Lubna Somjee: Here’s an overview of psychotherapy

The April column focused on questions people often ask about psychologists, psychology and psychotherapy. This column will focus on questions regarding the details of psychotherapy.

Is psychotherapy confidential? Psychotherapy is largely confidential, however, there are some exceptions which will be explained to you. For example, a psychologist must break confidentiality if they suspect their patient is in immediate risk of hurting themselves or someone else, by drawing on resources in the community to help that patient. If abuse or neglect is suspected toward a minor, they must report this to the New York State Child Protective Services. Should you decide to use health insurance, your insurance company does access your information and/or contact your psychologist for information anytime they want — just as they do with your medical records. In the past few years, insurance companies have been asking for personal health information more frequently and in more detail. During treatment, you may decide you want the psychologist to be able to speak with someone else such as a physician or family member to help coordinate care. In that case, you would fill out a form giving permission to do so. More detailed information about the limits of confidentiality will be given to you during your first visit.

How can I find a psychologist? A good way to find a psychologist is through word of mouth. Asking friends or family is a great way to find someone who may be a good fit for you. Contact your primary care physician, or other medical providers, and ask for specific names of professionals she or he has worked with. Calling your local or state psychological association can be another good resource. The Hudson Valley Psychological Association is our local psychological association and their website lists names of some psychologists in the area, as well as their specialties (www.hvpa.org). The New York State Psychological Association has a referral service as well (www.nyspa.org). You can also find names of psychologists, and other mental health professionals, through your insurance company. Once you have names, call to see who is available, and find out if they work with people who are dealing with similar situations as yourself.

Will my insurance cover the services? Many insurance plans provide mental health benefits but it is always good to call your insurance company to find out. Most plans cover individual, group and family psychotherapy. Couple's therapy is rarely covered. Note all insurance plans purchased through the NY State of Health marketplace have to include some mental health coverage. A trend occurring around the country is that more psychologists, similar to medical providers, are not accepting insurance. Your psychologist may not be part of your insurance plan. If that is the case, some insurance companies provide out-of-network benefits, and you may be reimbursed for part of your psychologist's fee, once you pay the full fee. Some people choose not to use their insurance due to confidentiality and pay out of pocket. Some psychologists may offer sliding scale fees if you are paying out of pocket. This is where they base their fee on your income and circumstances.

What can I expect during an initial psychotherapy session? Psychotherapy is one service a psychologist can offer. Anticipating an initial session can create anxiety. Your psychologist will have you fill out paperwork initially and the first few sessions in particular involves information gathering. You will be asked why you decided to obtain treatment as well as background information. Questions will include relationship and work history, medical history, assessment of your symptoms and other psychological history, previous psychotherapy experiences, and questions regarding your cultural background and family to name a few. This process, depending on the psychologist and the needs of the patient, is done formally or informally. You will be provided with initial impressions by the psychologist and an outline of your treatment plan, usually within the first one to three sessions. You can ask the psychologist the same questions you would ask your medical providers regarding their professional background, experience working with your issues, and any questions you have regarding the psychotherapy process. As treatment progresses, it will look different for each person depending on the psychologist's training and your needs. One thing to keep in mind is that psychotherapy requires patient engagement. In order for treatment to work you have to be engaged, or involved, in your treatment. You and the psychologist are both active participants, as opposed to you being the passive recipient of treatment. The more engaged you are, the more you will get out of the process.

Psychotherapy can seem daunting initially, however, many patients feel more comfortable once they have had their first session. You are there to be heard, assessed, provided feedback and treatment so that you can work on ways to help you feel healthier overall.

May is mental health month. One in four people deals with mental health issues that affect people emotionally, cognitively, their relationships — and also medically. 'Mind your Health' by keeping mental health in the forefront.

Lubna Somjee, Ph.D., is a psychologist practicing psychotherapy and consulting in the mid-Hudson Valley. Visit www.LubnaSomjee-phd.com. For information on local resources, go the Hudson Valley Psychological Association at www.hvpa.org.

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