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How do I know if therapy is right for me?

I work with a range of presenting problems, including but not limited to: anxiety, depression, addiction (to substances, media, and/or behaviors), stress, relationship difficulties, recovery from infidelity, phobias, trauma, grief, low self-esteem, a sense of meaninglessness or purposelessness, stage-of-life transitions, personality disorders, and obsessive or intrusive thoughts. You do not need a formal diagnosis or even a specifically-defined concern to contact me to see if I can be of help. If something is interfering with your well-being or daily life, or you simply want greater self-understanding, you may feel free to reach out to me for a free ten-minute phone consultation. I will do my best to offer a referral in the event that I am not suitable to be your clinician.

Be advised that therapy sessions with me are not an emergency service. In the event they seem needed, the possibility of unscheduled calls or short-notice sessions with me can be discussed once we have met and begun assessment. If you are searching for a clinician because you are currently in immediate danger or acute crisis, please use one of the following options:

• Santa Cruz County 24/7 Access and Crisis Line / Mobile Crisis Response Team (MCRT): 1-800-952-2335.

  • This is the main local line for behavioral health or substance use crises.

• 988 Suicide & Crisis Lifeline: Call, text, or chat 988.

  • Free, confidential, 24/7 support for suicidal crisis, mental health distress, or substance-related crises.

• 911: For immediate life-threatening situations 

  • Appropriate in the case of active self-harm in progress, or mental health distress that has led to violence or a medical emergency.

  • Request a CIT (Crisis Intervention Team) officer if possible.

What does the structure of therapy look like?

• I normally begin with clients meeting once or twice per week depending on the nature of the presenting problems.

• When working with individuals, my first three sessions consist of assessment and goal formation:

  • In the first, I focus on hearing about your presenting problem: its origins, development, and current impacts on your life. I also start to learn about your family of origin and significant life experiences that inform how you think and feel about yourself, relationships, and the broader world.

  • In the second session, it is not uncommon to find that deeper issues emerge as we find a central emotional tension or maladaptive coping strategy beneath the immediate issues that brought you to therapy, and we start to see how it has manifested in other times and places than your recent history.

  • In the third session, I reflect what I have seen to you so far and offer an initial hypothesis about the nature of your problems and their possible resolution. We then collaboratively make a treatment plan with specific, measurable goals and objectives.

• Every ten sessions, I will discuss with you whether and how we are meeting goals and recalibrate accordingly.

• As you recover and find more stability, we first taper to less frequent sessions and, eventually, close the case. My door remains open to past clients to get back in touch if they would like to meet again, and I prioritize fitting returning clients into my schedule.

I’ve heard of people being in therapy for many years — is that how this would work?

• My view of psychotherapy is that it is meant to address specific problems in a client’s life, rather than to serve as a perpetual practice for someone who is generally healthy, high-functioning, and not suffering from any defined pathology. My hope, in a way, is to ‘put myself out of business’ by examining and understanding your presenting problems, making effective interventions, and teaching you skills you can use on your own.

• Most of my cases last from several months to just over a year. I occasionally have cases last a couple of years or longer because they involve complicated, serious issues like trauma or addiction that require long-term care.

• When I make the assessment that we have accomplished our agreed-upon goals and that you are in a stable place of recovery and growth, I will propose we decrease the frequency of sessions (generally going from weekly to bimonthly or monthly) and begin to move towards closing our case. I of course never want to rush anyone out of care, and termination is always something to be discussed carefully and approached cooperatively.

What is your cancellation/missed-session policy?

Because I understand life is unpredictable, I allow one last-minute cancellation without penalty. After that, I ask for at least 24-hours notice (calculated from our scheduled start time), or I will charge a cancellation fee of $50 except in extraordinary cases. This fee is not only necessary to respect my own time, but also to emphasize that psychotherapy needs a consistent structure to be effective.

What if I realize after a few sessions that we just don’t ‘click?’

Not a problem at all; a sense of intuitive compatibility is important for working together. I am happy to make a referral and will of course not take personal offense at the request.

Do you work with children/adolescents?

I generally work with adults, but I am open to working with adolescents of around fourteen years of age or older, depending on the individual’s emotional maturity. Working with younger clients is more suited to play therapy specialists rather than my approach. 

My issues are of an extremely private nature — can I be completely sure the contents of our sessions will not leave the room?

What you share is protected by professional confidentiality and ethical standards, similar to the laws and ethics that govern other licensed professions like doctors, lawyers, and accountants. There are a few very limited legal exceptions (e.g., imminent risk of serious harm to yourself or others, or certain court orders). These will be explained clearly at the outset and is also touched on in my list of duties to you as a clinician (link to “Confidentiality and Privacy” section on “My Philosophy” page).