Glencairn - Adults

Using a Contextual Approach to Treat Adult Problems

Webster defines the word "context" as "words surrounding a word or phrase." We always hear people trying to explain things that have become misunderstood by saying; "You took that out of context." Adult problems can be misunderstood by taking them out of context just as language can be misunderstood by taking it out of context. When you look in a thesaurus words related to "context" are words like background, circumstance, situation, perspective and environment. Contextual therapy places a person in context in order to understand and correctly address his or her problems.

A person's life circumstances and particular situations are determined by environmental events that occur over time interacting with biological make-up. Two of the most important contexts that affect people's lives are family background and developmental history. These two contexts have great influence over our perspectives (how we view our lives). Because each person's "context" is unique, it must be understood in order to learn to deal with the stress of everyday problems in a healthy way.

People are unique but problems aren't. For example, "depression" or "anxiety" is a problem for everyone to some degree. We all feel the stress and strain related to living in a complex world. Even people who have never been diagnosed with a serious mental illness must learn how to lead balanced lives in order to manage the stress of living in an unpredictable and mostly uncontrollable world.

A person is not a label and, for example, just labeling someone as "depressed" does not give information about how to deal with it although we all know something about depression. When you come to therapy, I see a unique person with a family background and particular set of family genetics who finds her or himself feeling depressed on a particular day or time in a certain situation. I treat each person with three things in mind--our scientific knowledge. how it applies to your particular context, and how to create balance in your life.

I use a practical approach to clinical interventions with contextual therapy and interdisciplinary ideas and research from sociology, social psychology, family studies, systemic family therapy, and social constructionism. Within this framework I am able to treat people from diverse ethnic, cultural and religious backgrounds and sexual orientations for a wide range of problems.

Couples Therapy

Typically couples seek marital therapy for two reasons. Half of the people who come in for therapy want to improve their relationship and the other half are looking for an exit strategy. Both are good reasons for coming to couples therapy, but each reason will have a different set of goals. Do you want to spend some money to save your marriage or spend your money on property settlements, custody battles, and lawyers fees?

Couples therapy is traditionally not indicated when one or more of the following conditions is present: Substance abuse dependence, domestic violence and on-going affairs. Talk to Dr. Smith if you have a desire to pursue couples therapy even if you find yourself in one of these difficult situations. She can help you individualize a couples treatment plan to address any or all of these problems.

Couples Therapy Process

Couples therapy usually consists of two or three sessions of assessment and subsequent hour and a half treatment sessions typically on a weekly or biweekly basis. If you are coming from out of town or would like quicker results, arrangements can be made to have longer sessions or for several consecutive days or a weekend of intensive therapy. All therapy is completely confidential. Only the Glencairn Center intake staff will know you are in therapy and only I will know the details of your treatment.

Private pay couples therapy begins with a three step assessment of the relationship as well as each partner individually. This assessment provides the direction for your therapeutic journey. The goal of our work together is not to make you dependent on a therapist but rather to provide you with the skills you need to maintain intimacy and good feelings during a lifetime in your relationship. Each couple is unique and your own needs will determine the number of sessions that will be necessary to improve your relationship. I will work with you to decide the frequency and duration of your sessions.

Individual therapy may be indicated for one or both parties involved in couples therapy as a necessary and separate component due to problems that one person is experiencing that is interfering with the couples therapy process (i.e. depression, anxiety, trauma, family-of-origin issues, bereavement, lack of commitment, etc). If one or both need individual therapy I will help you find an appropriate therapist for your individual treatment.

Cost for Couples Therapy

Many studies have shown that separated and divorced individuals are at increased risk for physical and mental health problems and the dramatic impacts of divorce on some children. Marriage is also valuable in creating and maintaining personal happiness but staying in a distressed marriage reduces the health benefits of being married. While the physical and emotional benefits of staying in a good married are great, the financial costs of divorce are devestating.

In a recent study published in the July 2007 issue of the Journal of Marital and Family Therapy, the average cost of divorce was estimated at $30,000 while the reduction in yearly health-care usage after completing marital therapy was about $3,000 per couple.

Marital therapy not only reduces the likelihood of divorce, but it also reduces the amount and degree of conflict in a marriage. This in turn appears to impact not only the health of the couple but also the health of any children in the family. Given the facts, effective marital therapy is a great investment.

The Glencairn Center fee is $130 per clinical hour (60 minutes) but couples therapy works better scheduled in hour and a half sessions ($195). Clients are requested to pay at the time of service or work out a payment plan with Dr. Smith. Despite the proven benefits and cost effectiveness of marital therapy, most insurance companies will not allow enough time or will not authorize the appropriate diagnostic codes to complete marital therapy. You will need to look into your particular insurance plan to determine if they will approve marital therapy. No insurance plans cover the cost of couple relationship assessment or marathon sessions.

Couples therapy will give you lasting benefits. When you pay for couples counseling, Dr. Smith can individualize the time you need and will make a committment to make sure that you have the breakthroughs and results you desire. It is hard to put a price on that. Her intensive therapy or couples weekends provide the equivalent of years of counseling in a short amount of time. Attending intensive therapy or a couples weekend saves you $$$ as well as affords you the opportunity to receive phenomenal results.

An hour and a half marital therapy session $195
Marital assessment using questionnaires and biofeedback $600
One half day marathon session (4 hours) on one specific (predetermined) issue $450
A whole day (7 hours) session $750 (in office)
A private couples weekend with Dr. Smith at a local bed and breakfast $1,500