Photography by Jesper von Wieding & Lasse Hieronymus / Design and webdevelopment by 
Photography by Jesper von Wieding & Lasse Hieronymus / Design and webdevelopment by
Most patients attend individual and couples psychotherapy once a week. Because I believe consistent meetings are important both in building the therapeutic relationship and developing and sustaining therapeutic momentum, I do not generally agree to see patients less than once a week. In some cases I advise meeting two or more times a week. This happens either where there is some element of crisis or when a certain momentum in the therapy is established and both the patient and therapist believe there could be even more efficacy in meeting more often. Psychoanalysis is conducted three or four times a week. Family therapy ranges in frequency but usually is once a week. Sometimes family therapy can effectively take place bi-monthly or even monthly.
Most often, psychotherapy is conducted sitting across from the therapist. I do have a psychoanalytic couch which some patients prefer to use or which I may suggest to some patients as a means of promoting a more relaxed, associative state. When a patient moves to psychoanalysis, I encourage the patient to use the couch. This issue is always up for discussion and I would never insist that a patient use the couch.
Medications can be effective for managing more severe mood and cognitive symptoms. The choice to take any medication should be a careful one. As a psychologist, I cannot prescribe medications. However, I can help you think about this whether this option might be helpful and will make referrals for a medication evaluation when I think one may be warranted. Although some primary care doctors do prescribe psychiatric medications, I believe that a psychiatrist – a medical doctor who specializes in psychological and cognitive issues - is the most qualified referral for medications for mood or difficulties with thinking. I prefer to work in close consultation with psychiatrists I refer to in order to offer the best level of coordinated care. The role of psychotherapy does not diminish when a patient uses medications. Research shows that medications combined with psychotherapy have far greater efficacy than the use of medications alone.
Individual psychotherapy sessions last 45 minutes, however I usually spend an hour the first time I meet with someone. Couples therapy lasts between 50 minutes and one hour per session. Family therapy is between one hour to an hour and half, depending on the nature of the family's problems and my determination.
In terms of duration over time, different patients have different needs and it is impossible to say how long the whole process will take. Sometimes a few sessions can help if there is a discrete issue that can be cleared up quickly. More often, duration is of several months and sometimes more. Some patients, recognizing the increasing value of psychotherapy over time, choose to continue for longer periods of time. Although there might be a number of reasons for staying in psychotherapy for some time, I firmly believe that an important part of psychotherapy is planning for and executing an ending of the psychotherapy. After ending psychotherapy, atients are always free to return to work with me at any time they feel it might be useful.