Intake and Assessment
I am going to annoy you by asking a variety of questions that you may not feel are relevant, and I am going to ask you to fill out numerous administrative oriented forms to satisfy legal requirements, insurance companies, and whatever else is needed. I will ask you to fill out questionaires that deal with previous treatment, alcohol or drug use, family history, medical conditions, medications, and your history of hospitalization, any past criminal charges, etc. I will ask you about depression, anxiety, and traumatic experiences you may have experienced. This is called a Psycho-Social history and I am screening for various mental health conditions both past and present. By gathering this information, I will be able to determine if there are areas that require further exploration with you. I may ask you to sign releases of information in order that I may send for your records from previous treatment episodes, and to communicate with your primary physician.
Many people are frustrated with the initial session(s) because once they decide to "talk" they want to "jump right in." Therapy does entail some risks, so for me to partner with or guide you, my first priority is to try to keep you safe emotionally. There is the concept of "rapport." It is important to consider "pacing." We are building a "therapeutic relationship." An individual who tries to go too much- too fast, will often drop out of therapy very quickly due to the immediate relief they feel from "venting." This temporary relief may falsely convince them that they are "all better now and don't need further sessions." They may become embarrassed afterwards because they they have revealed so much to someone who is a total stranger. A person may also become completely overwhelmed by trying to do too much too soon and go into emotional crisis.
If you have come into my office as an EAP referral to deal with an immediate problem, we probably will jump right in and address that particular problem. We are going for Solution Focused goals and Brief Therapy. EAP referrals are not focused on "personal growth." If, after a certain number of sessions, you determine that there are long standing issues you would like to address, we then go into another process and begin more insight oriented therapy. Many EAP referrals are Work/Life issues. The exception may be Trauma related issues due to workplace violence of one variety or another. In some cases, I may need to refer you to another therapist or to another treatment modality due to your particular needs or administrative constraints. It is very important that you clearly understand the role, restrictions, and conditions of your EAP and your insurance benefits beyond EAP. Please clarify any questions you may have with your EAP. Many EAP companies also have very good web sites with a variety of suggestions and tools that may be very helpful to you.They are usually available via telephone to answer your questions as well.
Therapy is work. It is often uncomfortable and sometimes downright painful. It is not uncommon for someone to feel worse temporarily once they begin the real work in therapy. Memories and old pain may surface after many years of being forced "underground" or medicated through a behavior or substance. Recognizing patterns of behavior that have led to the risk and reality of repeated trauma will present one with a choice to either continue repeating the pattern or change. We may say "change is good," but the vast majority of us are afraid to leave our "comfort zone" no matter how painful and uncomfortable that zone appears to an objective third party. It may come down to your readiness to "change." My role is to encourage and try to motivate you to consider the possibilities of change- while respecting your ambivalence to change- in order to improve your life. Any actual change is up to you.