David Cranford, Ph.D.

Licensed Clinical Psychologist

1800 Town Center Drive, Suite 420, Reston VA 20190

Phone: 240-303-2141    Fax: 703-662-0544    Email: david@davidcranford.net

Tell Me More


How do I choose the right therapist?

Finding the right therapist is more about finding the right fit between you and your therapist than just about the psychotherapist alone. It is a very personal decision. A therapist should be professional, honest, appropriate, easy to understand, non-judgmental, empathic, and non-punitive. It is important to feel understood, safe, and comfortable with the therapist you choose. If the therapist is a good fit for you, you should feel a sense of validation by the comments he or she makes. Therapy can be challenging and self-disclosure can make you feel extremely vulnerable. It’s not always easy. The quality of the therapeutic interaction, the feedback you receive, and the comfort and safety provided will probably be the best determining factors in helping you decide whether that therapist is right for you.

It's important to take the time to find someone you feel you can trust and that you enjoy talking with. You have a right to expect acceptance, and know that your psychologist will not pass judgment on you. Because psychotherapy is an interpersonal process, it is very important that your psychologist possess good interpersonal skills such as the ability to express warmth, empathy, and the quality of being genuine.

Training and credentials are extremely valuable criteria in determining the quality of your therapy.  This might seem extremely obvious, but well trained and experienced therapists know how to handle the issues you bring to the therapy experience better than less trained and experienced therapists. You have the right to receive a high standard of care. If you are considering seeing a psychologist, you should look for someone who has completed their degree from a well-established, reputable university graduate school program in Clinical Psychology that is accredited by the American Psychological Association. Their internship should have also been accredited, he or she should have passed their state boards, and hold a valid license to practice clinical psychology in the state in which the office is located. You should also look for a psychologist that adheres to a strong code of ethics, maintains solid professional boundaries, and provides high quality of care.
 

Do I need therapy?

If you are considering psychotherapy, I’m sure your reasons are valid ones. Trust your judgment. Consider how you might benefit from talking to a therapist about yourself and your circumstance. Making the call is the first step in right direction.  Here are some indicators that you will benefit from psychotherapy or counseling services:

• You are interested in pursuing change.
• There is a curiosity about self-discovery.
• You feel ready and able to self-disclose.
• There has been a sudden change in life circumstances or you are going through a life transition. 
• You find yourself sorting through the past, and feel the need to put life experiences into perspective and gain some clarity. 
• You need support and do not want to burden family or friends.
• You are interested in a reliable, informed and objective point of view. 
• There is a specific behavioral or emotional problem which is affecting your happiness and quality of life, or your ability to cope. 
• You have experienced loss, illness, job dissatisfaction, financial struggles, or relationship difficulties. 
• You are embracing a new beginning. 
• You might question, “How could this have happened to me?” or “Who am I, really?” or "Who am I now?”

 
Does therapy help? 

Yes, taking the time for therapy most definitely helps.  Here is what therapy can do:

• Understand your personality, your coping strategies, and your present difficulties
• Define and reach wellness goals and strive toward health
• Overcome fears or insecurities
• Cope with stress
• Make sense of past traumatic experiences
• Bring perspective to present experiences
• Separate your true personality from your mood swings
• Identify triggers that may worsen your symptoms
• Improve relationships with family and friends
• Plan for the future
• Understand your needs
• Establish a stable, dependable routine
• Feel more self-reliant and self-secure
• Understand why things bother you and what you can do about them
• Modify unhealthy behavior and long-standing patterns
• Navigate life’s obstacles more effectively
• Increase self-confidence, inner peace, vitality, and well-being
• Understand and stick with treatment to benefit from therapy
• Enhance your overall quality of life

 
How does therapy work?

If you are reading this online, then you have some knowledge and experience with computer technology, even if it is limited to internet browsing, email, or simple word processing. To this end, let me use a word processing metaphor to explain how therapy works. After all, metaphors and analogies are often used in psychotherapy to help reframe issues under discussion, so that they make clearer sense.

In thinking about psychotherapy as a process analogous to word processing on the computer, visiting and revisiting painful thoughts and memories without any therapeutic intervention would be similar to calling up an old document on the screen. You take a look at it, read it over but do not edit or add to the document in any way. When you close or exit out of the document, it remains unchanged, keeping the original time and date stamp of when the document was created. It returns to its original location among the many folders on file. Psychotherapeutic treatment, on the other hand, would be analogous to calling up a document on the screen, reworking it, editing it, modifying it, etc., and then saving it. The therapist metaphorically offers updated software, tools, and resources in which to enrich the document, thereby improving it with more accurate and timely modifications that last continually, until the next edit. The document is then saved with a new time and date stamp. It can also be filed in a new folder, to be retrieved more readily in the future. So are psychotherapeutic discussions, which offer more readily available coping mechanisms and resources.

Make sense? If not, I’ll find another way of framing how therapy works that makes clearer sense to you and that you can relate to more readily. And that’s exactly how the process of therapy works.
 

Are all psychotherapists psychologists? 

The term “Psychotherapist" is actually an unregulated title, meaning that anyone can use it to identify the type of work they do. There are no legal restrictions on designating oneself as a psychotherapist. The training and experience of each of these professionals is different and therefore their approach to psychotherapy will most likely be different. Typically, psychotherapists are one of the following:

Clinical Psychologist 
A Clinical Psychologist is an individual with a doctoral degree (usually a Ph.D.) in clinical psychology who has training and experience in understanding human behavior, brain-behavior relationships, and the diagnosis and treatment of emotional disorders.  They may provide psychotherapy, psychological testing, and supervise other mental-health providers. Clinical psychologists have acquired their skills through a rigorous graduate school curriculum that is accredited by the American Psychological Association, received substantial training experiences in mental health settings, extensively researched an area of academic interest, and written and defended a dissertation. In order to become licensed to practice psychology, individuals must complete an approved internship, receive significant post-doctoral experience under supervision, and pass a series of licensing exams (written and oral).

Psychiatrist 
Psychiatrists are physicians who earned a medical degree (M.D.) and completed specialized training internships and residency in psychiatry (a medical specialty focusing on the study, diagnosis, and treatment of mental illness). They often go on to train in post-doctoral fellowships in psychiatry and have ample psychiatric hospital experience. Psychiatrists are specialists in the prescription of psychotropic medications, and are the only mental health specialists who can prescribe medications that treat psychiatric conditions.   

Clinical Social Worker 
A Licensed Clinical Social Worker holds a masters degree in social work. Many go on to secure further clinical training in areas of specialized interest. They are trained in both psychotherapy and social interventions aimed at helping the individual cope with problems in his or her environment and/or relationships with others. They may also provide case management and community consultation, but cannot do psychological testing, nor prescribe medications. 

Counselor 
Counselors (usually individuals with a masters degree in education or counseling) may become licensed by the state to practice counseling. Counselors are oriented toward working with people who are doing reasonably well in their lives but are experiencing some form of distress. Counselors generally focus on prevention, development, and adjustment. They often provide psycho-educational techniques focusing on lifestyle and career development, social, cultural, or family issues, and substance abuse.
 

How much does therapy cost?

Many people worry about the cost of therapy. Yet therapy compares well with the price of other important services and personal needs such as auto repairs, dental work, health and fitness club memberships and services, legal services, accounting services, etc. Your mental health affects your physical health, and investing in your emotional well-being can be very cost-effective in the long run.

The following are estimated figures of fee ranges for the different kinds of therapists, based upon their education, training, and years of clinical practice and experience.  Regional and geographical differences also affect professional fees. These figures are typical for the Metropolitan Washington, D.C., Reston, Ashburn area.

Psychiatrists = $220 - $320 per clinical hour (45 or 50 minutes).

Clinical Psychologists = $160 - $250 per clinical hour (45 - 50 minutes).

Psychological evaluation costs are higher in that administration, scoring, interpretation, and documentation are involved. 

Licensed Clinical Social Workers (LCSWs) = $140 - $170 per clinical hour.

Counselors = $110 - $150 per clinical hour

(Fees typically increase $10 per session per year)