What Kind of Help Do I Need?

Psychotherapy or Counseling has been proven to be effective in dealing with psychological disorders such as Anxiety, Depression, PTSD, Obsessive-Compulsive Disorders, Eating Disorders, and a host of other psychological problems.

Sometimes Psychotherapy coupled with psychotropic medications can be the only way to deal with severe psychological problems. However, the type of client I deal with in private practice psychotherapy does not necessarily suffer from a severe mental disorder. I deal with a wide-range of issues in psychotherapy. Because my credentials include licenses in both Psychology and Marriage and Family Therapy and a certification in Sex Therapy, I can treat many problems, both for individuals and for couples and families.

Let me give you an idea of who might come to psychotherapy by describing to you who I might see for psychotherapy in any given week. A full-time caseload for a private practitioner is anything over 20 clients (or patients) per week. The reason for this is that each client requires not only the face-to-face 50 minute session (typically once a week), they require paper work which must meet the ethical guidelines for the practice of psychology. This paperwork must also meet the criteria for insurance companies who establish their own quality-control for psychological services. Speaking of insurance companies, many individuals use their insurance coverage for outpatient mental health services. Until services are available free of cost to everybody, insurance allows people who would not be able to afford psychotherapy to get help. Medicare also covers this service.

So, a typical week in the professional life of a psychologist might look something like this:

Day 1

10:00: Rachel has Bipolar Disorder and is on long-term disability for her condition. Rachel also has a psychiatrist who monitors her medication. Rachel comes to therapy weekly to help her deal with functioning with a chronic mental illness. Right now she is working on her weight which is affecting her general health.

11:00: Jackie who is in the process of getting a divorce and is dealing with the guilt, depression, and anxiety associated with this major transition.

12:00: Jim and Renee who have had a distant and difficult marriage. They have been together 30 years and want to have a better relationship now that Jim is retiring. If they cannot improve their relationship, Renee is considering a divorce.

1:00: Todd is single and caring for his aging mother. He is feeling overwhelmed, guilty and depressed. He has put his life on hold, but now finds himself unable to function. He has a large family, but the responsibility has fallen on him to care for his mother.

2:00: Janet is the mother of five children and has always functioned quite well. Recently she has had a self-described “break-down” where she cries a lot and can hardly get out of bed. Her marriage is fine, but she recently remembered she was sexually abused as a child and does not want sex with her husband. She is also tremendously unhappy and depressed.

3:00: Amy comes in after school on the same day each week to work through her issues dealing with an eating disorder. Amy has been bulimic for four years.

4:00: Rob is trying to rebuild his life after his wife suddenly divorced him. He has been having panic attacks and is anxious a lot. He didn’t want the divorce and is having trouble moving on.

5:00: Joan is in a new relationship and is thinking about marriage. He seems perfect, but she has a history of marrying abusive men. She wants to make sure she doesn’t make the same mistake again.

6:00: Doug and Chris are trying to see if they can salvage their marriage. Doug had a one-time sexual encounter with a coworker and the couple is trying to work through the betrayal in their relationship.

Day 2

12:00: Jan is having trouble with her teenage son who doesn’t want to go to school and has recently gotten into trouble with drugs. He is in a drug-treatment program which has a family component, but Jan also wants extra help with her codependent and enabling behavior.

1:00: Rachel is just coming out as a Lesbian and is dealing with feeling misunderstood and rejected by her family.

2:00: Joe is depressed and doesn’t really know why. He comes from an alcoholic family where his father was extremely abusive to him. He easily flies off the handle and can’t seem to control his anger.

3:00: Angie is 17 and hates school. She doesn’t feel popular and doesn’t fit in. Her boyfriend recently broke up with her and she’s been cutting herself. She says she doesn’t really want to live.

4:00: Paul has been mentally ill for the last 15 years. He was a responsible supervisor in a plant when there was a explosion where people died. He hasn’t been the same since and has serious mood swings where he can be suicidal. He also sees a psychiatrist on a regular basis.

5:00: Carla has been in therapy for several years because of PTSD. She has worked through a lot of her issues of being sexually abused as a child. She and her husband, Kirk, have just started couple therapy to get their sexual relationship back on track.

6:00: Robin and Bob have been married for 10 years. Robin doesn’t think she loves Bob any more. She agreed to come to couples therapy to see if she wants to work things out.

7:00: Steph and Carol have been life-partners for 3 years. They are having trouble resolving conflicts in their relationship. They have huge blow-ups that are wrecking their relationship.

8:00: Jill and Jonathan recently had a baby and Jonathan feels that Jill has lost interest in him and their relationship. He resents the time and energy she spends on the baby. Jill is angry and feels that her husband is acting like a spoiled child. They want to get this worked out because they love one another and their new son.

Day 3:

9:00: Dave’s wife died after 40 years of marriage. He has been grieving for over two years and can’t seem to move forward. He has many opportunities for a social life, but he just isn’t interested.

10:00: Cindy was in a relationship with an alcoholic who recently went into treatment. She thought things would be better once he stopped drinking, but she’s still very unhappy.

11:00: Corey is in her sixth month living as a person of the opposite gender. Corey was born male, but has always felt she was in the wrong body. She is in her early twenties now and has recently started hormone therapy. She plans to have sex reassignment surgery sometime in the future. Now, she’s dealing with coming out at work.

12:00: Val and Bruce have a loving relationship, but Val is not really interested in sex anymore. She would like to be sexually active with her partner, but everytime she tries, it ends badly.

1:00: Karen has been diagnosed with breast cancer. Her prognosis is not good. She has a loving husband and two small children. She is devastated by this news.

2:00: Dawn has been depressed for about 6 months and has no idea why. She’s here to see what the problem is.

3:00: Melissa has been overweight her entire life and now has diabetes and high blood pressure. Her primary care physician has referred her for bariatric surgery. Her surgeon has referred her for a psychological consult prior to approving her for surgery.

4:00: Teri is seeing a married man and has been in the relationship for over two years. He keeps promising her that he will get a divorce, but he feels sorry for his wife and two kids, and needs to time the separation so they won’t be as hurt. Teri doesn’t know what to do because it never seems to be the right time.

From the above schedule, you can see that people come for psychotherapy for a number of reasons. Maybe this will help you determine if you or someone you love needs this kind of help. Psychotherapy can be a life saving intervention for many people.

How to Find the Right Psychotherapist for You

Psychotherapy: Finding a Gay/Lesbian/Bisexual/Transgender Affirming Therapist

Psychotherapy: Book Recommendations


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