FAQ - Dr. Scott’s Point of View

Therapy is an endeavor of growth. Anytime we try something new, it is natural to feel nervousness or trepidation. That’s one way our hearts and minds inform us that we are genuinely turning towards change. It’s also natural to feel nervous to let a stranger so close to our fears, insecurities, fantasies, and emotions. The therapy relationship is unlike any other relationship in modern society. We sometimes let therapists closer to our inner emotions than we let our partners, spouses, parents and our friends! Once we make a decision to begin this endeavor it is imperative that we find a therapist who we feel genuinely can meet us where we are. Someone that we get the sense can actually hear us, can give us reflections, and can engage with us honestly - while also having our best interests in mind.

How do I choose a therapist?

Therapists love to talk about the theory and “modalities” that inform their work. However, research suggests that despite the increase in available number of modalities, the effectiveness of psychotherapy as been consistent over the last 40 years (Miller et. al, 2020). In other words, just because there are more modalities does not mean therapy has become more effective. Research consistently shows that a strong therapeutic alliance is associated with better treatment outcomes, regardless of the specific therapeutic approach used (Prusinski, 2022),

That being said, I do think understanding something about modalities can be useful as you endeavor to find a therapist - as long as we have the caveat that the therapeutic alliance is the most important aspect. There are so many modalities, I can’t go into all of them here but I can provide some general ideas below.

So about those modalities…

The truth is, psychotherapy is not a monolithic or unified field. There are many different epistemologies, or theories of knowledge, applied under the umbrella of therapy. It is not essential that you know all about all of them. However, having some sense of what you are looking for could be helpful. CBT is the most widely practiced form of psychotherapy in the US. It focuses on the relationship between our thinking, our emotions, and our behavior. Other therapy approaches definitely focus on these things, however CBT tends to do so in a highly structured way.

I am not a proponent of CBT. I think it is useful at times for some people, but I find it to leave much out. My training is eclectic, meaning I have training in different modalities. Most therapists do, however there are some who have dedicated themselves to primarily one form or modality of therapy.

My training, education, and experience has led me to embrace elements of psychodynamic, analytical, intersubjective, humanistic-existential, postmodern and transpersonal psychologies. I admit I am not an expert in any one of these in particular. I personally believe that any therapy process that doesn’t include the body, or the felt-sense in the body, is ultimately going to be limited in its depth. You might say I am heavily somatically biased in my therapy orientation. Many therapists are, especially if they are trauma-informed.

My approach to therapy is influenced by developmental psychology, the understanding of childhood development and trauma, as well as the potentiality for transpersonal development in our adulthood. I see challenges that we face as being calls towards more consciousness. As we bring that down and into us, into our bodies, our lives can change for the better in many ways.

How do I know if you are the right therapist for me?

Take your time to read through my website. If you sense that I may be a good fit based on what you are reading, you can email me or sign up for a consultation.

During a free phone consultation, you can ask me what a typical session with me is like, ask how I work as a therapist, or any other questions you may have that are specific-to-you. You’ll also be able to share what’s going on for you and I can share my ideas around how I can help you.

The most important factor is feeling comfortable with your therapist, which can take time to develop. During sessions, you'll gauge how you feel working together. My approach may not suit everyone, and it's crucial to find someone who feels like the right fit for you.

Does what we talk about in therapy remain confidential?

Confidentiality is a cornerstone of the therapeutic relationship. What you discuss in therapy sessions remains private and protected by strict ethical and legal standards. Therapists are bound by confidentiality rules, meaning they cannot share your information without your explicit consent. There are, however, a few exceptions to this rule, such as situations involving imminent harm to yourself or others, or cases of abuse. These exceptions are in place to ensure safety and well-being. Understanding these boundaries can help you feel more secure in sharing openly during your sessions. Confidentiality fosters a trusting environment where you can explore your thoughts and feelings without fear of judgment or exposure.

How long will therapy take?

The duration of therapy varies greatly depending on individual needs and goals. Some people may find relief and achieve their objectives in a few sessions, while others might require months or even years of ongoing support. Factors such as the complexity of the issues being addressed, the frequency of sessions, and the therapeutic approach used can all influence the length of therapy. It's important to have open discussions with your therapist about your progress and any adjustments needed in your treatment plan. Remember, therapy is a personalized journey, and the time it takes is unique to each individual. The ultimate goal is to achieve meaningful and lasting change at a pace that feels right for you.

Very often, however, progress is non-linear. This is what I have come to expect in therapy. We may take two steps forward and one step back. Sometimes we take several back. However, each time we learn something new about ourselves that we can apply in the future. We deepen our awareness into our emotional patterns giving us more freedom and flexibility.

What can I expect during the first session?

Overall, you can think of the first session as a structured assessment that helps me get to know you and the challenges that brought you into treatment. I’ll invite you to share more about yourself and we can also talk about what’s worked or not worked for your mental health in the past.

Some questions that I like to ask during a first session include:

What brought you to therapy?

What’s present for you in your life right now?

Have you gone to therapy before? How did that go?

You can ask me questions as well. You might be curious about about why I'm a therapist or how I've helped other clients like you.

The most important part of a first session is that you see if you feel I’m a good fit for you. If you feel supported, seen, and at-ease with me, we can discuss if you’d like to meet again.

How can I get started?

I'm here to talk during a free phone consultation where you can share what’s going on for you and I can share my ideas around how I can help you.

Email me today to get your free phone consultation at scott@scottmenasco.com.

or sign up through the calendar below!

References

Miller, S. et. al. (2020). Better results: Using deliberate practice to improve therapeutic effectiveness. Washington, DC: American Psychological Association.

Prusiński T. The Strength of Alliance in Individual Psychotherapy and Patient's Wellbeing: The Relationships of the Therapeutic Alliance to Psychological Wellbeing, Satisfaction With Life, and Flourishing in Adult Patients Attending Individual Psychotherapy. Front Psychiatry. 2022 Jan 31;13:827321. doi: 10.3389/fpsyt.2022.827321. PMID: 35173642; PMCID: PMC8842997.