Question 1

What is the nature and purpose of counseling?

Accepted Answer

Therapy assumes that the individual is the best source of personal understanding, insight, and change. That progress is made through a willingness to participate, share, and risk experiencing new things about one’s self and the world; and that the best answers to personal questions and problems come from within. In helping you work through this process, I can provide you with a fresh perspective and helpful guidance whenever a lack of self-awareness, distorted perception, irrational fear, or an unhealthy reaction might impede your ability to grow and change. My intent is to help you work through problems, challenge old beliefs and behaviors, and – where appropriate – question and possibly establish new views of reality. The end-goal is improving your ability to get to where you need to be, so you get more of what you want out of life, and achieve greater happiness.

Question 2

What happens during the first session?

Accepted Answer

The initial session is the time for you to start to share your story, talk about your goals and what you would like to change. Another important aspect of the first session is deciding if we are a good fit. Do I seem like someone you can trust? We are establishing a relationship that will become the foundation for working together. You will begin to figure out some goals; I will begin to figure out how to help you get there.

Question 3

What are sessions like?

Accepted Answer

As a client in therapy, you will be participating in a collaborative, non-judgmental process where we share views and opinions relevant to your emotional well-being. My job will not be to tell you what to do or to believe, but rather to provide you with the perspective, sensitivity, presence, and support that enables you to effectively explore how you see yourself, relate to others, and cope with life’s challenges. During these times, you may experience surprises or a heightened sense of awareness. You’ll also be asked to reflect upon what it is you want, and how much you’re willing to change to get it, since change is a basic goal of therapy. As such, my role will include helping you to deal with change and any related emotional experiences. Our initial time together will be an opportunity for us to discuss your concerns, to obtain historical information, and to clarify issues appropriate for focused treatment. This initial process generally takes up to four sessions, and is both evaluative and therapeutic. Successful treatment will be a direct result of our mutual effort, honesty, and collaboration.

Question 4

Does therapy have risks?

Accepted Answer

While therapy has many benefits to offer, it also has downside risks. The benefits can include relief from distressing symptoms, improved emotional and physical health, new approaches to problem-solving and decision making, and more intimate and satisfying interpersonal relationships. At the same time, the process of approaching feelings and thoughts that you may not be aware of – or haven’t thought about for a long time – can be stressful and painful, and may include periods where feelings become intensified. Making changes to your beliefs or behaviors can be scary, and sometimes disruptive to existing relationships. In addition, the therapeutic process can involve feeling worse before feeling better, and (as with most things) there is no guarantee that any of your goals will be achieved.

Question 5

What is the most essential factor in choosing a therapist or counselor?

Accepted Answer

Research findings are clear – the most important factor in therapy outcomes is the quality of the relationship between the therapist and client. If the relationship is good (the client feels safe, trusts the therapist), therapy will have a much greater effect. When selecting a therapist, you can ask yourself – Do I feel comfortable with this person? Did he or she focus on the issues that are important to me? Do I trust he or she has the skills and expertise that I need to heal? It is totally okay to go with your gut on the answers to these questions – how you feel with your therapist is very important.
The bottom line is that you must feel safe and comfortable for therapy to work. If you don’t feel safe with your therapist, you should either have a conversation with them, or you should keep looking. Most people have a good sense of whether I am the right counselor to help them within the first session or two.

Question 6

What should I expect from a good therapist?

Accepted Answer

There are some basics that you should look for in the first few sessions:
Did the therapist focus on you?
Did the therapist answer any questions you asked about him or her?
Did the therapist focus on the issue you are interested in resolving? If the therapist focuses on something that doesn’t make sense to you or doesn’t seem on target with what you want to work on, speak up. If they don’t re-focus when you speak up, you may want to find a different therapist.
Was the therapist professional? You can expect a good therapist to be on time, organized, provide you with your full session length, and fully focused on you (does not eat or answer his or her phone during your session time). You have paid for your time, and it should be fully dedicated to you.
Are you getting results or learning something valuable about yourself? You should feel you are getting something out of most if not all sessions, and moving towards your goals. If you feel you are making little to no measurable progress, you should talk that over your therapist. If you are not satisfied, you should feel free to try another therapist. As with other relationships, some individuals are going to be a better fit for you than others.

Question 7

My partner is not ready to attend counseling, but I would like to get help. Can I come in alone to work on my relationship?"

Accepted Answer

Yes. Doing your own counseling can help you approach your partner differently and create a safer, more connected relationship. This might increase your partner’s willingness to engage in couples counseling. More importantly, the changes you make might be enough to change the relationship in the direction you want.

Question 8

How often should I come in?

Accepted Answer

Most individual clients find weekly sessions helpful. However, you can choose the frequency that works for you. For couples in distress, I generally require weekly sessions at the outset of therapy. This is because it can be very hard to make progress towards understanding and healing relationship issues when there is a large gap between sessions. When much of the relationship is healed, I am happy to accommodate a less frequent schedule.

Question 9

How long does therapy take?

Accepted Answer

The answer to this question is “it depends.” Every individual and couple are unique, so how long the therapy process takes varies considerably. After we have met and I have an idea of what you would like to achieve, I may be able to give you an idea of how long therapy might be needed based on using my experience. And I can, of course, update you along the way. You should also know that it is always your choice as to when to end therapy, and that you can end therapy at any time and for any reason, even if your therapist recommends that you should continue in treatment.

Question 10

Can we meet virtually? Do you provide online counseling?

Accepted Answer

I find that the best therapy happens with face-to-face sessions. Established clients, who usually meet with me in the office, can occasionally conduct sessions by phone or a secure Zoom video platform to help meet their needs when traveling out of town, inclement weather, home with a sick child, etc. It should be noted that the California licensure board precludes providing phone or online (telemedicine) counseling across state lines, unless the foreign state recognizes or accommodates a California MFT license.

Question 11

Do you accept insurance?

Accepted Answer

No, I do not accept any insurance. I will collect payment in full from you at the time of service. If you want to submit a claim for out-of-network reimbursement, I can provide you with an invoice to submit on your own to help facilitate any reimbursement you may be entitled to. Please note that submitting an insurance claim means I will need to give you a mental health diagnosis.

Question 12

What is your cancellation policy?

Accepted Answer

I require 24-hour advance notice of cancellation or you will need to pay for the appointment. An occasional exception may be made in the case of an emergency. It’s important that we meet consistently in order to make progress.

Question 13

Do you prescribe medication?

Accepted Answer

No, I am not a medical doctor. Many of my clients find medication is helpful, but many of them also progress well in therapy without medication. If you want to be evaluated for psychiatric medication, either contact your primary care physician or a psychiatrist – if desired, I can provide you with referrals. If you are already taking medication, I can coordinate care with your doctor.

Question 14

Are there any issues or types of clients that you don’t work with?

Accepted Answer

I only work with couples, adults, and teens aged 13+ (not children). I neither conduct child custody evaluations, nor do I provide custody recommendations. I also don’t provide treatment for eating disorders or psychotic disorders (schizophrenia, schizoaffective disorder, etc.). Due to state licensing laws, I can only provide therapy and counseling to individuals residing in California.

David Michalicek, M.A.
Licensed Marriage & Family Therapist
1885 The Alameda, San Jose, CA
408.628.9179

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