Therapy Questions and Answers

I've never been to therapy before. What is it like?

Therapy requires you to be honest and open so that your counselor can learn as much as possible about you.  Your therapist will use this information to assist you in meeting your treatment goals. For adults, the first session will involve an assessment of your needs where  historical information is gathered about you, your family, your childhood, current situation and problem areas.  By the end of the assessment, your therapist  will be able to offer you some first impressions of what your treatment will look like.  Once therapy begins, some people experience uncomfortable feelings for the first few sessions like sadness, guilt, anger, frustration, loneliness, and helplessness since counseling often involves discussing unpleasant aspects of your life.   As you progress through therapy , you should begin to become more capable of handling problems, develop better insight and coping skills, and feel a reduction in the symptoms that caused you to seek therapy. 

It is my belief that therapy should be time-limited and brief to assist you in attaining your treatment goals.  If progress it not noticed within an established period or you are not satisfied with your treatment, reassessment of your treatment goals including the possibility of ending therapy or referral to a another therapist who can better meet your needs will be discussed.   

Is there anything required of me for counseling?  How long do I have to attend?

Therapy requires a commitment of time, energy, and money. Therefore, you should be very careful about the therapist you select.  Therapy isn't something you can attend once and expect maximum results.  Most therapy requires a minimum of a three months or 12 sessions to see maximum results; however, a recommendation will be made for you specific to your issues.  Second, it requires a commitment of energy & effort.  Clients who are involved in & take responsibility for their treatment experience a better outcome than those who show little to no effort.  Third, it takes a commitment of money.  Although insurance may pay the greatest amount of your treatment, there are still co-pays and deductibles. 

What about therapy with children?  Is it different?

Yes, it is.  Children do not recognize or discuss their feelings, emotions and problems the same way as adults. Children also respond differently than adults to trauma, stress and emotions. In fact, they often lack the conceptual awareness of their own behaviors and how they are related to their feelings, fears and experiences.  However, children do engage in play easily.  This play is a expressive form of communication.  Therapist trained in play therapy have specific techniques to engage children in play to assess their issues, help children express what is happening inside of them, and work through problem solving, natural progression and moving past issues that are causing them distress.  As a parent, you are involved in the process from assessment to treatment.  There may be points during treatment that your child's therpist asks you to join the session, but that depends on your child's needs.

What is an LCSW?

A LCSW is a "licensed clinical social worker".  This means the person is credential by the State of North Carolina to be professionally skilled and competent to provide mental health treatment.  The professional must have achieved their Master in Social Work and completed a minimum of 2 years of post-masters clinical employment experience while receiving on-going clinical supervision.  Then, they must pass the state licensure exam that measures their clinical skills.  LCSW's must educate themselves continuously by attending trainings so that they can keep their skills sharp.  

LCSW's are social workers.  This means they not only treat the person, they also look at their family, environment, and support systems.  People are members of complex social systems and do not operate alone, even if they feel as if they are.  Social workers have several key values by which they practice including unconditional positive regard for their client, always involving the client in their treatment planning, nothing about the client without the client, a sense of social justice, respecting a clients right to determine their own path, and the belief that people do have the ability to change and grow.

What results can I expect from counseling?

Therapy is not like a medical doctor visit.  Instead, it calls for a very active effort on your part.  In order for therapy to be most successful, you will have to be an active, motivated, participant in your treatment.  Good results require you to honestly disclose your history, describe your problem and assist in setting your own treatment goals. You must also be committed to work on things you discuss with your therapist both during sessions and at home.

On the other hand, therapy has also been shown to have many benefits. Therapy often leads to better relationships, coping abilities, solutions to specific problems, and significant reductions in feelings of distress.  People who have engaged in therapy often describe an increase in self confidence, self worth, feelings of competence in their lives, and increased resolve.  However, no clinician is able to guarantee what you will experience. 

My child needs help but he doesn't really want to talk about it.  Can play therapy help?

Yes!  Play therapy addresses children's needs and meets them where they are comfortable and naturally communicate- through play. A trained play therapist can interpret many things from a child's play.  Once a child successfully engages with a therapist through play and no longer feels stressed or under-pressure, they often began to become more verbally open and expressive.  

Is this really confidential?

The law protects the privacy of communications between a client and their therapist.  In most situations, information can be released about your treatment to others only if you sign a written Authorization Form.  Your therapist will go over any releases that they feel are important to your treatment where you will have to give consent prior to the information being shared such as discussing your treatment with your insurance company to assure coverage.  Therapist take confidentially seriously and make every effort to protect it!

However, there are some specific & serious situations where your therapist is required to disclose information without either your consent or authorization.  If we are specifically ordered by the court to release the information, if a government agency is requesting information for health oversight activities, if a client files a complaint or lawsuit and the counselor has to prepare a competent defense, and if a client files a worker compensation claim and services are being compensated through workers compensation benefits.  

There are some situations where your therapist is legally obligated to take actions, which they believe are necessary to attempt to protect others from harm: If your therapist has cause to suspect that a child under the age of 18 or disabled adult is abused or neglected, the law requires that any therapist file a report with the County Director of Social Services, if a therapist believes that a client presents a imminent danger to the health and safety of another, they are required to disclose information in order to take protective actions, including initiating hospitalization, warning the potential victim if identified, and call the police.