ANSWERS to Frequently Asked Questions
How do I know if I need a Therapist?
When you feel stuck, overwhelmed, depressed, anxious or when you need another perspective on a difficult situation, you may need a therapist. I offer a 1/2 hour session on the phone or in person at no charge to evaluate your situation together.
Are my sessions confidential?
One of the most important aspects of professional counseling is confidentiality. It is important that you know you can share anything without concern that your private information will be shared with others.
However, please be aware, there are issues such as physical injury to the client or to others (or immediate mental or emotional injury), when reporting may be necessary to help keep you or others safe.
These situations are rarely straight forward and do require individual assessment. I will discuss these situations with you in therapy if they apply. The assurance that your private information be kept confidential is primary to our work together.
How much does it cost?
Sessions are billed at $150 per client hour (50 minutes). Pastors and clergy are billed at $135 per client hour. Half-hour consultations for first time clients are at no charge.
Do you accept insurance?
If you have a PPO, your plan will likely reimburse you. More than half of my clients have utilized this option and they receive 60 to 100 percent reimbursement. A "Superbill" will be provided to you which is then submitted to your Health Insurance Provider. Please contact the office at (210)593-8141 for further information.
Do you see children?
I see clients age 12 and older.
Do you integrate Faith into Therapy?
Many of my clients have a strongly held faith, and some do not. My personal faith is Christianity, however, integrating a client's personal faith into the session depends on the client's personal preference. Many clients prefer this, and it is a comfort to them. Others do not and that is of course, okay.
Is there hope for my marriage?
Most couples can find their way out of a broken marriage. However, finding the right counselor whom you both trust can provide the hope and strength you need to keep going until the relationship begins to stabilize. There are many resources available to help with isolation, lack of guidance (where do we go from here?) and anxiety/depression associated with a difficult relationship.
What is Sex Addiction?
A persistent and escalating pattern of sexual behaviors acted out despite increasingly negative consequences to self or others.
What are Some Sex Addiction Symptoms?
Some out-of-control, repetitive behaviors which may reflect sexual addiction include:
- Chronic masturbation
- Multiple anonymous partners
- Sexual aversion
- Simultaneous or repeated sequential affairs
- Cyber sex/phone sex
- Unsafe sexual activity
- Strip clubs and adult bookstores
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy or CBT is a form of psychotherapy or “talk therapy” that helps a person understand the thoughts and feelings that influence their behavior. At the heart of CBT is the idea that that what we think greatly affects how we feel, the choices we make, and the actions we take in life.
CBT is a concrete, collaborative and participatory form of therapy. It gives clients specific strategies and techniques for addressing their concerns, as well as reading assignments and exercises to help them reach their goals.
CBT is often employed to treat various forms of Anxiety and Depression, and is popular because it is well-supported scientifically.
What is EMDR?
Eye Movement Desensitization and Reprocessing or EMDR is an extensively researched form of treatment used to enhance the results of psychotherapy. EMDR helps your brain properly process memories & events from your past, so that healing can proceed.
EMDR has been scientifically proven to be particularly effective in the treatment of trauma and PTSD.
What is Generalized Anxiety Disorder?
Everyone worries or feels anxious from time to time. But when a person worries excessively, even when there is little or no reason to do so, and this pattern continues for 6 months or more, it may be GAD, or Generalized Anxiety Disorder. GAD affects about 3% of American adults in a given year, including twice as many women as men.
According to the National Institute of Mental Health those suffering from GAD “…can’t relax, startle easily, and have difficulty concentrating. Often they have trouble falling asleep or staying asleep. Physical symptoms that [may] accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes.”
GAD often develops slowly and can be quite subtle. Those suffering from it may contact a doctor or mental health professional about a related symptom rather than the anxiety itself, and it may take some time for the disorder to be recognized.
What are Phobic Disorders?
A Phobia is an irrational fear of a particular subject, activity or situation strong enough to produce a conscious avoidance of that subject, activity or situation. Those suffering from phobias usually recognize that their reaction is out-of-proportion, and yet their feelings persist.
Phobic Disorders collectively are the most common of all disorders clients face, surpassing even substance abuse and mood disorders like Major Depression. They include Social Anxiety Disorder, Specific Phobia, and Agoraphobia:
- With Social Anxiety Disorder or Social Phobia a person experiences an intense and persistent fear of social situations in which they may be scrutinized by others or embarrassed.
- With Specific Phobia a person experiences a strong fear or anxiety about a specific object or situation, for example dogs, snakes, heights, water, blood, needles, flying, or enclosed spaces.
- With Agoraphobia a person suffers from a fear of being in places or situations from which a rapid exit might be difficult or in which help might not be available should the person experience embarrassing symptoms such as a panic attack.
What is Panic Disorder?
Panic Disorder involves repeated Panic Attacks combined with the fear of having another attack and the avoidance of situations which might bring on an attack. Panic Disorder affects 6 million American adults, and is twice as common in women as men.
According to the National Institute of Mental Health symptoms of a Panic Attack can include “… pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain.”
Due to the similarity of symptoms, a Panic Attack can be mistaken for a heart attack. However, should you experience these symptoms you must seek medical attention immediately since you may be experiencing a heart attack or other serious condition.
Left untreated, Panic Disorder can lead to Agoraphobia, a Phobic Disorder. The good news, however, is that Panic Disorder is one of the most treatable of all Anxiety Disorders.
What is Trauma?
Dictionaries generally define trauma as a deeply distressing or disturbing experience. Events that create trauma are wide ranging and can even exist within normal human experiences such as bereavement.
What Causes Trauma?
Some common causes of trauma are:
- Adults who were neglected or sexually, physically, or verbally abused as children
- Car accidents or fires
- Domestic or intimate partner violence
- Rape or Sexual Assault or Abuse
- People who learn of sudden unexpected death of a close friend or relative
- Combat veterans or civilian victims of war
- Major catastrophic events such as a plane crash or terrorist act
- Natural disasters, such as tornadoes or earthquakes
- Disasters caused by human error, such as industrial accidents or medical mistakes
- Professionals who respond to victims in trauma situations, such as, emergency medical service workers, police, fire fighters, military, and search and rescue workers
- Other random acts of violence such as those that take place in public, in schools, or in the workplace
- Those diagnosed with a life-threatening illness or who have undergone invasive medical procedures
What is PTSD?
All of us have a natural “fight-or-flight” response when we experience danger. However with Post-Traumatic Stress Disorder (PTSD) this response is somehow changed or damaged such that a person may feel stress or fear even though the threat of danger no longer exists.
According to the American Psychiatric Association, PTSD can occur when a person has experienced or witnessed an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others, and which involved fear, helplessness, or horror.
Traumatic events that may trigger PTSD include fire, earthquake, accidents, abuse, crime or combat. Note that a person may develop PTSD simply by witnessing such an event happen to others, including strangers.
PTSD can affect any person at any age, but not everyone exposed to a traumatic event will develop PTSD. In fact, only about half of those who witnessed the terrorist attack on 9/11 developed PTSD.
Symptoms of PTSD fall into three categories:
- “Re-Experiencing Symptoms” such as flashbacks, bad dreams, and intrusive thoughts;
- “Avoidance Symptoms” such as feeling emotionally numb, having trouble remembering the event, avoiding places, activities or objects that bring the event to mind, or feeling guilt, depression or worry; and
- “Hyperarousal Symptoms” such as feeling tense or on edge, being easily startled, having difficulty sleeping or having angry outbursts.
Treatment for PTSD can include medication, psychotherapy such as Cognitive Behavioral Therapy or EMDR, or both.
What is the Treatment for Anxiety?
Anxiety is typically treated using some form of psychotherapy, for example Cognitive Behavioral Therapy (CBT). In some cases medication may also be recommended, for example to alleviate symptoms. Finally, EMDR can be quite helpful, especially for PTSD.
If you feel you are experiencing any symptoms of Anxiety, contact a professional counselor to get help. Anxiety is a treatable condition!
What is Major Depression?
Everyone is sad or blue at times in their life. But when these feelings persist for weeks and affect a person’s ability to work, study, sleep, eat or enjoy life, it may be Major Depression, also known as Clinical Depression and Major Depressive Disorder.
Major Depression is very common, affecting 6.7% of U.S. adults every year. Between 20 to 25% of U.S. adults will experience Major Depression at some point in their lifetime, with women being 70% more likely than men to do so.
According to the National Institute of Mental Health, symptoms of depression include "... persistent sad, anxious, or "empty" mood; feelings of hopelessness, pessimism; feelings of guilt, worthlessness, helplessness; loss of interest or pleasure in hobbies and activities; decreased energy, fatigue, being "slowed down"; difficulty concentrating, remembering, making decisions; difficulty sleeping, early-morning awakening, or oversleeping; appetite and/or weight changes; thoughts of death or suicide, or suicide attempts; restlessness, irritability; [and] persistent physical symptoms."
Depression can be effectively treated, even in severe cases. Typical treatments are medication and psychotherapy, for example Cognitive Behavioral Therapy.
What is Chronic Depression?
Chronic Depression, also known as Dysthymia, is a less severe but longer lasting form of depression. Chronic Depression is characterized by a depressed mood that lasts 2 years or more. The symptoms are the same as for Major Depression above, but are fewer and less intense.
About 2.5% of American adults will suffer from Chronic Depression at some point in their life. It is considered very treatable via medication, psychotherapy, or a combination of the two.
What is Postpartum Depression?
Many women experience the “baby blues” after childbirth. But when the hormonal and physical changes plus the responsibilities of caring for a newborn become overwhelming, it may be Postpartum Depression (PPD).
PPD affects approximately 13% of U.S. mothers, and can be thought of as a form of Major Depression that begins within four weeks of delivery.
Those suffering from PPD experience the same, normal symptoms of the “baby blues”: despair, sadness, irritability, and anxiety. However, their "baby blues" symptoms are more intense and are also mixed with symptoms of depression.
Postpartum Depression is considered very treatable with medication and counseling.
Getting treatment is important, especially if you experience any auditory or visual hallucinations or delusions about yourself or your baby. You could be suffering from Postpartum Psychosis, a rare but very severe postpartum reaction which requires immediate medical attention.
What is Seasonal Depression?
Seasonal Depression, also known as Seasonal Affective Disorder or SAD, is a form of Major Depression that occurs seasonally, most often in the winter months when the sunlight is less intense and the days are shorter.
According to the Mayo Clinic, the symptoms of "winter-onset" SAD are:
- Tiredness or low energy
- Problems getting along with other people
- Hypersensitivity to rejection
- Heavy, "leaden" feeling in the arms or legs
- Appetite changes, especially a craving for foods high in carbohydrates
- Weight gain
SAD is more prevalent in the northern latitudes, ranging from 10% of the population in northern New England to just 1% in Florida.
SAD is often treated with light therapy, also known as phototherapy, or medications, typically antidepressants.
What is Bipolar Disorder?
Bipolar Disorder, formerly known as Manic Depression, is characterized by episodes of extreme highs followed by extreme lows.
During the lows a person will exhibit the symptoms of Major Depression, for example feeling lethargic, feeling hopeless, or sleeping too much or too little. During the highs or “mania” a person may experience sleeplessness, sometimes for days.
According to the National Institute of Mental Health, symptoms of a manic episode include “… talking very fast, jumping from one idea to another, having racing thoughts, being easily distracted, increasing activities, such as taking on new projects, being overly restless, sleeping little or not being tired, having an unrealistic belief in one's abilities, [spending recklessly,] behaving impulsively and engaging in pleasurable, high-risk behaviors.”
Bipolar Disorder is a serious condition that cannot yet be cured but can be effectively treated. Treatment involves medications such as mood stabilizers and psychotherapy such as Cognitive Behavioral Therapy. Since Bipolar Disorder is a life-long problem, psychotherapy provides important support, education and guidance to both the patient and their family.