Joshua B. Lerner

Practice Specialties or Interests:

Depression
Self-esteem
Anxiety Disorders/Phobias
ADHD
Adjustment Disorder
Adoption Issues
Bipolar Disorder
Child Abuse
Conduct Disorder
Dissociative Disorders
Gender Identity
Grief/Loss
Impulse Control Disorders
Oppositional Defiant Disorder
Parenting Issues
PTSD
Relationship Issues
Schizophrenia and/or Other Psychoses
Sexual Abuse
Women's Issues

Age Specialties:
Children
Adolescents
Adults

Session Formats:
Individual
Couples
Family

Treatment Approaches:
Cognitive/Cognitive-Behavioral
Developmental
Interpersonal
Object Relations
Play Therapy
Psychoanalytic
Psychodynamic

Demographic Specialties:
Jewish

Education:
B.A, Oakland University, 1971

M.S.W., University of Michigan, School of Social Work, 1979

Qualified Psychoanalyst ( MBPAS)
British Psychoanalytic Institute, 1996

License #:44SC05161300
License State:
New Jersey

Additional Licenses/ Certifications:
Board Certified Diplomate in Clinical Social Work
Fellow, International Psychoanalytic Association

Professional Affiliations:
* International Psychoanalytic Association
* New York Freudian Society
* American Psychoanalytic Association
* New Jersey Institute for Training in Psychoanalysis
* Institute for Psychoanalysis and Psychotherapy of New Jersey
* Association for the Treatment of Sexual Abusers
* National Organization of Forensic Social Workers
* International Association for Forensic Psychotherapy

Fee Schedule:

My standard fee is $175 per session.
I have a limited sliding scale dependent upon the individuals financial situation

Accepted Insurance:
Any PPO
Any Out of Network Plan

Insurance and Billing Instructions:
I accept cash or check in payment. I accept most PPO and Traditional Master Medical insurance and also provide sliding scale rates for individuals who are uninsured, if there are financial issues. However, due to the intrusion of managed behavioral health companies in the delivery of appropriate treatment, I am no longer accepting insurance contracts which restrict the quality of care I can provide.

As an LCSW in New Jersey, all insurances that have out of network benefits must reimburse for my services.

I have practiced as a Child, Adolescent and Adult Psychotherapist, serving the people of Bergen County for years. I have experience with the differing and diverse population in this area and would like to be able to help you in your time of need.

Types of Available Psychotherapy

The most common type is one-on-one psychotherapy, which involves an individual client meeting with a therapist to talk about his or her problems. This type of therapy tends to be intrapsychic and focuses on the person's mind and emotions.

Marital or couples therapy is designed to help people resolve relationship problems. Both partners attend therapy and the focus is on the relationship, rather than on the individuals. It has been my experience that marital therapy is most effective when the partners are still on relatively good terms. Often times, people go to couples therapy as a last resort when it may be too late for them to resolve their differences. Couples who receive marital counseling early on improve their chances of success.

In my work as a Marital Therapist I find that most couples are attempting to save their relationship and make it work. Try to imagine how your relationship was in the beginning. I will help you build on those feelings, so that you can find the love that you have lost.

I work with traditional and non traditional couples who are: dating, in long term relationships, living together, engaged, newly weds or couples who have been married for years.

Some people say to me "Are you in favor of saving the marriage?” My answer to them is:" Yes, as long as it is not physically and/or emotionally destructive to either of you.” Relationships are one of the most important things in our lives and it's not always easy to get along with so many difficult situations that arise.

During my 30 years of being a marital therapist, I have learned that there are many things we can do to help couples with problems. I can teach you how to: improve communications; deal with emotional pain, and anger.

Together we can figure what has gone wrong and what it takes to rebuild your relationship. Not attempting to hide the problems, but instead facing them and working them through. I will help you to find answers to difficult problems in your relationship.

How to choose a Psychotherapist

A psychotherapist is a professional who is trained in the area of mental health and whose job it is to treat mental and emotional disorders. Usually this is done through talk therapy.

Psychotherapy is a form of treatment for mental and emotional problems. It can be used to help people with many kinds of difficulties, from fairly common ones (such as having trouble coping with stress) to less common, more severe ones (like being unable to leave the house because of crippling anxiety).

A psychotherapist helps people understand their problems from a new perspective by offering an objective point of view, helping to understand the underlying problems that are causing difficulties and new ways of thinking about and responding to problems. Going through the therapy process tends to change people's feelings about themselves and their situations, and they become happier, more self-confident, and more effective in dealing with life's stresses.

Types of Available Psychotherapy

The most common type is one-on-one psychotherapy, which involves an individual client meeting with a therapist to talk about his or her problems. This type of therapy tends to be intrapsychic and focuses on the person's mind and emotions.

Marital or couples therapy is designed to help people resolve relationship problems. Both partners attend therapy and the focus is on the relationship, rather than on the individuals. It has been my experience that marital therapy is most effective when the partners are still on relatively good terms. Often times, people go to couples therapy as a last resort when it may be too late for them to resolve their differences. Couples who receive marital counseling early on improve their chances of success.

Family therapy is designed to help families resolve problems that affect everyone in the family unit. Family members attend the sessions as a group and work on understanding their differences from each other's perspectives. The goal is usually improved communication, less conflict, and greater empathy and cooperation.

What Kind of Training do Psychotherapists Have?

Psychotherapist is a generic term describing anyone who practices psychotherapy. There are several different academic degrees that allow people to become psychotherapists.

Clinical social workers typically receive about two years of graduate training in mental health during which they develop expertise in psychotherapy and in personality and diagnostic assessment They typically have two years of three days a week in an internship. Clinical Social workers who are psychotherapists must have a LCSW (Licensed Clinical Social Worker) degree. This degree means they have received more than 3,000 hours of psychotherapy training and have passed a licensing exam.

In New Jersey, there are therapists with a degree in Marriage and Family Therapy. People with these degrees typically have about two years of graduate training in psychology and have attained Master's degrees. They have experience in practicing psychotherapy with an emphasis on working with couples and families.

Psychiatrists are MDs whose medical specialty is psychiatry, the branch of medicine concerned with the diagnosis and treatment of mental, behavioral, and emotional disorders. They receive the same medical training as other doctors, and then complete a four-year residency in psychiatry. Because they are MDs, the primary focus of their training and practice is intervening medically by evaluating patients and prescribing medication. While psychiatrists are legally allowed to perform psychotherapy, they usually have little training to do so and most choose not to do it.

A clinical psychologist has a doctorate (PhD or PsyD) in the field of clinical psychology, which is the scientific study of all forms of human behavior. Clinical psychologists' training includes an average of five years of graduate training (including a one-year, full-time internship), during which they develop expertise in psychotherapy and in personality and diagnostic assessment. They also have extensive training in personality theory, methods of psychotherapy, and psychological research. The psychologist you work with should be licensed and from an accredited program.

Psychoanalysts are usually either clinical social workers, clinical psychologists or psychiatrists who have had an additional five to eight years of further training in a particular type of psychotherapy called psychoanalysis. This typically involves three to five years of course work and additionally two to five years of intensive clinical work with individuals while under weekly supervision for each patient on a weekly basis. The psychoanalyst may see the patient “on the couch” or sitting up. In addition recently Psychoanalysts are receiving further training in less intensive types of therapy as well.

Child therapists can be members of any of the above group of mental health clinicians. Typically the child therapist will have additional years of training and experience in work with children and adolescents.

A survey of psychotherapy patients published in Consumer Reports showed that as a group, patients had no particular preference for psychotherapists from any of these different fields. Their satisfaction with their therapist was most affected by the level of experience the therapist had, not by his or her academic background. This study suggests that it may be important for you to find out not only about your therapist's credentials, but also how long he or she has been practicing. One of the key issues in the success of treatment is the level of experience the therapist possesses.

You should also be aware that in New Jersey, it is legal for anyone to call him or herself a psychotherapist without having training or a license in one of the accepted fields. Before you start to work with a therapist, find out what degree he or she has and whether it is from an accredited institution. To verify that a therapist's license is up-to-date and in good standing, consult the state board that oversees licenses of mental health practitioners.

How Do I Know if I Would Benefit From Seeing a Psychotherapist?

All of us experience painful feelings at one time or another. Sadness, hopelessness, anxiety, and distress are examples of natural feelings that arise in the course of living. It is normal, for instance, to feel grief when a parent dies. Most students feel anxious before taking exams. In some cases, however, these feelings can begin to overwhelm you, making it hard for you to function normally on a day-to-day basis. If you are crying more than usual, having trouble sleeping or eating, drinking or using drugs excessively, fighting a lot with your spouse or children, having trouble controlling your temper or getting along with other people, then you should seriously consider seeing a therapist.

Most people experience intense emotional reactions during times of particular stress: after losing a job, getting divorced, or becoming widowed. Others, however, find that they have chronic problems adjusting to life, even when they are not in periods of extreme stress. They may have patterns of bad relationships, trouble holding onto jobs, and habitual difficulty getting along with others. Psychotherapy can be helpful for people with these chronic kinds of problems, too.

There are also specific kinds of symptoms that should alert you to the need for professional attention. Hearing disturbing voices of people who aren't present, seeing things that aren't there, feeling terrorized because you believe people are plotting against you, having periods of extreme highs and lows are all signs that evaluation and intervention by a mental health professional would be helpful.

What Qualities Should I Look for in a Psychotherapist?

Once you have decided that you would like to begin psychotherapy, the issue arises of how to choose a therapist who will be able to help you. You will find that therapists vary a great deal in their approaches to problems and in their personal styles.

Good chemistry between patients and their therapists is extremely important. Feeling comfortable talking to your therapist is necessary because to get help, you must share private thoughts and feelings. Therefore, you should look for a therapist who listens closely to what you tell him or her and who responds openly and no defensively. It is part of a therapist's job to evaluate how well the therapy is working for you, so any concerns or questions you have about how your therapy is progressing should be open for discussion. If you feel that your therapist is not being responsive, point that out. One sign of a good therapeutic relationship is a therapist's ability to adapt to the unique concerns of different patients. If the therapist cannot do this, you may want to consider whether he or she is the right one for you.

When choosing a therapist, look for someone who has the ability to express how he or she approaches the therapy process. This would include an articulation of how change occurs and how the two of you will go about working together to bring change about. If you don't understand the process and how your therapist works, it will be more difficult for you to use the therapy effectively.

Another important characteristic to look for in a therapist is high standards for ethical and professional behavior. Generally speaking, psychotherapists who behave professionally keep their personal issues and problems out of the therapy. They avoid dual relationships with their patients, which means that they have only one kind of relationship with the patient-the therapeutic one. They do not have patients who are also students, employees, or personal friends because having other kinds of relationships with patients interferes with the therapist's ability to remain objective.

Therapists start and end sessions on time and scrupulously maintain confidentiality. Ethical therapists give patients clear information about office policies, fees, and what they can expect from therapy. They are up-front and above-board about their rationale and motivations and respond openly to any concerns their patients have. This kind of behavior is essential to having trusting relationships with patients. Without it, psychotherapy cannot be successful.

Conclusion

The most common type of psychotherapy is when one individual meets with a single therapist, although couples and family therapy also are practiced. The term psychotherapist can refer to several different types of professionals: clinical social workers, psychiatrists or clinical psychologists. Psychotherapists can help clients deal with stressful changes in their lives. They also treat more long-term, chronic difficulties of adjustment to life. A good match between you and a psychotherapist is crucial.

I have 10 years of training as a psychotherapist and psychoanalyst and 30 years of experience. Let me bring this training and experience to help you deal with the problems that you are facing so that together we can work to make your life more fulfilling less stressful and more satisfying.

Most of the patients that I see come for psychotherapy and not for psychoanalysis. However, my understanding of how each person comes from a psychoanalytic perspective of human growth, development and functioning. The following is a brief explanation of psychoanalysis.

About Psychoanalysis

What is psychoanalysis?

Psychoanalysis is a therapy based on the observation that individuals are often unaware of many of the factors that determine their emotions and behavior. These unconscious factors may create unhappiness, sometimes in the form of recognizable symptoms and at other times as troubling personality traits, difficulties in work or in love relationships, or disturbances in mood and self-esteem. Because these forces are unconscious, the advice of friends and family, the reading of self-help books, or even the most determined efforts of will, often fail to provide relief.

Psychoanalytic treatment demonstrates how these unconscious factors affect current relationships and patterns of behavior, traces them back to their historical origins, shows how they have changed and developed over time, and helps the individual to deal better with the realities of life.

Will a course of psychoanalysis help me?

Because analysis is a highly individualized treatment, people who wish to know if they would benefit from it should seek consultation with an experienced psychoanalyst.
The person best able to undergo psychoanalysis is someone who, no matter how incapacitated at the time, is basically, or potentially, a sturdy individual. This person may have already achieved important satisfactions - but is nonetheless significantly impaired by long-standing symptoms: depression or anxiety, sexual incapacities, or physical symptoms without any demonstrable underlying physical cause.

Some people come to analysis because of repeated failures in work or in relationships, brought about not by chance but by self- destructive patterns of behavior. Others need analysis because the way they are - their character - substantially limits their choices and their pleasures. Others seek analysis definitively to resolve psychological problems that were only temporarily or partially resolved by other approaches.

Whatever the problem - and each is different - that a person brings to the analyst, it can be properly understood only within the context of that person's strengths and life situation. Hence, the need for a thorough evaluation to determine who will benefit - and who will not - from psychoanalysis.

Is psychoanalysis appropriate for children?

Some psychoanalysts specialize in the analysis of children. Child psychoanalysis – an offshoot of adult psychoanalysis - shares with it a common theoretical framework for understanding psychological life, while also using additional techniques and measures to deal with the special capacities and vulnerabilities of children. For instance, the young patient is helped to reveal his or her inner feelings and worries not only through words, but also through drawings and fantasy play. In the treatment of all but late adolescents, parents are usually consulted to round out the picture of the child's life. The goal of child and adolescent analysis is the removal of symptoms and of the psychological blocks that interfere with normal development.

What will undergoing analysis involve for me, or my child?

Analysis is a partnership between patient and analyst, in the course of which the patient becomes aware of the underlying sources of his or her difficulties not simply intellectually, but emotionally - by re-experiencing them with the analyst. Typically, the patient comes four or five times a week, lies on a couch, and attempts to say everything that comes to mind. This situation, called ‘the analytic setting’, permits the emergence of aspects of the mind not accessible to other methods of observation.

As the patient speaks, hints of the unconscious sources of current difficulties gradually begin to appear - in certain repetitive patterns of behavior, in the subjects, which the patient finds hard to talk about, in the ways the patient relates to the analyst.
The analyst helps elucidate these for the patient, who refines, corrects, rejects, and adds further thoughts and feelings. During the months or years that an analysis takes place, the patient wrestles with these insights, going over them again and again with the analyst and experiencing them in daily life, in fantasies, and in dreams. Patient and analyst join in efforts not only to modify life patterns and remove incapacitating symptoms, but also to expand the freedom to work and to love. Eventually the patient's life - his or her behavior, relationships, sense of self - changes in deep and abiding ways.

What qualifications and experience will my analyst have?

We recommend that you work with an analyst who is a member of the IPA. As a graduate of a psychoanalytic society or association and the IPA, your psychoanalyst is connected to a tradition of training, treatment, scholarship and research that meets exacting standards recognized around the world. You can therefore be sure that you are receiving the highest standards of modern professional psychoanalysis in the Freudian tradition
IPA analysts are graduates of one of its constituent societies or regional association in over 30 countries that together comprise the IPA.

How do I find an IPA psychoanalyst?

The IPA does not recommend individual analysts, but please feel free to contact a local Constituent Organization about finding a suitable analyst. A number of these analysts are capable of conducting analysis in a language other than the principal one of the Constituent Organization.

How can I find out if an analyst is a Member of the IPA or not?

Please email the IPA with the full name of the analyst and the IPA Membership Services team will be able to tell you.

What code of ethics do IPA analysts operate under?

As a member of an IPA component society and the IPA itself, your analyst adheres to a strict codes of ethics at both the national and international level.
Your analyst may also be a member of another health discipline, professional body or educational institution as well as being qualified to practice psychoanalysis.

Who is a psychoanalyst?

All members of the IPA are psychoanalysts. However, legislation regarding who may call himself or herself a "psychoanalyst" varies from country to country and sometimes between regions within a country; so that is some places: anyone, even an untrained person, may use the title. It is therefore important to know the practitioner's credentials before beginning treatment.
Graduate psychoanalysts trained under the auspices of the IPA have had very rigorous and extensive clinical education. Candidates accepted for training at an accredited psychoanalytic institute must meet high ethical, psychological, and professional standards. These candidates are either physicians who have completed a residency program in psychiatry, psychologists or social workers who have completed a doctoral program in their fields or hold a clinical masters degree in a mental health field where such a degree is generally recognized as the highest clinical degree; all must have had extensive clinical experience.

How does psychoanalysis differ from other mental-health therapies? Here are some characteristics that help differentiate this treatment from other forms of psychotherapy:

* Psychoanalysis is not short-term treatment but its results are often lasting with positive effects that are usually realized in the years following the completion of treatment.

* Patients often use the couch, which fosters thinking, emotional experience and self-reflection and allows for privacy and connection in equal measure.

* It is the power of self-understanding in the context of a facilitating therapeutic relationship that allows psychoanalysis to be effective.

* Patients are encouraged to attend frequent sessions during the work week. This allows for continuity and intensity of focus and is not a measure of how severe the problem. Psychoanalysts are specifically trained to work in this intensive, dedicated manner in a close partnership with each patient. A wealth of experience and research has confirmed that this is the best way to help patients evolve and change in meaningful ways.

Child Psychotherapy

Children who have experienced considerable change in their lives or who have survived traumatic events need to express and understand their feelings. Children who have behavioral problems are usually expressing by their behavior the fact that they are experiencing emotional problems they are not able to deal with. These problems may be depression, high anxiety, low self-esteem, anger, fear, feelings of rejection etc. Through the therapeutic use of play and talk, children are given the opportunity to discover and express their feelings in a safe and benign environment. When a child is helped to feel that what they feel can be looked at and they will not be criticized, judged or punished, they can gradually change their feelings and behaviors.

Therapy allows children to internalize the message that they are good and not bad and that they are loved. It enables them to change their negative views of themselves and their families with a more positive healthy feeling. The pain, anxiety, depression , fear will gradually change to where a child will feel more positively towards themselves and better able to deal with the problems both within themselves and within their families.

What children need Child Therapy?

• Children who are dealing with parental conflict, separation or divorce.

• Children who have been traumatized (sexual, physical or emotional abuse).

• Children who have been adopted or are in foster care.

• Children who are dealing with issues of loss, such as illness or death of a loved one.

• Children who have been hospitalized or experienced major illness, accidents or disasters.

• Children who express feelings of low self-esteem, sadness, depression or who may feel that they do not want to live anymore.

• Children who experience high anxiety over issues where this anxiety is not realistic.

• Children who are extremely oppositional, unwilling or unable to behave in appropriate ways given their age and developmental stage.

• Children who do not seem to be able to make or keep friends, are lonely and or isolated.

• Children who are not able to perform academically at their potential.

• Children who have witnessed domestic violence.

• Children diagnosed with Attention Deficit Disorder (ADD/ADHD)

• Children who have experienced serious accidents or disasters.

Signs to be aware of:

• Excessive anger, worry, sadness or fear.

• Aggressive behavior (hurting others or self).

• Inappropriate separation anxiety.

• Excessive shyness.

• Behavioral regression.

• Low self-esteem.

• Learning or other school problems.

• Sleep, eating or elimination problems.

• Preoccupation with sexual behavior.

• Difficulty adjusting to family changes.

• Physical symptoms such as headaches or stomachaches that have no medical cause.

Q & A Questions and Answers

1. I am not sure I need psychotherapy. What should I do?

Come in for the first therapy session, which is also an assessment. Remember: at the end of the assessment, I may agree that you do not need psychotherapy. And if I do think you need psychotherapy, you will have a chance to talk about your doubts or worries and to make a choice. You can always decide against entering therapy.

In my experience, this question sometimes comes from people who are afraid of the emotional risks. If the fear is about the emotional risks or pains, remember that I have 30 years of experience, enough to say with confidence that I will help you past such fears in our first meeting.

2. What is your approach to therapy? And how can I know if you are the right therapist for me?

Come to a session; you can judge and experience for yourself. You will ultimately decide if you want to begin the therapy process with me. In my experience, the answer is almost always yes, but if the answer is no, I will actively work to find you a suitable therapist. There are many good therapists in Bergen County, where I work, and the most important outcome from the assessment process is that you begin to receive the help you need.

3. How do I begin? What happens in the first sessions?

You begin by calling for an appointment and coming to it.
Our first two to four therapy sessions are also an assessment time so I have a clear understanding of the issues and you have a chance to meet me and decide if you are comfortable working with me. The very first session is mostly about why you are seeking therapy now, though we may wander on to other topics. You will have time to ask me questions. I also need to obtain certain information at the end– address, phone number, etc.– and there are a few forms to complete.

If I think I can be of help, I will offer to continue psychotherapy with you beyond these assessment sessions. I will share my initial thoughts about the issues you raised and give you my recommendations. Everyone is different and what you need in regards to therapy will be different from someone else may need. In general, everyone can benefit from a safe confidential talk with a trained therapist they trust who strives to understand them . But on rare occasions, the therapy help you need is not work that I do. I would then explain what kind of therapeutic help you need and where you might get it. I would offer to assist you track down the proper treatment and offer to stay in touch by telephone or in person until you had successfully made the transition to the new treatment. Since most people who see me already know they need psychotherapy, this outcome is uncommon.

4. What happens in a psychotherapy session?

You talk about what is on your mind and I make comments. The basic rule is to simply say what ever comes to mind. thoughts, feelings, sensations, memories, dreams wtc. That may sound pretty bland, or even boring, but actually it should become deeply meaningful and very intense. After all, you are talking about your life.

5. Why come to long-term therapy two to five times a week?

Many people choose long-term psychotherapy to understand themselves in depth and to attempt more fundamental change . In addition, when problems are persistent or severe, long-term psychotherapy is essential. Once a week long-term therapy is a very intense experience but patients who can manage coming more often have a more powerful experience. Considerable energy in once a week therapy goes in to working through the events of the past week; this is important of course, as it is your life. But coming more often enables us to work on the deeper patterns.

6. Most therapists bill for missed sessions—do you? Why do therapists do this?

I do; indeed, every therapist I know does. The reason is simple: when we set up a regular appointment with you, we are giving you exclusive access to that time slot, which is not how other professionals work. Physicians usually work with a waiting room filled with people so if one person is late they just see the next person. Other professionals, such as lawyers or accountants, can fill the cancellation time with other billable work such as work on briefs or tax returns.

The only billable work most therapists do is their time seeing patients and the time we schedule with you is exclusively yours, not available for anyone else. With enough advance notice we can do something productive with the time created by a cancellation but with little or no notice we literally sit in our office waiting for you.

7. Do you provide medication? Do you work with people on medication?

I do not provide medication; a psychiatrist would do this. I am comfortable working with patients on medication. I occasionally refer a patient to a psychiatrist for a medication review.

However, medication does not replace psychotherapy; it should just provide enough relief that the work of psychotherapy continues. I have had many patients who either rejected my suggestion that they see a psychiatrist for a medication review or who did go and then refused medication, and in all these cases, they continued to do very successful work in psychotherapy.