Why am I Requested to Fill Out Paperwork at the First Session?

You took the first step. You picked up the phone and called a counselor. The first appointment is set. The therapist may request you come in early to complete paperwork or some are now email the paperwork to you, so you can fill it out in the comfort of your own home. You see the packet...you cannot believe how much paperwork there is to complete! It begins to feel overwhelming. Why do some therapists have you complete paperwork while others don't?

In the world of insurance and lawsuits, now more than ever many therapists are outlining their policies and procedures to protect you, the client, and themselves. If all the policies are spelled out, then you know exactly what to expect from the therapist and the therapeutic process. From a therapist's point-of-view, clients can feel anxious and overwhelmed coming into the first session and may not remember the policies discussed. For this reason, many therapists will require you complete the paperwork.

Another possible reason for the paperwork is the HIPAA (Health Information Portability and Accountability Act) laws, which went into effect in April 2003. As clients choose to use their insurance for counseling, therapists are turning to the internet to expedite billing procedures. Therapists who are utilizing the internet to bill for services must become HIPAA-compliant, which requires the therapist provide you with a copy of the Notice of Privacy Practices (NPP), which discusses how your health information can and cannot be used. The therapist is mandated to obtain a signature from you demonstrating you received such a copy. This doesn't mean you agree with the policy, only that you've received one.

But what if I'm not using my insurance? I'm just paying for therapy out-of-pocket. According to HIPAA law, regardless of the means of pay, if the clinician must be HIPAA-compliant, then they have to provide all clients with an NPP and treat their information according to HIPAA laws.

All in all, the paperwork, while it may seem unnecessary, protects you, the therapist and may be required by law.

Understanding the Counselor's Role

Have you experience a kind of "distance" between you and your counselor? It's almost as if one moment there's a "connection" between you and the next moment, that connection is lost. It makes you wonder, "what happened?"

First and foremost, it's essential to remember that the counselor is not your friend. You don't pay your friends money to listen to your concerns and your friends may not have the ability to pull themselves away emotionally to see how your concerns may or may not be skewed. They only see your pain and want to fix it. They do not have the training or experience to be able to help you understand your pain and work with it in a way most beneficial to you. This may be where you feel this "distance." The therapist must keep a level of distance to maintain objectivity. If they become too invested in the emotions, then they can become as ineffective as some of your friends and family in the matters of helping you with your concerns.

Can I Be Friends with my Therapist?

Many people seek counseling due to some sort of crisis within their lives. They seek out someone neutral, objective, like a counselor, because their family and friends provide advice based on emotions and the connection with the person.

Once in counseling, you may start to have feelings for your therapist. This is very common. You start to feel like you really could like being friends with them. You feel like the therapist understands you and really listens to you. They may laugh with you n sessions, they allow you to cry when you need to. They accept you for where you're at. As a result, you may want to see your therapist over lunch, at a coffee shop, etc.

The California Association of Marriage & Family Therapists (CAMFT) establishes the Code of Ethics. They state, therapists should not engage "in a close personal relationship with a patient" as it may skew the therapy. Is this person now your friend or your therapist? How do they maintain that professionalism? Are you now paying your therapist or a good friend to help you? It can all become confusing and counterproductive.

Another issue is your relationship wasn't based on the makings of a friendship. Counseling is a business transaction with personal impacts. How much do you know about your therapist, really? Friendships are struck based on commonalities, such as interests, likes/dislikes, and personal experiences. How much of these things do you know about your therapist? Probably not as much as you think. Therapists don't disclose too much about themselves during your sessions. They can be likable people, but it doesn't mean you know that much of their lives outside the office.

CAMFT recommends a 2-year waiting rule to be extended to all types of relationships with clients, including friendships. There are several reasons for this. First, you may decide to return shortly after ending the therapy, which is common. Second, there is a belief that if a client and therapist want to engage in a relationship (friendship or otherwise) outside the therapy, 2-years to determine if a friendship could really sustain beyond the parameters of therapy.

If you have additional thoughts about becoming friends with your therapist, I recommend to discuss this directly with your therapist. It would be a good process for you in figuring out what characteristics you need for friendships as well as keeping the therapist in their role and allowing them to do their job...to provide you with a safe, valuable service.

Wanting More From Your Counselor

Counseling is a very interesting process. You come in spilling your guts to another person who is practically a stranger. You tell them things you've never told anyone else. You may have broken down in tears when you're upset, or maybe have turned to them when you're feeling like you're at your lowest point. And all this time, they've never judged you or shamed you...just provided the support and guidance you needed to get through these rough times.

Suddenly, you may find you are having feelings towards this person. You may want to become friends with them or even closer...maybe even have feelings of love. So what's the problem?

If your counselor is true to your therapy, they cannot reciprocate your feelings. It's understandable you would have such strong feelings for your counselor. You have put your trust in them and become vulnerable during some difficult times. For your counselor to share your feelings could have detrimental effects. They will not be able to maintain the objectivity, which you sought out in the first place. Counseling is a professional relationship which can sometimes feel very personal. However, it isn't personal. Do you pay your friends and family to talk to you? Probably not.

Your counselor is trained to deal with these issues. They can help you process your feelings in a positive way. However, if your feelings begin to overtake the therapy, your counselor may recommend (as a last resort) to transfer your therapy to another counselor, who can continue the work. Although this can feel like rejection, the counselor is really doing what is in your best interest. They want to see you succeed in life, and will not be able to help you achieve this if they are personally involved in your life.

Getting the Most Out of Counseling

If you've never been to counseling before, you may wonder what to expect out of the process. Counseling requires hard work, not in the way of using physical exertion, but more of working towards your goals. Wait! That means you need to have goals! So, you're going to counseling. What do you want to get out of it? What would you like to accomplish from your time with your therapist? How will you know when you're finished with your therapist? If you give yourself an opportunity to think about these questions and discuss them with your counselor, you'll be able to determine an appropriate path towards accomplishing your goals.

Now your goals are set and you have worked out a plan with your counselor. Now the work begins. Your counselor cannot do the work for you. This is your life and your responsibility to change it. Your counselor can provide you with tools to help you change your life, but if you aren't actively using these tools, you won't get very far and begin to get frustrated with your counselor and the therapy process.

Look at it this way. Your counseling sessions are only 45-50 minutes a week. This means you have an additional 6 days, 23 hours and 10 minutes before your next session. This provides you with ample opportunity to take what you've learned in your counseling and apply it in your everyday life. It's real easy to take the stance of "Out of sight, out of mind." However, your life isn't either. Your life is always in sight and staring you in the face. You now have the opportunity to take control and do something with it. You're paying good money to see this therapist. You owe it to yourself (and your wallet) to put the work into it.

If your feeling challenged by the work or the process is bringing up uncomfortable feelings, inform your counselor! It helps your counselor to know how you're reacting to the therapy. If you feel like you're hitting a wall each time you make the attempt to do the work and don't inform your counselor, that wall will feel bigger and higher trying to do it on your own. The counselor can help you process and work through what you're experiencing.

Counseling definitely follows the adage, "You get out of it what you put into it." Put your "all" into it and you'll have a better chance for therapeutic success!

I Have My First Appointment - What to Expect

So you've made the decision to get some counseling. Good for you! Counseling is an extremely beneficial means to obtaining support, guidance and a safe outlet to explore and overcome struggles, which may be plaguing you. Now you might be asking, "What will happen when I get there?"

You may need to attend your first appointment a bit early to complete intake paperwork. Like visiting a new doctor for the first time, there is paperwork which needs to be filled out. With the age of technology, some therapists have their intake paperwork online for you to download and complete. Your therapist will provide you with instructions as to what will be required from you.

Upon getting to the office, you might see a wall panel with your therapist's name and a light switch next to their name. Go ahead and flip that wall switch. The light indicates to the therapist of a client in the waiting room. At this point, have a seat and wait. If you need to complete the intake paperwork, now is the time to fill it out. Your therapist will leave out a clipboard for you with all the paperwork for you to review and complete.

At this time, your therapist will come out to the waiting room and take you back to their office. Their office may look like a living room, with couches and chairs. Ultimately, it should feel comfortable. Have a seat!

The therapist will ask you why you're seeking therapy, how they can be of help to you, and let you know of any policies, which will help you understand the process of therapy. Ultimately, it's a "get to know you" session. Some therapists may need to know specific information and ask specific questions. Others may give you the floor to discuss your needs, concerns and expectations.

However your therapist directs the session, allow yourself an opportunity to notice how you're feeling about the environment and the therapist. This is your time to see if the therapist is the right "fit" for you. If you don't feel comfortable, let the therapist know. They are trained to process your feelings with you and together, you may determine the "fit" isn't right. There's nothing wrong with this. Finding the right "fit" is the most important dynamic of the counseling relationship. Give yourself the opportunity to find your "fit." You'll know when it's right for you.

Is My Problem "Worthy" of Therapy?

I get asked this question all the time. Clients make statements like, "You must hear things SO much worse than my problem," or "You must think I'm crazy for spending money on a problem as insignificant as mine."

If the problem is plaguing you and you're having difficulty overcoming the problem by yourself, then it is worthy of therapy. Therapy isn't limited to people with major mental health disorders or to people who are suicidal. Therapy is for anyone who needs support or an outsider's view of the issue. No problem is significant. If it's bothering you, then it's worth exploring and overcoming.

Someone once told me, "I always thought you had to be crazy to come to therapy. Now I realize you'd have to be crazy not to seek therapy!" Why go through a tough time by yourself? You have the right to have a fulfilling life.

If you feel you aren't satisfied and you're ready to explore avenues to achieve the lifestyle you hope for, then pick up the phone and begin your journey!

Finding the Right Counselor for You.

You realize you need some help. You are struggling and recognize you can’t solve your problems alone anymore. Where do you start? Where do you look? How do you know your choice is the right choice for you? Here are some steps to take to help you work towards the help you’re seeking:

1. Begin by looking up counseling directories. The benefit of accessing such directories is the ability to check out multiple therapists in your area. There are many on the web, many of which verify the counselor has a valid license to practice. Some examples are PsychologyToday.com, Find-A-Therapist.com and MarriageFriendlyTherapists.com.

2. Look for a therapist who works with your problems. Therapists have license to work in many disciplines and with many populations. However, no one can be an expert in all fields. Some therapists focus on working with children and adolescents. Others work with trauma. Still others focus on couples work. Read the therapists’ profiles and see which one seems to “speak” to you. Narrow down the field to 2 or 3 so you can make the best selection for you.

3. Making contact. You’ve found a therapist who seems to be a good “fit.” Now’s the time to contact them. Most on-line directories have a feature where you can contact the therapist via email. If you email the therapist, you may have to wait for a response. Keep your emails brief, as some therapists prefer not to engage with a client via email, to protect your confidentiality and request you call them. Therapists want to see if there is a connection, which is difficult to determine over email.

The other option is to call the therapist. Leave a message if they don’t respond. If you call on a weekday, most therapists will return your call within a few hours. If you call on a weekend, they may not return your call until they return to the office.

4. Asking the right questions. Now you have them on the phone, what do you say? Let them know what prompted you to call them. The therapist may be calling you in between clients, so do not take it personally if they cannot spend a long time on the phone with you. However, the right therapist will take the time to answer your questions and feel comfortable and open with discussing their fee. But what are the right questions? Ask the therapist:

•If they have experience in working with your problem.
•What their education and training is in relation to your issues.
•What their fee is.
•How long their sessions are.
•What their availability is.
•Where their office is located.

5. How is the therapist responding to you? Pay attention to the therapist’s responses to your questions and information. Do they seem genuinely interested in you and your pain? Listen to your own feelings. Does this therapist feel like they would be the right person for you? If not, you can continue your search. If you are feeling a connection with the therapist, make an appointment.

6. Attending the first appointment. Make sure you attend on time and prepared. Some therapists already have their intake forms on the internet, for you to complete prior to your first appointment. Others require you to arrive to your first appointment early to complete the paperwork. To get the most of your appointment time, follow the therapist’s request. If you come unprepared, you may have to use a portion of your time to complete the paperwork.

You may leave your first appointment feeling like you made the right choice. Congratulations if this is the case! If you find after a couple appointments like you’re not making a connection with your therapist, let them know. It’s okay, really. Therapists are trained to deal with such issues and are willing to talk to you about it. If you still find you aren’t connecting, let your therapist know you would like referrals or your intent to search elsewhere. You ultimately have to feel comfortable with your therapist. If this connection isn’t occurring, you aren’t getting the most for your money.

How Can Therapy Help Me?

Have you considered going to therapy, but have yet to pick up the phone? What's stopping you? Are you worried what others might think? Are you wondering if therapy is really for you? Maybe you're trying to decide if spending the money is worth it.

When I scour the web, I read posts from many people looking for therapist referrals. They ask for "good therapists," or "therapists who use Cognitive-Behavioral therapy." If you check out message boards like, Craigslist.org, it's no wonder trying to figure out if there are benefits to therapy. There's so much pessimism about therapy that many people steer away from it.

However, there's good news! Researchers at The Institute for the Study of Therapeutic Change (ISTC) and Partners for Change have proven that there is value in therapy. However, the value isn't in the therapist's techniques or what school of thought the therapist works from. The value is inherently in the professional relationship between yourself and the therapist. In fact, the ISTC shows that about 60% of the success of therapy relies on this relationship. If you trust and like your therapist, there is a higher likelihood that you will have a greater level of success in therapy. The other 40% is based on therapist techniques and the therapist's confidence in those techniques.

With this in mind, how do you know if the therapist you're looking for is the "right one" for you? Well, there's no exact science here. There are plenty of outlets to find therapists, including online directories like PsychologyToday.com or state-specific directories like TherapistFinder.com. Read through the bios. Find a couple that "speak" to you.

When you call the therapist, you will probably only get a few minutes to chat with them to discuss the general issues you want to work on, how much it'll cost and set an appointment. If you get a bad "vibe" from the therapist, do not feel obligated to set an appointment. Move on to the next one.

Therapists work differently, so what to expect upon your first visit can vary. You can read more about what you can expect from me here. The therapist should feel comfortable responding to your questions about the therapy process and any expectations you have.

Hopefully this will help you take the leap to making changes in your life. Therapy is a journey and you have the opportunity to make it work for you!

My Clientele

Okay, I'm not going to talk about my cases here, but I did want to address the type of clients I work with. Many times, I get calls from potential clients stating, "I see you work with couples, but will you work with my issues even though I'm not a couple?"

I do a lot of marketing towards couples because it's an area that I'm very passionate about. My graduate program got me excited about working with couples after taking a 16-week course on couples counseling. From that point, I was hooked! I attend a lot of seminars on couples counseling to keep my skills fresh and I, in turn, provide better skills for my clients.

On the other hand, I like working with individual clients as well. It's exciting to have an individual client contact me. Hearing the motivation in your voice to want to work on whatever issue it is that is plaguing you really impacts me. Working in an one-on-one environment allows us to really delve into the presenting issues without distraction, which can happen in couples counseling.

I want to note that I maintain my practice for those 18 years of age and older. While I am qualified to work with minors, it isn't my forté and I don't feel that I can provide the services needed. However, I do have a close network of therapists who I confidently make referrals to and will provide potential clients appropriate referrals if we find that I am not the right "fit" for you.

If you have further questions about the clientele I provide therapy to, please leave me a comment and I'll respond as quick as I can.

Counselor, Social Worker, Psychologist...What's the Difference?

People have told me that they never know whether to call me "Dr. Blackley," Ms. Blackley or Jodi. Let me clarify how to distinguish the different degrees in the mental health field.

A social worker will have a Master's degree in Social Work and have a License in Clinical Social Work. Unless they sought out a Doctoral degree beyond their Master's, you would not call them a "Doctor."

A therapist will have a Master's degree in Counseling or Clinical Psychology and have a License in Marriage and Family Therapy. Unless they sought out a Doctoral degree beyond their Master's, you would not call them a "Doctor." For this reason, addressing me as Jodi is more than appropriate. If this feels too informal for you, Ms. Blackley is fine as well.

A psychologist has earned a Doctorate of Psychology (Psy.D.) or a Doctorate of Philosophy in Psychology (Ph.D.). You may call a psychologist a "Doctor" as they have earned the appropriate degree.

A psychiatrist is a doctor of medicine (M.D.). Like a general practitioner or a cardiologist, a psychiatrist has also gone through medical school, residency and has earned the appropriate degrees to be called a "Doctor."

Hopefully this will help clarify when to call a mental health practitioner a "Doctor" or not. As for me, please feel free to call me Jodi.

If you have questions about this or any other blog, Please feel to leave comments. I'll be happy to respond.

The Value of Therapy

I have been wanting to start a blog to help people understand what therapy is about and to help clarify what counseling is all about. There's so much confusion and miscommunication around counseling.

First, I'm a Marriage and Family Therapist. What does this mean to you? It means that I have a license with the California Board of Behavioral Sciences that demonstrates the completion of a Master's degree in Counseling, a 3,000-hour internship and 2 state board exams. My license allows me to work with individuals, families, children and couples. I must continue updating my education through workshops and classes to ensure that I am striving towards being the best therapist I can be. I cannot prescribe medications. This is limited to those with an M.D., like a psychiatrist or a general practitioner.

I cannot work with all problems. You wouldn't want to take your Volvo to a Toyota mechanic, right? When you call me to make an appointment, I want to know that I can provide the quality of care you deserve. For this reason, I will ask you about the problems that are causing you to call me. You deserve to have a therapist who is a good "fit." My questions aren't meant to be intrusive, but they are to help me determine if I'm the right therapist for you. If we decide that we won't be able to work together, I have many alternate, qualified therapists that I refer to and will provide you with the appropriate referrals so you can get the help you're seeking.

I will continue with this blog and help demystify counseling for you to make the process feel more comfortable. If you have specific questions or would like me to address specific issues regarding the counseling field, please leave comments for me and I'll be happy to answer them!