Service Goal: I am committed to helping you and your family to reach the goals you entered services to achieve. Some examples of goals that individuals, couples, and families often begin therapy for include (but are not limited to): Resolution of personal difficulties or a painful past Improvement or establishment of healthy marital, family, or other interpersonal relationships Help in coping with overwhelming life stressors, circumstances, or emotions Gaining the ability to managing one’s own thoughts, emotional states, and/or behaviors Learning how to help a loved one in trouble or crisis Learning basic life skills for personal, family, or professional stabilization or growth Alleviating unwanted behaviors or symptoms caused by mental illness or traumatic events Along with these immediate concerns that people often seek to resolve, there is commonly also a larger goal, such as the achievement or reinstatement of a sense of peace, contentment, enjoyment, independence and/or control of one’s own life (lives). My goal is to help you to resolve both your immediate concerns and achieve your larger goal(s) in a way that helps you to experience your own personal power and to grow as an individual and/or a relational unit. Therapy Service Approach: I use a holistic, strength-based, psychodynamic approach within a systemic framework to provide you with individualized, personalized, effective therapy. Brief descriptions of exactly whate these therapeutic approaches mean are as follows: Holistic services address the entire person (or persons), recognizing that there are many components of a person and family that make up the whole and contribute to overall well-being. An individualized treatment plan based on a comprehensive needs assessment will be developed with each person, couple, or family that comes in for services. This plan will not only address what will be worked on at Hope Harbor, NY, but will also include other community service providers and resources that may be needed to ulitimately achieve the identified goal or goals. I will help you and your family to find, access, and connect with any other services, information, and resources needed, and will assist in keeping these services coordinated and consistent with the overall treatment plan throughout the course of your treatment. A Strength-Based Approach recognizes that no matter what difficulties an individual, couple, or family is having, he/she/they also possess many strengths and skills that often move out of sight in the wake of problems. This approach identifies these already existing strenghts and builds on them to achieve problem resolution, allowing a positive approach to treatment. Psychodynamic Psychotherapy recognizes that past relationships and experiences have a strong impact on human development and can often continue to unconsciously influence a person's belief systems, thinking patterns, and worlviews - which, in turn, can contribute to on-going emotional reactivity or behavioral and relationship patterns that cause pain, poor decision making, and/or negative consequences for the individual. This therapeutic approach focuses on increasing one's awareness of these unconscious thoughts and behaviors, developing new insights into motivations and impulses to feel and behave in ways that continue to create distress, and resolving the intra-psychic conflicts that continue to maintain those painful patterns of thinking, feeling, and/or behaving. Once these unconscious motivators become conscious, they can be identified, controlled, and altered, which results in increased personal power, freedom through choice, positive decision making, and overall personal well-being. A Systemic Framework means that all services are based on Family Systems Theory, which contends that humans do not function independently but rahter that they operate within the larger systems that maintain or discourage patterns of behavior through reciprocal interactions and feedback from those systems. This theory contends that the family is the most basic and influential system, however, it recognizes that additional systems outside of the family context(such as neighborhoods, communities, schools, workplaces, peer groups, and cultures)also influence behavioral patterns of family members. It is also a component of this theory that family members are never blamed for presenting difficulties, as patterns develpo to serve some function, maintain some balance, or are motivated by unconscious or habitual behaviors or reactions that the person may not be aware of - or the person may not have the information needed to operate or meet his/her own needs in any other manner. Often times, parents or family members avoid entering therapy due to a fear that they will be blamed for all of the problems a child or the family is having. If this fear is preventing you from entering services, Hope Harbor, NY is a safe place to come for treatment. Therapy Services Offered: Sessions are held at regular intervals, with frequency being dependent on need. All therapeutic services are confidential and will continue until the you have achieved your goals. Individual Therapy may be provided to an adult, child, or adolescent through one-on-one sessions that usually last 50 minutes to 1 hour in length, unless individual characteristics indicate that shorter or longer sessions would be more beneficial than the traditional hour session. When treating children and often adolescents, family involvement is paramount in facilitating treatment success. This involvement may require family meetings, case conferences with multiple service providers, school personnel, and/or other support persons, or participation in family therapy services either through Hope Harbor, NY or with an external community provider. New York State law also mandates that parental consent is clearly given for minors (individuals under the age of 18) to receive counseling or psychotherapeutic services. Couples Therapy is offered to all types of couples in 1 - 1 1/2 hour sessions. The sessions focus on exploring the issues, conflicts, or frustrating interactions that are being experienced, and on finding solutions or alternate patterns of relating to improve the relationship. Sometimes, during the course of this therapy, it becomes clear that one or both individuals in the couple have personal issues from his/her past that are interfering in his/her ability to effectively and productively function in a relationship. In these instances, individual therapy for one or both partners may be necessary before relationship work can be effective. If this is the case, I will link you to another provider for the individual work needed. It is also sometimes beneficial for couples work to continue as one or both partners are working on individual issues when partners can support the individual work of the other. In these cases, we will continue with couples therapy as requested by you. Family Therapy sessions are generally a little longer than individual or couples sessions, and it is usually recommended that they include all members that influence the overall functioning of the family system. This service helps family members make self-determined decisions about their families and/or children with the help of the Therapist. During these sessions, I will work to provide a safe, supportive setting and ensure that discussions are meaningful and respectful while facilitating communication, problem solving, insight development, and positive, productive interactions. The function of this service is to identify ineffective family patterns and to assist your family in altering these patterns to improve family relationships, reduce conflict, and/or improve family functioning. An additional goal of this service is to protect family relationships by improving communication, increasing understanding, and building effective conflict resolution strategies. Family mediations may also be provided between custodial and non-custodial parents, or for cohabitating parents for the purpose of strengthening unity in parenting strategies, developing an effective working relationship between the parents for the purpose of effective parenting, resolving conflict between parties that are interfering with effective parenting, and/or assisting in resolving parent-child conflict. Trauma Recovery Counseling is available for children, adolescents, and adults who have experienced traumatic events such as childhood physical, sexual, or emotional abuse, neglect, attachment trauma, domestic violence, natural or manmade disasters, combat trauma, assault, rape, school or workplace violence, community violence, or other traumatic events. It is delivered through individual therapy sessions that implement psychodynamic techniques and exposure therapy, which may also incorporate cognitive-behavioral techniques or other therapies and psycho-educational materials. The function of this service is to assist in decreasing reactivity to the event or events and alleviating troubling symptoms that may result in dysfunctional behaviors, sleep problems, extreme distress, or relationship problems. Therapy Service Process (What to Expect): Appointments are made by telephoning the office for scheduling. If contact is attempted outside of regular office hours, a voice message including your name and phone number can be left (voice messages are reviewed according to confidentiality practices), and your call will be returned during the next business day. If immediate assistance is needed or you are experiencing a psychiatric emergency, please call the crisis line number located in the emergency number section of your phone book, go to the nearest emergency room, or contact the police if an eminent danger is present. The initial meeting generally lasts 1 1/2 - 2 hours. The first part of the session consists of a review of confidentiality guidelines, gathering your personal (demographic) information, completing the necessary forms to begin services, and addressing any questions or concerns you may have related to the services. Next, we will explore your reasons for entering services, clarify your expectations of services, and identify your personal and family strengths. In order to identify the most effective and beneficial services and treatment modalities for you and your family, a thorough history will be gathered and a comprehensive assessment will be completed. Finally, we will develop an initial treatment plan together, which will include the frequency in which we will continue to meet. If we identify that you would like additional services or are in need of additional resources, we will link you to those services and/or resources and sign relevant releases of information to allow communication between providers to ensure continuity of your treatment. We will then meet at a frequency that we agreed upon to address the issues and goals that we identified in your initial plan. Usually by the third session, we will have a very clear picture of all of your strengths and the issues and goals you want to address. At this time, we will create a comprehensive, specific treatment plan that we will work on for the remainder of your services. We will periodically review your treatment plan together during subsequent sessions to look at the progress you are making, to note the goals you have achieved, and to modify any goals that may become void during the course of treatment. The length of services will depend on your goals and rate of progress. Once you have achieved all of the goals on your treatment plan, we will discuss your “discharge” from services and create an “aftercare” plan that you can take with you. Because this service is completely voluntary, you are also free to discontinue services at any time for any reason. If, for some reason, you are not satisfied with the services you are receiving at Hope Harbor, NY but continue to want or need similar services, I will be glad to make referrals for you to receive services elsewhere and assist in any way to connect you with these services. Cost of Services and Payment Options: The cost for all therapy services is $75.00 per hour. These fees are self-pay, meaning insurance is not accepted. Receipts for services, however, will be provided if you want to pursue insurance reimbursement on your own. There are many benefits in self-pay therapy services that I would be glad to explain to you upon your request. Payment is expected at the time services are rendered. Payment is accepted in the form of cash, checks, Master Card, Visa, Discover, American Express, or Debit Cards. Other Services: Mental Health Consultation is provided for local agencies, schools, or other service providers upon request. For fees and availability, please contact Raquel Spears, MA, LMFT, LMHC at (716) 952-9618 Community Mental Health and Provider Training programs are designed and delivered according to assessed community need or per public request. Attendance is open to the general public and the menu of topics continues to expand based on requests or identified community trends. Examples of training topics available include general Adult or Child Mental Health, Reactive Attachment Disorder – Causes, Symptoms, and Interventions; The Effects of Childhood Physical, Sexual, Emotional Abuse. For available classes, schedules, costs of seminars, attendance and registration information, or to request a specific workshop or seminar, please contact Raquel Spears, MA, LMFT, LMHC, CTS at (716) 952-9618

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