Assessment for adults usually consists of approximately two to three sessions, during which I gather information about your overall family, work/school, and wider interpersonal situations. I also gather information regarding the clinical symptoms (such as sadness or frequent worry) you are experiencing, as well as the life-problems that stem from and perpetuate the symptoms. Additionally, I get a sense of your strengths and resources so that we can employ them effectively in the treatment. Finally, I gather information regarding what you would like to change in your life so that we can formulate the goals and objectives of your treatment. The goals that you set with me organize and focus your therapeutic work. Goals usually involve positive changes in your view of yourself, your functioning in relationships, work and family, and your symptoms.
In most cases, assessment for adults can be completed through the clinical interview process alone. In other cases, I do administer various psychological measures in order to clarify more complicated diagnoses. At the end of the assessment process, I provide you with recommendations about how you might want to move forward.
Individual therapy is a process in which you take a deeper and more focused look at problems and conflicts in your life so you are better able to change them. It is done in a setting that is safe, non-critical, and supportive. Through the therapeutic process, you start to get a better idea of the stressors you are facing, the methods you use now to cope with them, and potentially more constructive alternative methods that you could be apply. You also start to get a sense of stressors you faced in the past and how those situations might continue to influence you today. Also, you get to know the strengths and resources that are at your disposal, but that you might not be accessing currently. Individual therapy is, for the most part, guided by the goals that you set at the end of the assessment phase. Some courses of individual therapy can be relatively brief--for instance 16-20 sessions to address a particular issue. Individual therapy can also last longer, especially in cases where multiple problems, both past and present, exist. Effectiveness of treatment is often associated with the frequency with which sessions are held.
Therapy for couples is typically recommended when a couple is experiencing consistent and ongoing problems in communication, expectations regarding the relationship, intimacy, parenting, and/or navigating life transitions effectively.
When a couple presents for assessment, the assessment process typically involves at least one interview with the couple, individual interviews with each member of the couple, and a feedback session in which I provide the couple with recommendations about how they might want to move forward. If there are clinically significant issues (such as depression or anxiety) in one or both members of the couple, I typically recommend a course of couples therapy, along with a referral to another clinician for individual therapy for one or both members of the couple.
The work of couples therapy as I practice it involves several main objectives.
First, I want each member of the couple to better understand their past learnings about how relationships operate, as well as their current expectations of relationships. I also want the other member of the couple to better understand their partner's relational background and how that might impact their partner and the relationship now.
Second, I want the couple to better understand their communication style and to identify any aspects of it that tend to disrupt effective communication. Once these aspects have been identified, the couple can practice alternatives that are more effective. Also, I want the couple to recognize behaviors that tend, often unknowingly, to perpetuate relational problems. Once these behaviors are recognized, alternative behaviors can be identified and practiced.
Third, I want the couple to understand the attributions they make regarding their partner, their partner's behavior, and the relationship itself. Attributions involve the meanings we apply to events that occur in our lives. The meanings we make will impact how we feel, how we think, and how we behave. Attributions, especially in times of increased stress, can sometimes be inaccurate and can therefore be a significant source of tension within a relationship. Understanding the attributions each partner is bringing to the relationship is key to making fundamental changes within the relationship.
Finally, I want the couple to practice and re-practice at home the communication skills, more effective and connection-building behaviors, and cognitive self-monitoring skills that they learn and practice in the therapy.
Therapy for the entire family follows the same format of multi-session assessment, specific goal setting regarding the identified problems, and subsequent family sessions designed to encourage greater understanding of each family member's perspective, to identify unhelpful communication patterns and other problem-perpetuating behaviors, and to understand the attributions and cognitive sets each family member brings to the situation. Like individual and couples therapy, family therapy is guided by the goals that the family members set as a group at the end portion of the assessment phase.