Q. Who asks for help from a psychotherapist?

A. Many people talk to a therapist. As a matter of fact, more than 10 million Americans see a therapist every year. Of these, about two-thirds are women and about one-third are men.

Q. What are the most common problems people have?

A. Relationship difficulties is the number one problem presented to therapists. Anxiety and depression are also common complaints. Alcohol and drug problems are also frequently discussed.

Q. What usually stands in the way of individuals entering therapy?

A. Some individuals think that therapy is only for those who are severely disturbed, and therefore think that it might not be helpful to them. Others had difficulty admitting that they do have problems; or that there is anyone who might be able to solve their problems. Some are concerned that they wouldn't feel like themselves if they made changes. And other individuals think that they can't financially afford therapy.

Q. What types of psychotherapy does Dr. Miller use?

A. Although there are many different types of therapy, the primary two theoretical approaches are psychodynamic and cognitive-behavioral approaches.

Psychodynamic therapy uses psychoanalytic (or Freudian) principles and techniques. This includes examining and resolving unconscious conflicts. The client's early history is seen as extremely important in the formation of the character structure of the person. There is an assumption that the client will be able to make desired changes only after the underlying causes are resolved. Although many therapists use these principles, formal psychoanalysis is relatively uncommon.

Cognitive-behavioral therapy focuses on helping clients identify and examine faulty beliefs, distressing emotions, and ineffective behaviors. The client then learns to choose more realistic beliefs, which will lead to feeling better, and then acting more effectively. In this system, the present is more important; and history is seen as less relevant.

Since no one therapy approach works for all problems, Dr. Miller borrows from different approaches as needed to help clients.

Q. How long does therapy usually last?

A. Therapy lasts as long as the client chooses. Some individuals feel satisfied after a few sessions. More commonly clients remain in therapy for about 15 to 20 sessions. Sometimes clients require more therapy to reach their desired goals. The major client factors that contribute to the length of time include: the presenting problem(s); the client's current situation; the client's history; the client's personality; the client's capacity and willingness to make any necessary changes.

Q. Is therapy effective?

A. Two out of three clients report that, because of therapy, they feel better about themselves and more confident that they can handle the problems of their lives. However, some people aren't satisfied with therapy. Factors that may contribute to the success or failure of therapy include: the difficulty of the problem; the competence of the therapist, the motivation and capability of the client to apply therapeutic principles, and the length of therapy.

Q. What are the differences between a psychologist, a psychiatrist and a social worker?

A. A psychologist received a Ph.D. or a Psy.D. from a university (after completing about 6 to 9 years of post graduate training and an internship). A psychiatrist received an M.D. from medical school (after completing about 8 to 10 years of post graduate training and residency). A social worker received a M.S.W. from a graduate school (after completing about 3 to 5 years of post gratuate training and internship). Although they all do therapy, a psychologist is additionally trained in assessment and a psychiatrist can prescribe medication. Dr. Miller is a clinical psychologist.