Therapeutic Perspectives

I work with people primarily using depth-oriented Coherence Therapy.  Some people come in with a very specific problem they want to target as quickly and effectively as possible, and to only check back in for tune-ups if necessary.  Others want the support and interaction of an “unbiased” professional who can give them feedback and practice excellent listening skills, something many crave but lack in their lives.  If the following description is too complex to follow, please don’t worry that you have to understand all the theories I have studied and use—that’s my job!

The dominant influences in my assessment and work with clients are:

·         Coherence psychology, originally called Depth-Oriented Brief Therapy

      (Bruce Ecker and Laurel Hulley), (www.CoherenceTherapy.org ), is a system
      of psychotherapy that allows therapists to consistently foster deep emotional 
      shifts, dispelling clients’ symptoms at their emotional roots, often in a small
      number of sessions.
·         Compassionate (or Non-violent) Communication (Marshall Rosenberg),        
      (www.CNVC.org), which is very compatible with Coherence Therapy as a
      method to learn deep listening and empathizing;

·         Object relations theory of development, which helps me understand the early childhood family-of-origin issues a client needs to work through to improve self-esteem and relationships.

I place emphasis on both cognitive insight and emotional/experiential work, often using techniques such as visualization and focusing on sensations in the body and breathing to achieve greater awareness.  Through this work clients often recall previously unconscious levels of memories that become more vivid. The goal is to integrate perspectives and decisions made during those early experiences into present day reality.  This helps the client achieve greater ability to make more desirable choices about how to live life now.    

Obviously, there are many factors that add or detract from people's mental health. I invite my clients to consider the balance in their lives of such things as exercise, use of mind-altering substances, and connection to community/spirituality, in the larger picture of their healing.

           How often and long will we meet?

        The duration of therapy is impossible to predict before beginning the work.  I am most comfortable seeing most clients weekly for at least the first three sessions.  Although the majority of clients continue on a weekly basis, I am open to other scheduling patterns.  Please let me know what time period you have in mind, if any, and I will attempt to help you accomplish your goals in as close to that period as possible.  We can do that by staying even more focused in each session on working on very specific issue(s) that you see as problematic, rather than exploring related areas, secondary issues or general history.  I recognize that different people want different experiences from therapy, and will keep in mind your preferences.

 
            The couples and individuals I work with and range of issues

         My practice includes adults who experience a wide variety of life problems, including relationship difficulties (present, past, in or out of) as well as depression, anxiety and long-term issues of low self-esteem.  I welcome people who are in recovery in 12-step programs and encourage the use of such programs when appropriate with clients who are unfamiliar with them.  In most cases I do not see clients who are in therapy with someone else concurrently, except if I am seeing an individual who is in couple therapy with someone else, or vice versa.  If clients come as a couple and want to be seen individually, or come as an individual and want to include a partner, we will mutually discuss whether all parties involved are comfortable with changing the therapeutic relationship in this way.  If not, I will be glad to furnish referrals to other therapists.

In my work with couples, I emphasize clarity of communication and increased understanding of and compassion for the impact of such differences as family-of-origin circumstances and cultural- and gender-related socialization on the relationship.  This helps people determine whether there is sufficient connection and caring to work through their difficulties.  We then explore unconsciously held positions about each person’s relationship beliefs to others, which often uncovers what is stuck and points to how to go forward for one or both.  
             

             My fees are $125 per 50 minute session, and payment is due at the time of the session, by cash or check.  I periodically raise my fees, and will give one month's notice before doing so.  Fees are negotiable upon request.  I will not raise the fee of a client who cannot continue therapy as a result of the increase.
            I charge the full agreed upon fee for a missed appointment, unless I have been notified more than 24 hours in advance by telephone/message.  This policy is not meant as punishment but as a necessary business practice on my part.  Reduced fees are negotia­ble for clear emergency cancellations. If you are ill and not sure whether you will be able to attend a session, please call to notify me as soon as possible; if you feel better, we can usually reschedule at the same time or soon thereafter.  If not, neither of us loses time and money.  Notice of cancellation on my answering machine is fine; however, please do not call before 9 a.m. (10 a.m. on Sundays) or after 9:30 p.m.
        If you are being reimbursed by a health insurance policy, I will provide you with a billing statement at the beginning of each month for the previous month.  Some plans require a physician's referral for counseling by an MFT; if possible, a written note from the physician is best, with or without direct reference to me.  Unless your plan calls for copayments only on your part, I prefer that you are the party being reimbursed, not me. In this case do not sign the line that calls for "assign­ment" of payment, since that means they will send a check to me.  Please note that couples therapy is not covered by insurance, which requires a mental health diagnosis, except in cases in which one person has a diagnosis and the other is accompanying them to "conjoint therapy" in order to learn more or help deal with the symptoms.
         Regretfully, I no longer accept any form of insurance, even if I am listed on your plan's website. There have been too many instances of claim rejections due to "carve outs" of mental health that have been expensive either for my clients or me to absorb later.  

            Confidentiality

Our sessions are confidential, except in the following situa­tions: Under Tarasoff vs. Regents of the University of Califor­nia, if a therapist becomes aware that a client poses a serious danger of violence to another person, the therapist is obliged to use reasonable care to protect the intended victim against the threatened danger.  The discharge of this duty may call for the therapist to warn the intended victim or take whatever other steps are reasonably necessary under the circumstances.

In cases of threatened suicide, the therapist must move to prevent the patient from attempting the contemplated self-harm through clinical interventions.  Under Section 1024 of the Evidence Code, the therapist has the right to make disclosures to others who are deemed by the therapist as necessary to notify to prevent a threatened danger such as suicide.

The third type of situation in which confidentiality must be breached is if the therapist has knowledge of or observes a child in her/his professional capacity whom she/he knows or reasonably suspects has been the victim of child abuse, including sexual abuse, physical abuse, and neglect.  This law does not apply to learning about abuse of an adult when she/he was a child, an adult being a person over the age of 18 in this instance.

The last type of situation occurs when a client signs a waiver of confidentiality when it would be helpful for the therapist to speak with another professional who is familiar with the client, such as a previous therapist, referring physician, or lawyer.