The answer you get depends on the assumptions that a psychologist makes about the nature of human behavior. For psychotherapy to work, it is important that the assumptions are consistent with your own beliefs about yourself and people in general. Briefly, I believe that human beings are feeling beings who happen to think, not thinking beings who happen to feel. Our feelings are the most difficult part of ourselves to identify and understand because we learn to hide our feelings to survive your family experiences. Psychotherapy is the process of learning how our behavior reveals those emotions, and to better learn to use our emotions to solve interpersonal problems.
For more information, please read how I view human behavior in another section (see “The Nature of Human Behavior” below) to understand better how psychotherapy benefits my patients.
There is only one requirement for the patient to enable psychotherapy to work – be emotionally honest with yourself and your psychologist. Don’t leave out pieces of information that may reveal the truth, especially regarding how you feel about your therapist. Tell all and you will learn the most about yourself.
Yes, you can ask anything that you want to ask. I think it is your right to know some facts about my personal and professional life to ensure that you are comfortable with my approach to treatment. What I cannot answer is facts that concern other people in my life and reveal information about them. My advice is to ask anything you feel you need to know and let me decide if I can give you an answer.
There is usually some period of time, typically 4-6 months, devoted to understanding your emotional world followed by periodic consultations as needed. In that sense, your psychologist is no different than your family doctor or dentist. You use each of them throughout your life to help yourself become healthier. When emotional events in your life overwhelm you or prevent you from functioning at your best, consulting with your psychologist will enable you to more quickly and efficiently understand and resolve the problems that you are facing.
Treatment works best if the time interval between sessions is one week. Weekly visits are recommended during the initial 4-6 months of treatment. The treatment schedule after that phase will depend on the nature of the problems confronting the person and can range from weekly to monthly to an as-needed basis.
You may be charged for the consultation time. If it is a first offense, there is no charge as unavoidable circumstances happen to everyone. If it occurs a second time without sufficient notice, you will be charged for the time as the time cannot be given to another patient.
If you are emotionally overwhelmed and need help, you need to call to discuss whatever is going on. I do not carry a beeper so am not available to return a call until the next break in my schedule. After hours, my service will contact me to return your call. Press “O” for operator and you will be put in contact with my service. If I am not at home when they call, there may be a delay in getting back to you. I will return the call when I return. Care must be taken to evaluate the need for a phone consult as you will be charged at a rate of $50.00 per 15 minutes or portion thereof paid at your next visit.
Cost per 50 minute session typically ranges from $125.00-$175.00 and will vary depending on your area. I currently charge $160.00 per consult. As I do not participate with any insurance carrier, the out-of-network reimbursement in your health care plan will determine the extent of your coverage.
The in-network psychologist has agreed to accept a fee schedule and a review process that will determine the number of sessions that will be covered. An out-of-network provider sets his own fees and is not limited to a set number of sessions. The advantage to the in-network option is cost. Payment is typically a co-pay that varies with coverage. The disadvantage is the loss of freedom to determine the length of treatment. With the out-of-network arrangement, the treatment plan and payment is set between the doctor and the patient, not the insurance company.
I believe that psychotherapy works best when the treatment choices are made by the doctor and the patient, not by a third party. As a result, I do not participate with any plan and work out any fees or schedules with my patients based solely on their needs.
Because of the large number of plans, the insurance company needs specific information to tell you exactly how much will be covered. In brochures for example, the statement ,”50% of mental health costs” still does not tell you how much will actually be paid. There are often hidden limits that determine the amount to which the 50% is applied. When you call your insurance carrier for coverage information, ask for the specific amount that will be paid for a 50 minute session, procedure code 90806 in area code 19047.
Unfortunately, there is a wide difference in training among even licensed psychologists. Formerly, a two year Master’s Degree in Psychology qualified you to sit for the licensing exam. Now, a doctorate in either clinical or counseling psychology is required, but are not the same. A doctorate in counseling psychology is an Education Department degree. A doctorate in clinical psychology is a Psychology Department degree. Courses in education are focused on educational issues. Clinical psychology training contains more extensive training in abnormal psychology and the full range of human behavior. The doctorate in clinical psychology is the premier training for a psychologist who does psychotherapy.
I would not recommend any treatment done by a provider who refers to themselves as a “psychotherapist”. While technically anyone who practices psychotherapy is a psychotherapist, psychotherapist is a term used by people with low level training in psychology to avoid the accountability of the licensing laws. The licensing law in Pennsylvania is a title law that restricts the use of the term “psychologist” but not what they do in practice. It is not a function law that protects what a psychologist does. As a result, anyone can use the term “psychotherapist” and do treatment without sufficient training to ensure that no harm is done. What the law protects is the use of the term, “psychologist” and is the most highly trained provider for psychotherapy.
A psychiatrist is a medical doctor who goes to medical school for four years, then three years of internship and residency where they learn to use medication to manage psychiatric symptoms A psychologist earns a doctorate for four years of study of clinical psychology plus three years of internship and residency to learn psychotherapy for mental health problems. In general, the psychiatrist treats the biological aspects of the problem while the psychologist treats the psychosocial elements to the problem. They often work together to blend the use of medication with psychotherapy to provide the most comprehensive and effective care.
When considering the use of medication, care must be taken to avoid the potential impact on a person’s psychology. Ultimately, the person is the source of the cure. Medication provides symptom relief, not change. The use of medication can confuse these issues and reduce the patient’s self-worth. As a result, I tend to be very conservative about the use of medication and prefer to avoid it unless absolutely necessary. Psychiatric medication is needed on a short-term basis in a crisis where the person is overwhelmed or if the person’s biology is compromised (not sleeping, unable to eat, etc.). Chronic biologically based conditions such as a bi-polar disorder or schizophrenia require lifelong use of medication. In most non-biological cases, the over reliance on medication should be avoided if at all possible.