Frequently Asked Questions
How does individual counseling work?
You and the psychologist or psychiatrist will decide upon a meeting schedule that feels right for you. Some physicians like to meet every week, others every other week, and some once per month. This may depend on how much support you would like and how flexible your schedule is. Counseling sessions can last between 30 and 60 minutes, depending on your availability and needs. The psychologist or psychiatrist can help you identify goals that you would like to work on. Usually the first couple of sessions are spent getting to know you and exploring your presenting concern(s). After that, the style of counseling can be flexible, depending on your preference. Some physicians like highly structured, directive sessions (for example, where the psychologist facilitates specific activities or interventions), and others like more supportive, unstructured conversations. For more information, see this page by the American Psychological Association.
Will the psychologist "get in my head" and analyze me?
This is a common concern, especially given how the popular media has historically portrayed the field of psychology and the practice of therapy. You are not going to lie on a couch and talk about your mother (unless, of course, you feel that it is important for you to do!). The practice of psychology is similar to the practice of medicine in that the psychologist will ask you questions and engage you in conversation. They may make observations. But all of the "data" comes directly from what you as the client choose to supply. A psychologist is not a mind-reader. Some people equate therapy to talking to a coach or a mentor: someone who genuinely cares about your well-being and may be able to offer you an outside perspective and some wisdom, while still respecting your autonomy.
Isn't counseling for people with mental illness? Can going to a psychologist be seen a sign of weakness?
Everyone can benefit from wellness coaching, even those who are already well-adjusted. Some practitioners enjoy having a confidential, non-judgmental, and supportive place to let down their guard and be a human rather than a hero. Others utilize the psychologist's expertise in human behavior and relationships to improve their clinical practice, communication skills, and patient satisfaction. Counseling psychology is a field that, by design, focuses on human strengths, not weaknesses.
Rest assured that if you choose to use services provided by APWI, you are not alone. At one well-established resident and physician wellness program, 2019 data shows that 38% of eligible residents and physicians chose to take advantage of the services.
Does research actually support the efficacy of counseling?
The very simplified answer to this question is yes. A meta-analysis of the outcome of psychotherapy was conducted by Smith, Glass, & Miller (1980). They analyzed the results of 375 therapy outcome studies. The results produced an effect size of .68, which suggests that an average client receiving therapy would be better off (i.e., improved) than 75% of untreated (control group) clients.
The more complicated answer is that because therapy is an interpersonal relationship, the outcome of any specific therapy is going to be influenced by both clinician factors and client factors. After client factors (e.g., motivation for treatment, active participation, hope for change, etc.), the most significant predictor of therapy outcomes is the relationship between the therapist and the client. Specific treatment modalities and theoretical orientations tend to account for the least of the effect, but there are some treatment approaches that are individually empirically validated.
For more information, see this page by the American Psychological Association.
What kinds of things can counseling help me with?
Almost anything. Common presenting concerns for individual counseling and for physicians may include but are not limited to:
• Adjustment difficulty
• Anger management
• Assertiveness training
• Bereavement / Grief
• Boundary setting
• Career decision-making
• Communication skills enhancement
• Compassion fatigue
• Coping with COVID-19
• Cultural stress
• Eating concerns (emotional eating, binge eating, restrictive habits)
• Emotional wellness
• Family conflict
• Financial strain
• Gender issues
• Health concerns
• Impulse control
• Intimate partner violence
• Managing difficult patients
• Medically unexplained illness
• Mindfulness coaching
• Mood swings
• Obsessive thoughts or tendencies
• Panic attacks
• Patient satisfaction
• Performance enhancement
• Post-partum depression
• Racism or prejudices
• Relationship conflict
• Relaxation techniques
• Religious or spiritual concerns
• Self-esteem and self-efficacy
• Sexual identity concerns
• Sex problems
• Substance use
• Suicidal ideation or thoughts of death
• Smoking cessation
• Time management
• Trauma / Abuse
• Weight loss
• Work-life balance
• Workplace stress
Are there any concerns or conditions that APWI cannot help me with?
There may be times when we determine that you need specialized care that we are unable to offer. Some examples might include: formal addiction medicine treatment, multidisciplinary eating disorders treatment, intensive outpatient programming, and/or inpatient hospitalization. Required evaluations (such as for child custody, adoption, sexual reassignment surgery, pain management, workers' compensation, fitness for duty, etc.) would also need to be referred out.
If you need to be referred for more specialized care, we will work with you to secure a referral. We can stay connected with you and your new providers to ensure that you are receiving what you need. In these cases, you would become a client of the treating agency. Your health insurance company may be billed and they may utilize a different documentation process than APWI.
Do you offer telehealth visits?
We prefer that the initial appointment be in person, but after that, we are happy to offer telehealth visits. The "gold-standard" for psychology is to use audio + video software, so we have chosen to employ this technology using a platform (doxy.me) that is not affiliated with MyChart, Epic, or either major hospital system. The psychologist can walk you through this option if desired. In cases where you are unable to use video technology, a phone session can be offered, with the understanding that this is not the highest standard of care. Because of licensing laws, you must be present in the state of Ohio during your telehealth visit.
What if I am in crisis after-hours?
At this time, we are unable to offer after-hours on-call crisis counseling. We are available to assist you urgently during regular business hours (8:00am - 5:00pm Monday through Friday). If you need support outside of these hours, please consider these local and national crisis resources. If you feel that you are in immediate danger of harming yourself or others, please dial 911 or proceed directly to the nearest emergency room.
What if I start coming, but decide I don't like counseling, or that the provider is not a good fit?
All of our services are completely voluntary. You can change to another one of our providers without consequences or request referrals to a provider in the community. Nobody at APWI will be offended. We understand that the success of treatment depends on the relationship between the client and the therapist.
How are your clinical records kept?
Each APWI client will have their own unique paper chart. These paper charts will be stored in a locked filing cabinet in the psychologist's or psychiatrist's office. When unoccupied, the office door will always remain double-locked. We do not document anything in an electronic health record such as Epic, CarePath, or eClinicalWorks. We will never disclose any information related to your care without your expressed written and signed authorization, except in a threat of harm to yourself or others. All client-physician privilege laws apply to your care.
Will I have to report my treatment to the medical board?
In almost all cases, the answer is no. Below are the exact questions that you will find on the Ohio State Medical Board’s licensing application and renewal:
- Have you ever been diagnosed as having, or have you been treated for, pedophilia, exhibitionism, or voyeurism?
- In the past five years, have you been diagnosed as having, or been hospitalized for a medical condition which in any way impairs or limits your ability to practice medicine with reasonable skill and safety? You may answer “NO” to this question if you hold a current training certificate to pursue training in Ohio and the only such medical condition is chemical dependency or substance abuse, and you have successfully completed or are currently receiving treatment at a program approved by this Board and have adhered to all statutory requirements as contained in Section 4731.224 and 4731.25 O.R.C., and related provisions. Any questions concerning approval can be directed to the board offices.
- Do you use chemical substance(s) which in any way impair or limit your ability to practice medicine with reasonable skill and safety?
- Are you currently engaged in the illegal use of controlled substances?
- At any time since submission of your last application for renewal have you been addicted to or dependent upon alcohol or any chemical substance; or been treated for, or been diagnosed as suffering from, drug or alcohol dependency or abuse? You may answer NO to this question if you have successfully completed treatment at, or are currently enrolled in, a program approved by this Board and have adhered to all statutory requirements during and subsequent to treatment. You must answer YES if you have ever relapsed.
These questions focus on impairment, not diagnosis and treatment. See also the Federation of State Medical Boards’ Policy on Physician Impairment.
Will my medical program or employer find out I am coming to APWI?
No. We do not share any information with medical programs, chief residents, clinical supervisors, employers, or leadership. The only exception to this would be in the case of identified impairment, as noted above. We are not involved in teaching or evaluative roles with resident physicians that we treat.
What if I run into my APWI provider in another context?
We will maintain your confidentiality in all circumstances. Our providers will not acknowledge you unless you choose to be acknowledged by initiating a contact. If you choose to say hello, our provider will not identify him or herself as your provider.
What if another provider that I work with or am friends with is also coming to APWI?
The confidentiality of our clients is of the utmost priority. We will maintain both your confidentiality and the confidentiality of anyone you may know or who may know you. In rare circumstances, it may be determined that there is an ethical conflict in providing care to both parties (for example, if the psychologist is seeing spouses who are both residents and whose presenting concern is marital conflict). In these cases, one of the parties would be referred to a different APWI provider or to an outside agency.
Can my spouse, partner, or other family member come to APWI?
Will I have to take psychotropic medication?
No, you are never required to take medication. If you are interested in medication, the psychologist can connect you with an APWI psychiatrist who can discuss options and write a prescription for you.
If I choose to start a medication, will this appear in my medical history?
Not from us. We do not use an electronic health record and do not participate in health information sharing without your written authorization. The psychiatrist can provide you with a prescription, and how you choose to fill that prescription is up to you. Some pharmacies do have their information linked to Ohio Health Information Partnership and this may appear on the medication reconciliation tab in Epic if you have a chart there. However, there will not be a diagnosis associated with the medication, and many psychotropic medications can also be prescribed for physical health conditions. If you choose to use your insurance company to pay for the medication, this information will be submitted to your insurance company from the pharmacy, but not to or from APWI.