Frequently Asked Questions

Questions Regarding Therapy

• What is the best way to decide on the right therapist for me?
• Therapy seems like another way of bothering people with my problems. Shouldn't I
       be able to help myself?
• My friends say, "Why pay to go to therapy when you can talk to friends and family for
       free?"
• It seems like therapy is simply a never-ending complaining session, in which we
       blame others for our problems and dwell on the past. Is this true?
• Will therapy take a long time?
• Does psychotherapy/counseling always work?
• Is everything confidential?
• Should treatment include psychotherapy and medications?
• How will I know if therapy is right for me?
• What is a LCSW?
• How long does a therapy session last?
• Is there is any difference in seeing a male or female therapist?
• Will therapy still be helpful if I see you without my spouse?

Questions Regarding Office Policies

• How do I make an appointment or get more information?
• Do you have evening or weekend appointments available?
• What is your fee?
• Will my insurance cover your services?
• How can I be sure that our conversation is confidential?

What is the best way to decide on the right therapist for me?
It is important for you to feel that the therapist is genuinely interested in you, listening and responsive to what you share and the concerns you raise. Sometimes seeing a therapist for several sessions before making a final decision is helpful. Once you have confirmed that your therapist is qualified and experienced, your feelings are a good guide. Pay attention to your instincts. If you have questions, ask your therapist even if it feels a little uncomfortable to do so. Feeling safe and confident in therapy is very important to the success of your treatment. If you continue to feel that the therapist is not a good fit for you, it is always appropriate to discuss this with your therapist and to ask for another referral to another therapist. Your therapist should be able to handle your concerns and requests in a professional and respectful manner.

Therapy seems like another way of bothering people with my problems. Shouldn't I be able to help myself?
Therapy is often confused with dependency and weakness. On the contrary, seeking therapy is a sign of strength in one's ability to seek assistance when needed, and therapy is always a journey in which you are in charge that change. A competent therapist will assist you in clarifying your thoughts and feelings and provide you with helpful tools and feedback but you will always make your own choices. The goal of therapy is to help you gain independence and decision making power over yourself and your behavior.

My friends say, "Why pay to go to therapy when you can talk to friends and family for free?"
This question is a very common one. Good friends who are able to listen and are understanding are an asset. However, a professionally trained psychotherapist has the skills to help objectively challenge you uncover the things that are really bothering you, see the patterns in your life that have led to your current situation and assist you to recognize and change those patterns. Psychotherapy is a process that focuses on growth and change. Talking about our issues, assessing and understanding our feelings in an objective, client centered setting makes it possible to become more aware of the source of our problems. Psychotherapy enables us to make the most out of the options we have available to us from a trained, objective, yet genuine and empathetic professional. Therapy actively helps us find ways to deal more effectively with our feelings, identify more appropriate patterns of behavior and improve our relationships. Supportive friends and family will offer understanding, love and comfort; however, psychotherapy can offer more in terms of objectivity, the ability to challenge and point out patterns, tried and true suggestions for insight and change, in a confidential setting.

It seems like therapy is simply a never-ending complaining session, in which we blame others for our problems and dwell on the past. Is this true?
Always know that you and your therapist work together to determine the course of your treatment, your goals and your comfort. Your therapist may suggest exploring certain areas, but there are many ways to approach this exploration; reliving you past does not need to be one of them. Nevertheless, understanding how your past has affected you can be very helpful in breaking free of relationship patterns, fear, sadness or guilt that can interfere with your quality of life.

Will therapy take a long time?
Because each of us is unique, there is no single answer to this question. The length of therapy depends on factors such as the types of issues you are working on, how long you have been struggling with your problems, the complexity of your situation, and what you are looking to accomplish. Sometimes brief interventions are very helpful. In other cases, months and years of work are invested in an in-depth exploration of your personal conflicts. The choice is always yours and it can always be discussed with your therapist.

Does psychotherapy/counseling always work?
Psychotherapy usually helps - sometimes a great deal and sometimes not so much. When you are talking to someone who has professional training and has helped many others with problems similar to yours, that person is able to see the patterns in your life that have led to your unhappiness. In therapy, the work is to help you recognize these patterns and help you find ways to change the ones you want to change. It is important to share your concerns in an honest, serious and sincere manner and this definitely contributes to the success of your therapy. But it must be acknowledged that there are times when psychotherapy, even in combination with medication doesn't help very much. There are never any guarantees when dealing with the human psyche.

Is everything confidential?
Over time, you need to develop the kind of trust in your therapist that will allow you to share private thoughts and feelings Confidentiality is basic to therapy and the patient has the right to control access to information about the treatment. But many insurance companies require certain information from the therapist as a condition for payment. If this is a major area of concern, it should be one of the subjects covered when you meet for the first time so that you are clear about your therapist's policies and procedures regarding confidentiality and what information insurance companies require. This is one of the reasons why many persons also choose to pay cash (fee for service/private pay) only for their therapy services.

Should treatment include psychotherapy and medications?
Research suggests that the use of medication and psychotherapy together have been shown to be effective in treating mental illness. The type of treatment used depends on the nature of the problem. Since everyone is different, there is no one correct approach. The medication offers relief from severe symptoms, while psychotherapy enables you to gain knowledge and control of your life and yourself. The success of your treatment and attainment of your goals depends on three factors: therapy, lifestyle changes, and when needed, medication. However, please note that the choice to take medications is a personal choice. The result, however, is usually improvement of quality of life.

How will I know if therapy is right for me?
People seek out therapy as an individual and personal choice. There are numerous reasons why people engage in therapy. At times it is to deal with long-lasting psychological issues, recent stressors or difficult life changes, or problems with depression or anxiety. Therapy can help address many types of issues including:

• Anxiety
• Depression
• Codependency
• Stress management
• Anger management
• Identity issues; cultural, gender, life phase
• Improving communication
• Self esteem, personal growth
• Family transitions, such as leaving for college, arrival of a new baby, or loss of a
      loved one
• Life transitions - e.g., retirement, relocation, serious physical illness
• Premarital counseling

Other times, therapy may be in response to unexpected occurrences in life, such as a recent death, job loss or divorce. You may seek the advice of a therapist to pursue your own personal growth. A therapist can help provide support, insight, and a new strategy for life's challenges. Therapy is right for anyone interested in improving their life by creating greater self-awareness, taking responsibility, and making active changes in their lives.

What is a LCSW?
Licensed Clinical Social Workers have completed a Master's (MSW) or Doctoral Degree within the fields of social work, counseling and psychology, from state board accredited universities. They are required to complete a minimum of 3,200 hours of supervised clinical experience before becoming eligible for licensure. LCSWs (or LICSWs) are recognized and practice throughout all 50 U.S. States.

LCSW's are established and recognized core mental health practitioners trained to assess, diagnose and treat individuals, couples families and groups. They may be trained in a variety of therapeutic techniques and approaches and usually often perform social service functions other than psychotherapy, such as resource referrals and applications in the community, social advocacy and administrative/managerial community functions. An LCSW credential means that person is trained with strong clinical knowledge and applications of Social Work foundations based in advocating and assisting persons or populations who are underrepresented, disadvantaged and vulnerable, help others meet unmet needs - whether they are basic needs and/or that of the psyche. Most LCSW's approach psychotherapy with clients from a person-centered, strengths based perspective rather than symptom focused or psychopathology based.

The license number issued by the Board of Behavioral Sciences will contain LCS followed by five to six digits. Some may have additional advanced-practice certification as a Board Certified Diplomate (BCD) by the American Board of Examiners in Clinical Social Work.

How long does a therapy session last?
Each session typically lasts 45-50 minutes with most therapists. How long treatment will last depends on a number of things, such as the complexity of the issues, the individual's motivation, and their goals. Typically, brief therapy has specific goals or focuses more on a specific issue and can last a few weeks to a few months. Longer term therapy deals with issues of more complexity and can last up to a year or longer.

Is there is any difference in seeing a male or female therapist?
Some people are more comfortable discussing their problems with a woman, while others prefer a man as their therapist. Most people find that "it's all about best fit" - that they and their therapist have compatible personalities. How comfortable you are with a particular therapist is more important than gender.

Will therapy still be helpful if I see you without my spouse?
Changes in a relationship can still be affected by a change in one partner. Many people have improved their relationship as a result of therapy without the other spouse present.

How do I make an appointment or get more information?
Please call the office number at (858) 525-2937. My voice mail receives messages 24 hours a day. Normally calls will be returned within 24 hours, during normal business hours or in the early evening. Please leave your day and evening phone numbers when calling. If it is an emergency, do NOT leave a message at the general office number - contact 911 or the Crisis Access Line at 1-800-479-3339 or go to your nearest Emergency Room.

Do you have evening or weekend appointments available?
Yes, afternoon, evening and Saturday appointments are available in an effort to make therapy accessible to working persons, professionals, students' and families' schedules.

What is your fee?
Please feel free to contact me about my current fees. I currently charge $120 for a 50 minute session. I do offer a flexible sliding scale to accommodate those clients who have financial hardships and truly cannot afford this fee. If this includes you, then please let me know. We can go over my sliding scale, and we can arrive at a fee that is mutually agreeable. Sliding scale fees are based on income and ability to pay, on a time-limited basis, and I encourage you to let me know should you need a reduced fee. If I cannot accommodate your needs, I will do my best to find appropriate referrals for you.

I accept some forms of insurance, and most PPO plans will offer coverage or benefits even if I am outside of their network. I would be happy to contact your insurance company to determine coverage. If you are covered, your PPO plan will reimburse part of your fee.

Will my insurance cover my sessions?
Health insurance plans typically pay for a certain number of mental health visits. However, they may require in-network providers only. It is best to find out about your benefits as they are different from person to person. Aileen Cunanan-Dwight (LCS23448) is generally able to accept insurance as an Out of Network Provider. Unless special arrangements have been made in advance, payment is due at the end of each session. I accept cash, personal/business checks and Visa/Mastercard. To determine if you have mental health coverage, the first thing you should do is check with your insurance carrier. Check your coverage carefully and find the answers to the following questions:

• Does my plan include mental health benefits?
• What is my deductible and has it been met?
• Total number of sessions per calendar year allowed?
• What is the amount of coverage per therapy session?
• What is my copayment to see a therapist?
• Is primary care physician approval required?
• Is the therapist I have in mind within my network?
• If not, can I see my therapist using "Out of Network" benefits/Is there a payment
      agreement for out-of-network providers

How can I be sure that our conversation is confidential?
The law protects the relationship between a client and a psychotherapist. All personal information discussed in therapy is completely confidential. Your personal information cannot be released to a third party without your written permission, except when disclosure is required by law.

Information Disclosure is Required if:

• Suspected child abuse or dependant adult or elder abuse.
      The therapist is required by law to report this to the appropriate authorities
      immediately.
• A client is threatening serious bodily harm to another person
      The therapist must notify the police and inform the intended victim.
• A client intends to harm himself or herself.
      The therapist will make every effort to enlist their cooperation in insuring their safety.
      If they do not cooperate, further measures may be taken without their permission in
      order to ensure their safety.