Outpatient Psychotherapy

To make a complex topic very simple, psychotherapy is the process where a patient uses talking AND LISTENING to get better. It is important to clearly state this fact because many patients think that all they have to do is to go into a therapist's office and to talk and to be heard; when I hear them tell me this, I reply that is what friends, bartenders, and hairstylists are for. Certainly a good therapist will listen to a patient, but the work only begins there; indeed it is the change recommended and the work done outside the session where progress is truly made.

Psychotherapy primarily started with Sigmund Freud, an Austrian neurologist who starting in the late 19th century had ideas that there was conflict IN THE ACTUAL BRAIN that needed to come out. Words like ego, superego, conscious and subconscious all come out of his work.  These are the classic images of a patient lying on a couch, staring at the ceiling, talking and talking with the therapist making interventions only periodically. Psychiatry was known as “the talking cure,” frankly because no medications were really available to help people. 

Psychotherapies that developed in the 20th century have primarily focused on helping people change the way they think and feel (called cognitive-behavioral therapy).  These therapies are the major modalities of treatment today and, in the end, they have more in common that they differ. The best way to explain how these treatments work is through the analogy of another common type of therapy, physical therapy. If someone sprains an ankle, there may be a brief period of rest and support, but after that, a patient is expected to engage in (often painful) exercises to strengthen the joint.  Modern psychotherapy is the same way. A therapist may ask a patient to change the way they think about a panic attack, or the automatic negative thoughts that can flood a person's mind, or the way they think about a loved one. A therapist may then ask a patient to tolerate the anxiety of a panic attack, or the fatigue associated with getting out of bed, or the distress associated with physical pain. All of these are forms of psychotherapy, and by clear and convincing evidence, that they have been shown to be effective for every psychiatric condition.  

Common terms for therapy include:

• Cognitive-behavioral therapy
• Acceptance and commitment therapy
• Behavioral activation
• Existential psychotherapy
• Cognitive processing therapy
• Exposure and response prevention

South County Psychiatry offers outpatient psychotherapy for a variety of diagnoses and problems in living. Therapists at SCP learn about their patients’ lives, symptoms, and the issues they are facing, as well as about patients’ values and goals.  We work with patients to help them learn ways to make room for difficult emotions in ways that are healthy, while also helping patients orient themselves toward what matters most to them in their lives. We  are committed to delivering high quality empirically supported treatments, and to translating evidence-based principles to a private practice setting.  We currently have psychologists and therapists who specialize in geriatric mental health, young adult, and adult psychotherapy.

Therapy begins with an intake evaluation. During that evaluation, the therapist will ask questions to get to know you and your background. Your therapist will learn about your life, the issues you are currently facing, any symptoms you have, and what you would like to accomplish in treatment. The therapist will talk with you about the treatment they can offer, and whether that feels like a good fit for what you are looking for. You can then decide whether proceeding with treatment makes sense for you.

Therapy meetings can be anywhere from 30 to 55 minutes.

You and your therapist will decide together what you want to work on. If your work is targeted, therapy could be short term, for example between 8 and 16 meetings. If you have a number of issues you want to address, it could go on longer.

Individual therapy is both practical and values driven. Therapy helps patients to identify what is most important to them, and to orient their actions toward those values. Therapy also helps patients learn to identify and make room for their emotional experiences in ways that are both safe and relationship enhancing. Third wave behavioral approaches to treatment guide individual outpatient therapy, including ACT, DBT, and CBT principles. We use a collaborative approach to coordinate care with other behavioral health providers both in the SCP practice and in the community.

There are typically tasks to complete between meetings that you and your therapist agree on together. The tasks are meant to help you move toward the changes you want to bring about in your life. For example, if you are struggling with loneliness, the tasks might involve reaching out to people to connect, or identifying groups or classes that you might want to learn more about or join.

A SCID interview refers to the Structured Clinical Interview for DSM (Diagnostic and Statistical Manual of Mental Disorders). The SCID is a widely used diagnostic tool in clinical psychology and psychiatry for assessing and diagnosing psychiatric conditions. It provides a systematic approach to gather information about a person's symptoms and experiences, and it helps clinicians make accurate and reliable psychiatric diagnoses.

The interview consists of a series of questions that cover a wide range of psychiatric symptoms and experiences. The interviewer follows a specific format and scoring system to guide the assessment process.

SCID interviews may be used as part of the assessment and evaluation process.

South County Psychiatry accepts most major insurance carriers.

You can decide to end treatment at any time. Typically, you and your therapist will talk about what you set out to work on in therapy, the progress you are making, and whether you want to continue.