Frequently Asked Questions
Seeking therapy can feel a bit scary at the start, but you have taken a step in a positive direction by being here. I hope that the following FAQs will help guide you, though please feel free to contact me if you have further questions.
- How do I know when to seek psychological help for myself or my child/children?
- How long does one usually have to go to therapy before feeling better?
- What can I expect the first session?
- What are evidence-based approaches to treatment?
- Do I (or does my child) need medication in order to make progress in treatment?
- How much does therapy cost?
1. How do I know when to seek psychological help for myself or my child/children?
Although many emotional problems, such as anxiety, sadness, problems paying attention/focusing, and problems in relationships can sometimes improve on their own, often they can feel overwhelming and can begin to intrude on everyday life. There are a variety of resources available in bookstores, on the Internet and through other forms of media that can serve as self-help tools. But therapy is often very helpful in identifying the best strategies for each individual’s needs and specific challenges.
As a clinical psychologist, I can provide guidance to clients when certain strategies do not bring relief to symptoms and problems as soon as one had hoped. It can be very discouraging to read about strategies that seem to have helped others while not effective in changing your personal situation. I work individually with clients to assess various factors that can affect progress. It can be really helpful to gain an objective perspective on problems that have persisted for a while without relief. As a therapist, I am trained in strategies and techniques that self-help resources may not include and have expertise in treating emotional and behavioral problems.
2. How long does one usually have to go to therapy before feeling better?
Some problems, such as simple phobias (i.e. fear of spiders, fear of dogs, fear of flying, etc.) are often effectively treated within 12-16 sessions. Other problems are more chronic and persistent and require more time before noticeable improvement can be experienced. There are several factors that can affect how much time it takes to start feeling better:
- Meeting weekly with a therapist can increase the probability that you will improve more quickly and feel better. Research studies have shown that weekly therapy, especially in the early stage of treatment, yields better results. Momentum is gained through meeting weekly and there can be more problem-solving achieved if initial coping strategies and interventions are not working.
- The history and severity of the problems, the frequency with which symptoms reoccur, and the magnitude of interference in everyday life impact progress. It can feel frustrating to know that you are in therapy working on these issues and they are still bothersome and disruptive to your life. But when problems have been more severe and persistent, it can take several months to notice significant improvement. However, I work with many clients who have chronic problems and monitor their progress so that problem-solving can be achieved and alternative solutions can be developed.
- The age and developmental level of clients affects the length of treatment. Children are less able to make progress as quickly because they do not enter therapy of their own accord most of the time. They may not understand therapy right away or it may take them a few sessions to feel comfortable discussing problems or working on coping strategies. However, I develop an intervention plan that is tailored to the age and stage of life for each client to maximize clients’ personal strengths. Meeting clients where they are and understanding their unique challenges can result in greater progress.
3. What can I expect the first session?
The first time I meet with clients, I am conducting an assessment and gathering important information that will be used in developing a treatment plan. There will be some paperwork for clients or their parent/guardian to complete. I also will discuss procedures, office policies, and payment options with clients. The initial session provides an opportunity for clients to ask as many questions as they have about how therapy works and what will be involved.
Once all questions have been answered, clients will sign an Informed Consent that explains in writing what I explain to clients during the session. The Informed Consent also details HIPAA regulations and confidentiality. A follow-up appointment will be scheduled if desired by the client.
Generally, intervention is not begun during the first session. This is because I need to interview clients first and gather thorough background information on the presenting problems. I also want to give clients the opportunity to learn about my practice and ask questions. It may take a couple of sessions to gather information in some cases, but an initial treatment plan is usually formulated within the first few sessions and discussed with clients and appropriate family members (for younger clients under 18 years). Progress is assessed after several sessions and discussed with clients so that modifications in strategy can be made when appropriate.
For those clients seeking psychological or psychoeducational testing, the first session is generally the clinical interview. Subsequent sessions are scheduled to conduct testing and provide feedback. For group therapy and skills groups, the process varies and will be discussed in an individual session with group participants prior to the start of the group.
4. What are evidence-based approaches to treatment?
Cognitive-behavior therapy (CBT) is a widely-used form of intervention that encompasses a variety of techniques and strategies focused on problem-solving and generating solutions that are helpful in dealing with troublesome thoughts and feelings. Many people experience persistent worries, fears or negative thoughts that leave them feeling sad, frustrated, angry or hopeless. Research studies consistently provide empirical support for the efficacy of CBT in treating the most common mental health problems among people, including generalized anxiety disorder, obsessive-compulsive disorder, depression, bipolar disorder and post-traumatic stress disorder. CBT approaches help people rethink irrational thought patterns that are maladaptive; teach strategies for managing emotions so they are not as intense; and provide tools for living a healthier lifestyle, such as relaxation training and mindfulness. Many CBT strategies are also beneficial for clients suffering from chronic pain and medical illnesses that impact daily living.
Other treatment approaches to psychological problems with research support include Interpersonal Psychotherapy (IPT) and Family Systems Therapies. IPT focuses on improving relational and communication skills. Sometimes the ways that we relate to others and perceive others as relating to us can affect our mood and the quality of the relationships we have. Family Systems Therapies integrate other family members and their perspectives into the treatment process. These interventions are particularly relevant when the client is living with family members. Thus, family systems approaches, or aspects of them, are often incorporated into treatment plans for children and adolescents.
With younger clients eight year of age and under, play therapy is another useful intervention often integrated into the treatment plan. Children are not developmentally able to express themselves verbally as easily or readily as older children and adults. Therefore, play therapy allows them to find creative ways to learn to express their needs and feelings and to cope with emotional stress, disappointment or tragedy.
5. Do I (or does my child) need medication in order to make progress in treatment?
Research studies indicate that many psychological problems improve over time with therapy alone when evidence-based approaches to treatment are utilized. However, research also indicates that for some people experiencing chronic and severe problems with anxiety or depression, medication can be effective in conjunction with CBT and other evidence-based approaches. Sometimes medication reduces fatigue associated with depressed mood; allows people to rest better, and improves energy levels so clients can attend therapy regularly and be more motivated. I am a clinical psychologist, not a psychiatrist, but I will refer clients for a medication consultation when I believe that medication could be a beneficial component of the treatment process.
6. How much does therapy cost?
Carla Messenger, Ph.D. P.L.L.C. is a fee-for-service practice. This means that payments in full are due at the time that services are provided. I am an out-of-network provider, which means that I am not able to file claims with any health insurance plans. I can provide clients with documentation that is needed to self-file their claims with insurance companies. Many insurance plans allow claimants to obtain services from out-of-network providers and reimburse a percentage of the fees. Clients must contact their insurance plan to determine whether they have out-of-network benefits and learn the amount of reimbursement given by their insurance. Prospective clients may contact the office to learn the service codes that insurance companies may need to provide them with information about reimbursement. I accept payment preferably in the form of cash or checks. (Visa, MasterCard and Discover payments incur a small processing fee.)
The fee schedule for Individual Therapy is as follows:
- Initial Adult Intake Evaluation and First Session: $185.00
- 45-Minute Adult Psychotherapy $170 per session
- Initial Children’s Intake Evaluation and First Session: $285.00
- 45-Minute Children’s Psychotherapy $165 per session
- Group Therapy session: $75
- Workshops: varies
Fees for Psychological Testing and Psychoeducational Evaluations vary depending on the battery of tests given. The battery of tests is generally determined during the initial diagnostic evaluation, which is when important background information is collected and the presenting problems/reasons for referral are identified.
Fees for all group therapy, skills groups and parenting seminars also vary depending on the length of the group and the content. Detailed information about the breakdown of the cost will be given prior to enrollment.