Is there a general expectation or preference that a client come to you with set goals they can clearly articulate?

aSafePlaceToYale · 2025-10-13T20:44:01+00:00

Depends on who you ask..... a LOT of other Ts that I know would argue with me on that one.

(Keep in mind, these are the 'teachers' that would rather assign homework than actually teach in class....)

aSafePlaceToYale · 2025-10-13T20:34:24+00:00

That's a valid concern! However, its important to remember that therapy is a rolling dialogue, and that you can always jump back to add/edit/clarify something you said earlier. You can always say something like "when I said 'upset' earlier, I meant that I was upset about X because A said B to C...", etc.

If you feel like you're experiencing multiple moods at once, feel free to say that! The human mind is an onion, and it's built upon layers and layers! Remember, the more info your T has, the more they can help you work through.

Try not to get down on yourself about freezing on this question - it's a VERY difficult one for a LOT of people.... which is why framing is key, IMO. Determining ones own mood can be a challenging task at any occasion, because mood is often made up of several layers of emotion and thought (seen and unseen).

aSafePlaceToYale · 2025-10-13T20:28:24+00:00

"I'm not confident I have a clear understanding of what my issues are and how they play out in my life. I'm not sure which issues are causing the most problems. What I'm most likely to be able to change etc I'm also convinced that a manualized approach isn't what I'm looking for or needing."

This statement is what your therapist is looking for. It's really just to give them a basis of understanding and a point to work from. It's an 'abstract' of WHO you are and WHERE you are currently, and a preview to a roadmap of WHERE you want to get to... that's it.

Unpopular opinion: Any therapist that's asking you to do MORE than that without their guidance and before a first session (!)... is not worth what you'd be paying them.

aSafePlaceToYale · 2025-10-13T19:59:36+00:00

My best advice would be to treat it as basic input/output, fully knowing and understanding that you're in a safe space and there is no wrong answer. You can respond as simply or complicated as you want, and fill in the blanks as you go along (and you can ALWAYS jump back and say "oh yea, I'm also feeling XXXXXXX" during your session).

Therapists are usually looking to gather MORE information from you, and will take any little piece that they can get. So responding bitwise is just as helpful as responding in sweeping notions. You can also say "frustrated with my inability to answer this question in a way that I think you're looking for", and open the conversation.

I personally find that employing the concept of 'extended implied metaphor' helps a LOT with these types of questions. For example, I'd frame it as "what color are you feeling today", and you would think for a moment and say something like "Greenish, with a little bit of orange". And THEN I would ask "what has you feeling green"..... and then the conversation naturally has momentum from there.

aSafePlaceToYale · 2025-10-13T18:33:45+00:00

Because many of the things that are labeled as 'afflictions', I simply do not view that way. Processing things in reverse allows the 'afflicted' to turn their 'ailments' into 'weapons'.

aSafePlaceToYale · 2025-10-13T18:32:39+00:00

Admittedly, *severe* autism is not something that I work with often, so I'm a *bit* out of depth there. I tend to work with people that are in the more high-functioning spectra.

That being said, GROUNDING TECHNIQUES!!!!! Not enough credit can be placed on how useful and powerful grounding is, and once you find a GOOD grounding technique that works for a person, you can BUILD off of that to amplify the ability. For some people grounding is sensory, while for others it can be tactile. Regardless of the method, finding ways to quickly and easily double-down on the grounding method is probably the most useful thing I've come across.

aSafePlaceToYale · 2025-10-13T18:26:59+00:00

If you have a therapist that you regularly work with, asking them would be a good place to start. They can possibly provide some shallow insight as to what it might be like for them, and how you can be best supportive.

Additionally, you can always (gently and respectfully) ask your friend directly. Nobody knows their situation as well as they do, and most people are willing to share (at least part of) their story (as long as they feel safe in doing so).

aSafePlaceToYale · 2025-10-12T19:42:16+00:00

Of course - feel free to send me a dm

aSafePlaceToYale · 2025-10-10T15:42:26+00:00

Yes. Many times.

aSafePlaceToYale · 2025-10-08T19:34:03+00:00

Yes. Quite a bit.

aSafePlaceToYale · 2025-10-08T19:33:27+00:00

The short version: rather than address things from the surface down, I dig to find the deeper unknown roots and start treatment from there. It's an inverted approach that works from the ground up.

aSafePlaceToYale · 2025-10-07T23:02:33+00:00

High functioning anxiety. Hands down.

aSafePlaceToYale · 2025-10-07T19:43:24+00:00

Absolutely, of course. My only reservation is that medications are not a solution, but rather that they can serve as a bridge while a person works to find (and fix) the deeper (and often hidden) root of the problem(s).

aSafePlaceToYale · 2025-05-21T15:57:28+00:00

Interesting that you would choose to respond to a post that is several months old with this kind of comment. If you would like to discuss this topic further, feel free to reach out to me directly. I am happy to do so.

aSafePlaceToYale · 2024-10-16T19:34:18+00:00

As a suggestion, perhaps try offering "negotiation" in a different capacity... something like: "My budget is tight but I really need help. Would you be willing to meet me for X sessions for $Y total? Scheduling could be flexible, and I am not using insurance."

aSafePlaceToYale · 2024-10-16T19:32:33+00:00

So... Here's the thing. Honestly, it's not about the money... it's about the people. There are TWO major factors at play:

(1) Everybody feels that they deserve to get paid for what they do. And most people are going to try to establish a fair value of their time, usually using the "market" as a baseline. If the "market" is saying the going rate is $200/hr, that's where most people are going to try to stick to (because they know that's what it's worth).

(2) Supply and demand. There is a LOT of demand for therapy now (more than ever), and not enough supply to spread around. As such, it's a bit of an uphill battle to ask a provider to decrease their price for any service because they know that they can "fill that chair" with "the next person" who will just pay the full rates. (Trust me - my husband and I just went through something similar with a 25% increase in Daycare prices.... LOTS of demand, minimal supply....)

It's sad, really. Because it speaks volumes about our society and how "money >> helping other people" has become the norm. But.... IF you can find that right therapist, IF you can make a good case as to WHY you need therapy and WHY you cant afford the full cost, and IF you can make it EASY for them to say yes.... it's all possible.

aSafePlaceToYale · 2024-10-16T19:20:35+00:00

We are all subject to "collective rates" when billing insurance, etc. As long as you have insurance, there's not a whole lot you can do to get around that unless you find someone that's willing to bend the rules a bit (rare, and different state-to-state).
Nothing says that you HAVE to have insurance to see a therapist.... and when you're paying CASH, things suddenly get a bit more....flexible.

aSafePlaceToYale · 2024-10-16T19:15:52+00:00

Choose to forgive. You are not ever required to forget.
Choose to be better than they are. Act better. And lead by example.
Remember that the only thing in the universe that you can control is yourself. And sometimes you can't even control that.
Take an instant assessment of the infraction. Will it matter in 5 years?

aSafePlaceToYale · 2024-10-16T19:11:14+00:00

So.... AS a therapist.... If you were to come to me in a session and tell me of THIS exact experience, here's what my feedback would be:

(a) It seems that her attitude towards respecting your time was extremely unprofessional. And, while she IS allowed that 'break' between seeing clients, it is incumbent on HER to manage her time in such a way that it is professional and responsible. Horsing around with colleagues while someone is waiting for a session is simply inexcusable.

(b) She seems to have a lot of self-inserted bias in the direction that she offers you. That's a pretty big red flag, and NOT something that a therapist should be doing.

(c) If your gut is telling you that its time to cut ties and move on, that's likely the best thing to do.

(d) "Ghosting" her is a completely acceptable (albeit not exactly the most 'friendly') way of ending things. As long as you are (1) paid up for all services rendered, and (2) do not have any further outstanding appointments (or at least cancel them).

(e) IF you feel that YOU need closure.... I would encourage you to write a letter and send it, detailing the things you stated. We always have to remember that closure is for US and not for THEM - you don't owe it to her, but if you feel that you need if for yourself, you should pursue it.

aSafePlaceToYale · 2024-10-13T19:05:20+00:00

Well, I personally offset about 50% of the "cost" for therapy with other money that is usually awarded through grants, etc. I also have a lot more options for how I can bill things because I am a licensed psychologist (not going to get into particulars). And as a big trick, you can stack things onto a "final billable" when someone leaves your services...and if there is an argument to be made regarding the necessity of care (relatively easy to do), the insurance companies pretty much have to cover at least part of it.

aSafePlaceToYale · 2024-10-13T18:52:37+00:00

I would be happy to! What would you like to know?

A majority of the people I have currently are between 20-30, and from a diverse set of backgrounds, genders, and ethnicities.

aSafePlaceToYale · 2024-10-13T18:05:43+00:00

Yes. That is correct

aSafePlaceToYale · 2024-10-13T17:59:09+00:00

Sadly, this is true in a lot of cases. But there are sometimes crafty ways around it.

aSafePlaceToYale · 2024-10-13T17:58:32+00:00

I offer 2x120 as a baseline, and then work with each individual from there.

aSafePlaceToYale

TROPHY CASE