached to it.

EMDR is a powerful therapeutic technique and should only be used by people who have been fully trained. Christine has been trained in both level I and Level II with Dr. Laurel Parnell, an expert in this field. At this point, treatment for significant or complex trauma should be done in person, but EMDR can be appropriate for online work with issues such as anxiety, specific phobias, etc.

 

Question: How long will it take?

Clients usually feel some relief in symptoms in 6-10 sessions (and some problems can be resolved in this time.) More entrenched problems can take longer to resolve, but both CBT and EMDR tend to resolve problems more quickly than traditional psychoanalysis.

 

Question: How often are the sessions?

Sessions are usually weekly, but accommodations can always be made.  Most sessions are 50 minutes long, but sometimes it makes sense to schedule a double session.

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Question: Will it work for me?

Therapy is based on an interactive relationship with the client and the therapist. For therapy to be effective, you should feel that the therapist is supportive and caring, but also realize that, to be effective, the therapist will have to challenge some of your beliefs that are not healthy or accurate. It is important to remember that the success of therapy depends on your willingness to be honest about your feelings (including any issues that might come up about the therapy itself), your willingness to try new behaviors, and your genuine desire to change.

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Question: How will I feel during therapy?

You should start feeling a positive change in the first few weeks, however,  there will be times when therapy can trigger strong emotions of sadness, anger, etc. This does not mean that therapy is not working; in fact, this can be a time where a significant amount of change can happen.

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Question: Will I need to stop taking my medications?

The only reason to stop psychiatric medications would be if they were not helping with the symptoms.  (Always discuss this fully with your doctor before discontinuing any medication.) Often your therapist will ask for your permission to consult with your doctor so that all members of the treatment team are working together. It is important to let your therapist know all of the meds you are on (not just the psychiatric meds) because some medications for physical problems can cause changes in mood.

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Question: If I don’t feel therapy is helping, what can I do?

Be sure to discuss this with your therapist. Sometimes when you are in the middle of changing lifelong patterns, it is difficult to see that you are making positive changes. However, sometimes another type of therapy may be more useful and your therapist will make the appropriate referrals.

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Question: Is individual therapy better than group therapy?

No, in fact there are times when group therapy is the preferred treatment. This is something that you should discuss with your therapist to find the right fit for the issues you are working on.

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Question: What do I do in an emergency or crisis?

If the emergency is life threatening (for example, you are afraid you are going to hurt yourself or someone else) you should call 911.  If  the crisis has not reached this level of danger, you can call 988 or the local crisis line. Please note: I make every effort to return calls ASAP, but I am not able to be available 24/7. Because of this, I will need to refer people  who are actively suicidal, dealing with chronic issues of self harm or overwhelming interpersonal crises to providers who have the backup and resources to insure safety. 

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Question: What kind of records are kept?

Typically records include the dates of sessions, contact information, and brief clinical notes that describe and justify treatment. No information can be exchanged without your specific authorization. 

All clients are assured of complete confidentiality, unless they authorize (by signing) an information disclosure. There are, however, important exceptions where I am required by law to reveal information about you without your permission:
 

• The law requires that I notify the intended victim and the appropriate law enforcement agencies if I judge that a patient had an intention to cause serious bodily harm or death to another individual.

• I am obliged by law to report any suspected child abuse, neglect, or molestation to protect the child/children involved.

• I am obliged by law to report any suspected abuse, neglect, or molestation of an elderly person or dependent adult involved.

• If I assess a client to be suicidal, I am required by law to notify the individuals or agencies necessary to prevent self-harm, including initiating hospitalization on an involuntary basis, if necessary.

• In cases of alleged criminal or civil liability, I may be court-ordered to release treatment information and/or records.

• Some confidentiality may be lost in the insurance billing process. I will explain the issues surrounding these procedures if you have any questions.

• I may determine it clinically necessary to discuss some aspects of your psychotherapy with another qualified professional in order to further your treatment goals. If I seek such consultation, neither your name nor any identifying information will be communicated.

• I may release your name for collections processing. However, no treatment-related information will accompany the disclosure.