Psychotherapy, Counseling & Family Therapy
Counseling and Psychotherapy are terms that are often used interchangeably. Individuals, couples, and families meet together with the therapist in a respectful atmosphere to discuss difficulties, problems, and issues the client or patient is concerned about.
Any concern can be brought to therapy to discuss. People can know something is wrong but are not sure what it is. Some people seek therapy for a specific problem, while some want to change and understand a more general feeling that is distressing or confusing. The outcome of psychotherapy varies widely depending on what the problem is and what the goals are. While there are some exceptions due to the law, therapy is confidential.
Family Therapy focuses on important relationships and their role in many kinds of difficulty. When family relationships are a source of stress some changes in the relationships can make the difference in being able to solve and cope with problems of all kinds. Family Therapy can help individuals or couples who attend therapy sessions as well as their children, spouses or other family members who are unable or unwilling to attend therapy. Even issues in marriage can be addressed, with good results, when a spouse cannot or will not participate in therapy.
Frequently Asked Questions
With over 30 years of experience I have worked with many kinds of problems including:
- Anxiety and Depression
- Panic Attacks and Fears
- Self Regulation
- Stress Related Illness
- Emotional Effects of Physical Illness
- Life Transitions and Adjustment to Change
- Reaction to Death and Loss
- Stress management & PTSD
- Recovery from Drug and Alcohol Abuse and Addiction
- Mild to Moderate Eating Disorders
- Job Stress and Job Loss
Among the marriage and family issues I have experience with are:
- Conflict, Emotional Distance & Intimacy
- Child and Adolescent Problems
- Extended Family and In-Law Issues
- Problems of Aging
- Pre-Marriage Consultation
- Divorce Consultation & Children and Divorce
- Family Therapy for Mental and Emotional Illness
- Family Problems in Family Businesses
Among the workplace problems I have worked with are:
- Difficulty with Bosses, Subordinates and Coworkers
- Work group tensions and performance
- Performance Issues and Performance Anxiety
- Problems of Leadership and Responsibility
When you call (707-823-1848) you will reach my voice mail where you can leave a message. I will return your call most often with a 24 hour period. In a brief phone discussion, I will ask you what you are looking for, when you are available for an appointment, and determine whether my services are covered if you wish to use insurance. Then we can discuss the particulars of how to proceed. If my services do not fit your schedule or insurance needs, I can help direct you to other professional resources.
Insurance today can be difficult to understand. To assist you in this process, you need to know that some insurance plans reimburse you for services by any licensed psychologist. Some plans have a fixed network of providers but still allow you to see a provider outside their network and would reimburse you for some percentage of fees. If you have an insurance plan that does have a network of providers, please check with your insurance company and ask about your outpatient mental health benefit to see if they offer an out-of-network benefit, as well. In doing so, you will also want to clarify your policy’s requirements, limitations, deductibles, and co-payments.
Other plans have provider networks and require that you use only providers in their network. I have limited availability on the following plans with fixed provider networks: United Healthcare/United Behavioral Health, MHN/HealthNet, Blue Shield/Blue Cross/Anthem), PacifiCare and Medicare. I will, of course, provide the necessary billing information for you to submit to your insurer and advise you on procedures for working with your insurance company
People often wonder if the trouble they are having needs professional help especially when their problems seem to be those of ordinary living. When your usual ways of trying to solve your problems aren’t working and talking to those who you usually seek out to talk with such as friends, family, minister, priest, rabbi, etc does not help or helps only temporarily it can often be useful to get a professional consultation and then decide whether therapy might offer a new way to understand and approach your difficulty. Treat your first meeting or two as a consultation and let the therapist know that you are trying to figure out whether to pursue therapy.
The beginning of therapy is a period of exploring and evaluating the problems you are seeking help with. There will be many questions that you will be asked about the history of the problem, your personal and family history and previous efforts to deal with the problem. You may have questions about me and about therapy as well. The initial evaluation period usually lasts between two to five sessions after which goals and a direction for therapy are defined. Sometimes the result of the evaluation is that therapy is not indicated or appropriate or that some other approach or practitioner is recommended.
I am always happy to discuss questions about my approach to psychotherapy, counseling and family therapy. I believe that, with the right support, people can be resourceful in finding solutions to many of the complex emotional difficulties that surround their lives. In providing this support my approach is based in family systems theory. This includes a focus on thoughts and feelings common to many kinds of psychotherapy but within a broader interpersonal way of thinking about emotional patterns behind most problems. The emphasis at the beginning is stepping back from problems and pressures, observing emotional patterns and reactions, developing ideas about sources of emotional reaction and changes that could lead to improvement, and when ready, follow through with new actions to resolve problems. This approach emphasizes that every person and situation is unique and that each person’s individuality and best effort is important for a good result.
For children and adolescents, I will meet with the parents first or with the parents and the child together. Sometimes the whole family comes in together. For older adolescents who are working and are more independent it may be best to meet with them first. Any of this can be discussed but it is important that the first appointment is set up in a way that provides information necessary for an initial assessment to be made. After the first meeting, there is usually a plan for the recommended next steps and how many meetings it will take to do the next steps, and what is hoped can be accomplished in that time so that both you and your child know what to expect. I see children and adolescents only in the context of family therapy, which I believe provides the best long-term results. Sometimes parents and children are seen separately in family therapy, but regularly scheduled meetings with parents are expected. If you wish to have your child seen in individual therapy however, I can direct you in ways to find a different therapist for your child. One of the advantages of family therapy for children and adolescents is if they are unable or unwilling to participate in therapy, parents and others who attend family therapy can still have a positive impact on their children’s problems.
Often it is ideal for both partners to attend therapy for marital problems and other family problems including problems of children and adolescents. But often one spouse is unable or unwilling to attend. Fortunately, there can be very good results seeing one motivated spouse or parent and coaching them in family therapy. Even when both spouses are willing to participate there are occasions when either or both members of the couple will have separate meetings with the therapist. As in any treatment, if the plan the therapist recommends does not make sense to you or seem right, be sure to ask for clarification.
With very emotionally or developmentally impaired individuals as with children and young adolescents who are very dependent on parents, therapy is with the more functional and mature family members, usually parents, in family therapy. Very impaired individuals may participate in family group sessions if they wish and even be seen individually as a part of the effort, but family therapy can proceed and benefit severely impaired individuals even without their active participation in therapy.
Yes I will consider talking with an adolescent individually when one or both parents are willing to see me as well in an effort to address the family relationships. For older adolescents who work and are more independent it is sometimes possible for them to be more independent in therapy but it is still important for the parents to be involved. Early in therapy a meeting with the parents after meeting with the adolescent will determine the expectation for parents’ involvement.
Therapy sessions are from 45 minutes to one hour. Typically sessions are scheduled once a week to start until there is sufficient direction and momentum to sustain a meaningful effort between sessions that are spaced further apart. The effort to actively observe and think in new ways between sessions is essential to progress. Often after five or six weeks, sessions can be effectively scheduled every other week. When progress can be sustained meeting once a month then sessions are scheduled accordingly. When tension is high over a worsening situation, the frequency of sessions may be increased.
While people want to be able to plan ahead, this question cannot be answered in general. It is better addressed after a consultation. The answer depends on what you are looking for help with.
I do give feedback. In traditional psychoanalysis, the analyst listens and rarely speaks. While listening well is basic to good therapy, I bring a lot of experience and a way of thinking that is the source of frequent questions and comments made while conducting therapy. You will usually know how I am thinking about the problems you are working on even though it can take time to really understand a new point of view. People I work with are free to make use of the ideas that make sense to them, and to express differences when they see things differently. The goal of therapy is for a resolution that fits each unique person and situation.
I do not use a spiritual orientation to guide therapy but my approach respects the profound importance of spirituality and religion to many people. Often, when people have improvement in psychotherapy they find they are able to find the comfort and direction they seek or usually find in their religious or spiritual principles and practices.
As a clinical psychologist I am trained in psychological testing but I do not generally do psychological testing. I do offer formal evaluations of the family emotional system. The Redwood Psychological Association is a resource to find psychologists who do testing.
No. I am a clinical psychologist and am not licensed to prescribe medication, which only a medical doctor can do. People I work with who use medications for psychological and emotional symptoms are prescribed medication by their family doctors, internists or by their psychiatrists. I coordinate care and consult with my patients’ doctors who prescribe medications or are otherwise involved in aspects of their care relevant to psychotherapy whenever indicated but only with the patient’s consent.
In general, if you are being seen individually, what you tell your psychologist is kept confidential and cannot be released without written permission. There are some important exceptions that you should discuss with your doctor. For example, clinical psychologists are required by law to report suspicion of child abuse and possible suicide or homicide. Also, if you are involved in a court proceeding about custody or divorce, the family court Judge can subpoena your records, and psychologists cannot refuse to release the records. If you are concerned about any of these, you should discuss this in detail with your therapist so that you are fully informed.
Parents have specific questions about confidentiality out of their concern for their children’s welfare. When parents and children are seen together these issues arise less often. When they are seen separately, parents understand the therapist must maintain confidentiality so that their child can trust the therapist. On the other hand, parents are responsible for their child’s well being. This is particularly tricky when the child is a teenager. We can discuss the details of what information is shared and how to balance these two concerns.
Finally, when a couple or family is being seen, sometimes a member wants to share information with the therapist but not with the other family members. The issues are complicated and important and should be discussed.