What Is Psychotherapy?
Psychotherapy is a professional service whose purpose is to assess, prevent and treat emotional, behavioral or mental difficulties. These life concerns can range from mild to severe, more recent to long-standing. Psychotherapy is a collaborative and active process, whereby information is exchanged between therapist and client, with the intent of cultivating healthy emotional and behavioral states. Psychotherapy is sometimes referred to as therapy, talk-therapy or counseling. While there is much overlap between "psychotherapy" and "counseling," generally speaking, psychotherapy tends to be more of an in-depth, longer-term approach, whereas counseling can be more short-term, focused on one or two particular life issues.

Commons Issues That Bring People to Therapy
People come to therapy or counseling for a variety of reasons. Sometimes they recognize the need to get some additional help. Other times, it’s a loved one that recommends pursuing this option. Some of the common issues that bring people to therapy are discussed below.

1.) Anxiety: while everybody feels a certain amount of worry, it becomes a problem when it’s excessive and interfering in one’s life in a significant way. Anxiety exists on a spectrum from low level nervousness to full-blown panic. It can interfere with sleep and ability to focus. It can also contribute to irritability and decreased energy.

In the field of psychology, there are names given for different types of problematic anxiety, such as: generalized anxiety, panic disorder, post-traumatic stress disorder, phobias and obsessive-compulsive disorder. Sometimes people have a combination of the symptoms associated with these categories.

As a psychotherapist and clinical social worker, I have much experience helping clients deal with troubling anxiety, resulting in a greater sense of well-being, a decrease in habitual responses that are no longer useful, and more tools for increasing relaxation.

2.) Depression: feelings of sadness are common and it’s healthy to shed tears when faced with things like loss or disappointment. When one feels sadness most of the time, loses interest in normal activities, experiences a significant decline in energy and sees much of life from a negative perspective, then “depression” may exist.

There are different degrees of depression, such as: excessive sadness related to a specific stressor, sometimes referred to as an adjustment disorder; mild depression; major depression; and depression related to using substances. Some depression is recent, whereas other types are long-standing and chronic. Some people experience more sadness during the winter months, when there’s less sunlight and others can become depressed due to biochemical changes related to a medical illness or condition.

Psychotherapy has been proven to be an effective stand-alone treatment for depression, as well as when used in conjunction with medication. I have many years of experience in private practice and community settings helping clients increase their level of happiness, energy and inner peace.

3.) Stress: stress is a normal part of life, but when it’s experienced too often or too severely, it can lead to emotional, interpersonal and health problems. Harmful stress occurs when the demands placed on one’s life are perceived as being too great to handle. Sometimes these demands are truly overwhelming, requiring a redistribution of responsibilities. Other times, the stress response is due to lack of coping skills, which may include learning to relate to what’s causing the stress in a different manner.

Working with a therapist can be a great way to develop tools to manage stress better. I employ a variety of practical stress reduction methods that are easy to understand and implement. For more information about ways to reduce stress, read my article entitled Stress Management 101.

4.) Low Self-Esteem: feelings of shame, low self-worth and inadequacy are unfortunately, quite prevalent in our society that places heavy emphasis on rugged individualism and competition. These feelings can cause much emotional suffering, as they tend to permeate all aspects of one's life - including relationships, work and self-care.

Quality psychotherapy helps clients re-connect with their inherent goodness and value, by unlearning negative conditioning, increasing self-acceptance and cultivating more compassion toward self and others.

5.) Life Transitions: major life changes are often wrought with anxiety, fear and confusion. Sometimes, relying on friends and family to get through these difficult times is just what is needed. When that’s not enough, however, turning to a therapist can aid in relieving emotional distress and navigating the transition with more grace.

Examples of major life transitions include losing a loved one through death or divorce; becoming unemployed; being diagnosed with a major health condition; losing some aspect of physical ability through illness, aging or an accident; and a change in identity, such as coming out as gay or transgendered.

There are also types of life changes that are seen as “positive,” yet these can still be quite stressful, including: getting married; starting college; becoming a parent; moving to a new city; and getting a promotion at work.

As a psychotherapist in San Francisco, I take a personalized approach to helping clients cope with these major life transitions, which while challenging and painful, can often lead to an even deeper sense of psychological freedom and contentment.

6.) Relationship Difficulties: being in a relationship with another human being is complex and challenging, whether people like to admit it or not. Working with a therapist as an individual, couple or family can help relationships go from dysfunctional and destructive to supportive, loving and mutually satisfying.

Common relationship difficulties bringing people to therapy include: communication problems (frequent arguments, problems speaking up); stressors related to transitions (getting married, moving in together as a couple); infidelity and substance abuse in one or more family members.

As a counselor in San Francisco, I work with individuals, couples and families. Sometimes, I’ll supplement one type of therapy with another. For example, at times it can be helpful to meet not only with the individual, but to also include a family member or spouse in some of the sessions. A family member may be able to bring some added perspective or help with problem-solving. In addition, during these visits, important educational information can be provided to family members that can help with their understanding of the client situation.

7.) Coping with Illness: being diagnosed with a serious illness can be overwhelming. It’s common to experience much fear and uncertainty during these times. Lifestyle changes may include multiple trips to the doctor, new medication regimens, an alteration in diet, and taking time off from work. It’s been proven that individuals with certain health conditions, like heart disease and cancer, are more likely to become depressed.

Sometimes it’s not oneself, but a family member – a child or an aging parent – that becomes ill. This can also be a very scary and overwhelming time as all involved learn to cope with this major life stressor.

Counseling can provide valuable emotional support and tools for coping during these tenuous times. Having worked as a medical social worker in the past, I have a keen understanding of the challenges associated with illness and aging. In addition to providing in-office therapy, I work with seniors in their homes when appropriate and provide linkage to needed resources in the community.