May
07

What to Expect In Counseling

By
Anda Jines MS LCPC

Anda Jines MS LCPC

the treatment I provide may vary from client to client, based on your unique needs. I would be happy to address any questions you might have about the evaluation process or about therapy.

Mental Health Evaluation:

My evaluation consists of three or four, weekly, one-hour interview sessions, including discussion of your responses to intake questionnaires:

In the first session, I will ask you to talk about what brings you in, such as difficulties, concerns, stressors, symptoms, needs, and relevant history. This is a relatively unstructured discussion, in which you can get some things off your chest. At the end of the first session you will receive a questionnaire packet to fill out and bring back. If you are seeking couples therapy, I would like to meet with both of you for the first session.

In the second session, we will discuss your answers on the intake questionnaires and examine various factors that relate to mental health. If you are seeking couples therapy, then I would like to meet with each of you individually for the second and third sessions. If you are seeking help for medical stress, I may ask you to complete a half-hour, written assessment of your medical stress and coping methods.

In the next session, I will offer my feedback and recommendations, and we will discuss your mental-health-related goals. If we both decide to continue working together, we’ll specify a plan for working on your goals. (See treatment planning below.)

You may find it very relieving and meaningful to just tell your story, and to share what you’ve been struggling with. You may have been waiting to get things off your chest for quite a while. However, it is also possible that you may feel uncomfortable or awkward at first, especially until you get to know me better. Talking about things, even if painful, is useful in the long run, and will help you to address the problems that are troubling you.

Helping you to feel comfortable with my services:

To help you feel comfortable, I ask that you let me know about any preferences or concerns that you have about counseling, so that we can address them. It is important for you to tell me if you are ever uncomfortable with any aspect of counseling, or if what we’re doing isn’t helpful. I invite you to give me feedback throughout the counseling process. That way we can try to adjust things to better fit your needs. Counseling is a collaborative partnership between us, and I value your input. If I ever disagree about what would be most helpful, you can trust me to honestly and respectfully discuss this with you. There is no guarantee that we would always agree on the best way to approach your issues, but it is useful to openly discuss options, preferences and boundaries.

I want to assure you that all my services are voluntary. You can stop counseling at any time. Also, what we discuss will remain confidential. I follow all clinical and legal guidelines for confidentiality. You have received an explanation of privacy laws, including information about legally required exceptions to confidentiality. Please let me know if you have any questions about confidentiality.

I respect your right to choose:

After a few sessions you can decide whether I feel like a good match for you as a therapist. Finding the right therapist is an important decision, and sometimes it takes some shopping around. If you don’t think we “click,” then let me know. I will not take offense, and I will do my best to help you find another provider. What’s most important is that you get the help you need. I too will use the first few sessions to assess whether I am a good match for you as a therapist. If I conclude that I can’t help you, then I will do my best to offer you referrals to other providers.

Regardless of how long you’ve been seeing me, you may at some point want to try another therapist, or another type of help. This is fine, just let me know if you want to do this, so that we can process your transition and I can make appropriate referrals. Keep in mind though, that you should not see two different therapists at the same time, unless it’s for two very different services (such as individual vs. group vs. marital therapy).

Treatment Planning:

When we’re done with the mental health evaluation, we will create a treatment plan by writing down a few specific goals you want to work on, and we’ll discuss how we could work on them. We will decide how often we want to meet. Usually people start out meeting once or twice a week, depending on the severity of their issues. We don’t have to decide the exact length of treatment at the beginning, but it helps to discuss your expectations, preferences or limitations.

Treatment:

Usually counseling consists of weekly meetings, lasting 1 hour each. During these meetings, we will talk about your difficulties, thoughts and feelings. We will talk about whatever is troubling you each week, including stressors, relationship issues, symptoms, etc. and your efforts to manage and overcome your difficulties, with special emphasis on the goals that you have set for yourself. We may also talk about your past, and try to uncover the sources of deep-rooted problems.

I will try to help you to find ways to cope effectively, feel better, and be more satisfied and successful in life. I will strive to be a trustworthy and caring confidante, and to provide a supportive environment in which you can explore and express your thoughts and emotions without fear of judgment. I will give you feedback, emotional support, and encouragement. I will help you notice your strengths and accomplishments, reinforce positive thinking and effective coping, and share useful information with you. I may use handouts, assign “homework”, or recommend reading. Counseling is an opportunity for learning, growth, and an opportunity to try out new ideas and skills.

Because each person (or couple, or family) is unique, the treatment provided will be individually tailored. I draw on a variety of psychological theories and research, and use a variety of techniques, depending on what I believe is most appropriate and effective in each case. For couples, my approach is heavily influenced by Dr. John Gottman’s research. Your therapy may incorporate:

  • cognitive behavioral therapy (CBT)
  • supportive exploration
  • insight oriented therapy
  • interpersonal psychotherapy
  • emotion focused therapy
  • solution focused therapy
  • relationship work
  • developmental work
  • motivational interviewing
  • positive psychology
  • bio-psycho-social principles
  • therapeutic lifestyle change
  • psychoeducation and/or biblio-therapy
  • collaboration with other providers
  • and/or other approaches as relevant

As you start to work on your issues, you might find some relief right away, or you may find that things get more emotional or more difficult for a while before they get better. This may be because you are now actively addressing the problem. Making changes, acknowledging your emotions, and coming to realizations can be difficult work in the short run, but it is helpful in the long run. Emotional experiencing can be therapeutic in and of itself, even when the emotions are painful. However, if you feel overwhelmed with emotions, tell me so that I can help you learn to calm yourself. You may also want to give yourself some time to transition and soothe yourself after your sessions, before moving on to other tasks.

Integrative Care for Mental Health:

I believe in treating the whole person. It helps for me to collaborate with other medical providers, in order to recognize and address any physical problems that may be contributing to your mental health symptoms. Conversely, I can supplement the care you receive from other providers. This is especially important if you are receiving medication for mental health symptoms, or if you are seeing me because of medical stress.

If I have your permission, I will consult with your other provider(s) by sending them a copy of the mental health evaluation summary, including recommendations. If you elect to continue with psychotherapy, then I will send quarterly updates as well. I may also consult with your other provider(s) by phone at times, and ask for their input. Mental health topics can be sensitive, and I am mindful of that in the wording of my reports, and in my consultations with other providers. Working as a team will help us to help you feel your best!

Additionally, if you are comfortable with doing so and if it seems relevant, it may be helpful to involve family, friends, school personnel, or others in your treatment.  You may have family or friends join you in a session, you may want me to consult with school personnel, and/or we may talk about how to most effectively involve others in your treatment.

Treatment Plan Reviews:

I like to check in every three months to discuss how counseling is going, what progress you’ve made, your needs, whether to continue counseling, and if continuing – any adjustments we want to make to your goals, our approach to, or the frequency of counseling.

If you have been in counseling for a long time, and feel that you want to continue but need a break, you can also arrange a “therapy vacation” for a week, month, or season.

Ending Treatment:

How long treatment will last is hard to predict. Keep in mind that all services are voluntary, and you can stop at any time. However it is usually necessary to attend at least six to eight sessions to see any meaningful results. Often, more time is helpful. Someone who is coping with a difficult transition, trying to change a specific behavior (like smoking), or just wanting to learn some specific skills (like relaxation skills) might only come in for eight or twelve sessions. But someone who is dealing with lifelong issues or chronic and severe symptoms may continue in therapy for years, have multiple rounds of therapy through life, or stay in therapy indefinitely for “maintenance” treatment. Most people fall somewhere in-between. Financial considerations may also influence the length of counseling.

My goal in most cases is to help you get to a point when you don’t need therapy. But I’m also available if you need ongoing care for chronic issues. As you start to feel better, get control over your life, and need less support, we will gradually reduce the frequency of sessions. Usually people start out meeting once or twice a week, eventually switch to every other week, possibly come in for a while once per month, or switch to “as needed,” and then stop treatment.

Whether you take this gradual approach, or decide to stop treatment more abruptly, it is usually a good idea to meet one last time for a closing session, to talk about your reasons for stopping, what you’ve gotten out of counseling so far, what other support systems you have available, and how you plan to manage your issues independently. Of course, some people simply “drop out” of therapy, but I would prefer it if you could let me know when you want to cut back on therapy, to stop therapy, or to take a break.

It is also possible, but rare, that I may at some point conclude that I am not the right therapist for you. For example, I may realize that there is a conflict of interest if I treat you, I may realize that you need help for a condition that I don’t feel qualified to treat, I may realize that you need a different kind of service, or a system of more comprehensive wrap-around services, or I may conclude that you are not benefiting from my services. If this happens, I will do my best to help you find another provider who can better help you.

Also rare is the possibility that your insurance coverage may change or end, and make my therapy unaffordable for you. If this happens, we can problem-solve about the length or frequency of sessions, or I can help you find another provider who is more affordable.

Returning to Therapy:

My goal is that you will be able to cope effectively without my support once we’re done. However, after finishing therapy, you may at some point run into a tough situation, or need a little extra support, and feel the need for a “booster session” or a few, to help get (or keep) yourself on track.

Also, some people find it helpful to have several “rounds” of therapy throughout their lives, when new challenges arise, when symptoms return, or when they’re ready to “take another stab at it.” Different issues may come up in different circumstances, or you may see things from a new perspective as you grow and learn throughout life. It may be helpful to see the same therapist again, even years after your initial treatment, simply because they already know you. But then again, a new therapist might help you to approach your issues from a new angle. Regardless whom you choose to see, knowing that it is not unusual to receive more than one round of therapy can make it easier to seek it out again, if you need it.

I hope this gives anyone new to counseling an idea of what to expect.  If you have any further questions, or to make an appointment, feel free to call me at 708-429-6999.

 

Categories : About Counseling

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