Frequently Asked Questions about Counseling & Psychotherapy
Will therapy work for me?
Psychotherapy can assist anyone in finding help and understanding with the problems of everyday life. All of us at some point in our lives find we need help and are able to reach out for support. Some may consider reaching out a sign of weakness, or assign another negative meaning to it. Please know that seeking out help from a psychotherapist, Marriage and Family Therapist, psychologist, analyst or other mental health professional to assist with personal difficulties is a sign of courage, and a step in the right direction in dealing with the many challenges of life. You may also choose to go with a mentor or spiritual adviser who ever you chose the goal is for you to feel understood and that the provider is thinking about you and what you need.
Psychotherapy is often referred to as the “talking cure”. The core belief is that talking with a trained listener and developing a nurturing, supportive relationship with your therapist can shift how you feel about yourself. Having hope and strength within yourself radiates out into the rest of your world and helps you to handle the many emotional and physical stresses that accompany our world of today. Mental health professionals are not only skilled in listening they are skilled in listening in a particular style that directs their responses to get at the root of the problem.
Today there are many different theoretical and applied approaches to the process of psychotherapy. Some approaches are more effective than others for certain types of issues. Psychotherapists with many years of experience usually have been trained in several different approaches so that they are able to bring their training and experience together to focus on the problem presented by the patient/client. There are many different types of therapy, some deal with history and trauma, others focus on making behavioral changes and others focus on the physiological components and there are more and more styles appearing regularly.
Where do I start in finding someone to help me?
- One of the best ways to find a psychotherapist is to ask friends or family if they have a therapist they like. You can ask your physician or other health professionals if they have a referral for you.
- If you are going to use your medical insurance and want someone within your network, call your insurance company and ask for referrals.
- Your employer may have an employee assistance program, which will often pay for a several visits which can help you solve the problem or get you headed in the right direction.
- You can look through the phone book or search the Internet and use the questions below to research the professional’s background and experience.
I have been given several names, how do I know which person to see?
Interview the psychotherapist briefly on the phone when you first call and then continue the interview once you meet with them. You may want to ask:
Are you licensed?
How long have you been practicing?
Do you specialize in a particular type of therapy?
Have you worked with people with my types of issues?
How can I pay?
Will you accept my insurance?
Do they have space available at the time you need?
If it feels like this person might be helpful, schedule an appointment to meet. Realize that it takes several sessions for the therapist to assess you, and for you to assess the therapist.
Trust your intuition. Therapists should be clear about boundaries: rules, the limitations of the relationship, what they are responsible for and what you are responsible for. I would hope that in your first session you would feel heard and that the therapist understands your issues.
Therapists should keep the focus on you, rather than their own issues. If you have an issue with a therapist before you leave try asking the therapist for help in resolving the issue; the therapist should be willing and wanting to understand, should be able to discuss it (including his or her own contribution to the problem) in such a way that leaves you feeling understood.
Therapists should never have ANY other kind of relationship with clients besides the therapeutic one, no business or social relationship. Therapists are not to be romantic with, date clients, nor engage in sexual activity with them.
Will my insurance pay for your services?
I am no longer a provider on any insurance plans, if you want to use an in-network provider I suggest you contact your insurance company or go to their website where you can find referrals of in-network providers. Most PPO and POS insurance plans offer out-of-network privileges for psychotherapy services and should pay a portion of my services. Please check with your insurance company to verify coverage for outpatient mental health services by out-of-network licensed Marriage & Family Therapists.
I will provide a statement of services at the end of each month, which can be submitted to your insurance company for reimbursement and in some cases I will bill the insurance company directly for their portion of payment.
How do I pay and how can I make my insurance work for therapy?
How you will pay for treatment is a big consideration. Insurance and mental health benefits are more complicated today and to be sure you should call your health plan and ask them to explain your coverage. I will try and give an overview, what follows is a key to the terms you should know when using your insurance.
In-Network: using the providers that have a contract with the insurance plan.
Out-of-Network: using providers that are not part of the plan.
Some insurance plans will offer you out of network coverage others do not, when you call to verify your benefits ask for your coverage in-network as well as out-of-network.
Insurance companies offer various plans: PPO, POS, & HMO and others. PPO & POS are similar; Preferred Providers & Point of Service plans give you options to use the doctors in the plans network and pay reduced co-pay or to go outside of the network and use any professional of your choice at a higher co-pay. You may also have a deductible to meet that may be waived if you stayed within network.
HMO’s – Health Maintenance Organizations. These plans usually do not offer out-of-network benefits and the providers on their lists or panels have agreed to accept payment as defined by the organization and cannot bill you for anything beyond that agreed-upon payment. HMO’s usually have a primary care physician who manages your health care services and all referrals to specialists.
Managed Care – these are companies that Mental Health care companies have formed to reduce insurance cost and/or usage. They have their own panel of providers and reviewers who work with your insurance company. They are the “middle man” who regulates whether treatment should be provided and for how long. They primarily operate within the framework of “medical necessity”. This is based upon a short-term therapy model with an average treatment lasting 1 – 8 sessions.
To utilize your insurance benefits, a mental health diagnosis must be made. In some cases a manager will oversee your account and approve sessions based upon the information submitted by your therapist. It is the program — not always the therapist — that dictates the treatment when using these kinds of benefits.
Fee for Service: You pay the psychotherapist directly for their services. Some therapists have a sliding fee scale or will negotiate their fee. Out of ethical standards, therapists are not allowed to barter for their services. Fee for service is the only way to have therapy and maintain the most amount of confidentiality since there are no insurance forms submitted to insurance companies there is no exchange of personal information
What if I can’t afford to pay for therapy?
Many community mental health centers offer ‘sliding-scale’ fees: prices based on your income or ability to pay. Other advantages to these places may include broader on-site resources. They often have different types of in-house therapists and programs for other members of your family. Therapists are in training and supervised by a licensed therapist. Clinics might be part of government-funded mental health programs, graduate degree programs in psychology, or they may be part of a particular type of treatment and be a training institute.
What are all the different initials after therapist’s names (M.D., Ph.D., L.C.S.W., M.F.T)?
Psychiatrists (M.D.) are medical doctors and are the only ones who can prescribe medication. After completing their residency training, most psychiatrists take a voluntary examination given by the American Board of Psychiatry and Neurology to become a “board certified” psychiatrist. To check on complaints and licensure www.medbd.ca.gov/Lookup.htm
Psychologists (Ph.D. or Psy.D) have a doctorate in psychology, have completed an internship and are licensed by the state to practice. Psychologists are trained and licensed to administer psychological testing while Master’s level degree holders are not. Visit www.psychboard.ca.gov to check on license status of psychologists.
Licensed Clinical Social Workers (L.C.S.W.) have generally completed a two-year Master’s degree in social work. These counselors have some amount of supervised clinical training and are licensed in their state. In California check www.bbs.ca.gov
Marriage, Family Therapists (MFT or LMFT) have completed a Master’s degree in psychology or counseling psychology. They have completed an internship and are licensed by the state to treat clients. To check license status: www.bbs.ca.gov
Licensed Professional Clinical Counselor have completed a Master’s degree in counseling psychology. They have completed an internship and are licensed by the state to treat clients. To check license status: www.bbs.ca.gov
Psych-Assistants: Have earned their Ph.D or Psy.D, are registered with the licensing board and are under supervision of a licensed person earning their hours towards licensure. They should state clearly who is supervising them and that they are not licensed yet. Their registration can be checked with the same board as the licensed psychologist.
Intern is the termed used for someone who has completed their required degree, is registered with the licensing board and is working under the supervision of a licensed person, earning their hours towards licensure as a LCSW, LMFT, or LPCC. They should state clearly who is supervising them and that they are not licensed yet. Their registration can be checked with the same licensing board as the licensed LCSW, LMFT or LPCC.
You might find multiple degrees or initials after people’s names. I have a Psy.D showing that I have a doctorate in psychology, you may also see Ph.D. a doctorate of philosophy which can come from many different disciplines. There is the license that someone works under, M.D., Clinical Psychologist, Social worker, Marriage & Family Therapist and then there is the level of education they have completed. B.A., M.A., Psy.D and Ph.D.