Frequently Asked Questions about Therapy

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. 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.

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 (available on the Forms & 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 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. He 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 or 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 use, such as heroin, or a 16-year-old operating a motor vehicle while under the influence). Sexual behavior reported to Dr. Goldner is kept confidential except for situations in which the Michigan legal code compels him to act as a mandatory reporter to protect a minor child.

The number of therapy sessions depends upon many factors, including the severity of symptoms, the length of time the problem has occurred, and the client’s readiness for change. Therapy is a process, and 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 (for example, 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 (for example, 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, so the number of sessions needed 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.

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, a referral is not possible. In that case, you have to do a little phone interviewing. 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 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 that suits you, great; but if you want more direct feedback and guidance, you are likely to prefer a therapist who is interactive and talks things out with you. Do not be afraid to ask these questions — they are valuable, and how a therapist responds can tell you a lot about their personality and temperament. When it comes to therapy for children, 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 them — that the child is interviewing the therapist, and afterward you will ask whether the child felt comfortable. If not, promise you will try others before making a final choice. A child’s willingness often improves dramatically once he or she knows they have a say.

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 have transpired since the previous session, and what thoughts, ideas, problems, and objectives the client wishes to focus on that day. The specific content of each session evolves from there.

No. Dr. Goldner’s office has several chairs and a small sofa. Clients are encouraged to sit in whichever seat or position is most comfortable, and may sit or recline as they choose. The best therapy happens in an office environment that feels safe, comfortable, and respectful.

All kinds of people come to therapists: mothers, fathers, children, adults, clergy members, police officers, 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 one. The reality is that treatment for anxiety is the third most common reason people seek help from medical doctors — the only two more common reasons are treatment for the common cold and a general physical check-up. It is a normal experience to have difficulty managing life’s tasks and challenges. Therapists specialize in helping others talk through those challenges and find new ways to use existing strengths to cope with suffering and overcome obstacles.

Successful completion of therapy is different for every person, because each person has unique goals, strengths, limitations, resources, skills, and life experiences. Typically, therapy is considered successfully finished when treatment goals have been met and the person is satisfied with the changes and improvements they have made. Generally, a client will have a growing sense of satisfaction and completion that culminates in a decision to discontinue. A client may always choose to leave therapy at any time. Sometimes taking a break promotes further growth, and Dr. Goldner welcomes back past clients who decide to resume treatment. It is usually preferable for client and therapist to consult prior to terminating, so there can be post-therapy planning, recognition of successes, and a sense of closure.

The client has the final word on whether to continue working with a therapist. Productive therapy is usually the result of a strong, positive, and respectful working relationship. Keep in mind that a poor fit should be discussed with the therapist directly before discontinuing — it can provide helpful closure to both parties, and sometimes a client’s wish to leave can signal the presence of an important therapeutic issue that would benefit from being worked through. It is understandable to try to avoid 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, he will provide several referrals to other therapists.

Contact Premier Billing Specialist, 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.

You may also 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, and Dr. Goldner is committed to resolving them to his clients’ satisfaction whenever possible. He can also be reached at DrG@AaronGoldner.com.

It is usually most efficient to contact your insurance company to inquire about insurance-related issues such as deductibles, co-payments, and the 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. You can also 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 the biller is on the Fees, Insurance & Billing page and the Contact page.

Written records are kept in compliance with state law and professional mandate. Records include basic contact information (name, address, phone numbers, emergency contact information), clerical information related to billing and insurance, progress notes and treatment records, and signed forms necessary to authorize treatment or release of information. Dr. Goldner guards this information carefully with physical safeguards (locked doors, locked cabinets) and encryption technology (password-protected, access-encrypted files that only Dr. Goldner and his staff can reach). He provides clients with a copy of his HIPAA-compliant Notice of Privacy Practices at the time of the first (intake) session. A copy can be obtained from the Forms & Documents page.

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 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 is in the Notice of Privacy Practices, available on the Forms & Documents page.

The term confidentiality refers to the client’s right to privacy and the keeping of privileged information shared with a 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 to facilitate or coordinate treatment between helping professionals — for example, indicating in writing that Dr. Goldner may consult with school personnel or a psychiatrist.
• A court order in support of a subpoena that can compel Dr. Goldner to release records or, possibly, testify. This is a rare occurrence.
• The client’s request, in the case of a lawsuit or other legal matter.
• Dr. Goldner becoming aware that a client may present a danger to self or others. In that case he is obligated by ethical and legal code to break confidentiality to ensure the client’s safety through proper care, which can include admittance to a hospital emergency room or other qualified emergency mental-health facility.
• The legal and professional obligation to report suspected physical, sexual, or emotional abuse toward any individual under the age of 18.

For further information, please consult the Notice of Privacy Practices, available on the Forms & Documents page.

Therapy is widely accepted to be a safe and effective treatment under most common circumstances. The main risk 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 can enhance mood, self-esteem, and other important personal aspects. Increased personal insight, growth, positive change, and the accomplishment of one’s dreams, goals, and aspirations can all flow from successful therapy.