I’m a working therapist. I have a full-time private practice with a caseload of 20-25 patient sessions per week in good times, often less in the current (2011) economy. I struggle with issues of insurance, office costs, marketing, and billing: all of the usual problems most therapists face in private practice.
My main office is in Lynbrook, on Long Island. It’s a conservative, traditionally blue-collar and civil-service town. I also rent office-space in Park Slope, in Brooklyn, one day per week. My patients are ordinary people and most of their problems are the common problems that people face everywhere.
I’ve focused my practice on the treatment of anxiety disorders: generalized anxiety, panic disorder, specific phobias, social phobia, OCD (obsessive-compulsive disorder), and PTSD (post-traumatic stress disorder). These problems often occur alongside some amount of depression, especially when they have been problems for many years, depriving the patient of their ability to function and their enjoyment of life.
I also have patients whose main difficulty is coping with the stress of a difficult life situation. They ask me for relaxation techniques, coping skills, for an objective opinion, and for the type of listening that allows them to come to terms with their difficulties.
My approach to therapy is practical. If someone comes to me with anxiety disorder and/or depression, my first approach is going to be short-term cognitive behavioral therapy (CBT). CBT is based on methods and techniques that have been validated through clinical trials. They have a proven track record for patient’s responses. My goal is to get the patient on their feet and functioning as soon as possible. (Isn’t that what they’re paying me for?)
When a patient’s problems seem to require more work than a CBT protocol can offer, I switch gears slightly. I use a variant of Jeffrey Young and Janet Klosko’s schema therapy. It is a common sense model of personality formation and change, that seems to be very effective. I hope that in years to come there will be more clinical effectiveness and efficiency research on schema therapy.
I’m a very opinionated, directive therapist. I teach people how to change and cope. I share my opinions. Everything I do is direct and transparent without any sort of secret manipulation or hidden agenda. This can be quite a shock to people whose ideas about therapy have been formed by psychoanalytic, psychodynamic, and humanistic therapies, in which the therapist whether warm or cold is for the most part a mysterious expert. I’m too much of an egalitarian democrat to want that role or to work that way. Transparency enables informed choice, and my patients are competent adults who have a right to informed decision-making.
So, why am I blogging? Though I work with people every day, I work largely in professional isolation. I’d like to share my reflections on the profession, on theory and practice, and also the business of being a therapist. This is my platform to share opinions and information that would otherwise remain locked in my skull.
For more information on my practice, please visit my website: http://www.effective-therapy-ny.com
– Etan Ben-Ami, LCSW, 6/27/2011