Psychotherapy FAQ

Psychotherapy Frequently Asked Questions

How do you work?

My San Francisco psychotherapy practice is a general practice where I see individual adults. I have experience working with people who have diverse ethnic and social backgrounds. I welcome all people. Please learn more about my background and experience.

My intention is to work collaboratively. That means that I am an active participant during therapy meetings and periodically ask for feedback about your experience.

Working together is important so that we can understand the nature of your difficulties, the goals of the treatment, where to focus the work, and the best way to do it.

Do you ever work remotely by phone or on Skype?

I do. Online Therapy offers short term, intermittent and on-going therapy by telephone or Skype (VOIP: voice over internet protocol). I have found that it responds to the greater mobility of today’s population. And I often use it in conjunction with face to face office visits.

Using telepsychology also depends on the presenting circumstances and must be mutually agreeable. I never assume that we will use it. We have to discuss what the potentials are and what concerns may be present before beginning. It isn’t for everyone. But for many using phone therapy or internet is a viable alternate to traditional psychotherapy. Every safe guard is used to insure and maintain confidentiality  and privacy.

What can I expect in the first session?

Making a decision to begin psychotherapy is significant. Committing to a particular therapist during a phone call, email correspondence, or at a first session can add additional stress. In order to lessen your pressure and anxiety, I suggest meeting for a couple of sessions so you can experience what it is like to work with me. Then you can decide whether I have something to offer you that would be helpful and useful.

What are your fees?

My fee for a 45-minute psychotherapy hour is based on the usual and customary rates for licensed clinical psychologists the area. Payment by check or cash is preferred at the time of service. As my fee is occasionally adjusted, please call to discuss my current fee. I provide monthly statements for reimbursement from your insurance company.

Do you take insurance?

Many of the people I work with do not choose to use insurance. For those who do wish to use insurance, I accept all PPO and POS insurances that allow for out-of-network providers. Please check with your insurance company to verify coverage for out-of-network providers, to find out your reimbursement rates, how many sessions you are given, whether your deductible has been met and if you have a copay. If you have a “flex spending plan” through your employer, you can apply pre-tax dollars towards therapy or claim the therapy costs as a tax deduction, if applicable. Please consult with your tax preparer.

When can I get an appointment?

For someone in crisis, as soon as possible. Appointments are currently available. It is possible to get an appointment within a day of your call.

Call 415-956-1884 to get started

How do I get to your office?

The office is located in the historic Flood Building in downtown San Francisco. The Flood Building is located at the corner of Market Street and Powell Street. It is accessible by BART and bus, and parking is available in the Ellis/O’Farrell Garage 
(see contact page for a map and directions).

What are your office hours?

Monday through Friday with appointments available in the morning, afternoon, and evening.

What do I do in an emergency?

Dial 911 or go to your nearest Hospital Emergency Room.

What areas do you serve?

Throughout the San Francisco Bay Area : San Francisco, Berkeley, Oakland, Sausalito
Marin County, Alameda County, and San Mateo County.

Are my psychotherapy sessions confidential?

Yes, with some exceptions. It is important to consider that any communication between us once you have begun therapy is private and confidential. I am bound by the law and the code of ethics of The American Psychological Association to do so. 

Information about your therapy can be released to a third party after you have given written consent. However, there are certain requirements that mandate divulging otherwise confidential information.

  • If I have reasonable cause to believe that the patient is in such mental or emotional condition as to be in danger of harming him or her self, I will work to find a way to ensure safety without breaking confidentiality.
  • I will work to keep the patient as much in control of the process as possible. I may be obliged to take protective action, including seeking hospitalization or contacting family members or others who can help provide protection.
  • If I have knowledge of a child under 18 or I reasonably suspect that child under 18 that I have observed has been the victim of child abuse or neglect, the law requires that I file a report with the proper authorities.
  • If a patient communicates a threat of physical violence against an identifiable victim, I must take protective actions, including notifying the potential victim and contacting the police. I will work to keep both the victim and patient safe.
  • A judge can subpoena records in a court case.

These situations are unusual in my practice. But if they arise I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary. While this summary of exceptions to confidentiality should prove helpful in informing you about potential situations, you may also wish further information and may contact the California Board of Psychology. It is important for us to discuss any question or concern that you may have now or in the future.

Call 415-956-1884 to get started

Can therapy help?

Yes, in most cases.

Psychotherapy helps basically healthy people who experience the difficulties of a major life event such as the loss of a loved one, the loss of a job or home, the end of a relationship or news of serious illness. Working through these difficulties can return a person to functioning more fully and with greater peace of mind.

Therapy also helps people who experience serious depression, bipolar illness and character difficulties to learn how to maintain greater stability and manage their lives more effectively.

When you need to talk to someone, an experienced, licensed psychologist can help you get through the struggles and sufferings attached to what is overwhelming, so that you can move to a place in your life that has less suffering and more opportunity for vitality.

How hard do I have to work?

Psychotherapy is not like a visit to your medical doctor. It is collaboration between patient and therapist. This calls for an active effort on your part for a successful and satisfying outcome. Self reflective and thoughtful consideration about what we talk about outside our meetings is the active effort.

We all have what we need within us: the feelings, talents, sensibilities and ethics to live our lives well. Our work is to find them, trust them and learn how to use them.

What is helping adults to grow and mature?

No one arrives in adulthood in one piece. For various reasons parts of ourselves get stuck as we develop while other parts grow to maturity without difficulty. Stuckness becomes the reason many people have gaps in their maturity or discrepancies between their chronological age and their emotional or developmental age. In effect many grown-ups need to grow up in some areas of life as life eventually requires the use of all parts of the person, even those that are waiting to be developed. Therapy helps emotional and chronological maturity get in sync so that people can grow out of their stuckness and into a place of greater well-being, relational improvement, and more self confidence.

What is the trend in psychotherapy today?

The general trend these days is for psychotherapy to be a bandaid. What we need is more than a quick fix. We need much more. What about happiness and life satisfaction, living and moving in the right direction, achieving aliveness and vitality on a daily basis, managing life with all its ambiguities and changes?

The trend in my work is curative and healing. My patients get better. They learn what it means to fix themselves and do; and leave therapy with the insight and skills to live fully with satisfaction. Things don’t change overnight, but even small gains work to balance and reshape our lives. Major upheavals are unnecessary. Change comes in its own time.

Therapy is change. Change happens when you become more who you are. This is different than trying to make yourself something you are not. Finding our own path, our own individual way leads to satisfaction, insight and a more balanced fulfilling life.

Do I have to take medicine and do you prescribe medicine?

I see people who are taking medication and people who do not. Medication is not a barrier to therapy nor is it a substitute for therapy. For some the combination of medication and therapy is what facilitates change and wellness. For others, therapy alone suffices.

As a licensed psychologist, I don’t prescribe drugs. But I have excellent referral sources for doctors who do, especially if you think that a medication evaluation would be helpful.

Call 415-956-1884 to get started

Dr. Thomas Ervin, is a licensed Clinical Psychologist with many years of experience offering psychotherapy to individuals in San Francisco. Dr. Ervin specializes in issues related to:

  • Depression, sadness, and loss
  • Anxiety, panic, and anger
  • Managing chronic pain and illness
  • Achieving maturity and relating better as adults.
  • Relationship issues