What is Cognitive Behavior Therapy? CBT is an active, goal oriented approach to treatment that involves teaching patients a new set of skills for managing and reducing their symptoms. When using CBT, therapists are similar to teachers, coaches, and advisors, and the patient and therapist form a team to achieve the best results from treatment. In between sessions, patients will have "homework" (specific tasks to work on) to put their new skills to work. Specific therapy techniques include exposure and response prevention, in-vivo and imaginal exposure, self-monitoring, modeling, cognitive restructuring, diaphragmatic breathing, and stimulus control.
What are the steps involved in starting therapy? During the first appointment I will review my office procedures with you and gather basic information regarding you and your life situation. Then we will begin a detailed assessment of the problem you are experiencing and any factors that might be contributing to it. When this assessment is complete (usually after several sessions), a treatment plan will be outlined and treatment will begin with the therapist and patient working together to establish goals and choose what skills to focus on first.
Do you do family therapy? I do not do "traditional family therapy" in which addressing family relationships are the primary means for achieving change in your symptoms. However, when patients are comfortable with doing so, I often work with family members including parents, spouses, and siblings when doing so can enhance the individual work we are doing. Educating family members and providing them with strategies to assist in treatment or cope with symptom related family stresses can often serve a crucial role in treatment.
How long do sessions last and how often will we meet? Sessions last for 45 minutes. Ideally, we will meet once week during the initial phase of treatment; I can do the best job at gaining an understanding of your situation and generating a plan if we meet weekly at the beginning of treatment. This also helps us to gain momentum in working toward your goals. After therapy is underway and gains are being made, we gradually increase the time between sessions as your symptoms improve and your confidence grows. However, some people are unable to meet weekly during the initial phase because of time or financial constraints and we may need to proceed at a slower pace.
How will I pay for your services? The fee for the initial session is $185 and $170 for subsequent sessions. When patients come to see me they pay me directly with a check or cash. I do not take credit cards. I do not participate with managed care, insurance company plans, medicare, or medicaid. If you are able to see out-of-network providers in your plan, you can submit claims on your own to receive the reimbursement you are entitled to; the billing slip I will give to you at the end of each session usually has the information you need to file your claims. Most of my patients submit claims to their insurance company and are reimbursed a portion of their cost.
What are your office hours? I work Monday through Friday mornings and early afternoons, from 8:30am to 2:30 pm AND Monday and Tuesday evenings until 6:30pm.
Do you do home visits or "in-vivo" sessions (ie., leaving the office to work in real-life situations)? Yes, home visits and in-vivo sessions can serve an important role in CBT, particularly if you have difficulty applying the skills we work on during sessions to the "real world." For these sessions, the total time away from the office is charged (i.e., including travel time), so sessions sometimes need to exceed the usual 45 minutes to allow for travel time.
Are there services you do not provide? I do not do child custody evaluations, court work, substance abuse treatment, or formal academic assessments.
Ruth Stemberger, pH.D., LLC