Frequently Asked Questions about Therapy
New clients, or those new to therapy, frequently have questions about what they can expect when they come in for therapy. This is a guide that asks and answers many of those questions. You are welcome to contact Dr. Goldner by phone 248-894-4935 or email if you have any questions that aren't answered here.
Q: How much does therapy cost?
A: The cost of therapy varies depending on whether or not you have health insurance with mental health care benefits. See the Fees, Insurance & Billing page for specific and detailed information. If you have insurance, then deductibles and other specifics of your plan may apply. If you have insurance, the insurance provider sets the fee and determines any co-pays owed by you. Always contact your insurance company to determine the specifics of your benefits prior to coming to your first session.
Q: When you go to Dr. Goldner, who knows about it?
A: Your therapy is a private matter and knowledge of your participation and attendance is kept in the strictest confidentiality. An effective therapeutic relationship requires that the client's confidentiality is kept. In the case of an adult (age 18+), no information concerning treatment may be shared by the therapist with any other individual unless the client authorizes it in writing by completing and signing a Release of Information Form or visit the Forms and Documents page. A client (or client's parent or legal guardian) uses this form to indicate what information can be shared, to whom, for what purpose, and for how long. It is common for clients to sign release authorization forms to allow the therapist to communicate with physicians, health care professionals, school personnel, mentors, spouses and others who may be beneficial to the therapeutic process.
There are exceptions to the rules of confidentiality:
Dr. Goldner is obligated by law to break confidentiality if he suspects an adult client has become a danger to him or herself or others, is planning to commit a crime or is the perpetrator of physical, sexual, or verbal/emotional abuse toward a minor child.
In the case of a child client (under age 18), Dr. Goldner will maintain the child's confidence and privacy. Dr. Goldner will not reveal to parents or others the specific details or information shared by a child client unless the child is an apparent, imminent threat to harm self or others, or is the victim or perpetrator of physical, sexual, or emotional abuse. Dr. Goldner is also required to report any incidence of child abuse, including neglect and physical violence or endangerment, at the hands of adults, including parents and other family members.
Dr. Goldner maintains the confidentiality of his minor clients, however, he can share basic information about the child's diagnoses, overall condition and general impressions about his or her progress and needs. Dr. Goldner includes parents in the therapeutic process as much as possible and is obligated to report any suspected child abuse to the proper authorities. Dr. Goldner maintains confidentiality for teenagers over the age of 13 with regard to their use of drugs and alcohol so long as the drug/alcohol use does not appear to present imminent life-threatening potential (for example, a child using a drug that could kill them on the first instance of usage, such as heroine; or a 16 year old operating a motor vehicle while under the influence of drugs/alcohol). Sexual behavior reported to Dr. Goldner is kept confidentiality except for situations that the Michigan legal code compels Dr. Goldner to act as a mandatory reporter to protect a minor child.
Q: How long does therapy take?
A: The number of therapy sessions depends upon many factors, including the severity of symptoms, the length of time the problem has occurred and client's readiness for change. Therapy is a process and as such the benefits develop over time. Achievement and success can be felt as early as the first session; however, the larger scale change and growth a client seeks may require numerous sessions. Typically, substantial gains can be seen within the first 1-5 sessions (e.g., learning to view problems differently, experiencing some improvement in self-esteem, feeling relief from suffering), although larger changes can take anywhere from 2-3 months to 12-16 months or more (e.g. changing the way one deals with life in order to reduce anxiety and depression or developing confidence and assertiveness and using these to improve relationships and social success). The good news is that when one has a good fit with his or her therapist, sessions are enjoyable, progress follows in a comfortable way, and goals are achieved at a satisfying pace. Each client's needs are different, and therefore the number of sessions needed to accomplish his or her goals varies. The harder a client works both in and between sessions, the more progress tends to be made in a shorter timeframe. The client always has the power to choose to continue or discontinue therapy at any time.
Q: How do I pick a good therapist?
A: Finding a good therapist is about more than finding a competent clinician. There also needs to be a good fit between the therapist and the client in terms of personality, attitude, and style. The therapist and client need to be compatible, but not identical. It is helpful to get a referral from a friend, colleague or physician. Sometimes, though, it is not possible to obtain a referral. In this case, you have to do a little bit of phone interviewing to find a good therapist. It is recommended that you ask a few essential questions before entering treatment:
What training and experience does the therapist have in treating problems like yours?
What is the therapist's approximate success rate treating the problems like yours?
How does the therapist typically work with his or her clients?
Keep in mind that some therapists prefer to sit back and let the client do most of the talking. If this suits you, great, but if you want more direct feedback and guidance, you are likely to prefer a therapist who will be interactive and talk things out with you. Do not be afraid to ask these questions of a potential therapist. They are valuable, important questions, and how the therapist responds to you asking them can tell you a lot about the therapist's personality and temperament. When it comes to therapy for children, it is important to make sure the clinician has experience working with children and has a warm, supportive, and respectful demeanor. One tip for a child nervous about coming to therapy: Sometimes it helps to tell the child he or she is only meeting the therapist and will not be forced to see the therapist. You can tell the child that he or she is interviewing the therapist and that afterward, you will ask if the child felt comfortable. If the child did not, promise you will try others before making a final choice. Sometimes a child's willingness to participate in therapy improves dramatically once he or she knows he or she has a say in the matter.
Q: What do you do in a therapy session?
A: The activity of a therapy session varies depending on each individual client. Dr. Goldner custom tailors his approach as much as possible to fit the client's needs, preferences and goals. It is common to do a lot of information gathering and goal choosing in the first session. Later sessions frequently involve talking, storytelling, problem-solving, conflict resolution skill development, and dream analysis. Dr. Goldner tends to begin sessions by asking how the client feels at the moment, what events transpired since the previous session and what thoughts, ideas, problems and objectives the client wishes to focus on today. The specific content of each session evolves from there.
Q: Do I have to lie down on a couch?
A: No. Dr. Goldner's office has several chairs and a small sofa. Clients are encouraged to sit in whichever seat or position that is most comfortable. Clients may sit or recline as they choose. The best therapy happens in an office environment that feels safe, comfortable and respectful.
Q: What kinds of people go to a therapist?
A: All kinds of people come to therapists: Mothers, fathers, children, adults, clergy members, policemen and women, grandparents, teenagers and more. What most people do not know is just how universal mental health and emotional concerns are. For example, people with anxiety disorders often believe that nobody else they know has anxiety disorders. The reality is that treatment for anxiety is the 3rd most common reason people seek help from medical doctors. The only two more common reasons are a treatment for the common cold and to obtain a general, physical check-up. It is a normal experience to have difficulty managing life's tasks and challenges. Therapists are people who specialize in helping others talk through life's challenges and find new ways to use existing strengths to cope with suffering and overcome obstacles.
Q: How do I know when I have successfully finished my therapy?
A: Successful completion of therapy is different for every person because each person has unique goals, strengths, limitations, resources, skills and life experiences. Typically, we would consider a person's therapy to have been successfully finished if treatment goals have been met and the person is satisfied with the changes and improvements he or she has made. Generally, a client will have a sense of growing satisfaction and completion that culminates in a decision to discontinue therapy. A client may always choose to leave therapy at any time. Sometimes taking a break from therapy promotes further growth, and Dr. Goldner welcomes back past clients who decide they would like to resume treatment. It is usually preferable for the client and therapist to consult prior to terminating therapy. Having a final discussion allows for post-therapy planning, recognition of successes and gives a sense of closure.
Q: What do I do if I don't feel my therapist and I are a good fit?
A: The client has the final word on whether he or she wishes to continue working with a therapist. Productive therapy is usually the result of a strong, positive and respectful working relationship between therapist and client. Keep in mind that a poor fit should be discussed with the therapist directly before discontinuing therapy. This is because it can provide helpful closure to both parties when terminating a working relationship. Sometimes, a client's wish to leave therapy can signal the presence of an important therapeutic issue that would benefit from being worked through. It is understandable to try and avoid tackling difficult problems, but there are substantial benefits to facing and overcoming them with your therapist's help. If a client decides to terminate therapy with Dr. Goldner for any reason, Dr. Goldner will provide the client with several referrals to other therapists.
Q: What do I do if I have questions or concerns about billing?
A: Contact Premier Billing Specialists, Dr. Goldner's Billing service, at 586-751-6034. They can answer any questions about bills, go over statements, fees, and payments to confirm accuracy and even take credit card payments over the phone.
Call 248-894-4935 to speak with Dr. Goldner or leave a message and he will call you back. From time to time, clients may have concerns about billing, insurance co-payments or other matters. Dr. Goldner is committed to resolving such matters to his client's satisfaction whenever possible. Dr. Goldner can also be contacted at DrG@aarongoldner.com.
Q: Who do I contact if I have questions about my insurance?
A: It is usually most efficient and effective to contact your insurance company to inquire about insurance related issues, such as deductibles, co-payments, and a number of authorized sessions. If you do not know the contact number for your insurance, look on the front and back of your insurance card. There is almost always a customer service number on your insurance card to facilitate customer satisfaction. You can contact Dr. Goldner's biller to ask specific questions about your balance related to insurance and fees. Please keep in mind that some insurance information can only be obtained by the insured client. Contact information for Dr. Goldner's Biller can be found on the Fees, Insurance & Billing page, and the Contact page.
Q: What kinds of records does Dr. Goldner keep and how is my privacy protected?
A: Written records are kept in compliance with state law and professional mandate. Records include basic contact information (i.e., name, address, phone numbers, emergency contact information), clerical information related to billing and insurance (i.e., social security number, insurance policy numbers), progress notes and treatment records, and signed forms necessary to authorize treatment or release of information. Dr. Goldner guards such information carefully with professional and business level physical (locked doors, locked cabinets) and encryption technology (password protected, access encrypted files that only Dr. Goldner and his staff have access to). He provides clients with a copy of his HIPAA compliant Notice of Privacy Practices at the time of the first session (Intake Session). A copy of the notice can be obtained from the Forms and Documents section of this website.
Q: Who has access to my records?
A: For private pay clients, only Dr. Goldner and his clerical and billing staff have access to your records unless you sign a release of information. Clients using insurance should know that insurance companies frequently have full access to your records and may review them at any time. Finally, your records can be subpoenaed and/or ordered released by a judge for the purpose of legal proceedings. More information on this topic can be found in the Notice of Privacy Practices document (available in the Forms and Downloads area of this website).
Q: How do the rules of confidentiality work? And under what circumstances do they not apply?
A: The term Confidentiality refers to the client's right to privacy and the keeping of privileged information a client shares with his or her therapist. All information is considered confidential, as is the client's participation in therapy, both past, and present. Dr. Goldner may not reveal or repeat any information shared during treatment, reveal the client's involvement in treatment or reveal events that occur during treatment unless special circumstances exist. Special circumstances can include:
A client choosing to release information for the purpose of facilitating or coordinating treatment between helping professionals. For example, the client may indicate in writing that Dr. Goldner may consult with school personnel or a psychiatrist.
A court order in support of a subpoena can compel Dr. Goldner to release records or, possibly, testify. This can be considered a rare occurrence.
At the client's request in the case of a lawsuit or other legal matter.
Dr. Goldner becomes aware that a client may present a danger to himself or others. In the case of danger to self or others, Dr. Goldner is obligated by ethical and legal code to break confidentiality in order to ensure the client's safety through proper care. Such care can include admittance to a hospital emergency room or other qualified, emergency mental health care facility.
Dr. Goldner is obligated by law and by professional codes of conduct to report suspected physical, sexual, or emotional abuse toward any individual under the age of 18.
Q: What are the risks associated with psychotherapy?
A: Therapy is widely accepted to be a safe and effective treatment under most common circumstances. The main risk associated with psychotherapy is that discussing troubling symptoms and past events can temporarily increase feelings of discomfort such as anger, shame, and fear. However, such increases can, in fact, pave the way to processing and resolving past hurts and enhance mood, self-esteem, and other important personal aspects. Increased personal insight, growth, positive change, accomplishing one's dreams, goals, and aspirations can all flow from successful therapy.
Q: What should a client do if he or she might be a danger to self or others? What should a client do in the case of a life-threatening emergency?
A: If a client believes that he or she is an immediate danger to self or others, or a life-threatening emergency occurs, the individual should Dial 911 on any telephone, or arrange for immediate transport to the nearest hospital emergency room.
**Do Not attempt to contact Dr. Goldner first in the event of a life-threatening emergency. Dial 911 or go to the nearest emergency room first, then arrange for someone to contact Dr. Goldner since Dr. Goldner cannot provide emergency services.