Please note that the answers to these questions are my own opinion and may not represent the opinion of other mental health professionals.

Q: What is the difference between counseling and psychotherapy?

A: There is no officially recognized distinction between the two terms and they are often used interchangeably. Both terms generally refer to talk therapy as distinguished from pharmacological, surgical, or other medical treatment.

Q: What is the difference between a counselor, psychologist and psychiatrist?

A: In North Carolina, a number of different licensed professionals provide mental health counseling services. A Licensed Clinical Mental Health Counselor (LCMHC) has successfully completed the National Counselor Examination and a M.S. (Master of Science) or M.A. (Master of Arts) in counseling, psychology, or other mental health discipline, along with a 2,000 hour/two year supervised internship in order to be licensed to provide psychotherapy. An LCMHC may provide assessment or testing as well, based on individual qualifications. A psychologist has completed a PhD (Doctorate of Philosophy), Psy.D. (Doctorate of Psychology), or Ed.D. (Doctorate of Education) and also provides assessment along with treating clients with psychotherapy. A psychiatrist is a M.D. (Doctor of Medicine) or a D.O. (Doctor of Osteopathy) who has completed specialized training and a clinical residency addressing mental health. Typically, psychiatrists focus on medication management although some provide psychotherapy or counseling. In addition, other masters level practitioners such as Licensed Clinical Social Workers (LMSCW) and Licensed Marriage and Family Therapists (LMFT) may practice psychotherapy. According to accepted research, the outcome of counseling tends to depend less on the background of the practitioner and more on the quality of the relationship established between the counselor and client.

Q: Does counseling really work?

A: Yes, as evidenced by a number of rigorous scientific studies as well as a substantial professional literature. Both research studies and client reports indicate beneficial changes as a result of counseling, often greater than changes obtained with pharmacological interventions. In virtually all cases, clients who utilize counseling or counseling combined with medication fair far better than those with no treatment or who use medication alone. It has also been demonstrated that clients who participate in counseling for a longer time generally tend to obtain greater and longer lasting results than those who participate in brief treatments. Clients who are active in working with their counselor tend to demonstrate greater improvement. Finally, the quality or fit of the counseling relationship has been shown to be one of the most critical factors in producing a positive outcome so it is important to be mindful when selecting your counselor.

Q: How does counseling work?

A: This varies depending on the theoretical orientation of the practitioner, but my belief is that developing an increased, detailed awareness of yourself and the issues that bring you to counseling will typically bring about the change you desire. In most situations, people find the answers they seek within themselves through the guidance of the counseling process. Common benefits include improvements in self-esteem, confidence, hope, relationships with others, and taking an active and responsible role in one’s life. I will accept you into my practice only if I believe you have the capacity to resolve your own problems with my assistance. In general, once you and I agree on your specific counseling goals, I may offer vehicles for you to use in the achievement of those goals. It is crucial that you make active use of these vehicles to create the change you desire in your life. I feel counseling should be taken very seriously as it typically involves an extensive commitment of time, energy, and money. It is important to determine if one is willing to engage the process fully as the benefits are usually proportional to one’s efforts

Q: How long does counseling take?

A: It is usually determined case by case. Each person’s individual history and symptoms are different and people respond differently to different treatments. Speaking very generally, if your concerns have a relatively recent onset with clear precipitating circumstances, then treatment may be fairly brief, e.g. 10-12 sessions. If your problems are more long standing or related to core aspects of your personality, then treatment may be considerably longer. However, individuals with long standing concerns may still benefit from short-term interventions.

Q: What can I expect in the first session?

A: I treat the first few sessions fundamentally as a consultation in order to determine if we are a good fit in working together. This allows me to begin to understand you and your concerns and for you to get a sense of how I work. In our initial session, I will be interested in understanding your concerns from your point of view as well as why you would elect to seek professional help at this point in time. If we decide to continue, the following few meetings generally involve obtaining a developmental history in order to contextualize what you are currently experiencing within the broader scope of your life. At that point, I am usually prepared to establish a treatment plan including frequency and type of counseling as well as provide any additional referrals, if necessary. If I feel your concerns are beyond my expertise or that you would otherwise benefit more from another counselor, I may provide alternative referrals for you. At the outset, you may feel frustrated that you don’t obtain immediate results from your initial sessions and may be tempted to drop out of counseling. This is common and it is important to discuss your feelings with your counselor in order to resolve to continue and achieve the eventual benefits

Q: Do you accept insurance?

A: Yes, in certain circumstances. Typically, I see clients on an out-of-network basis in which you are responsible for the full fee at the time of service and then the insurance company will reimburse an established percentage of the fees directly to you. At times, I do participate in-network with some insurance providers, however my status may change frequently. Please see the services page or contact me for more information.

Q: Is counseling confidential?

A: As a general rule, everything disclosed in a counseling session is confidential. However, there are some exceptions to this. For example, confidentially may be violated in the following situations: 1) if you express that you may harm yourself or someone else; 2) if you disclose abuse or neglect of a child, elderly, or disabled person; 3) if treatment records are requested by a subpoena; 4) in order to obtain payment for services rendered; 5) if evidence of treatment is requested by third party payers, i.e. insurance companies. Please note that this listing may not be exhaustive. If you have further questions, please see the privacy policy page or contact me for further information.

Q: Will my counselor think that I am crazy, a failure, or weak for seeking counseling?

A: No. I feel it requires a great deal of honesty and courage to discuss one’s personal struggles with a professional. In the same way that one is not a failure for seeking appropriate professional treatment for a medical problem, seeking professional treatment for a psychological or emotional problem is often the wisest course of action, not a weak one.

Q: When is counseling completed?

A: Some short-term approaches sometimes specify an endpoint at the outset (e.g. limited to 10 or 20 sessions) in order to focus the work on a specific problem within a time limit. Longer term, open-ended approaches end, ideally, when one’s treatment goals are achieved. In either case, one or more termination sessions are encouraged in order to review and bring closure to the process. However, it is important to recognize that counseling is a voluntary activity and may be ceased at any point and for any reason.

If you have any further questions please call 919-537-8791 or email for a no cost initial consultation.

“Everything has been figured out, except how to live” — Jean Paul Sartre