- How long will therapy last?
- How long are the therapy sessions themselves?
- What are your hours? Can I have my appointments in the evening or the weekend?
- What is an intake evaluation?
- How is a therapist chosen for me?
- Are there homework assignments?
- Does cognitive therapy involve medications?
- Do you provide couples counseling or family therapy?
- Do you offer group therapy?
- Do you provide therapy for children and adolescents?
- What if I want to get therapeutic help for someone else?
- Can I receive cognitive therapy even while I am receiving additional treatment elsewhere?
- Does insurance cover my treatment?
- What if I have a legal problem at the time I am seeking therapy?
- Can you help me with my psychiatric disability claims?
The length of therapy is quite variable, and the final decision regarding the length of therapy rests jointly with the patient and therapist. Some patients stay for two or three sessions, while others are in therapy for two or three years or more.
Regardless of the length of treatment, we strongly recommend that the final session be planned, so that the therapist and patient can summarize the work that has been done in therapy and say "good-bye." This resolution is associated with better long-term outcome for the patient than an abrupt termination.
Patients may choose to have "booster sessions" after regular therapy sessions have ended. For example, a patient may have had 16 weekly sessions and decide that is sufficient. The patient can call for a follow-up session several months or a year after weekly sessions have ended. These booster sessions serve as a sort of “tune-up” to help patients stay on track and continue to use the skills they have learned in therapy, thus maximizing their long-term benefit from therapy.
Typically, patients meet with therapists for 45 to 50 minutes. Patients also spend 5-10 minutes filling out short questionnaires that help the therapist know how they are feeling and to get feedback on how well the sessions are progressing. The patient spends about an hour on the session and the paperwork.
Most patients attend one session per week. Depending on the schedules of the patient and therapist, sessions can be held on the same day and time each week, or the session times may vary.
If a patient's problems warrant more frequent sessions, it is possible to meet with the therapist twice per week (though this is not the norm and is dependent on the scheduling availability of the therapist, as well as the evaluation and approval of the director). Conversely, if a patient feels that it is time to taper off the sessions, he or she may choose to schedule sessions every other week.
Additionally, some patients choose to meet less frequently for financial reasons. The Center for Cognitive Therapy allows for this arrangement so patients can receive treatment without undue financial stress.
A: The initial intake evaluations are dedicated time slots in the morning and early afternoon on weekdays. Thus, your first appointment generally requires that you take off a morning or an afternoon from work or school. After that, most ongoing therapy sessions occur between the hours of 8:00 am and 5:00 pm, though on some occasions it is possible to have an appointment after 5:00 pm, depending on your particular therapist’s availability. Unfortunately, we do not have weekend hours.
What is an intake evaluation? How does this differ from the therapy sessions that I will be receiving afterward?
The goal of the intake evaluation is to collect information to provide to the therapist in an efficient way. The interview is conducted by a clinician-in-training, who is supervised by a licensed clinician. Patients should expect to spend between two to three hours in the interview, with at least one break.
The benefits of this initial meeting include:
- The report that is written after the intake gives the therapist a great deal of clinical information, so therapy can get off to a running start with a preliminary diagnosis.
- Decisions can be made for patients individually. For example, does this patient require specialized attention for such problems as suicidality or substance abuse?
- The patient can ask a senior clinician any questions he or she might have, and can determine if the Center for Cognitive Therapy is a good fit for him or her.
- The Center for Cognitive Therapy can determine whether alternative or additional forms of care are required and whether referrals elsewhere are warranted.
The director, Cory F. Newman, PhD, in conjunction with the senior clinician who meets with the patient during the intake evaluation, decides which Center for Cognitive Therapy therapist will treat which patient. This decision is based partly on patient request (to see a female therapist, for example, or a therapist who specializes in a certain area). The decision is also based on the best match of the expertise of the therapist with the needs of the patient, and on practical concerns, such as scheduling issues. The therapists at the Center for Cognitive Therapy are well trained across a number of areas, and thus are able to see a wide range of patients.
Each therapist focuses on establishing a sense of mutual acceptance, respect, and teamwork with their patients. Our therapists are willing to work on any issues that may cause discomfort in the therapeutic relationship. If, as happens occasionally, a patient decides that he or she would prefer to work with a different therapist, Dr. Newman is available to discuss this matter, though it is our policy to require the patient and therapist to have at least one session to try to resolve the difficulty before transfers are made.
The most important, positive changes that you will make in your life will occur in your everyday experiences outside of your therapist's office. To help you make these "real life" changes, your therapist will help you design homework assignments. These assignments will show you how to apply the ideas and skills you've learned in therapy between sessions. This process will enable you to become your own therapist once your work with your cognitive therapist is complete.
There are many types of homework assignments. Some include learning how to observe and measure your own thoughts, feelings, and actions so you can improve your awareness of your strengths and weaknesses. Other assignments ask you to change your ways of thinking about certain matters so that you feel more hopeful and productive. Some projects involve reading, to add to your knowledge about your difficulties and how to improve your life, while others might involve listening to an audiotape of your session or rereading your notes to review what has been discussed.
Many of our patients especially appreciate the assignments called behavioral experiments. Patients try a new approach to an old problem and document the results, often learning that doing things that may be new, challenging, or even scary can result in dramatic changes in their lives.
Homework is not required, but it will help your progress in therapy if you give it a try. You will never be criticized for not doing the homework, or for having difficulty with it. It is your therapist's responsibility to create an environment in which you will feel free to explore and learn and in which you will not have to worry about being judged.
Research on cognitive therapy homework has demonstrated that the patients who take part the most in designing and doing between-session assignments tend to make quicker and more long-lasting progress than those patients who, for whatever reason, choose not to involve themselves with the homework.
Does cognitive therapy involve medications? Am I allowed to take medications if I'm in cognitive therapy? What if I need medications- can you arrange this for me? What if I prefer not to take medications at all?
Many patients at the Center for Cognitive Therapy are on medications, such as antidepressants, mood stabilizers, etc. In fact, some research suggests that a combination of cognitive therapy and the proper medications can be very useful. If you wish to start medications along with cognitive therapy, we can help arrange a medical evaluation at the Outpatient Clinic of the Department of Psychiatry.
In most cases, if you do not wish to take medications, you will receive cognitive therapy alone. If you and your therapist believe it is warranted, you can discuss the relative merits and drawbacks of adding medication to the treatment plan. In some cases, we may require that a patient be well maintained on medication before we begin therapy.
We do not currently offer couples counseling or family therapy. In some cases, individual patients may choose to invite a partner or family member to attend one to three sessions of their individual treatment, to provide information to benefit the individual patient’s care.
Although most of our patients are over the age of 18, the Center occasionally treats older adolescents on a case-by-case basis. All parties agree on what information will be shared with the parent(s) and what information will be confidential. Most often, however, we will make a referral to a therapist who specializes in treating children or adolescents.
Sometimes people call us to seek treatment for a friend or relative. If you are calling to try to arrange a course of therapy for someone over the age of 18, we will be happy to listen to your concerns, but you will not be able to make an appointment for anyone other than yourself. The patient himself or herself must call to be scheduled for an appointment. Once the appointment is scheduled, we cannot share any further information with you, due to confidentiality concerns, unless the patient gives written permission.
If you are concerned or frustrated because you wish to arrange an appointment for a person who does not wish to come in for treatment, we sympathize with your predicament, but your options are limited. First, you may choose to arrange a one-time "consultative appointment" for yourself. This is a 50-minute session with a therapist who will attempt to answer your questions about how you might deal more effectively with the individual. Second, you may choose to begin therapy yourself, especially if your life has been adversely affected by the other person, and you are looking for ways to change your situation. Third, you may try to gain the individual's cooperation in entering therapy by offering to go into therapy together.
In most instances, we do not recommend being involved in two or more ongoing courses of individual therapy. Unless the various therapists share the same orientation to therapy, there is the risk that the patient will receive conflicting advice, which may impede the patient's progress. The old saying that "too many cooks can spoil the broth" is applicable here. It is important that the patient receive consistent feedback and direction in order to get the most out of therapy. In addition, having more than one therapist can work against the ultimate goal of having the patient learn to depend on himself or herself. Cognitive therapy works well, in part, because we teach people the skills that they need to have faith in themselves. Having multiple therapists may slow down the process of achieving this sense of heightened self-sufficiency.
In some cases, patients have additional providers who fill different roles than that of a therapist. If you need medications, for example, you will see a psychiatrist who will prescribe and monitor whatever psychiatric medications you need to take. In this scenario, it is important for you to give your psychologist and psychiatrist permission to speak with each other, so they can best coordinate your care.
It may also be useful for you to be in a different modality of therapy at the same time as you are receiving cognitive therapy. In other words, if you are in individual therapy at the Center for Cognitive Therapy, you may benefit from being in group therapy, couples therapy, or support groups (such as Al-Anon) simultaneously.
In rare instances, patients see another individual therapist while in individual treatment at the Center. This necessitates discussing the issues and ground rules in advance.
The Center for Cognitive Therapy is out of network with most insurance carriers. With the exception of HUP employees and some Penn employees and Penn students, obtaining reimbursement from insurance companies is the responsibility of the patient. Payment in full is expected at time of service. You will be given a receipt which has all the information usually required by insurance companies to be reimbursed. If you have questions about seeking reimbursement, please speak to our Administrative Assistant, Tina Inforzato (reachable at 215-898-4118 until the end of December, 2012 – more information to follow after that time), who is always pleasant, understanding, knowledgeable, and helpful in trying to help patients clear up insurance and reimbursement ambiguities. However, since there are so many variables, it is wise to call your insurance company with specific questions about your coverage.
For HUP employees and their families who are covered under any HUP insurance plan, there is a $10 co-pay per visit for services at CCT. For Penn employees and their families who are covered under Penn's Penn Care plan, there is a $20 co-pay per visit for services at CCT. For Penn employees and their families who are covered under Penn’s Aetna POS plan, there is a $30 co-pay per visit for services at CCT. Authorization/referrals are not required and there are no visit limits for any of these plans. For Penn students who are covered under the Penn student plan (Aetna/Chickering), there is a $30 co-pay per visit. No referral is required and there is a 50 visits limit per plan year (08/15- 08/14).
As of January 1, 2008, the Center for Cognitive Therapy is no longer a participating provider under Medicare. If you are a Medicare patient we can provide you with a referral. The Center for Cognitive Therapy also cannot see CBH patients. We refer CBH patients to other practitioners.
Generally speaking, we recommend that you seek the services of a forensic psychologist or psychiatrist if you are involved in a legal matter that may require the involvement of your therapist or clinical records. We will be happy to schedule you for an evaluation here at the Center for Cognitive Therapy once your legal matter is resolved. We can also give you a referral to a forensic psychiatrist affiliated with Penn.
We do not do evaluations for disability, and our approach is to enable patients to improve their functioning so that they are able to go to (or return to) school or work.
Call (215) 898-4100 (option 2); or (215) 898-4506.