James S Matter MFT
call 415 541 5080 info@jamesmattermft.com
Q: Where is your office located?
Q: What if my problem is not covered by my insurance?
Q: How long will I be in therapy?
Q: What's the definition of a good therapist?
Q: How do I know if I have a problem with alcohol (or drugs)?
Q: Do I have to stop drinking? Can I stop for awhile and return to normal drinking?
Q: I just got out of a program. What do I do now?
Q: My family say that I have a problem, but I don't think I do. Who is right?
Q: Where is your office located?
A: 30 Monterey Blvd. San Francisco 94131
A: I do not currently accept insurance; I will be happy to provide documentation you may need to bill your insurance. Please check first about using an out of network provider. t
Q: What if my problem is not covered by my insurance?
A: This is something you need to check with your insurance and is one of the lest welcome surprises-- there are many problems that people might want help with that are not covered by insurance. Even when a particular therapist is acceptable, the particular problem may not be. Only certain behavioral health issues are covered, and typically only a certain amount of help.
Q: How long will I be in therapy?
A: I believe that therapy should be as short as possible. Some extraordinarily severe problems may require long term therapy, but many conditions can be successfully treated in a period ranging, with weekly sessions, from weeks to months. My typical practice is to wind down therapy by going to biweekly, then monthly sessions before terminating, so if gains are holding, we have a chance to double check. Just as with any health care provider, you may have a problem that requires treatment, and then end treatment when the problem is resolved. And if you get another problem, you can come back. I remember one of my early clinical mentors, a psychiatrist who I respected very much, pointing out that “just because you have once problem doesn't mean you don't have another one.” This can complicate t hings for some people, but it also means that your problems don't have to all happen at the same time!
Q: What's the definition of a good therapist?
A: Here a some web sites that give ideas of what to look for in a good therapist: http://psychology.wikia.com/wiki/What_makes_a_good_clinical_psychologist http://www.goodtherapy.org/what-is-good-therapy.html http://www.psychologytoday.com/blog/in-therapy/201105/dichotomastery-the-hidden-talent-good-therapists http://online.wsj.com/article/SB10001424052970204346104576636923254728228.html Ultimately, no matter how good the therapist is, it comes down to chemistry. In her therapy manual, Seeking Safety, Dr. Najavits cites research that indicates that you'll know if it's a good fit by the third time you see a therapist. Whether it's me or any other therapist, don't hesitate to call for a phone conversation or schedule a face to face visit. If you try someone and the chemistry just isn't there, don't continue. Any good therapist will understand.
Q: I know everything that goes on in therapy is supposed to be confidential, but how confidential is it, really?
A: California and Federal laws strictly define confidentiality and its limits. If a client tells a therapist that they're about to commit a violent crime, the therapist is required to notify the intended victim and the police. If a client tells a therapist about suspected child abuse, the therapist is required to notify Child Protective Services (or the appropriate authority if there's no CPS).
To bill insurance, the therapist is required to notify the insurer of the diagnosis and may be required to disclose other information in order to justify extending therapy longer than the insurer wants to pay for. The requirement to disclose to an insurer is one reason people may pay for their own therapy, even if their insurance would cover it. So there are some limits. Those special circumstances aside, information disclosed to a therapist is protected from discovery in a civil suit, and under a wide range of other circumstances-- including crimes that may have been committed in the past. In practice, therapist disclosures even for the mandated reasons are quite rare. Disclosure to friends and family members can only be made with the client's written permission.
Q: How do I know if I have a problem with alcohol (or drugs)?
A: There are many screening tools such as the MAST, CAGE, or the 20 questions.(provide links) which can provide an opinion, but they don't tell you much about the nature of the problem or how to deal with it. That's where a conversation with a professional comes in.
Q: Do I have to stop drinking? Can I stop for awhile and return to normal drinking?
A: Some people do stop drinking and stay stopped. There are an estimated one million people following that path through participation in Alcoholics Anonymous. Other people who have been engaged in problem drinking can return to moderate drinking.
Q: Should I go to a 30 day program? I can't really afford to spend that much time out of my life away from my responsibilities.
A: I have met people who thought that all alcohol and drug treatment involved going to “rehab.” This is not true. Even if you want to do a structured treatment program, there are low intensity outpatient programs, high intensity programs, and also residential programs that last longer than 30 days.
Q: I just got out of a program. What do I do now?
A: Your program gave you a set of recommendations on what to do to maintain abstinence after completion, of course. You probably received referrals to an aftercare program or be participating in your program's aftercare if you live close enough. The adjustment to being back in your old environment can be difficult though, and you may need extra support. Patterns that probably took years to develop aren't erased in 30 days. It may help to have a counselor to check in with to keep yourself on track during the transitional period.
Q: I'm having withdrawal symptoms from my prescription pain medication when I try to cut down or stop. Do I need addiction treatment?
A: Developing tolerance, and feeling withdrawal symptoms when you cut down or stop prescription medications, do not mean you are addicted. People who are prescribed medication for pain and use it as directed typically do not become addicted. Addiction includes additional changes in behavior beside tolerance and withdrawal. Please communicate your concerns fully with your prescriber. You may also feel free to contact me to discuss this further, of course.
Q: My family say that I have a problem, but I don't think I do. Who is right?
A: You may have a problem with alcohol and drugs, or you may have a family problem-- or both. It's not for nothing that alcoholism has been called “the family disease.” This means that patterns of disrupted family life can persist from generation to generation-- including an inherited vulnerability to developing problem drinking-- and it can mean that one person's drinking can disrupt the relationships in the family in the present time. Not only that, a spouse who grew up in an alcoholic family may feel deeply threatened by another family member's use of alcohol or recreational drugs, even if the use doesn't amount to a problem by itself. If someone comes from a culture where drinking is strongly discouraged, any use may seem like a problem. Other cultures are very tolerant of alcohol. There are many reasons that a family might be in conflict about this issue, and not all of them are due to alcoholism in and of itself. Each case is different. That's why a neutral observer can sometimes help sort out conflicts.
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