What's the difference between psychologists, psychiatrists, and counselors?
As above, psychologists have an average of about eight years of graduate training in psychology by the time they are licensed to practice independently. Psychiatrists first go to medical school for four years and then enter a three or four year residency in psychiatry during which they study psychology, neurology, biologically based disorders, and the use of psychiatric medicines. Unlike psychologists, psychiatrists prescribe medications. Counselors come from a variety of different types of training programs (education, social work, family development, to name a few) but most have two years of graduate education leading to a master's degree followed by about 18 months of supervised experience before they are eligible for licensure.

How do psychological services help?
That depends on the individual and the issues being addressed. Sometimes services are limited to assessment and referral. Sometimes services are brief and consist mainly of counseling or education. Often they take the form of "therapy," a more intense and complex type of teaching in which the relationship itself plays an important role in the learning process. Therapy usually is aimed at achieving greater insight and self-knowledge, particularly about our deeper reactions to important situations and people in our lives.

After an initial assessment lasting one to three sessions, we will discuss with you your situation and your treatment options.

Is treatment really effective?
After surveying 4,000 readers who had sought professional help, Consumer Reports concluded in 1995, "Our survey showed that therapy for mental health problems can have a substantial effect…Most people reported they were helped with the specific problems that brought them to therapy, even when those problems were quite severe….Overall, almost everyone who sought help experienced some relief-improvements that made them less troubled and their lives more pleasant." Consumer Reports also found that "The longer people stayed in therapy, the more they improved. This suggests that limited mental health insurance coverage…may be misguided….we believe that improving mental health coverage is important." While we're on that subject, it is also a well-established fact that people who make use of mental health services experience, on average, a reduction in other medical expenses that more than offsets the cost of the mental health services.

How come some people don't seem to benefit?
Any form of psychological help involves teamwork between psychologist and client. The people who do best in counseling or therapy are people who want to know more about themselves and are motivated to change. Some people are forced into getting help and are resistant. Others are frightened of change, even if they know it would be helpful in the long run. Some people are just not ready to confront difficult issues. They may "explore" getting help, drop out, and then return months or years later to do some very good work. This is a little like the people who waver in their commitment to a college education and then return later to become very successful students.

Another possibility is a mismatch between therapist and client. Since therapy is a relationship, personality variables can be important. We are not all likely to be attracted to the same kinds of therapists anymore than we are attracted to the same kinds of people in other areas of life. Also, not all therapists are equally skilled at helping with all problems. In general, though, you should know after three or four sessions if you are likely to have good "therapeutic rapport" with your therapist. If you feel you do not, discuss this during a session. Competent, ethical therapists understand and are not threatened by this, and they will help direct you to someone else with whom you may work better.

How should I choose a therapist?
To quote Consumer Reports (1995) once again, "If you want to see a therapist, you should approach therapy as an active consumer. In our survey, the more diligently a person "shopped" for a therapist-consulting with several candidates, checking their experience and qualifications, and speaking to previous clients-the more they ultimately improved. Once in treatment, those who formed a real partnership with their therapist-by being open, even with painful subjects, and by working on issues between sessions-were most likely to progress….When you look for a therapist, competence and personal chemistry should be your priorities. You'll be sharing your most intimate thoughts and feelings, so it's important to choose someone who puts you at ease….Our readers who located therapists through personal or professional references felt better served than those who relied on ads, their managed care company's roster, or local clinics."

Will my health insurance pay?
If you have private insurance, your plan will probably pay 50% to 90% of the cost of our services. We are Blue Cross/Blue Shield Preferred Providers, and we accept most insurance including Medicare. We are also network providers for Midwest Select, Midlands Choice and Value Options. Our experienced office staff can confirm your coverage for you, and in most cases we will be able to submit your claims for you.

If you are in a managed care plan, you may need to call a case manager to pre-authorize services, and only a limited number of office visits may be allowed. You should check in advance with your insurance provider for answers to both these questions. On your first visit here our staff will be happy to verify your coverage and review it with you.

Will my visits be confidential?
With few exceptions, the content of our conversations is strictly confidential, and no information is released without your written permission. One exception is possible child abuse, something we are required by law to report. Other exceptions are life-threatening situations such as serious suicide or homicide threats in which the law may require that we take actions necessary to prevent harm. Also, if you are involved in a court case and inform the court that you have utilized our services, you may be waiving your right to keep your records confidential. You may wish to consult an attorney if faced with this question.

What does it cost?
Many problems respond well to short-term therapy. On average, people are seen in our office about 8 to 12 times, and their out-of-pocket cost is $100 to $1000 depending on the terms of their insurance coverage. Some issues take longer to resolve, and some people prefer to stay in occasional "maintenance" contact for some time.

Do I need to be referred to your office?
No, you do not need to be referred to be seen by us. You can make an appointment simply by calling. However, if you are in a managed care plan, you may need a referral from a "gatekeeper" physician in order to utilize your insurance benefits. A call to your insurance provider should answer that question.