I am a state-licensed psychologist. In California, a psychologist must have a
doctorate degree in psychology (or closely related doctoral degree). [If you're
wondering how I think about psychotherapy and psychology, take a look at
my page on adult development theory.
It's not meant to emphasize all that I believe is important about
psychotherapy, but I will be happy to answer all questions upon our
initial consultation.]
Psychologists are trained in the practice of
psychotherapy or counseling. In addition, they are specialists in the scientific evaluation of clinical data.
They are
also trained to both use and understand specialized tests for psychological
measurement and testing, such as I.Q. tests or personality inventories. (If you
want to know something about my background, please see my résumé.)
Psychologists try to understand human behavior in an integrated,
multi-dimensional fashion.
Psychiatrists are medical doctors (MD) who have chosen psychiatry as a
specialty. They have completed a residency in psychiatry, and are specialists in
the prescription of psychotropic medications. They are the only mental health
specialists who can prescribe drugs. Many psychiatrists use the medical model to
understand human behavior.
Licensed Clinical Social Workers (LCSWs) have received
at least a master's level advanced degree. They are trained in both
psychotherapy and social interventions aimed at helping the individual cope with
problems in his or her environment, or dealing with government or social
agencies. They cannot do psychological testing, nor prescribe medications. They
typically hold a master's degree in social work.
Marriage, Family and Child Counselors (MFCCs or MFTs) have
received at least a master's level advanced degree. They are trained in
psychotherapy, working primarily with individuals and/or their families to
ameliorate problems. They also cannot do psychological testing nor prescribe
medications.
Other individuals may offer kinds of mental health
interventions or counseling, within the scope of their licensed practice and
training, e.g. Master's level psychiatric nurses, non-psychiatric MDs. There are also non-licensed individuals
who practice some kind of psychological counseling. These range from pastors or
clergy (who have traditionally done this, and often have been trained for this
role), to peer or volunteer counseling. Unfortunately, there are quacks and
charlatans in the therapy field, as in any other. When pursuing any form of counseling or
psychotherapy, you should always ask your provider about their credentials.
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Therapy and counseling are sought for numerous reasons: an
immediate problem, mandate from a government agency, personal self-exploration,
among others. Usually this question is asked when someone feels they already
need some kind of help, but aren't sure if their problems are either normal,
will go away, or are capable of self-solution. I have noticed that people will
live with a lot of pain before they seek help from someone. Going to see a
therapist is a sign of personal strength and wisdom, a recognition of the
importance you give to yourself and your well-being.
The stigma of seeking psychological help is unfortunately
part of what we are typically taught in this society, but in therapy you will
find acceptance, as well as, hopefully, the help you desire. Of course, you can always try self-evaluation inventories found in
numerous magazines or books. I have one on Depression elsewhere on this
website. I also have information on this site about coping
with stress and anxiety and on shyness.
The bottom line is that if you bothered by problems with
emotions or behaviors, if your ability (as Freud once noted) to love and/or work
are being negatively affected, then you may need some kind of mental health
intervention. Millions of people seek or have sought this kind of help, with
very positive results.
Will therapy work for me?
Psychotherapy has been reported to help many individuals suffering from mental
or relational distress or mental disorder. The American Psychological
Association (APA) has gathered a number of research results on their webpage, "The
Efficacy of Psychotherapy". Please note: no treatment is for everybody.
No provider will be able to help everyone they meet. Furthermore, there are potential ill
effects from therapy, primarily increased emotional distress, which should be
discussed with any clinician you meet with, if you are unduly concerned. As a
therapist, I cannot guarantee anybody that they will get better or feel better
by seeing me. However, after we have met and discussed your situation, I will
have a better idea of how I can potentially help you, how long that might take,
and what you and I can expect from such an outcome. And I confidently can say
that I feel I have helped the vast majority of people I have worked with.
Choosing a therapist is a very personal decision. I suggest
checking out the APA's
Help Center website, which has information about how talking to a psychologist can
help someone, and how to choose a psychologist. From my standpoint, a therapist should be professional,
honest, easy to understand, non-judgmental, and non-punitive. There may be some
special quality or characteristic you desire in a therapist. Try to give the new
therapy relationship a little time before you make up your mind about whether
it's for you or not. Give feedback to your therapist, and see how you feel about
the dialogue that ensues. Listen to your feelings.
Therapy can be challenging
and even at times seem threatening. The quality of the feedback from the
therapist, the safety he or she provides, will probably go a long way in helping
you decide whether that therapist is right for you or not. (And, by the way,
seeing multiple therapists at the same time is not a good way to make the best
decision. In my experience, it's confusing for both client and therapist(s), and
interferes with producing the kind of atmosphere and relationship with a
professional helper that is conducive to positive change.)
The length of therapy is determined by a number of factors, including the needs of the client, the assessment by the therapist of the client's needs, the ability of the client to attend treatment, financial considerations, the amount of time the problems have persisted, etc. Popular culture has given many people the idea that therapy will take months and years, or never even end. However, research on frequency of therapy treatment shows repeatedly that most people see a therapist for from one to two sessions up to three to six months. Outcome research shows that a majority of patients feel helped within this general time period. Individuals who need or want therapy for longer periods will discuss this situation with their therapist. Longer treatments occur for a variety of reasons, including anything from serious mental illness or ongoing environmental stressors, to a commitment on the part of the patient to more intensive, self-examining personality change and self-awareness. I suggest you discuss any concerns you have about this at the outset with myself, or anyone you choose to work with.
Please note that Gay and Lesbian clients are welcome in both individual and couples counseling.
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I think therapy is a bargain, but why should you believe me?
Well, read on and see what you think . . .
Most people get their maximum benefit from therapy in
anything from one session to three to six months of therapy. (See Consumer Reports (1995), "Mental health: Does therapy
help?" pp. 734-739. Click
here for more information on this study). Therapy at a
low-fee clinic may be had for as little as $35-$60 an hour, though often there is a
waiting list, or the therapy is with trainees, and there is usually a time
limit.
The following are "ballpark" figures of fee ranges
for the different kinds of therapists, based upon my experience. Some therapists
will go lower, or charge higher than these ranges, so you must always ask
the specific provider. Note that there are often regional or geographical
differences in rates. To some extent, differences in prices are based on amount
of training and experience. To some extent, prices reflect differences in social
status of the occupation.
Psychiatrists - $150 to
$300 per hour
Psychologists - $80 to $220 per hour
LCSWs - $80 to $160 per hour
MFTs - $75 to $150 per hour
In my opinion, therapy is a tremendous bargain for those who need or want to substantially change their lives.
Therapy is an investment in yourself. It can help remove painful, awkward, or
undesirable symptoms. Therapy offers the opportunity to change old
patterns or gain control over the problems that pursue you. If you are willing
to pursue it, it can also induce positive character change. It's important to note, however, that nothing is foolproof, and your experience
with therapy or counseling (or for that matter, psychotropic medication) will be
unique to you. And, like any other treatment, there are risks involved. In
psychotherapy, that usually refers to the occasional emotional or psychic
discomfort that arises in the course of talking about your problems or your
life.
What about insurance? While
I believe third-party payers, such as insurance companies, can potentially
interfere with effective treatment and raise issues around
confidentiality, I usually will accept indemnity insurance, where the
patient pays in full up front and then submits an invoice for reimbursement from
their insurance company. I am also a Preferred Provider for Blue Cross of
California. If planning to use insurance, it is best to call me to see if your insurance coverage is applicable or
accepted by me.
The
policies and benefits offered by insurance companies are in a state of seemingly
perpetual change. Many people do not even realize that their mental health
benefits have been "carved-out" to sub-contracting providers. For
instance, some years ago Blue
Shield of California "carved-out" most of their mental health
benefits to U.S. Behavioral Health (USBH). I have chosen not to join the
provider panel of USBH, and many other
managed care providers, because of the intrusive control and
micro-management I feel they exert over the treatment. (Also, to be honest,
their reimbursement rates are far below market rates. More experienced and/or
talented therapists won't work at the very low reimbursement rates.) Mental
health benefits are, despite recent efforts at reform, typically reimbursed or
covered at far lower levels than other health benefits. Please read your insurance
policy carefully or contact your insurance provider so you know what your
benefits do and do not provide.
Also, you should know that I believe that using third
party payers for reimbursement carries a certain amount of risk as regards your
confidentiality, privacy, or future capacity to obtain health or life insurance.
Mental health information given to insurance companies are entered into their
computers, and may in the near future, if Congress approves, also be forwarded
to a national medical data bank. (See the American Psychological Association's
article about insurance-confidentiality concerns at http://www.division42.org/PublicArea/IPSpg00/Ethics/Hibel.html.
For more general risks regarding confidentiality and computer databases, see the
article from the online journal Online Medicine, "When
privacy and the public good collide".)
Recent news events have demonstrated that computers are vulnerable to break-ins
and unauthorized access. (See the January 2002 USA Today article, "Computer
theft leads to search for stolen military records"; the theft was from
TriWest Healthcare Alliance -- half a million patients' confidential information
was
jeopardized!) Unfortunately, mental health problems still carry a
stigma in this society, and you may be concerned that your problems and
treatment remain as confidential as possible. If that is the case, then you
should seriously consider the issues involved in utilizing insurance company
reimbursement for your treatment. Private pay can be both more safer and
surprisingly affordable, for the benefit treatment can bring.
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I regularly work with couples, both married and not, who are struggling with issues of intimacy, jealousy, commitment, anger, and trust. I usually have evening hours, as often one or both partners work. My orientation is to increase understanding of the couple's relationship patterns, and decrease destructive (but all-too-human) tendencies to focus on blame and guilt. My work with individuals in a relationship is non-judgmental. There is no relationship that is not without its problems. I have found that working with couples in counseling to achieve better understanding, better communications, and acceptable expectations can profoundly affect the quality of the relationship. But, there is no guarantee that couples therapy will heal old wounds or patch up a crumbling relationship. Expectations about the therapy are discussed at the outset. Participants can be expected to be treated as two adults, with respect for the life course and goals of each of the partners. Couples therapy can be very challenging, even an adventure in self-discovery. (See my web page on Relationship Problems.)
"My partner doesn't want to go" or "My partner is very wishy-washy about the whole thing... doesn't believe in therapy." I have heard the above, or some variation of it, many times. The absolute truth is that you can't force someone to do something they don't want to do. However, if the partner is assured that they are not entering into something that will be embarrassing to them, or blaming, or judgmental, or attacking, they may be willing to give it a try. I tell everyone that our initial meeting is just that, an initial assessment and look-see at me and the entire therapy process. No one will be forced or pressured to do anything or say anything they don't want. Just knowing that sometimes reduces the anxiety or resistance associated with seeing a therapist. Still, the initiating partner must understand that often the fact that their partner is unwilling may become an early focus of the treatment. After all, it is most likely one aspect of a relational pattern that involves more than a discussion of whether to go to therapy.
If you wish to discuss this more, please feel free to call me at my office: 415-362-8262.
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The choice to get counseling or therapy is that of the
adult individual alone. Some people, in trouble with school or the law, may be
mandated or essentially forced to seek therapy. This is not the best way to be
introduced to help, but sometimes psychological intervention may still be
effective, even in such cases.
When the person is an adult, and there is no external force
mandating therapy, and if they do not wish to see a therapist, then there is
little to be gained by trying to morally coerce them, or blackmail them.
Exhortation of unwilling individuals is also very tiring for the helper. As people who have tried to get resistant alcoholics into treatment may
be painfully aware, the individual who needs help may have to discover for him
or herself, through troublesome experiences, that they need assistance.
Minors present a special case. Young children may not be able
to effectively give consent, and the right to seek treatment rests in the hands
of their parents. Older children or adolescents may in some cases be able to
legally seek treatment without their parents' knowledge. They may also feel
willing or forced to go see a therapist at behest of parents and/or school. Each
of these situations is usually treated by a therapist on a case by case basis.
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Call me directly at 415-362-8262. If you leave a message,
give me a phone number to reach you at, and a couple of good times you are
available to talk (the better to avoid "phone tag"). I will return
your call usually within a few hours, at minimum within 24 hours.
Or you can e-mail me at sfpsych
at gmail dot com.
I check my e-mail at least once a day, but I may not get back to you as
quickly as by phone.
Please do not send e-mails to this site or anyone associated
with it that may include confidential information. (Before e-mailing me, please read my e-mail policies and
warnings about confidentiality on-line by clicking here.)
Generally, I will be able to see you the same week as you
call. I have office hours days, evenings, and on Saturdays.
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Yes, I do. My experience on the Internet is that many visitors have specific questions about the MMPI, a well-known and often used psychological test. For more information about the MMPI click here.
I also provide educational testing and assessment for learning disorders and disabilities. Parents looking for such testing for their children should know that public law mandates their children be tested for learning problems by qualified personnel in their school districts. Parents should contact their special education department, or ask their child's teacher how to make a formal request. Regardless of this benefit, parents may wish their child to see or be tested by a psychologist outside the employment of their child's district. For instance, the schools are not mandated to test for SAT exceptions. Please call me if you have any questions whether formal assessment is appropriate for your child, or if you are an adult seeking testing for yourself.
Fees for testing are generally higher than for therapy, as this work requires time outside of the testing hour (for scoring, evaluation, writing up results, etc.). Testing is usually done to evaluate mental and emotional functioning, memory, learning disabilities, intelligence, and personality characteristics. Testing is often required to document certain kinds of disability (e.g. court-ordered evaluations, workers compensation, special education/individualized treatment plans for children, etc.).
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Here's a few links you can try. (You can also go straight to my More Help page.) They are more or less official sources of information, or websites that I think could be helpful. I cannot endorse the full content of these sites, as I am not in charge of them. You may also bookmark this page for future reference.
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You can try searching the web for other psychologist or therapist listings. I recommend calling the referral line of the American Psychological Association. They will connect you with your local psychological association chapter, who will assist you with referrals. Call 1-800-964-2000, and press option "0". You may also wish to try one of the numbers I have listed elsewhere on this site. Click on the appropriate link below:
[Listings
for Referrals in All U.S. States and Canada]
[Referral Listings in California by
City]
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Help/Links]
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Notice]
Last modified: July 08, 2009
Copyright © 1999-2005 Jeffrey Kaye, Ph.D.
All material provided on this website is for
educational and informational purposes only. Direct
consultation of a qualified, licensed health care provider or
therapist should be sought as necessary for any specific
questions or problems. This web site should not be construed
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therapeutic relationship is established by use of this site.
Please do not send emails to this site or anyone associated
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