Sunday, May 29, 2011

Five Things Your Therapist Wants You To Know

This is my first post for this blog. I'm a licensed psychotherapist in New York City. You can learn more about my practice at

As a sole practitioner, I am the receptionist, office manager, billing clerk and quality assurance director for my practice. Most patients don't think about the complexities of running a professional practice, nor should they. But for my first post for this blog, I've decided to be upfront and tell any prospective psychotherapy patients a few things that the therapist they are going to see (me or anyone else) wants them to know BEFORE they call to make the first appointment:

1. We need to know what time you are available to attend a WEEKLY appointment. Psychotherapy isn't a one-shot deal, or an annual visit like a physical exam or dental cleaning. Even if you are "interviewing" several therapists to find the one that's right for you, it doesn't make any sense to schedule even one appointment with a therapist if that person doesn't have a slot that fits your schedule. Instead of saying "Are you taking new patients?" when you call or email, state the times/days that you would be available to attend weekly. "Are you taking new patients?" is a superfluous question, because if we aren't taking new patients, we will let you know.

2. We need to know how you're going to pay. I know this is an unpleasant subject. But if you're going to be attending weekly sessions, you need to know (and we need to know) if you can afford the treatment. Recently I turned away a prospective patient (whom I referred to a clinic) because he had no health insurance and an annual income of $18,000. Putting people into debt only increases their mental health problems. Sadly, our society limits healthcare for people with low incomes. This is a problem that I as an individual cannot solve.

3. We don't know the details of your health insurance plan. This is something every plan member should find out for themselves. Aside from scheduling psychotherapy, you need to know the details of your plan in case you need surgery or hospitalization. (If you want to see some dramatic stories of what happened to people who didn't know how bad their health insurance was, see Michael Moore's documentary film "Sicko.") Every major insurance company sells many different plans. If you have health insurance through your job, your plan may have a custom design.

4. The 6 p.m. slot is usually taken. Most people work 9-5 or 9-6, so many therapists are always booked between 6 and 7 p.m. If you can arrange with your employer to take a long lunch once a week, or you're willing to find something else to do between 6 and 7 p.m. and come to an appointment around 8 p.m., you're more likely to find a therapist who can give you an appointment. Long-term patients sometimes ask if they can be moved to a more convenient time once that timeslot opens up. This is how many therapists fill their 6 p.m. slots.

5. Your problems didn't develop last week. I will see people on an urgent basis (1-2 days) if they have had a recent crisis such as being the victim of a violent crime, or if they are mandated by their job for an assessment. For emergencies such as suicidal intent, I send people to the emergency room of the closest hospital. Most people, however, have problems such as chronic depression or relationship issues. Since these problems developed over months, years or decades, the first appointment for therapy does not need to be this week. If you can't wait one week to start your therapy your difficulty in tolerating a wait may be a pervasive issue in your life and this might be one of the issues you need to address in therapy.