Therapy with Jay
From your perspective, what is therapy?
Therapy is a collaborative process focused on client self discovery and self actualization. I consider my role to be that of facilitator. I provide a safe and supportive space for clients to explore issues and come up with solutions. I assist clients to discover patterns in their thinking and behavior through interpretation, application of psycho-dynamic concepts, and open and honest discussion.
Please share 2-3 anonymized examples of how the work can play out and/or look in the room.
Example 1: A client presented with depression, anxiety, and substance abuse issues. I obtained a detailed history of the client’s past, including treatment history, risk issues, family relationships, and current symptoms. The primary focus of the initial sessions was around building trust and rapport with the client, and assisting him with emotion regulation. The client eventually disclosed a history of physical abuse by his father. Simultaneous to the exploration of underlying issues, we worked on practical supports in the moment that included a psychiatric consult, attendance at a 12 step program, relaxation techniques, increasing contact with supports, and other methods to address current symptoms.
Example 2: A client presented with work stress. Initial focus was on her giving examples of what she likes about her job, and what issues she is facing, such as conflict with her supervisor, poor work/life balance, and not feeling attuned with the overall company mission. It soon became clear that alignment with mission was an important variable for this client to feel work satisfaction. We continued to explore career goals, and along with this exploration other underlying issues became apparent, such as the client’s relationship with her parents, and her views on relationships based on her parents as a model.
Are there any philosophies or values that inform your work that I should know about?
I am primarily a psycho-dynamic psychotherapist, which in practical terms means that I am interested in past relationships and developmental patterns, and how they relate to current thinking and behavior. I like to discuss issues in the moment, and help clients to see the connections to their past in order for them to deepen self understanding. I also use much more practical present-focused techniques derived from cognitive-behavioral and short-term solution focused theory.
A grounding theory that informs all of my work is that of Rogerian client centered therapy; this perspective maintains that clients ultimately know what is best for them, and have the ability to heal and self actualize. Some of the tenets of this theory include being genuine, empathetic, and providing unconditional positive regard.
4. How much do you share about yourself during our time together and why?
I am careful about self-disclosure, and want to insure that any information I provide about myself is aimed at serving the client’s needs and not my own. I’m not opposed to some limited self disclosure if it serves to deepen the relationship with the client by illustrating empathy and shared understanding.
5. How participatory are you during sessions?
I can be quite participatory and engaging, but will assess the client’s needs and receptivity. I do not want to get in the way of clients’ self expression, and I believe that clients need to come to conclusions on their own. That being said, I can certainly offer my expertise and guidance when appropriate, and want clients to feel as comfortable as possible.
6. Do you assign homework, activities, or readings for me to do between sessions? Why or why not?
I do not usually assign homework per se, but this would depend on the client’s situation and needs. I have certainly encouraged clients to take action steps between sessions (e.g. attend a 12 step meeting, monitor sleep patterns, keep a thought record, monitor grief symptoms), but my primary focus would be on helping clients in the session to determine their own level of motivation and subsequent action plans.
7. How will our relationship be different than relationships I have with friends/loved ones?
The therapeutic relationship is in many ways one-sided; it is focused on you and your needs, unlike friends and family members who will often have a more reciprocal relationship with you. The therapist also operates based on professional ethics and training, offering an objective framework to help you to address your concerns.
8. Is there ever a time when you would encourage me to leave or graduate? Or how do I know when it’s time to end or move on, or time to stay and explore more?
I believe that the termination phase is an important part of effective therapy. When and how you terminate treatment is something you should openly discuss with your therapist, and something that optimally should be done collaboratively. I would usually only encourage termination if a client is clearly not benefiting from treatment (e.g. due to lack of commitment).
9. Where did you work before going into private practice?
I have over 20 years of clinical experience. I have worked at a large hospital (in the psychiatric ER, Medical ER, and supervising a team of 25 social workers in various departments), in an outpatient mental health clinic, and at a Human Resources Consulting firm and Employee Assistance Program where I am still employed part time - In this role I consult with human resources about employees with performance issues due to mental health, substance abuse and other personal issues, as well as conducting organizational assessments and implementing solutions. I’ve maintained a small private practice for over 10 years, but I am now working part time so that I can expand my practice further.
10. Do you have experience (5-10 years+) working with any types of obstacles or people in particular?
I have over 20 years of experience working with people who have substance abuse issues, grief issues, mood disorders, and workplace performance issues. I have been providing executive coaching services as well for 5 years.
11. What led you to become a mental healthcare practitioner?
I started out with an interest in a more administrative role, working as a manager at a hospital and private business. My focus then was on positive social change, something I still believe in. However, I found working directly with individuals to be more personally rewarding, as behavior change in individuals is often more apparent than in larger systems. I continue to enjoy a blend of work at different levels, as a psychotherapist, executive coach, and consultant.
12. What is the best part of the work for you?
The best part of the work is getting to know people and building a collaborative professional relationship that yields positive results for the client.
13. What is unique about the work you do, or how have you found your work to be different than your colleagues’?
I believe that all skilled and competent therapists have a lot in common. That being said, my unique attributes are a combination of clinical expertise, business experience, and a direct and supportive style.
14. How do you approach diversity in the room or working with clients who may come from a different background than you?
I am in favor of acknowledging diversity and differences in an open and respectful way, and in gaining an in-depth understanding of the client’s experience.
15. How can you tell if I am benefiting from working with you?
Do you feel connected? Do you feel heard and understood? Are your symptoms improving? Is your work performance improving? Do family and friends comment that you seem to be doing better? Do you feel that therapy is helping you?
16. How can you tell if I am feeling stuck, unseen, or unheard?
There are many ways to tell if a client is stuck or is not feeling heard. This could come out behaviorally - e.g. missed sessions, arriving late; it could come out in the client seeming angry or reticent; it could come out in what a client says or how they say it. I like to look at all of these signs and have an open and frank discussion to get to the root of the issue, and help the client examine their behavior and reactions, not least their reactions to me in the moment.
17. How long should I commit to being in therapy, at least in the beginning?
How long you should be in treatment depends on the issue(s) you are addressing, how long they have occurred, how severe your symptoms, how much your life is impacted, whether you’ve been treated for the issue(s) before, and other personal factors such as your support network, health, and family history. I advise having a discussion about it with the therapist, usually within the first 1-3 sessions. In collaboration with the therapist, you can determine what seems to be the best course of action for you. For people dealing with a long term issue, such as chronic depression, I advise at least a 9 month course of therapy, depending on progress. For people dealing with a more short-term adjustment issue, such as getting used to a new job, or some sadness from a breakup, a course of short-term therapy as short as 6 sessions could be enough.
18. How should I prepare for my first session with you?
No preparation needed. Just try to be as open as possible to the process.
19. Do I need to bring anything with me?
A phone or calendar to schedule additional sessions, and your insurance card or payment method.
“I have known Dr. Jay Sandys for over 10 years. He is a highly skilled, empathetic, and principled clinician. Dr. Sandys is clinically astute, and engages well with diverse clients.” — Jose Hevia, LCSW-R, LP
“I’ve been seeing Jay for over three years, having originally sought him out to address issues including substance abuse, anxiety, and depression. Since then, my life and mental health have improved dramatically, and I owe much of that success to Jay.”
“Jay is extremely professional and genuinely empathetic. His years of experience as a counselor and clinician have made him an excellent therapist, well-equipped to help his clients overcome mental illness and personal difficulties. I highly recommend him.”