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Frequently Asked Question #1

How To Choose a Therapist

1. Ask friends and family

Ask friends who are in therapy if they like their therapist. If they do, find out what it is they like about them and ask your friends to ask their therapists for referral lists.

2. Shop online

You can find a therapist on Psychology Today's Therapy Directory. When therapist shopping I would look for therapists who are not selling themselves but rather those telling you about their work and their philosophy of working with patients.

3. A picture tells a story

Take a look at therapists' pictures on Psychology Today's Therapist Directory. Red lights for me: Therapists who use glamour shots or whose portraits seem in any way seductive. I would also steer clear of therapists who use a photo of themselves partaking in a favorite hobby or recreational activity. 

4. Gender

When choosing a therapist, almost all people have an instinctive idea on gender they would prefer to work with. For me, my default therapist choice is always male which, in fact, comes out of my relationship with my parents. I don't think there is a right or wrong when it comes to choosing which gender you prefer to work with. 

5. Theoretical orientation

This one is really tricky. There are many theoretical orientations and I certainly cannot explain them all in one single post. Here is what I can say in a huge and gross oversimplification: If you believe there is an unconscious motivation for your behavior, you might want to go to a psychodynamic therapist.


6. Call them

When you find a therapist to call, then call. It sounds easier than it is; I have had the numbers of therapists in my possession for weeks before I dared to call. Once on the phone, I had questions handy. Where did he go to school? The best schools don't necessarily make for the best therapists. When asking this, I am not looking for a certain answer. I just want to know for sure that it is an accredited school and not an online coaching certificate.  What is her specialty? I tend to be wary of people who specialize in everything. One can't be all things to all people. Has he worked with people with your issues? On the phone, share a little about your presenting issue and see how the therapist responds.


7. Notice

Notice how you feel on the phone with the therapist. Nervous was how I usually felt on that first call. I rarely have had an immediate "yes" feeling when I talked to a therapist on the phone. I usually felt a little weird and awkward. You may feel differently. Just notice how you feel on the phone and after you have made the appointment. Also, if you are doing psychodynamic therapy, you might want to write down any dreams you have had once you have made the appointment.

On your first appointment, notice how you feel when you are in the room with your new therapist. Do you feel heard when you speak? Notice how you feel in that person's presence. Notice everything. You might not decide on the first session if the therapist is for you. It may take some time to determine if you have picked the right therapist. If you decide that it isn't a good match, then you don't need to go back. It is best to tell the therapist what it is you're looking for and why she isn't the best fit for you. The therapist might have some ideas for a referral that would work for you. And sometimes that desire to not go back is motivated by some more unconscious anxieties about being in therapy. Best to discuss those, too.

Also notice if there are any red flags, any ethical, boundary issues, or cottage cheese eating that starts to arise. If there are, it might be time to pick another therapist.

Mental Health Matters Composition Notebook (AJW BOOKS)

Frequently Asked Question #2

When to Go to Therapy?

Therapy can help improve symptoms of many mental health conditions. In therapy, people also learn to cope with symptoms that may not respond to treatment right away. Research shows the benefits of therapy last longer than medication alone. Medication can reduce some symptoms of mental health conditions, but therapy teaches people skills to address symptoms on their own. These skills last after therapy ends, and symptoms may continue to improve, making it less likely people will need further treatment.

But only about 40% of people with mental health issues get help. Untreated mental health issues often get worse and may have other negative effects. They could also lead to:

Inability to work or go to school

Difficulty in relationships or taking care of children

Increased risk of health issues

Hospitalization

Suicide


Suicide is the second leading cause of death for people in the United States between the ages of 10 and 34. About 90% of people who die by suicide in the U.S. lived with a mental health condition.

DO I “NEED” THERAPY?

Telling someone they should go to therapy or that they need therapy can be stigmatizing. It may be difficult to watch a loved one deal with mental health challenges, but it’s important for people to choose to seek help on their own—as long as they aren’t putting themselves or anyone else in danger. Encouraging someone you care about to look into possible therapy options, even offering to review potential therapists with them, is generally a better way to show support. People who feel forced into therapy may feel resistant and find it harder to put in the work needed to make change.

While therapy can help people work through issues that lead to thoughts of suicide, it’s usually not the best option for people in crisis. If you are in crisis, you can get help right away by reaching out to a suicide helpline through phone, text message, or online chat. You may be encouraged to call or visit the nearest emergency room. A therapist can help support you going forward, once you are no longer in crisis.

SHOULD I GO TO THERAPY?

It may take some consideration before you decide you’re ready for therapy. You might want to wait and see if time, lifestyle changes, or the support of friends and family improves whatever you’re struggling with.

The American Psychological Association suggests considering therapy when something causes distress and interferes with some part of life, particularly when:

Thinking about or coping with the issue takes up at least an hour each day

The issue causes embarrassment or makes you want to avoid others

The issue has caused your quality of life to decrease

The issue has negatively affected school, work, or relationships

You’ve made changes in your life or developed habits to cope with the issue. If you experience any of the following emotions or feelings to the extent that they interfere with life, therapy may help you reduce their effects. It’s especially important to consider getting help if you feel controlled by symptoms or if they could cause harm to yourself or others. Overwhelm. You might feel like you have too many things to do or too many issues to cope with. You might feel like you can’t rest or even breathe. Stress and overwhelm can lead to serious physical health concerns.  

Fatigue. This physical symptom often results from or accompanies mental health issues. It can indicate depression. Fatigue can cause you to sleep more than usual or have trouble getting out of bed in the morning.

Disproportionate rage, anger, or resentment. Everyone feels angry at times. Even passing rage isn’t necessarily harmful. Seeking support to deal with these feelings may be a good idea when they don’t pass, are extreme compared to the situation, or if they lead you to take violent or potentially harmful actions.

Agoraphobia. People with agoraphobia fear being in places where they might experience panic attacks or become trapped. Some people may become unable to leave their houses.

Anxious or intrusive thoughts. It’s normal to worry about things from time to time, but when worry takes up a significant part of your day or causes physical symptoms, therapy can help you deal with it.

Apathy. Losing interest in usual activities, the world around you, or life in general can indicate mental health issues like depression or anxiety.

Hopelessness. Losing hope or motivation, or feeling as if you have no future, can indicate depression or another mental health condition. Feeling hopeless from time to time, especially after a period of difficulty, isn’t uncommon. But when it persists, it may lead to thoughts of suicide.

Social withdrawal. Many people feel better when they’re able to spend at least some time alone. Introverted people may need even more time alone than others. But if you feel distressed around others or fear being with other people, therapy can help you understand and deal with these feelings.

WHAT IF I’VE ALREADY TRIED THERAPY AND IT DIDN’T WORK?

Sometimes therapy doesn’t help right away. Even in an ideal therapy situation, it can take time for symptoms to improve. Going to therapy and seeing no change may cause frustration. It may seem like a waste of time and money. Many people stop going to therapy as a result.

Sometimes therapy doesn’t help right away. Even in an ideal therapy situation, it can take time for symptoms to improve.

Other factors can impact how effective therapy is. There is no single, correct approach that works for everyone. Not every therapist will work for everyone, either. Having a negative experience with a particular therapist or a certain type of treatment can make it hard to try therapy again, even if you want support.

It can help to look for a therapist who treats what you’re experiencing. If you don’t have a diagnosis, you can talk to potential therapists about your symptoms. An ethical therapist will let you know if they’re able to treat your concern. If they can’t, they may be able to recommend someone who can.

Keep in mind different approaches may be better for different issues. Being misdiagnosed can affect how treatment works. If you didn’t feel heard in therapy before, or if you experience different symptoms, a different therapist might be a better fit for you.

WHY SHOULD I GO TO THERAPY?

If you’re considering therapy, you may be thinking about the possible drawbacks. Cost might be a concern for you. You might also be aware that therapy is often difficult. Trauma or other painful events from the past can be frightening to remember, much less discuss with someone else. Even if you aren’t dealing with trauma, working through challenges isn’t easy, and therapy isn’t a quick fix. Therapy also requires honesty, with yourself and with the therapist you work with.

But if you’re willing to do the work, therapy can be rewarding. It’s a safe, judgment-free space where you can share anything, with a trained professional who is there to help.

Here are a few benefits of therapy:

You’ll learn more about yourself. Therapists listen to your story and help you make connections. They might offer guidance or recommendations if you feel lost, but they don’t tell you what to do. Therapy can empower you to take action on your own.

Psalms from the Psych Ward

Frequently Asked Question #3

What Do You Do at Therapy?

When you take your car to the car mechanic, you know what’s going to happen: Your car will get repaired.

When you break a bone and visit your doctor, you know what’s going to happen: Your bone will be set in a splint or cast and eventually heal.

But when you make an appointment to see a therapist, do you know what’s going to happen? Many people aren’t quite certain. Will you just talk? Will you have to discuss your childhood? Will you be “hypnotized?" And what’s the “point” of seeing a therapist, anyway? Why not just talk to a friend?

There is a great deal of uncertainty in our society about what actually happens during a therapy session, what types of issues and problems are suitable for therapy, and what benefits a therapy session can provide. I’d like to address a few typical questions—and misconceptions—about what therapy is, what it isn’t, and how it really works.

Q: Do I have to be “sick” or “disturbed” to go see a therapist?

A: No. Thinking that one has to be “seriously disturbed” in order to see a therapist is a myth.

While some therapists do specialize in severe emotional disturbances—including schizophrenia or suicidal thoughts—many focus on simply helping clients work through far more typical, everyday challenges like mapping out a career change, improving parenting skills, strengthening stress management skills, or navigating a divorce. Just as some physicians specialize in curing life-threatening illnesses, while others treat “everyday” illnesses like flus, coughs, and colds, psychotherapists can serve a wide range of clients with a range of needs and goals, too.

In fact, most of my clients are successful, high-achieving people who are quite healthy, overall. Most are challenged by a specific, personal goal—like losing weight, creating more work-life balance, finding ways to parent more effectively, or feeling anxious about dating again after a rough break up.

Q: How can I choose the right therapist for my goal/situation?

A: Choosing a therapist is like choosing any other service provider—it’s a good idea to visit the practitioner’s website, and read client testimonials or reviews (if they have any—many do not, for confidentiality reasons). It's also good to ask friends and family members, or your physician, for referrals (and of course, check to see who is covered in your health insurance network).

If you are hoping to work on a specific issue—overeating, smoking, making a career change—try to find a therapist with expertise in that area. Many list their specialties or areas of focus on their websites. There are therapists who specialize in relationship issues, parenting issues, anger management, weight issues, or sexuality—pretty much any issue, goal, or situation you can imagine. If you’re not sure about someone’s expertise, just call them and ask. If they can’t be of assistance with your issue, they may be able to refer you to someone who can.

Q: What actually happens during a therapy session?

A: Each session is, essentially, a problem-solving session. You describe your current situation, and your feelings about it, and then the therapist uses their expertise to assist you in trying to resolve that problem so you can move closer to having the life you wish to have.

At the beginning of a session, the therapist typically invites you to share what’s been going on in your life, what’s on your mind, what’s bothering you, or whether there are any goals you’d like to discuss. You’ll be invited to speak openly. The therapist will listen and may take notes as you speak; some, like myself, take notes after a session. You won’t be criticized, interrupted or judged as you speak. Your conversation will be kept in the strictest confidentiality. This is a special, unique type of conversation in which you can say exactly what you feel—total honesty—without worrying that you’re going to hurt someone’s feelings, damage a relationship, or be penalized in any way.

Some therapists (like myself) may give clients some homework to complete after a session. That homework might be to follow up with Vocational Rehabilitation for your vocational goals, or to exercise three times a week. It may be to spend some time each day applying for jobs on Indeed.com, make a nightly journal entry, or any number of “steps” and “challenges” relevant to your goals. During your next session, you might share your progress and address any areas where you got frustrated, stuck, or off-track.


www.morethantherapy.org
More Than Therapy

Q: Will I have to talk about my childhood?

A: Not necessarily. Many people think that visiting a therapist means digging up old skeletons from your childhood, or talking about how awful your mother was, etc. That is a myth. What you talk about during a therapy session will largely depend on your unique situation and goals. And depending on your goals, you may not actually talk about your past that much. The focus of your therapy is as likely to be your present-day reality and the future that you wish to create.

That being said, if you really do not want to discuss your childhood, the intensity of your desire not to talk about it might suggest that you should! When people have strong negative emotions—about their childhood or any other topic—it’s typically worth doing some excavating to figure out why that is. Whatever is causing them to feel such strong emotions about the past is more than likely impacting their present-day life in some way, too. 

Q: How long will I have to go to therapy?

A: This varies from person to person. I’ve had clients who booked one session, we worked out their issue(s), and they were all set: They marched out and didn’t need a follow-up session. Sometimes, one brave, honest conversation is really all you need.

Other clients have booked sessions with me over a period of several weeks or months, focusing on one issue, resolving that issue, then perhaps moving on to a different challenge. Then there are other clients who I’ve been working with for some time—they appreciate having a weekly, bi-weekly, or monthly “check-in.” They may share their feelings, sharpen their life skills as needed, or perhaps enjoy a deeply nourishing guided meditation or hypnotherapy experience to de-stress. As one client put it, “Every two weeks when I meet with you, I leave your office feeling like you pressed my reset button.”

Therapy is really about whatever a client needs—a one-time conversation, a temporary source of support during a life transition, or an ongoing experience to optimize health physically, mentally, emotionally and spiritually.

Q: Is meeting with a therapist over the phone—or through video chat—just as effective as meeting in person?

A: That depends on your personality and preferences. In the state of North Carolina, where I live, multiple insurers covers doing therapy virtually via video chat (like Zoom or Facetime). This makes it a convenient option for people. Many of my clients do enjoy having some, or all, of their sessions via video chat because it means they don’t have to take time out of their busy schedules to drive, park, and so on. They can just close their bedroom or office door, pick up the phone or log in, and away we go—very convenient.

Where feasible, I suggest trying out both ways—do a traditional, in-person therapy session and then try a video session—and see which format is the best fit for you.

Q: Why see a therapist? Why not just talk to a friend or someone in my family?

A: If you are blessed with caring, supportive family members and friends, by all means, share your feelings, goals, and dreams with those people. They are a big part of your support network, and their insights and encouragement can be very helpful. However, people who already know you might not always be completely objective when listening to you. For example, you may want to change your career, and you confess this dream to your wife. She may want to support you 100%, and try her very best to do so, but she may also be dealing with emotions of her own—such as anxiety about how a career shift will change your lives, not to mention your income. These emotions could make it difficult for her to listen and support you objectively.

This is why working with a therapist can be so valuable. It's a unique opportunity to share everything you’re feeling, and everything you want to create, without anyone interrupting you, imposing his or her own anxieties onto the conversation, or telling you that you’re “wrong” or that you “can’t.”

A therapy session is a space where you don’t have to worry about hurting anyone else’s feelings—you can be totally honest. It also means you have the potential to solve problems faster and with greater success. In the long run, that’s better for you and everyone else involved in your life, too.

To sum it up:

Therapy is a valuable tool that can help you to solve problems, set and achieve goals, improve your communication skills, or teach you new ways to track your emotions and keep your stress levels in check. It can help you to build the life, career, and relationship that you want. Does everybody need it? No. But if you are curious about working with a therapist, that curiosity is worth pursuing. Consider setting up one or two sessions, keep an open mind, and see how things unfold. You have very little to lose and, potentially, a lot of clarity, self-understanding, and long-lasting happiness to gain.

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