Therapy can feel strange if you are new to it.  Hope Great Water is ready to help you navigate the transition, so we are on this journey together.  If you have never been in therapy—welcome in!!

At its simplest, therapy is “talking with a therapist.”  Effective therapy has treatment goals, teamwork oriented, supportive, and intentional action.  Therapy can feel awkward when it starts but is very rewarding after you settle in.  The consultation session is a free 15-minute session to discuss your concerns and see if we match well together—as trust is very important.  If we agree the relationship feels good, we will schedule a 60-minute initial evaluation and diagnostic session.  During this session, we will go over your forms filled out prior to the session, review your history, develop an accurate diagnosis, and set goals and a direction in our relationship.  From there, general follow-up sessions of approximately 60-minutes are conducted at an agreed upon basis (from as needed to weekly) to work together toward our goals. 

Once you agree to engage in therapy, we usually recommend giving the therapist about 4-sessions to acclimate and determine goodness of fit.  Some find it awkward at the beginning because it feels one-sided.  The beauty of the therapeutic relationship is its one-directionality.  You are the focus of the relationship—one of the few things in life that is all about you.  The 4-sessions give enough time to move past the experience of therapy and get an understanding of the level of relationship.  During that time, we work toward goals, develop a relationship via engagement and feedback, and review of progress.

An evidence-based practice shown to be very effective is Feedback-Informed Therapy.  A standardized version of this was pioneered by Dr. Scott Miller and has demonstrated better outcomes in therapy.  These outcomes are supported by caring support within our relationship.  This is done by filling out a 4-question questionnaire (less than 30 seconds to do) about the session.  You would not want to receive any services from anyone without any say or ability to provide feedback.  Therapy is different than any other professional relationship—for us at Hope Great Water, the relationship is the most important aspect.  If you are building something, your tools must be calibrated and sharpened.  Feedback-Informed Therapy calibrates and sharpens the therapeutic relationship. 

Hope Great Water is committed to helping you get where you want to go.  We utilize Feedback-Informed Therapy frequently, if not at the end of every session.  We see it as a means of respecting your time and our relationship.  Treatment is completely participating and wanting to caringly engage.

Evidence-based treatment is therapy that has research demonstrating better outcomes when the therapy is given.  The outcomes can be very different depending on the research: decrease in symptoms (e.g., depression, anxiety, trauma symptoms, etc.), increase in positive things (e.g., quality of life, resilience, contentment, etc.), and everything in between.  The use of evidence-based treatment often decreases costs and time spent by you as the therapy has been known to help and directly target the key components.  Some of these treatments include: Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), Eye Movement Desensitization and Reprocessing (EMDR), Rational Emotive Behavior Therapy (REBT), and other treatments. 

Hope Great Water is committed to providing the treatment and support that would best serve you.  Obviously, as all people are different, so are all treatments.  Hope Great Water ensures to develop a partnership with our clients to find the best treatment match.  Just because EMDR worked a certain way with a friend of yours, it doesn’t mean you will have a similar experience.  That is why working together is so important to get us where we want to go.  From the first session where we determine our first goals until when we have achieved those goals, we will explore different interventions that will help us get there together.

You are looking for a therapist and you are talking about it with your friends and family. They say things like “ensure they are a CBT therapist” or “does she do DBT?” What the heck does all that mean?

They are referring to something called theoretical orientation. This is how the therapist views mental health and addresses concerns. It provides a kind of roadmap. A therapist who is strictly CBT, or Cognitive Behavioral Therapy, will usually structure their sessions with a review of homework, learning skills or discussing application of old skills, and giving the next homework assignment. They view therapy as a means to help you change ineffective thoughts to imprvoe mood. Contrasting to this, with someone who is strictly psychoanalytic, you get a very different experience. This is the old “lay-on-a-couch-and-talk-while-the-therapist-says-very-little therapy you think of with Sigmund Freud. They view the world as a person managing their internal drives and balancing them unconsciously. These are two different orientations in the geography of psychological services. There are many more orientations.

The majority of therapists, though having a preferences, would be considered integrative. What this means is they use different aspects of different orientations depending on the need. Therapy is not one size fits all and therapists generally want to help their clients to the best of their ability. This flexibility parallels the goals their clients have and ultimately promotes wellness.

Some people respond well with homework. Others respond well with someone being overly direct. When it comes to what works, the focus is on what is effective for you.

Yes—but we are biased.

Therapy, without medication, has been shown to decrease symptoms of anxiety, depression, traumatic response, AD/HD, sleep issues, illicit substance use, sexual dysfunction, and many other concerns. Research is conducted to verify the effectiveness of therapies utilizing the research method: form a hypothesis, test the variables against control groups, determine results, and attempt to replicate the results.

Interestingly, the MOST important aspect to any therapeutic intervention is the relationship forged between the client and therapist. At Hope Great Water that is where we think the magic is.

It truly depends on the individual. Some people use 4 - 12 sessions, find a stability, and no longer require sessions. Others find going to therapy is good for maintaining their mental health balance and may go for a much longer time. Some go weekly for a while and drop to once every month, while others go months without seeing a therapist and then go “for an adjustment” during a difficult anniversary. Insurance and finances also affect all of these decisions. There really is no size fits all with so many variables.

Hope Great Water suggests working with your therapist to determine good goals and see where the process takes you.

If you do not feel a connection with your therapist or believe it is not a good match, you should go where you feel connected. As the relationship represents one of the most important aspects of therapy, it is imperative to find one that you can trust and helps you feel a bond. If you wish, you may always sign of release of information to ensure records are sent over to your new therapist.

The most important thing is whether the therapy is helpful. If it is helpful, one cannot hope for a better outcome. If it is does not help any of your concerns, you are encouraged (and can be helped) to find where help exists.

Everything you say to your therapist is confidential and falls under the umbrella of legal privilege. That being said, there are a few limits to confidentiality. Specifically, if you are (1) a danger to yourself, (2) a danger to someone else, and (3) if someone vulnerable is in danger (e.g., a minor or someone elderly), we are required to inform someone. As mandated reporters, we are required by law to inform the proper authorities if a child is in danger.