Frequently Asked Questions
The Awakening Center
What is The Awakening Center?
The Awakening Center is a cooperative of independent professionals. We are a group composed of psychologists, counselors, social workers, and a nutritionist who have come together because of a shared approach and philosophy. We share our office space, website and newsletter, however, each helping professional sets her own hours, fees and policies.
Why are you called "The Awakening Center?"
Our name reflects our view that each of us has untapped potential to love, work, and create, that may be "awakened" when we surmount our internal obstacles. We believe that our clients have the answers to their own questions and dilemmas, and our role as therapists is to help you find these answers and facilitate your growth process.
Is The Awakening Center only for women?
No, while our staff is currently comprised of women, and we have expertise in treating women¹s issues, we work with men and couples as well. We also treat children, adolescents, and families.
Is The Awakening Center just for people with eating disorders?
No, eating disorders are some of the problems we specialize in, but we treat people with a wide range of symptoms and issues such as anxiety, depression, relationship difficulties, trauma, substance abuse, and compulsive self-injury.
Is The Awakening Center a day program?
No, The Awakening Center offers a range of services you can choose from to meet your needs, however, we are not a partial hospitalization or intensive outpatient program. If you are in need of intensive therapy, you may come several times a week..
What will happen when I call the intake line at The Awakening Center?
After you leave a confidential message on our voicemail system, one of our therapists will call you back and ask you a few questions about why you are seeking psychotherapy at this time. If we are the right place for you, she will then match you with a compatible therapist. Your therapist will then call you to set up an initial appointment.
How will my fee be set at The Awakening Center?
You and your therapist will discuss your fee in the first session. Your therapist has a ³full fee² based on her training and experience. Each therapist also has a limited number of ³sliding fee² appointments for clients with lower incomes. If you need a significantly reduced fee, you may see a therapist in training at The Awakening Center, when available.
If I already have a therapist, can I see the nutritionist at The Awakening Center, or join a therapy group there?
Yes, we are happy to collaborate with outside therapists, psychiatrists, or other professionals.
I don¹t like my current therapist. Can I switch to a therapist at The Awakening Center?
We suggest that you discuss the problems you are having with your therapist
first, to see if you can work them out. If this is not possible, we recommend that you inform your therapist of your decision to end your treatment with her before making an appointment at The Awakening Center. You may also set up a consultation appointment with us to discuss the problems you are having with your therapist.
What is psychotherapy?
Psychotherapy is a process in which you discuss your thoughts and feelings in order to gain insight into the issues that are causing you distress and to make positive changes in your life. Therapy is most effective if it addresses both current problems and the deeper issues underlying them.
What will happen in the first psychotherapy session?
The first session is a chance for you and your therapist to get to know each other and to assess whether the two of you think you can work together. Your therapist will ask you questions about the issues you are currently trying to cope with. She will ask you about your current life, your friendships/relationships, and your family and your background. The therapist will also devote some time to discussing her policies regarding fees, cancellations, vacations, insurance, etc. The first session is also a time for you to ask your therapist any questions you may have.
Is my psychotherapist going to focus mainly on my childhood?
You and your therapist will try to look at your past, present and future. Talking about your childhood may help you understand the conscious and unconscious messages you received from your family. Understanding your past can shed light on your current relationships and your internal struggles. However, your therapist will also help you learn to cope with current situations, as well as set goals for the future.
How often will I need to come to psychotherapy to feel better?
Psychotherapy is a very individualized process. Given your issues and therapy goals, you and your therapist will determine what schedule will be most helpful. However, it is usually recommended that you attend psychotherapy at least once a week to develop a sense of continuity between you and your therapist.
I have limited time/money. Can I come every other week?
In the beginning phase of therapy, we do not recommend that you attend less then once a week. We find that if a client comes less than weekly, it is difficult to form a connection with your therapist and your progress will be slow. We strongly suggest that you make your therapy a priority and make the time to come weekly. Some clients come less frequently after they feel significantly better, or are making the transition to ending therapy.
How long will I need to attend psychotherapy?
The length of time you will need to be in psychotherapy varies from person to person. It depends on your therapy goals, the amount of distress you are experiencing, the length of time you have been in pain, how often you attend psychotherapy. Most people attend for at least several months, and many for several years. If you have a specific problem, such as getting over a breakup, you may resolve this fairly quickly. More complex problems require more time. Even if you decide to or have to stop before you reach all of your therapy goals, the tools, insight, and accomplishments that you gained while in therapy will continue working for you. You can also choose to resume psychotherapy at any point in the future.
How will I find the right therapist?
Finding a therapist who is a "good fit" for you is essential. Try to listen to your "gut" about the therapist: Do you feel comfortable talking to her, do you feel that you could potentially tell this person thoughts and feelings that may be hard for you to share with anyone. Since beginning psychotherapy can be scary, you may need to meet with a therapist a few times in order to figure out whether you feel comfortable. Look for a therapist who has expertise in the particular area(s) that you think you want to work on. Ask whether the psychotherapist is trained and licensed in counseling, social work, psychology, or psychiatry. If she is not licensed, you should ask where she is being trained and whether she is under the supervision of someone who is licensed in one of the above-mentioned fields. All Awakening Center therapists are licensed or receiving supervision by licensed therapists.
What are the differences between psychiatrists, psychologists, social workers, and professional counselors?
A psychiatrist has undergone medical training and is authorized to prescribe medication. Some psychiatrists also practice psychotherapy while others handle medication management only. Psychologists, social workers, and professional counselors all receive training in psychotherapy. Each discipline approaches the therapeutic process from a somewhat different angle. However, as a general rule, it is better to base your choice of therapist on a personal connection rather than on their training background alone.
What if I have been in therapy before and it didn't work?
Your success in treatment depends on finding the right therapist for you. If one therapist was not able to help you, don¹t give up on therapy; keep trying until you find the right person. Talk to your new therapist about what went wrong in the past. Feel free to share your reactions to your therapist as your therapy progresses.
What if I am not sure what I need from therapy?
Many people who begin psychotherapy do not know exactly what they need. Clients commonly come in for a specific problem and come to realize they have other goals. A therapist can help you think through what your needs are, and after she gets to know you, can give you her professional opinion about what may be helpful for you to address.
What is the difference between outpatient psychotherapy and partial hospitalization?
Outpatient psychotherapy means you go to the office of a psychotherapist for a session that lasts between 45 minutes to one hour one or more times a week. Partial hospitalization means that you are attending a program, usually located in a hospital, that meets several hours a day, several days a week. A partial hospitalization program has many comprehensive services such as individual, family, and group psychotherapy, support groups, expressive therapy groups, and medication management.
What are the differences among psychodynamic, cognitive/behavioral, and experiential therapies?
A psychodynamic approach examines conflicts within yourself as well as patterns you tend to repeat in your relationships. There are many different psychodynamic models such as Self Psychology, Interpersonal and Relational Theory, and Internal Family Systems. Cognitive/Behavioral Therapy (CBT) addresses symptoms directly by focusing on maladaptive thoughts and behaviors. Dialectical Behavioral Therapy is an innovative form of CBT that focuses on managing strong emotions. Experiential therapy uses expressive methods like art and movement or strategies like mindfulness meditation. These techniques are ways to get closer to buried feelings and states of mind. The therapists at The Awakening Center are integrative or eclectic, blending elements of all these approaches.
What is the difference between psychotherapy and psychoanalysis?
In psychotherapy, your therapist is usually more interactive and you are sitting up facing the therapist. Psychoanalysis is a more intensive process. You might attend 3-4 sessions a week. You may lay on a couch while your psychoanalyst is seated in a chair behind you. Psychotherapy is a good treatment for most types of problems. You may want to try psychoanalysis if your problems are long-standing and deep-seated, if you are stuck in distressing patterns in your relationships, or if you have
tried several psychotherapists and have not experienced significant improvement.
Support GroupsHow do I join the support group? Do I have to pre-register?
Since the groups are ongoing, you may join any week by just showing up. If you are more comfortable speaking with the group leader before attending that is fine too. But, you do not have to "pre-register" or "sign up" before attending. The current members of the group are usually very warm and welcoming to new members.
Who attends the support group? How many attend?
Generally, most of the members of the support group are in their 20's and 30's, although we sometimes get those who are younger or older than that. Typically, about 6-14 people attend; the group grows larger in February and October and smaller in the summer and around the holiday season.
What eating disorder do most of the members have?
Usually more than half the members are recovering from bulimia. The rest of the members are divided between those recovering from overeating or anorexia. Even though the members' body sizes or behaviors may be different from your own, we have found consistently that the underlying issues are the same for all.
A. I don't feel like I am "recovering" at all. Is the group for me?
B. I no longer engage in the eating disorder behaviors. Is the group for me?
The group is open to members in any stage of recovery. Some members are in the very beginning stage of recovery, where they are just questioning whether or not they have an eating disorder and if they want to recover at all. Many have accepted that they do have an eating disorder, but they still struggle with the behaviors and symptoms. Several are farther along in that they have an understanding of their symptoms and issues and have more of a handle on their symptoms. Some are fully recovered and keep attending for support to reinforce their recovery and continue to work on their issues.
How is a meeting structured?
In the beginning of the group I read from a book of affirmations. Then I say a short introduction with the "guidelines" for the group. After that, members introduce themselves and "check in": give agenda items, what issues they want to talk about. After introductions and agendas, I open the meeting up to a discussion. After the discussion we have a brief "check out" and a can is passed around for donations for expenses. We end the group with another reading from the book of affirmations.
What do you talk about in the meetings?
While food, eating, and weight are discussed in the meetings, ordinarily I try to get the group to talk more about the underlying issues. For example, if someone says they binged because they were lonely, we will talk about loneliness. Some common themes are: loneliness, emptiness, anger, anxiety, powerlessness, control, trust, relationships with friends and family, coping skills, stress, and fear.
Is there a fee? How much does the group cost?
Our suggested donation is $5.00/week, but you may give more or less according to your own income and expenses.
Do I have to be in individual or group therapy to be in the support group?
No, any woman who has any problem with eating, food, weight, exercise, etc. can attend the support group. You do not have to be in therapy to attend the support group.
If I attend the support group, do I still need to go to individual or group therapy? Isn't being in the support group enough?
While a support group can be therapeutic, it is not a therapy group, nor is it meant to be a substitute for individual or group therapy. It is meant to provide support to you while you work on your personal issues in individual or group therapy. We believe that while it is possible to recover without individual or group therapy, it would be very difficult to do so.
What is the difference between the support group and a therapy group?
There are several differences. In a support group, whoever shows up at any particular meeting, whether it is 3 people or 13 people, that is the membership of the support group for that meeting. New members are allowed to join any week and members can stop attending whenever they want. While a core group, members who attend on a regular basis, does form in the support group, there is no guarantee of continuity of members. In a therapy group the number of members is fixed, usually at 6, and the members are committed to attend every week. There is a prescreening process to see if someone is appropriate for the group and if the group is appropriate for them. New members are only allowed to join when a member leaves the group, and the group will process their feelings about allowing new members in, as well as feelings about current members leaving. Because the same members attend on a weekly basis, a therapy group can build a level of trust and intimacy that is not found in a support group. This trust and intimacy is necessary to take the risks necessary to produce growth within the group setting.
My role and how the groups are led is different also. In a support group, I act as a leader and moderator, not the therapist. Discussions are on general topics and I tend to "teach" about eating disorders and their underlying issues. Generally, the members' personal issues are not explored at length. Members are not required to speak; they may just sit and listen for the entire meeting. In a therapy group, I act as a therapist. While some topics are discussed generally, most of the time is spent exploring the members' personal issues and feelings. If a member does not speak, it is treated as a therapeutic issue and will eventually be explored.
In both kinds of groups, I feel it is important that a feeling of safety for each of the members. In the therapy group, because members are taking more risks, it must be done in a supportive and safe manner: "If I reveal my issues to you, I know you will not reject or shame me, because I know that you have the same feelings too. If I need to back up from the group's intimacy, I know that my need will be respected."
Can family members or significant others attend the groups?
Yes. Because the Tuesday group has two leaders, it is open to family, friends and other support people. After check-ins, the two groups split up and the meetings are held in separate rooms. This way both groups feel free to talk about whatever concerns they have without worrying about their family member or friend. Occasionally, if only one leader is present or the two groups request a joint meeting, the two groups may remain in one room for the entire meeting.
New laws which may affect your mental health insurance have gone into effect January 1, 2010.
A new law, The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, went into effect January 1, 2010. In simple terms this law says that your mental health insurance coverage has to be equal to your medical insurance coverage – if you work for a company with 50 or more employees. If you had a heart condition the insurance company could not say, “We’ll pay for 10 visits to a cardiologist and we’ll only pay for 15 days in the hospital.” Therefore, in theory, the insurance company is not supposed to limit the number of sessions with your therapist, nor put limits on inpatient hospitalizations.
Your medical insurance and your mental health insurance are two different insurance policies. Just because you have “good medical insurance” does not mean that your mental health insurance coverage is the same. You may find that the insurance company that covers your medical claims is not the same company which covers your mental health claims. Your mental health insurance may have to be pre-certified or pre-authorized. If you do not get the sessions pre-authorized, your mental health insurance company can deny all claims and pay NOTHING for up to a year!
Another common “surprise” is that your insurance company will pay for six sessions without pre-authorization, and then require pre-authorization for future sessions. Future sessions can be then denied because they were not preauthorized.
Some insurance companies will pay for medical nutrition counseling. We recommend that you call your insurance company and ask. You may need to get a “prescription” from your medical doctor in order for your insurance company to justify the need for these services.
All of the therapists at The Awakening Center are in network with BCBS of IL PPO. Some therapists are also in network with Aetna, Cigna, Humana, Magellan & Unicare. Even if we are not in network with your insurance company, we can submit the claim to your insurance company directly or give you a receipt which you can send to your insurance company for reimbursement.
The therapists at The Awakening Center all have a limited number of sliding fee appointments. We offer very-low-fee therapy with therapists-in-training for clients who do not have mental health insurance. Please be aware there may be a waiting list for very-low-fee therapy. We are sorry but we cannot accept Medicare or Medicaid.
We cannot tell you what your insurance coverage is – as each policy is different, even within the same company. We recommend you call your insurance company directly to verify your mental health insurance coverage before you begin therapy. This will eliminate any “surprises” which may interfere with your therapy later on.
It is very important that you call your insurance company to verify your mental health insurance benefits. This must be done before your first session with your therapist. The phone number is usually on the back of your insurance card. If you have any problems calling your insurance company, please feel free to talk with your new therapist.
Here are some suggested questions you may want to ask your insurance company about your mental health coverage. There is usually an 800 number on the back of your insurance card. We recommend that you print out this page and fill it out as you speak with the insurance company. Please make a copy of the answers for your therapist at your first session.
Name of insurance company:
Insurance phone number:
Date of call to insurance company:
IMPORTANT: Name of person you spoke with:
Say: “I would like to verify my insurance coverage for outpatient mental health services. Is my mental health insurance coverage the same company as (name of medical insurance company)?”
Is (Therapist name or The Awakening Center) an ‘in network provider’?
What is my deductible?
Have I met my deductible?
What percentage will you pay for each session?
Is there a maximum number of sessions per calendar year?
Is there a maximum amount of benefit payments per calendar year?
Is there a pre-existing condition clause? What conditions are in the clause?
Will you cover CPT code 90837?
Do the sessions need to be pre-authorized or pre-certified?
What is the procedure for pre-authorization?
What is the address to send claims?
Dialectical BehaviorDialectical Behavior Therapy (DBT) FAQ
Could DBT be helpful for me?
Maybe. You can get an idea of whether it might be by taking the Emotion Management Quiz.
My therapist suggested I do DBT. Does that mean I have Borderline Personality Disorder (BPD)?
It makes sense that people think DBT is only for BPD. It was originally developed to treat BPD and most books and articles published regarding DBT are about treating BPD. But the truth is that DBT is helpful for folks with many other diagnoses too -- including eating disorders, drug or alcohol problems, depression, and even pathological gambling. What all these disorders tend to have in common is that they stem from emotional dysregulation. Emotional dysregulation means that emotions are intense, seem uncontrollable, and can lead to impulsive behaviors that may relieve the distress temporarily, but create dissatisfaction with one’s life in the long run. DBT can help people feel less emotionally dysregulated.
What does “dialectical” mean?
It’s a term from philosophy. Dialectics can seem difficult until you work with them for a while, so don’t be too concerned if it seems complicated right now. The idea is that absolute “truth” is never a certainty. In fact the world is full of paradox and contradiction. Dialectics as they’re used in DBT are a mode of thinking through which contradiction is a starting point for contemplation, where every “absolute” has a polar opposite with which it can be synthesized (combined) to form another “absolute,” and so on. So rather than viewing opposites as ideas that clash and can’t be reconciled, from a dialectical perspective opposites are a jumping off point for reaching a more realistic view, a closer approximation of “truth,” but one that’s always open to question.
What does DBT treatment entail?
“Full” DBT treatment at the Awakening Center entails attending a 90-minute skills training group once a week and one 45-minute individual DBT treatment session. However, many people who are already in individual therapy with a non-DBT therapist can benefit from coming just to the skills training group and sharing what they learn in DBT with their individual therapist.
What is DBT about?
DBT is about learning options for managing emotions and the behaviors that happen as a result of them. Participants identify “target behaviors” which are things they do when distressed that they would like to stop doing. They apply DBT skills to help reduce or eliminate their target behaviors. There are four skill areas that make up the “DBT skills”, which are the foundation of the treatment. Briefly, the skill areas are:
1) Mindfulness: cultivating awareness of thoughts, emotions and present-moment experiences.
2) Emotion Regulation: understanding what emotions are and ways to deliminate, de-escalate or change them.
3) Interpersonal Effectiveness: ways to get your needs met without damaging relationships.
4) Distress Tolerance: ways to tolerate distressing emotions when you can’t change or eliminate them.
For a more detailed discussion of DBT and the skill areas, go to http://www.borderlinepersonality.info/dbt.htm.
Why do some people struggle so much to manage emotions and other people don’t?
According to Dr. Marsha Linehan, who developed DBT, some people are born more sensitive to emotion than others. Not only do they feel emotions more quickly and intensely than other people, but it also takes them longer to “come down” from an emotion. That can work out fine if you learn skills for coping with strong emotions early in life within your family or elsewhere. This means that people around you acknowledge the reasonableness of your feelings, help you learn ways to soothe yourself, and/or show you what to do with strong emotions by demonstrating skillful behavior when they themselves have strong emotions. However, if you are raised without the opportunity to learn to cope skillfully with strong emotion AND you’re emotionally sensitive, everyday life -- and the emotions that accompany it -- can be quite difficult.
What are the requirements for being in a skills training group?
1) You have to have an individual therapist and you have to be seeing them as often as they recommend. It doesn’t matter if that therapist isn’t doing DBT with you, but they must be willing to support your DBT work. Your individual therapist doesn’t have to be an Awakening Center therapist.
2) You have to meet with the DBT Skills Group leader once individually before joining a group. In that meeting, you’ll hear more about what DBT is and decide together whether it might be beneficial for you. If so, you’ll make a formal commitment to being a DBT group member. You’ll also set initial “target behaviors.” These are things that you do when you experience strong emotion that you’d like to stop doing.
What if I don’t like being in therapy groups? Is there some other way to do DBT?
If you’ve determined that you don’t like therapy groups based on past experience, you might be surprised at how different a DBT group is. Unlike traditional “process” groups, where members discuss their reactions to each other and work through their conflicts, DBT groups are more structured, and feedback among members is expected to be supportive. Skills learning is at the center of the groups and it may often feel more like an interesting class than a traditional therapy group. While being in a group is the best way to learn DBT skills, in certain circumstances, individual skills coaching is available at the Awakening Center. Particularly if there is some reason it’s impossible to attend a skills training group.
What happens in the skills training group?
The agenda we usually follow is: 1) brief check-in about how each member’s feeling; 2) group mindfulness exercise; 3) homework review; 4) new skill learning and discussion; 5) homework/practice assignment for the week; and sometimes 6) another mindfulness exercise. For a good description of what DBT is like from one participant’s perspective (though not an Awakening Center DBT client), visit http://www.growingstrong.org/mental/dbt.html
What about the group members? How many are there? What kinds of problem behaviors do they engage in?
The groups are small -- typically from 4 to 7 members. Members engage in a wide variety of target behaviors, including self-injury, binging and/or purging, alcohol and/or drug use, isolating, interpersonal aggression, and others.
I’m embarrassed about my target behaviors. What if no one else has the same target behaviors that I do? What if other group members can’t relate?
Many people experience embarrassment around their problem behaviors. It takes courage to seek treatment. One of the guidelines of DBT group is that the members accept rather than judge each other. It’s likely there will be another group member who engages in at least one of your target behaviors. If not, remember that everyone in the group shares the same basic difficulty in managing their emotions. All group members can relate to that.
How much does it cost? Can I use my insurance?
For DBT Skill Training Groups, the fee is $60 per group. For Individual DBT Therapy or Individual Skills Coaching, the fee is $90 per session. There are a limited number of reduced-fee slots available. Fees are due at the end of each session for individual treatment, and at the end of each month for group treatment. If you want to use your insurance, Dr. Gulin Guneri-Minton (the DBT therapist) can provide you with a monthly statement you can submit for reimbursement. Dr. Gulin Guneri-Minton does not bill insurance companies directly. Many insurance companies cover the cost of DBT treatment. Dr. Gulin Guneri-Minton is not a member of any insurance network or panel, so if you have an HMO, DBT will likely not be covered and if you have a PPO it will be covered at the out-of-network rate.
How do I get started?
By calling Dr. Gulin Guneri-Minton (773) 929-6262 ext 18 to set up an individual appointment to discuss whether DBT makes sense for you and, if so, make a plan to get you started. If you’re already an Awakening Center client, you can start by discussing DBT with your treatment staff.
What if I have to miss a skills training group?
If it’s impossible to come to skills training group, you must call at least 24-hours in advance. Otherwise, you will be charged for that group. DBT can be hard work and coming to group can feel burdensome sometimes. The cancellation policy is designed to support your commitment to coming and give you a reason not to act on an impulse to miss the group. If you’re getting reimbursed by insurance, you should be aware that they will not pay for sessions you have missed.