Facilitating Real, Lasting Change: An Interview with Psychotherapist Ephraim Portnoy

Ephraim Portnoy is an MCSW psychotherapist who currently provides individual and group therapy to patients, in addition to his work at Kiryat HaYeled children’s home in Jerusalem. He previously worked as a social worker at Social Services as well as in private practice. 

What type of psychotherapy do you do? 

I try to fit the therapy to the client. In general, when a client comes with a specific issue, it’s preferable to use evidence-based therapies, such as cognitive-behavioral therapy and its offshoots, such as acceptance-commitment therapy.  

Some believe CBT is superficial and deals with the symptoms rather than the root of the problem; this misconception stems from a superficial understanding of CBT and how it views the roots and sources of our difficulties.   

Sometimes a client might not have a clear, specific problem, he might just be feeling stuck or have a general need to figure things out. In these cases, I would use talk-based therapies, such as object-relationship or other psychodynamic frameworks. These therapies fit better for someone who is looking to develop their self-awareness.  

Often, through talking things through, a client may come to a resolution on his own. Other times, he may choose to tackle some issues that came up through a more focused, CBT- or ACT-based therapy. 

Who are your clients? 

Lately, because of my work, I’ve been seeing mostly teens, but in the past, I’ve worked with adults as well. 

Do teens usually come on their own volition or only when prompted by a parent, teacher or other influential adult? 

They almost always come when prompted to by an adult.  

However, I find it important that the client himself initiate contact with me, even after a parent approaches me. He shouldn’t feel like he’s just being sent by his parent. If the teen doesn’t take an active step asking for help, the therapy ends up being forced. 

I find the same thing applies to men in general. Men don’t usually look for therapy on their own, but I’ll have wives asking me to treat their husbands. I find that if the husband doesn’t afterwards take the initiative to call and ask for help, the therapy ends up feeling forced and is ineffective. 

How long do your clients usually stay with you? 

Contrary to popular belief, if a client has something specific bothering him, then real, lasting change can be achieved in just a few months. However, if a client’s motivation for seeking help is less defined, then they may benefit from more time. 

What are issues that many teens struggle with, that if not addressed will easily follow them into adulthood? 

Teens often struggle with trust issues, the ability to develop relationships based on mutual trust; understanding their place as an individual within society; and with issues involving sexuality. 

How can being in a group cause clients to open up more than they would in an individual session? 

The point of group therapy, or even therapy in general, isn’t necessarily to have someone “open up.” 

In group therapy, the group provides the client an opportunity to become more aware of himself and how he reacts and feels when put into various situations and interactions such as: when he feels like talking and when he feels like listening, what he feels when he hears what other participants are saying, how he feels about the other participants’ reactions to him?  

However, even in one-on-one therapy, a client can learn about himself when he pays attention to how he reacts and feels in his interactions with the therapist. This helps him understand how he works with individuals, especially authority figures. 

In some groups, people struggling with similar issues may bond and come together. When a participant learns how other people are dealing with and reacting to similar situations, it can help him learn more about himself and how he might take a healthier path in dealing with his own struggles. 

In both individual and group therapy, I sometimes help the clients express themselves using games, toys and colors to express how they feel about things. In a group setting, I use games which involve all the participants. 

Who would you not recommend group therapy for? 

I believe that most people will benefit from group therapy, though an issue that might arise is breach of trust. There are very few individuals who would break the trust of a group and they shouldn’t be part of one. 

What do you enjoy most about your work?  

Getting to know people, to empathize with their struggles and growth, the opportunity to have a meaningful role in someone else’s life. 

About Ephraim 

Ephraim Portnoy is a Jerusalem-based psychotherapist trained in CBT and classical psychotherapies who works with teens, adults and couples. 

Ephraim can be reached at 058-528-5228 or 

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