Clinical Psychology

Dr. Simon’s professional activities include a range of Clinical Psychological services with children, adolescents and adults as well as couples and families. 

What Is A Clinical Psychologist?


There are various types of psychologists, some of whom are involved in working with clients and some of whom are not.  A Clinical Psychologist is an individual trained in the application of psychological knowledge to the assessment, diagnosis and treatment of individuals with various types of psychological, emotional and interpersonal concerns. 


What Is Psychotherapy?

Psychotherapy is a set of techniques and a process that takes place between the psychotherapist and client (patient) that aims to increase the client’s feelings of emotional well-being, self-esteem, and self-concept and broadens their coping and problem solving skills within themselves and in their relationships.  Typically, psychotherapy is a verbal process that looks like a discussion or conversation although it differs in significant ways from everyday interpersonal conversations and discussions.  Because the focus is on the client’s needs and goals and because the therapist avoids injecting his/her own needs into the process, a unique and abiding sense of trust and rapport develops. This allows the client to become more open with themselves and to be able to talk about things and receive input that would be difficult in everyday dialogue with others.

The presence confidentiality and clear boundaries (for example, the client and psychotherapist maintain only the psychotherapeutic relationship – they are not social friends nor does psychotherapy EVER include sexual intimacy) helps to place a vital safety net around the therapeutic process, allowing it to grow, expand and deepen.


Isn’t Psychotherapy For “Mentally Ill” People?

Not at all!   This concept is rooted in the history of psychology and "bad reputations" are hard to get rid of.  Historically, psychotherapy developed out of the “medical model” which sees “symptoms” as signs of illness and dysfunction. Thus, people sought therapy because they were “ill” and needed help

Today, we understand that psychotherapy is a process that is extremely helpful in enhancing wellness and well being.  Sure, people with mental and psychological sstruggles and challenges receive and benefit from psychotherapy – for example, people with depression, anxiety, impulsivity and substance abuse issues.   However, modern psychotherapists are trained and well versed in a range of therapeutic approaches that both treat those with psychological problems and illness as well as enrich the psychological well being of individuals who are absent of significant “symptoms”. Enriching, enhancing and expanding wellness and well being is a more and more common role for the professional psychologist.  Even when it comes to "symptoms", current psychological thinking views such "symptoms" not as a sign of illness but, instead, the individual's efforts to cope, adapt and grow.


What Are Some of the Different “Schools” Of Psychotherapy?       

Psychotherapy has its roots in the “medical model” of psychoanalysis. This model is one that treats “illness” and that understands people as being motivated by forces that are both conscious and unconscious.  There is a lot of controversy about whether psychoanalysis itself is useful or truly provides meaningful solutions.  However, psychoanalytic thinking has proven to be extremely fruitful and productive and giving rise to other approaches to psychotherapy – other “schools of thought.”
           

Some of the popular and effective psychotherapeutic approaches include cognitive therapy, dynamic (insight oriented) therapy, behavior therapy, supportive therapy and humanistic therapy and systems oriented psychotherapy.  All of these approaches have in common the unique and special nature of the client-therapist relationship and the use of talking as a primary means of treatment.  There are, of course, differences.

Cognitive Psychotherapy understands emotional pain as being the result of dysfunctional and unproductive thinking.  The idea is that dysfunctional thinking gives rise to unpleasant and painful emotions.  If cognitive or thinking distortions are addressed, then it is understood that feelings change.  Psychodynamic Psychotherapy understands people in terms of their development, the way in which their individual histories shape who they are and how they experience the world and gives deference to both conscious and unconscious motives.

Psychodynamic therapy emphasizes introspection and the formation of insight.  It helps by assisting clients in resolving “psychological conflict” and dealing with unexpressed and disguised feelings.  Behavior therapy sees unproductive behaviors as the root of treatment and the focus of change.

Behavior Therapy works well for specific problems such as fears/phobias and, generally speaking, utilizes successive approximation, reinforcement and reward and techniques such as “flooding” and “desensitization.”  Humanistic Psychotherapy grew out of dissatisfaction with the then-prevailing schools of psychoanalysis and behavior therapy.  Humanistic approaches to psychotherapy emphasize that human beings have free will and make choices and that they are responsible for their choices.  Humanistic thinking recognizes that people are intentional and that they seek meaning, value and creativity.

Also the Humanistic approach emphasizes that human consciousness includes an awareness of oneself in the context of other people.  Systems Oriented Psychotherapy is often used when working with couples and families.  Systems approaches do not treat individuals per se but, instead, the family unit or the couple relationship as a whole.  Communication skills, empathy and an appreciation for the way in which the members of the family/couple (i.e. system) together create the problems that affect them are the fundamental focus of systems approaches. 


Does Each Therapist Use Only One Of These Approaches?

No.  Most therapists are versed in a range of approaches to psychotherapy and work to fit the approach to the issues at hand and the style/preferences/needs of the client. Some psychotherapists emphasize only one kind of work in their practice (for example, psychoanalysis) but most are flexible and competent in a range of interventions.


What Is Psychotherapy Vs. Counseling?

Many people use these terms interchangeably to refer to work done with a psychotherapist.  However, technically speaking, there are differences.  Counseling is considered an exchange of opinions and ideas to effectively problem solve an individual’s daily living issues associated with his or her emotional, cognitive, or behavioral problems.

Psychotherapy is an approach in which a therapist establishes a relationship with an individual for the purpose of modifying self-defeating patterns of behavior and promoting positive personality growth and development. Psychotherapy is generally undertaken to gain self-knowledge. Most people come to therapy because their coping skills and “psychological defenses” which have served them in the past are no longer working or useful.

Clinical Psychologists and Counseling Psychologists may also have different training.  Training for clinical psychologists includes the study of abnormal psychology, psychopathology, psychometrics and psychological testing.  The training of counseling psychologist emphasizes more immediate pragmatics and problem solving and de-emphasizes an understanding of psychopathology and psychological development.  Most clinical psychologists are also versed and experienced in counseling approaches.  However, most counseling psychologists are not trained in or experienced in the skills possessed by clinical psychologists.


What Makes Therapy Work?
           

There has been a lot of thinking and research on this subject and, believe it or not, there still is no clear consensus answer to this.  However, several things are clear.  There must be trust and positive rapport between the therapist and the client.  Without trust, very little can be accomplished in therapy.  Confidentiality is also of paramount importance.  While there are some legal limitations to confidentiality (such as when a patient threatens to harm themselves or others or in cases of suspected child abuse), a qualified and professional therapist keeps what is discussed in psychotherapy entirely confidential and private.

While certain techniques have been shown to be more or less effective for certain problems and concerns, research consistently shows that the nature of the client-therapist relationship has a greater influence on the outcome of the therapy than does the specific techniques or approaches used in therapy.  Thus, the healing and transmuting power of the therapeutic relationship is the cornerstone of good and successful psychotherapy.  A therapist must at all times assure that the client is safe in the relationship and that the client’s trust is well placed.

For this reason, therapists do not engage in “dual relationships” with clients. An example of a dual relationship would be if a therapist’s accountant was also a psychotherapy client.  Therapists must be careful not to exploit or take advantage of clients who, at times in therapy, may experience themselves as dependent on the therapist.  Respect for the client’s privacy, autonomy, independence and fundamental humanity is the bedrock of professional and successful psychotherapy.

Dr. Simon will be happy to answer any other questions you may have about psychotherapy and his clinical services.  Please email him at rsimon@dr-simon.com