Next Session/ Intro

Next Session/ Intro

Focused Therapy Only 

  • My practice is geared towards focused therapy and our work will reflect this.
  • Focused therapy is like physical therapy to fix an injury: some difficult feelings, requires active efforts during yoursession AND active efforts on your own between your sessions.
  • On the other hand, supportive therapy is more like a massage at a spa: pleasant feelings, passive participation onlyduring your session, and no work is expected between sessions. Supportive therapy would include simply reporting on/updating about events between sessions without any new insights or actions, venting about things outside your control, coming to sessions not prepared with an agenda for why you booked the appointment, repeating the same concerns in therapy while also refusing the suggestions and steps offered, or simply attending therapy out of habit but not being ready to make further changes right now.
  • Insurance requires that our time be focused- just like physical therapy.
  • I’ve found that the more conscious/intentional (focused) you are about each and every session, the more you will getout of therapy.

Insurance Requirement for “Medical Necessity”

Insurance contracts don’t allow general, supportive counseling. Instead, they require that there be a: 

  • Medical diagnosis from the Diagnostic Statistical Manual-5
  • Formal treatment plan with objective/measurable goals that are routinely updated
  • Acute symptoms documented for every session’s progress note
  • Professional/skilled therapeutic interventions for every session’s progress note- not just supportive listening
  • Some form of resolution (i.e. progress towards goals, decrease in session frequency, discharge).

Your Job & Homework 

  • Take notes between sessions to process your feelings, track your progress and identify your stuck points.
  • Complete a “Next Session Worksheet” before each and every session to organize your thoughts and set your intentions.
  • Do not send me your Next Session Worksheet- just keep it with you to refer to during our next session.
  • You will lead every session by telling me where you’d like to focus during our limited time together.

Therapy with an Endpoint

  • To decide what you need to feel better- but then to get very clear about what you are actually ready to work on right now.
  • To identify what you can and cannot control, your morals, your belief system, and to bolster your sense of self.
  • To better understand how your choices and beliefs affect your happiness – even more so than external circumstances.
  • To utilize all the suggestions discussed in therapy that you agree would be helpful.
  • To internalize the unconditional positive regard that therapy fosters.
  • To problem solve, build internal muscles, and self-soothe more and more without therapy.
  • To build a support system for yourself that you practice connecting to the same way you connect to me.
  • To reduce the frequency of your sessions over time.
  • To return only as needed for booster sessions

Therapy for Loneliness & Connection

  • If you enjoy therapy mostly because it gives you a chance to share yourself unconditionally and have time dedicated just to you, that is wonderful- and that is more like supportive therapy, not focused therapy.
  • Being seen and heard unconditionally is an essential need, but my practice is geared towards insurance regulations and having time in my limited schedule to be available to help those in crisis to get professional help.
  • If you find that therapy has become more about your connection to me and not the work you doing on yourself, then we should talk about what kinds of closeness and intimacy you may need to nurture in your life outside of therapy.
  • I cannot act in a friend capacity due to the ethics of my profession and, therefore, enabling you to rely on me would be a deep disservice to you and the relationships in your life that may need deepening.

Scheduling Expectations

  • Appointments are generally scheduled approximately every 2 weeks, then drop to every 3 weeks, and so on. Therapy is not meant to continue for years at the same frequency.
  • Because we are a focused therapy practice and not a supportive therapy practice, clients in most need (e.g. safety issues or acute crises) will get priority scheduling.
  • Our practice does not take on new clients if we don’t have enough spots for current clients. However, appointment needs ebb and flow, and predicting this is sometimes out of our control.