Frequently Asked Questions

General Questions

At IT&W, we are aware that individuals who seek therapy often come from various backgrounds and different walks of life. Multicultural counseling, or culturally sensitive therapy, refers to a therapist’s ability to approach counseling through the context of the client’s world. This allows the therapist to gain and maintain cultural competence, which is the ability to first recognize and understand their own culture and its’ influence, and then understand and respond to their client’s culture that is different from their own. The need for this understanding may be based on characteristics such as age, beliefs,ethnicity, race, gender, religion, sexual orientation, or socioeconomic status. Being mindful of these practices may help the client feel more comfortable in therapy, thus making treatment more effective. Bottom line—IT&W is a welcoming, all-inclusive practice.

IT&W integrates the Respectful Model which takes 10 factors into consideration during the course of treatment. Being mindful of these factors helps the therapist-client relationship stay, as the acronym insinuates, respectful. This model provides therapists with the ability to progress appropriately, ethically, and holistically through each counseling session.  Click here for more details.

Symptoms of mental health disorders vary dependingon the type and severity of the condition. The following is a list of generalsymptoms that may suggest a mental health disorder requiring professional help, particularlywhen multiple symptoms are expressed at once. Please consult with a therapistif you are experiencing one or more of the following:

– Confused thinking
– Long-lasting sadness or irritability
– Extreme highs and lows in mood
– Excessive fear, worry, anxiety or experiencing panic attacks
– Social withdrawal
– Dramatic changes in eating or sleeping habits
– Strong feelings of anger
– Delusions or hallucinations (seeing or hearing things that are not really there)
– Increased inability to cope with daily problems and activities
– Abuse of drugs and/or alcohol
– Self-destructive thoughts and behaviors
– Chronic pain, physical illness
– Change in functioning after a traumatic event
– Domestic violence or abuse
– Difficulty adjusting to life transitions
– Acculturation stress
– Thoughts of suicide

You will uncover your strengths and learn new skills that will allow you to deal with the challenges that arise in life.  You’ll learn how to navigate your feelings, build better behaviors, and relate to your thoughts differently so you can live your best life. You might explore the following topics:

– Overcoming depression and grief
– Enjoying life without fear or panic
– Experiencing freedom from traumatic memories
– Gaining insight and understanding
– Having positive relationships with family and friends
– Choosing healthy behaviors and living a full life
– Ease stress and soothe challenging emotions
– Challenge limiting stories and behaviors holding you back
– Face challenges and become more resilient

The difference is between someone who can offer support and suggestions, and someone who has the training and experience to do that same thing professionally. A therapist can help you approach your situation in a new way—teach new skills, gain different perspectives,listen to you without judgment or expectations, and most importantly, help you listen to yourself. Furthermore, therapy is completely confidential, and you won’t have to worry about others “knowing my business.” Lastly, if your situation provokes a great deal of negative emotion, and if you’ve been confiding in a friend or family member, there is the risk that once you are feeling better you could start avoiding that person so you are not reminded of this difficult time in your life.

No, all people struggle emotionally and mentally at times. Individuals who seek therapy are interested in their own growth and adjustment to the world around them. Therapists at IT&W are trained to assist individuals in exploring alternative coping strategies and ways of dealing with themselves and their environment.

A therapist does not solve your problems for you. Rather, she/he helps you clarify issues and gain insight so you can solve problems on your own with their guidance, support, and expertise. The goal of therapy is to make you more self-sufficient, not more dependent.

Many therapists are used to potential clients coming in, asking them questions and gaining confidence in the therapist’s ability to work with them, so it is okay to have inquiries for your therapist during your first appointment.  It is important that you choose a therapist with whom you feel at ease—someone with whom you have a good rapport and working alliance.  Do you feel connected and engaged?  The best way to determine if she/he is right for you is to use your feelings as a gauge. Does this person appear kind,understanding, and non-judgmental? Do you feel listened to and uniquely appreciated?  Above all, the therapist’s behavior, attitude, and words should make you feel safe, comfortable, and valued.

Medication alone cannot solve all issues. What medication does is treat the symptoms. Our work together is designed to explore the root of the issue(s), dig deep into your emotions and behavior, and teach strategies that can help you accomplish your personal and/or relational goals. Medication can be effective and is sometimes needed in conjunction with therapy.


Teletherapy is a video-based platform on your computer, iPad or smart phone. Teletherapy combines telecommunication technology to deliver professional and confidential therapeutic services at a distance for client convenience.

Therapy provides a safe space for clients. Teletherapy provides clients with a virtually safe space through a screen. At IT&W, we use the HIPAA-secure platform Zoom. HIPAA-secure means that a client’s privacy is protected, and sessions are confidential. Benefits of Teletherapy:

– It is flexible and convenient.
– You can conveniently attend a session from your home/office.
– It is great for mothers with children who would otherwise need to arrange childcare for an in-office session.
– It still provides you the safety and privacy of therapy in the office.

1Privacy.  Your therapist will ensure privacy on his/her end by being in a private space and using a HIPAA compliant platform. Please ensure that you are in a private space where it is unlikely that you will be heard or interrupted.  You may need to ask others in your space to respect your privacy by doing things like turning on entertainment in another room, listening to something via headphones, or perhaps them leaving the house temporarily, if possible.

2Seating. Try to make yourself comfortable, but not too comfortable, as it may impact your ability to focus.  If you can,settle into a nice, comfortable chair.  A workspace, if you have it, is best. Avoid lying in bed, sitting on the floor or walking around. The best situation would be arranging yourself in a session-like position as possible.

3. Therapy Essentials. Have a box of tissues readily available. If you typically take notes during session, have a notebook and pen next to you. If you want, have something to drink near you to quench your thirst if the need arises.  Please try to leave eating for either before or after the session,as this would make it difficult for your therapist to understand you through the video platform.

4Attire. Please dress as if you were meeting at your therapist’s office. Even though the therapist may not be able to see you if the session is audio-only,or all of what you are wearing if meeting via video, research says that the clothes we wear affect our behavior, attitudes, personality, mood, confidence, and even the way we interact with others.  At times, your therapist also might guide you in a movement exercise or ask you to retrieve an item that might augment the session and strategy being taught, so all of what you are wearing may eventually be revealed.

5Electronic DevicesTo avoid unnecessary distractions, turn of for put to sleep all electronic devices, except the one you are using for your session.  If using a smartphone or computer, do your best to quit other programs and turn off notifications as needed. It is best to leave your hands free by using headphones.  If you are using audio-only, be sure to put your phone screen-side down. If using a computer for audio-only, please either turn off your monitor or completely darken your screen.

6Before and After Session. Try to leave yourself an additional 10-15 minutes both before and after the session for a transition time.  Remember that for in-person sessions you would have the time traveling to/from the appointment to process through your thoughts. After your session, you can decompress by taking a walk, stretching, meditation and/or deep breathing, journaling notes from your session, etc.  Taking the time to unwind following your session should provide a time of reflection before jumping back into the demands of your life.

7Time. Being on time helps you remain calm and collected while simultaneously showing the other person that you value and respect their time.


EMDR is an effective,evidence-based therapy for the treatment of trauma and related issues. It is endorsed by the American Psychological Association (APA), World Health Organization (WHO) and the Department of Veteran Affairs. EMDR has been extensively researched and recommended as a gold standard for Post-Traumatic Stress Disorder (PTSD). EMDR, rather than focusing on changing the emotions, thoughts, or behaviors resulting from the distressing issue, allows the brain to resume its natural healing process. EMDR therapy is designed to resolve unprocessed traumatic memories in the brain. Part of the therapy includes alternating eye movements or taps. For many clients, EMDR therapy can be completed in fewer sessions than other psychotherapies. With EMDR, healing typically occurs much more rapidly than in traditional psychotherapy. Because of EMDR’s ability to clear emotional blockages, many people experience healing,openness, and a newfound sense of joy.

High sensitivity, also called Sensory-Processing Sensitivity, is a well-researched genetic trait shared by 15-20% of the population. It is a variation that allows the nervous system and brain to process subtleties, information, emotions and details more deeply and in a way that most people miss. To the HSP, the world can often feel unpleasantly intense and overwhelming, thus HSPs need more downtime to recharge, expert skills for self-care and healthy boundaries. Being an HSP does not mean that you have a disorder which needs to be fixed—it simply means learning to understand how your nervous system works, as well as tools and skills for navigating life and relationships more effectively.

Perinatal pertains to the period immediately before and after birth. It starts at the 20th to 28th week of gestation and ends 1 to 4 weeks after birth. The postpartum period follows, and it typically refers to the first year of the baby’s life.

The baby blues last for about two weeks post-delivery and about 80% of new moms experience them. Common symptoms include mild ups and downs, feeling unhappy, weepiness, and stress. These symptoms typically go away on their own a couple of weeks after the baby’s birth.Post-Partum Depression, or PPD, is the most common PMDA and it affects about 1 in 7 new mothers. PPD is typically caused by a significant shift in there productive hormones. Common symptoms include feeling sad, hopeless, overwhelmed, sleep deprivation, inadequate nutrition, isolation, poor partner support, health issues for mom and/or baby, trouble bonding with the baby,thoughts about self-harm/harming the baby, or other major stressors. If you are experiencing any of these symptoms, please reach out to us or call your primary care physician immediately.

These symptoms safely represent each stage: anxiety, depression, excessive worry, sadness, feeling overwhelmed, guilt and shame, fearfulness, difficulty sleeping, anger, loneliness, irritability, and stress.

– Hopelessness
– Loss of interest
– Increased fatigue and sleep problems
– Anxiety
– Irritability
– Changes in appetite and weight gain or loss
– Uncontrollable emotions
– Thoughts of death/suicide

Even though your pain may seem overwhelming and permanent at the moment, there are ways to deal with suicidal thoughts, feelings, and overcome the pain. The reasons for this pain are unique to each one of us, and the ability to cope differs from person to person. If you are unable to think of solutions other than suicide, it is not that other solutions don’t exist, but rather that you are currently unable to see them. The intense emotional pain that you’re experiencing right now can distort your thinking, so it becomes harder to see possible solutions to problems or to connect with those who can offer support. IT&W therapists have the training to help you—please reach out. If this is an emergency, call 911 or go to the nearest Emergency Room immediately. For additional resources, please visit our Wellness Directory.

Common symptoms include:

– Worrying about more than one area of your life, such as personal finances, job security, or the health and well-being of family members.

– Difficulty controlling your worry whether at work, home, or school.

– Experiencing more difficulty than most people in social situations, such as talking and interacting with others either in person, by phone, or virtually.

– Avoiding social situations because you are concerned you may do and/or say something embarrassing and that others will reject you. Examples include avoiding speaking in front of others, job interviews, or asking for help.

– Recurrent episodes of intense fear and physical symptoms that seemingly happen for no apparent reason or from out of the blue, such as increased in heart rate, chest tightness, dizziness, upset stomach, feeling hot or cold, or tingling in your hands or feet. During this type of episode, which is known as a panic attack, you fear that that you might be dying, going crazy, fainting, or losing control. Avoiding situations that may provoke these episodes, such as being alone or in crowded situations, driving or riding in a car or public transportation, or going to movie theaters or church.

Eating Disorders are real and serious illnesses that can sometimes be life-threatening. It is important to seek professional help if someone you know shows any of these warning signs:

– An obvious increase or decrease in weight not related to a medical condition
– Abnormal eating habits, such as severe dieting, ritualized mealtime behaviors, fear of dietary fat, secretive   bingeing, or lying about food
– An intense preoccupation with weight, calories and body image
– Compulsive or excessive exercising, especially without adequate nutritional intake or when injured or ill
– Always feeling cold and tired Have irregular menstrual periods, or the menstrual cycle stops
– Going to the bathroom right after meals, or taking showers right after eating
– Mood swings, depression, and/or irritability

Children and Teens

Play Therapy is a structured,theoretically based approach to therapy that builds on the normal communicative and learning processes of children. Therapists strategically utilize play therapy to help children express what is troubling them and change the way they think about, feel toward, and resolve their concerns. Toys become the child’swords and play is the child’s language. Through Play Therapy, children learn to communicate with others, express and tolerate feelings, modify behavior,develop problem-solving skills, and learn a variety of ways of relating to others. Play proves a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development.

Mindfulness has been demonstrated through research to be an effective and evidence-based intervention to reduce stress and the physical and psychological problems that result. Using Mindfulness based strategies and interventions decreases anxiety and worry, improves social skills and relationships, enhances coping skills to manage life and school stressors, improves impulse control, decreases emotional reactivity and increases focus and goal-oriented behavior. People who use Mindfulness learn how to intentionally focus on emotions, reactions and behaviors and make thoughtful and wise judgments and decisions, in turn developing improved self-esteem and the ability to tolerate distress. For some,mindfulness is an effective anxiety therapy or even a significant aid to trauma recovery.

Depression is biological illness that affects our moods, thoughts and behaviors. Any changes in a child’s mood, their behavior, energy levels, habits or personality; you should consider depression as a possible reason for these changes. Here are the warning signs that your child might be suffering from Depression:

– Experiencing long-term bouts of sadness most every day for at least two weeks or more
– Having trouble performing & loss of interest in normal day-to-day activities, including avoiding social contact or withdrawing from activities Increased sleep or difficulty sleeping
– Decreased energy or fatigue Irritability
– Feeling helpless, worthless and hopeless
– Difficulty concentrating or making decisions
– Significant weight loss or weight gain
– Restlessness or agitation
– Thoughts of death or suicide

If you think your child has five (5) or more of these symptoms, understand that it can get better, but you need to take action. Get an evaluation from your child’s pediatrician or mental health professional as soon as possible. ITW offers several different approaches to depression therapy. Your child’s counseling services will be customized according to their needs.

Anxiety in children appears in physical, emotional and behavioral changes. When stressed, children regress.Anxiety is a sense of fear and worry whereas stress is a natural and normal response to a challenge. Stress can make children feel anxious and being stressed over long periods of time can create anxiety if coping strategies are not learned to manage the stress. Here are ways a child’s anxiety shows up and how to recognize if the changes you’re observing are more than just situational stress:

AngerChildren experiencing high levels of anxiety display increase danger and difficulty managing it. The perception of “danger” and stress is enough to trigger the fight or flight response leaving your child angry and without a way to communicate why.

Difficulty Sleeping: is a hallmark characteristic of children with anxiety, having more difficulties falling asleep and staying asleep.

Defiancechildren have difficulty communicating feeling out of control so they attempt to control a situation with oppositional behavior when they feel anxious and helpless.

Lack of Focus: children with anxiety are often so caught up in their own thoughts that they do not pay attention to what is going on around them,distracted by constant fears and worries.

Avoidancechildren typically try to avoid a particular person, place or task that increases their stress, worry or fear.

Chandelieringthis is when a calm child suddenly flies off the handle for no reason. They have pushed hurt and anxiety so deep for so long that a seemingly innocent comment or event suddenly sends them straight ‘through the chandelier’.

Negativitychildren with anxiety tend to experience negative thoughts at a much greater intensity than positive ones and view the world, their relationships and their value in negative terms.

If you feel anxiety has stopped your child from enjoying his/her life, then it will be beneficial to get an evaluation from a qualified mental health professional to diagnose the extent of their anxiety and to assist you and your child in finding healthier ways to cope and manage. Anxiety counseling can include a number of approaches to provide your child with healthy coping tools and skills.

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