What should we expect from initial session?
Think of the initial session as a bit of a "getting to know you" session. In terms of time frame, therapy sessions are scheduled for 45 minutes sessions. Bring as many relevant family members you want as it is often important to get multiple perspectives on the situation. In the case of children and adolescents, expect to begin by meeting as a family at the beginning of the session. Most often we will meet with the child or adolescent for some one-on-one time, followed by a brief summary discussion with the family as-a-whole. In regards to children, some parents like to come without their child for the first session so as to discuss pertinent information. We are open to either situation (e.g., parent(s) bringing the children for the first session or coming without their child). We like to close the session by giving our perspective on the presenting problem, the goals for treatment, frequency, and general estimate about length. Some time at the end of the initial session will be used to complete any initial paperwork.
In the case of an adult or couple, expect a similar data gathering process with a summary discussion and directions for treatment provided at the end of session. Remember, just try to relax, be open as possible, and know that by the end of the session we will get to all the relevant information and conclude with a direction for treatment.
In terms of working with my child, how much information can you share?
Children and adolescents ages 12 and up have full privacy, meaning that we can only share information with that child or adolescent's written/verbal consent. This privacy can be broken if the child or adolescent states that he or she is thinking about hurting him or herself or someone else. Additionally, as we are mandated reporters, any discussion of abuse (e.g., sexual, emotional, physical, or neglect) would not be considered confidential. Children and adolescents under 12 do not have this same right to privacy and they will be made aware of this during the initial session. As an additional thought that is important to note, even though your 12 and up child has privacy rights, our goal is to get the child/adolescent to feel comfortable enough to communicate difficult topics with our help and goal of resolution.
Will I be part of my child's sessions?
Definitely. We do not believe in working with adolescents and/or children on an island. Children and adolescents live in and outside of the home so issues arise in both contexts. When things are not going well outside of the home, children/adolescents often project or displace these feelings onto the family system. The general working model we employ is to have at least one of the parents bring the child or adolescent to each session. The first five or ten minutes will be spent with the parent and child to review what has transpired since the last session, the next 25-30 minutes will be spent with the child or adolescent, and the last five or ten minutes with parent and child so as to review any "homework" or what is to be expected for the next session.
Will you be able to contact my child's school, family doctor, psychiatrist, etc. if needed?
Yes, if the appropriate releases are signed for children and adolescents age 12 and up. We have developed strong working relationships with school liaisons, physicians, occupational therapists, and psychiatrists in the community. We believe in a multidisciplinary approach.
My ex-spouse and I have joint custody of our child. Do you need consent from both parents to treat our child?
When one parent brings a child in for the first session it is imperative that both parents approve of therapy. If one parent brings in the child, we will ask for the other parents' contact information so as to provide our perspective and ask for consent.
What's the difference between a psychiatrist and a psychologist?
Psychiatrists go to medical school and tend to place a strong focus on the biological aspects of behavior. They are trained in psychopharmacology and are licensed to prescribe psychotropic medication to treat problems with mental illness. Psychologists are trained through graduate school with a focus on psychological testing and psychotherapy. Only in a few states have they been permitted to prescribe medication. Thus, the traditional mode of treatment is talk therapy.
What are your views about medication?
As psychologists, we do not prescribe medication. However, we have both worked in inpatient and residential settings and understand the value of medication in cases in which the child or adolescent is not responding to various forms of psychotherapy. We offer recommendations for psychiatric evaluation only after considerable assessment has been undertaken and have a group of child and adolescent psychiatrists with whom we trust to provide quality care.
For couples therapy, will my significant other and I meet with you separately for the first visit?
We would prefer meeting initially as a couple to get a flavor as to how each of you communicate and address areas of potential conflict. If we think it is necessary, we will recommend a couple of individual meetings be scheduled.
What is the general approach for couples therapy?
Generally, we like to get a handle on each partners' family history and see how they match in terms of emotional expression, communication, and problem solving. We like to develop one to three assignments for each partner or the couple to work on until the next session. We like to spread the sessions out, once every two to three weeks to see the extent to which each partner, or the couple as-a-whole is working on the problem. Our experience has been that progress can occur within six to seven sessions if both members are open, present, focused, and emotionally available.
What are the most common problems among couples that you see?
The most common is what we call the "alienated roommate syndrome", where couples have sort of drifted into their own routines, lost their spontaneity, and emotional connectedness. This can occur also when one or both of the partners change and evolve over the life span. Other common problems center on family of origin conflict and differences in parenting styles.