For Patients

10 important points about Dr. Domian's psychotherapy
with individuals and couples

1. I treat the psychological components of problems as opposed to a behavioral or medication approach. I work with some patients for one or two sessions and with others weekly, even daily, as the problems dictate. My training includes the ability to work with long-standing complex issues in individuals or couples.
2. Patients do not have to come to the session prepared to work on a particular problem. It is your session and many patients come to therapy unclear as to what is exactly going on.
3. I will give you my ideas on what I am seeing as we go along. That way you can use my ideas to clarify whether or not what I am saying seems accurate or helpful in developing the problem further.
4. As a general rule, I do not use paper and pencil assessments as part of the therapy. I encourage patients to begin talking about why they came, and the precipitating event that led them to call me. If past history is relevant, it will come up naturally over the course of the sessions.
5. Emotional states like anxiety and depression are always about something. It is a matter of unpacking what the anxiety and depression mean. The only way to do this is to develop the problem through dialogue without prejudging what particular thoughts and feelings are all about.
6. All symptoms are lack of voice. This is another way of stating point 5, but is worth emphasizing. Psychological symptoms are signs that there is something troubling the patient that he or she has been unable to put into words.
7. The criterion for successful therapy is that the patient feels relief with insight into their problem and a new way to think about themselves. No relief means that we have not yet found words for the psychological meaning of the problem.
8. I have received intensive training so that I can work with the same partners individually or as a couple. It is important to understand that whatever is said in individual sessions is confidential. It is up to you what you tell your partner.
9. As with individuals, I explain my theory on what I am hearing that is going on in the couple relationship early in the sessions. This gives partners a quick understanding of what I am thinking so that they can clarify together if what I am saying sheds light on the couple dynamic and problem.
10. It is important to note that I emphasize relationships and look closely at interpersonal interactions. While sometimes challenging for patients, complex psychological and intimacy issues are why many people seek my services.Patients certainly may seek a second opinion or discontinue our relationship at any time.

Please visit the articles page for more perspective on my approach to psychotherapy, or the couple quiz for my ideas on couples.

See also: Patient forms page.