Psychotherapy

My therapeutic style is warm, empathic, supportive and non-judgmental.

I’m interested in all aspects of your life in the here and now. But I’ll also help you explore how past experiences, especially early in your life, have formed “templates” that affect ways you think, feel and behave in the present. When you become more aware of how old habits and expectations negatively influence your life choices and the ways you experience and relate to others, you’ll be able to make more conscious choices, enjoy more satisfying relationships and improve the quality of your life overall.

Therapy
Demystified

Scheduling an
Appointment

Individuals

It's important that you and I maintain an open dialogue about how best to help you reach your therapy goals

I most often work clients in weekly sessions. But some people choose to come more frequently, particularly if they are going through a rough time or want to accelerate their therapy. Taking into account your treatment goals as well as practical concerns (such as time and finances), you and I will collaborate to develop a therapy schedule that makes sense for you. And remember, nothing is ever cast in stone. As our work together progresses, we can always make changes—individual therapy can become couple or family therapy, once per week therapy can become twice, a Tuesday appointment can be moved to Thursday. The important thing is that you and I maintain an open dialogue about how best to help you reach your therapy goals.

Couples

To me a couple can be any two adults committed to sharing life and love.

If you’re seeking therapy for your relationship, either individually or with your partner, you might be worried to learn that I also work with separating and divorcing couples. You needn’t be. I’m not pro-divorce, I’m not even laissez faire about it. If you’re in a committed relationship and want to stay together, I will work with you to resolve your differences and strengthen your bond.

Children

I work with children and adolescents of all ages. I also offer parent guidance and consultation.

Lots more information about child therapy, including how to know when your child needs therapy, tips for preparing your child for therapy, how to help your child succeed in therapy, dealing with resistance and answers to common questions and concerns.

Is it Time?

Preparing
Your Child

Supporting
Your Child

Common
Questions

Families

There are many kinds of families…

Most people think of a family in the traditional way — a parent or parents and their child or children. Maybe that describes your family. But maybe you family consists of two moms or two dads, maybe you're a single or divorced parent, maybe you're co-parenting with someone you were never in a relationship with, maybe you live with aging parents, siblings, or in-laws, your adult child and their new spouse… Whatever family means to you, you're welcome in my practice.

I always begin family therapy with a "family assessment." Some people find the word “assessment” off putting, but it simply refers to a meeting or series of meetings in which I can get a sense of the nature of relationships among and between family members, what’s going well and what isn’t, what you might need going forward, and how I might be able to help. Click on the "what to expect" button to the right to learn more.

What to
Expect

How to Know When It’s Time to See A Child Therapist

In childhood — in fact, throughout
life — development is not linear.

You can expect to see your child struggle as he or she learns to master new challenges. Some back-sliding in development is normal, even necessary, as your child grows older. And if your child is showing signs of stress during a stressful time in your family, that’s not necessarily a sign that her or she needs therapy. For example, if you’re getting divorced (and your child is having to adjust to going back and forth between two homes), you should expect to see some sadness, irritability or clinginess in your little one-at least for a while. Those are the feelings that go with the situation and don’t necessarily indicate that your child needs therapy. In fact, putting a child in therapy when the problem is really between adults can be a bad idea, because it may send the message that he or she is the problem.

So how can you decide whether your child’s
difficulties fall within the normal range or not?

Here are some clues that it’s time to
see a child therapist for a consultation:

Your child’s symptoms aren’t transient, but persist over months
Your child’s symptoms interfere with his or her normal functioning (at home, at school, or with peers)
Your child’s symptoms interfere with the normal functioning of your family
You feel angry, exhausted, and disappointed in your child a lot of the time
You find you don’t like your child, even though you may be too ashamed to admit it
You’ve felt for a long time that something is wrong
Trusted others have expressed concern
Your child has been physically or sexually abused
If your child of any age ever expresses a wish to die or harm themselves or others, get help from a child psychiatrist immediately. Do not delay, even if you think the threat is not serious or is simply a "cry for help." And do it even if your child recants or objects to your plan.

Tips For Preparing
Your Child For Therapy

The idea of child therapy is sometimes more complicated and anxiety-producing for parents than for their children. Most of the children I see are relieved and happy to have a professional to talk to, and don’t have any trouble understanding my role or the nature of our work together.

So how can you decide whether your child’s
difficulties fall within the normal range or not?

What’s the best way to break the news?

Wait for a calm moment

Don’t raise the issue of therapy with your child when either of you is actively upset, especially following an argument or crisis (such as your young child injuring a sibling or your older child running away). If she’s riled up, your daughter won’t be able to take in what you’re saying.

And if you’re angry, she’s likely to think of therapy as a punishment.

Identify the problem

Tell your child what you see that has you worried for him. You might say, “Honey, I know you’ve been getting in a lot of fights at school”, or “Daddy and I have noticed that you’ve been having a lot of nightmares lately.”

Offer compassion

Tell your child you know she’s been unhappy and you want to help. For example, you might say, “It just be really hard to have the other kids angry at you” Or: “Nightmares can be really scary. No one likes to be scared.”

Explain therapy

Once you’ve identified the problem and offered compassion, tell your child you've spoken to someone who can help. For example, you might say something like: “Sometimes when children like you feel scared a lot of the time, it helps to go to someone whose job it is to help kids understand their feelings and worries by playing and talking about them. Daddy and I went to meet a person like that last week. Her name is Ms. Kate and she’s really nice. She likes children, and she has helped a lot of kids like you. We think if you met with her it might help you to understand better why you’ve been having those nightmares. She might even be able to help us understand how to help you not be so scared.

Tips For Helping Your
Child Succeed in Therapy

Lots of parents want to know what their role will be in their child’s therapy and how they can support them in having a good therapeutic experience. There’s no simple answer - a lot depends on your individual child. But no matter what your family circumstances, the relationship between you and me will be a collaboration. Here are some general thoughts to get you started.

What are the best ways to support
your child during this process?

Here are some ideas…

Don’t grill your child after sessions. It’s a tall order, but try to resist the urge to ask your child for reports.

Questions like “What did you and Ms. Kate talk about today?” are likely to meet with either silence or an answer designed to please you. It’s important to let your child’s therapy be a private place, and to use your meetings with me to get the information you need.

Remind your child that she has therapy as
a resource, but don’t harp on it.

When difficulties come up for your child, there’s nothing wrong with gently suggesting that she talk about them in therapy. For example, if your daughter gets in a fight at school you could say “You know, Honey, if you feel like talking with Ms. Kate about what happened, she might be able to help you with the problems you’re having on the playground.” But try not to bring therapy up too often, or your child will feel you’re intruding. If there’s something you want me to know, the best bet is to call me yourself. Usually, this doesn’t present a threat to your child’s confidentiality with me. Your call can be a download to me, rather than an upload that your child hasn’t yet blessed. It’s best to inform your child before reaching out, though, so he won’t feel we adults are conspiring.

Don’t use therapy as a threat or form of discipline.

A comment like, “If you don’t start cooperating I’m going to tell Ms. Kate” is counterproductive. A better one would be, “Lately it’s been really hard for you to cooperate with me and Mommy. I think it would be a good idea for us to talk to Ms. Kate about ways we can all get along better.”

Answers to Common Questions
About Child Therapy:

If you’re a parent, you know that kids rarely talk about their feelings directly until they are close to adolescence. Even if they say they’re sad or mad, they can’t go much beyond the general words. They certainly can’t be expected to sit in a therapist’s office and converse the way adults and (most) adolescents do. Children express their inner worlds by playing about them. Besides being fun, play gives kids a medium in which to work out their inner conflicts and explore new feelings and ways of being. The technique I use in treating children is called “play therapy.” With children, as with my adult patients, I first work to establish a trusting therapeutic relationship. I’m likely to get down on the floor with your child and play with the materials in my office, such as a doll house, puppets, Play-Doh or crayons and paper. As a play therapist, I’ve been trained to understand the meaning of your child’s play, and to communicate that meaning back to them.

Confidentiality is tricky when it comes to kids. On the one hand, children won’t feel safe to open up in therapy unless they can be assured that what they say will be kept private. On the other hand, you have a right (and a need) to know how your child is getting along. In general, I tell children that while I’ll be speaking with their parents from time to time, I won’t share specifics of our work unless the child and I have agreed beforehand. The exception (and I make this explicit if I have any sense it may be an issue) is that if I ever have information that the child is suicidal or involved in any dangerous activities I will have to inform their parents. But even in cases where I feel I must report something that a child has told me in confidence, I will inform the child and explore his or her feelings first. Protecting your child’s privacy and keeping you in the loop are not mutually exclusive. In fact, therapy with your child is a collaborative partnership between us. After all, I see your child only a few hours a month—you’re the one she lives with and loves, and you know her best.

The younger your child, the more often I’ll want to meet or speak with you. These contacts will give you a chance to update me about events in your child’s life (I’ll be interested in your information and opinions), and to voice any new concerns. At these meetings, I’ll give you a general report about how your child is progressing. I may also offer you guidance on how to manage your child better at home.

I do not meet with a parent or parents immediately before or after your child’s session, and I don’t use part of a child’s session for a parent meeting. In fact, I never meet with parents when the child is in the waiting room. Our conversations will be planned in advance and happen outside of your child’s scheduled time with me. With rare exceptions, I meet with both parents either together or separately, or at least make sure both are in the loop. But if you and your co-parent and are not comfortable a couple and are comfortable to meet with me together, I’ll meet with each of you separately. And if your child’s other parent is not in the picture (but not estranged from or dangerous to your child). I'll reach out. If that parent is non-responsive, I’ll let it go.

You don’t consult your child about medical treatment. If the doctor prescribes an antibiotic, your kid has to take it-- no matter how much he protests. Therapy should be no different. If you’ve decided it’s important for your young child to see a therapist, then yours should be the final word (this isn't necessarily true with older children and adolescents). You should prepare your child thoughtfully (see the tips above), but don’t give her a choice. If she says, “I’ll go, but you can’t make me talk,” say “fine.” Let me, the therapist, deal with her resistance.

If a crutch is something you lean on as you heal, then yes, therapy is a good one. But the point of any therapy is to foster independence, not dependence. I work to help my patients—both children and adults—to figure out why they’re having difficulties managing, and to develop the skills to manage better. And the good news is that children, because they haven’t lived as long and are not as fixed in their habits as adults, learn much more quickly and easily than we do.

Actually, there’s nothing more stigmatizing to a child than suffering with, say, anxiety or depression, because:

Symptoms get in the way of normal social functioning. If your child is unhappy, the problem will likely show itself in her friendships and at school.
Children who suffer with emotional problems automatically assume there’s something wrong with them.
Therapy is private, but emotional problems in kids are public knowledge-- even if you or your child wish nobody knew. If you present therapy as something that will help her to feel better about herself, your child will be relieved that you recognize she needs help and that you’re willing to get it for her.

Parenting is a tricky and complicated business, and when something goes wrong there are always several factors. I’m not interested in blame, I’m interested in understanding. My job is never to point a finger at you and tell you how you’ve screwed up. In fact, you and I will have to be partners and collaborators if your child’s therapy is to succeed. And helping your child to be closer to you (and to the other important people in his life) is a primary goal of therapy.

Children want, and need, to know why and how. Often, kids won’t bring up certain subjects, or won’t press them, if they’ve learned that these subjects make you uncomfortable. For example, if you offer the stork explanation when your child asks where babies come from, she won’t buy it (at least not for long), but she might not ask again. Instead, she’ll have to rely on friends or figure out her own explanation. And whatever she comes up with will be wrong, and probably scarier and more confusing than the truth. If your child is unhappy, she’ll look for an explanation for that, too. And unless you give her a reason not to, she’ll decide that she’s responsible for everything that’s going wrong. Coming to therapy doesn’t put ideas in children’s heads, it offers a realistic understanding of the ones that are already there.

The symptoms of ADHD can just as easily be caused by emotional factors as biological ones. Also, emotional and biological contributions are not mutually exclusive. Not only can they coexist, but a biological problem often leads to an emotional one. Children who have trouble controlling their impulses, thinking clearly, or behaving appropriately often suffer from low self-esteem, anxiety, or depression as a consequence. Medication on its own is rarely adequate in the treatment of ADHD. However, it can be a good complement. If I suspect your child could benefit from medication, I will suggest she be evaluated by one of the child psychiatrists or psychologists with whom I have a collaborative relationship. Then you, I, and they can work together to determine the best course of action.

If you, I, a teacher or your child himself have substantial worries about any area of your child’s development or learning, I will suggest your child be evaluated by one of the child psychologists with whom I have a collaborative relationship. I will work with you to prepare your child for the testing. Afterwards you, I , and the psychologist will work together to understand the results of the testing, to integrate them into your child’s therapy, and to find your child any additional services she might need (such as occupational therapy, organizational coaching, or tutoring).

Getting Started in Family Therapy:
The Family Assessment

To start, I'll meet with the adults. So if you're a couple, I'll meet with both of you together. I may then ask for individual sessions with each of you (and with any other participating adults). If you are a single parent or if your child/ren’s other parent is not in the picture, you and I will meet together in this first phase.

I’ll then meet with child/ren, individually and/or as a sibling group. It’s best if all members of your immediate family participate. Later, in family sessions, even babies and toddlers should attend if possible. Since every member of your family is important and has something unique to contribute, I’ll often ask to have a phone call or video meeting with older children who no longer live with you or are away at school.

Finally I’ll meet for a second time with you (and probably any other adults involved in the therapy) to discuss my impressions, answer your questions and suggest a path forward.