If you have decided you might benefit from working with a therapist, you are not alone; according to the CDC, almost 20% of adults in the U.S. received some type of mental health treatment in 2020.

The first step of course, is finding a therapist you would like to work with, which can sometimes be a frustrating process, but is important to your success. Study after study has shown that the quality of the relationship between therapist and client is the strongest predictor of a good therapeutic outcome. Only you can decide exactly what qualities you would like in a therapist, but no matter what those are, you want to find someone who you can see yourself trusting with what might be some difficult things to talk about.

Sometimes when we are starting a new professional relationship with someone like a doctor, dentist, trainer, or therapist, it can feel like our only choice is to make a first appointment and hope for the best, that is certainly what I’ve experienced myself in the past, and it is because I recognize what a frustrating experience that can be that I offer the chance to meet over the phone, video, or even in-person for an initial no-cost consultation.

During our initial consultation it is a good idea to be ready to give a brief description of what is bringing you to counseling. Based on that, I’ll probably have some basic questions about the history of your issue and what you have tried so far to address it. I will also give you an idea of my experience with your particular issue and some insight into typical treatment approaches. (You can also read more about me here.) Some things you may want to ask are:

• How often will we meet?
  The answer to this will vary based on what you are coming to therapy for, how intense your distress is, and your availability. Meeting once a week is most common, but sometimes meeting more than once a week or only every two or three weeks is a better fit.
• What options are available for meeting?
  My hours are posted on this site, and sometimes special times outside of them can also be arranged. My own feeling is that meeting in person is the preferred way to go, but I do also offer telehealth via a secure, HIPAA-compliant system. I do not offer therapy via text or over the phone.
• What is the payment policy and options?
  I accept major credit cards, check, and Venmo. In pre-arranged cases I am happy to bill third parties for services as well. I do not accept insurance, however if you have out-of-network benefits as part of your plan, I am happy to help you find out if those can cover our work, and provide you with the documentation you need to be reimbursed.

Our first meeting together (after an initial consultation) is what is called an intake session. I understand that clients coming to therapy are anxious to get to work on their issue, and we will talk about it in this initial session, but it is important to get some other information as well. Besides asking you to talk in detail about what is bringing you to counseling I will also ask about your family, health, school, work, and social history. I will be interested to know what strengths you believe you are bringing to counseling, and what your preferences are for meeting and working together. We will also have our first conversation about what the specific goals for our time together should be, and how we are going to measure whether we are making progress.

Once we have had our initial session, we will start to explore the issue that has brought you into therapy. There can be a lot of variability depending on what we are working on, how long we have been working together and where we are in terms of making progress, but a typical session usually goes something like this:

1. Five minutes or so of checking in on how you are generally since the last time we met and if there have been any major changes or events.
2. Picking up where the last session left off, maybe including going over the results of any reflection or “homework” I might have asked you to do. This usually makes up the bulk of our time.
3. Wrapping up by summarizing any insights gained in the session, and talking about where we will pick up the next time we meet.

EMDR sessions have a particular structure of their own, so if we are doing EMDR we will follow that instead.

At the end of the session I may ask you “was this useful?” This isn’t a “gotcha” question, it is important to me that you find our time together valuable and if a session feels to you like it went sideways, I want to know. Sometimes progress can feel slow in coming, especially when we are just starting, but I always want my clients to feel like they are a full partner in the process.

Tell me! I work hard to gauge progress and adjust as needed, but you are the most important judge of whether therapy is helping you. If you feel like things aren’t progressing at the pace you expected or would like, or if it feels like we’re straying off course, please tell me. We will use that conversation to review your goals for therapy and decide how to adjust moving forward.

I believe that successful therapy depends on setting clear, realistic, attainable goals up front. When our time together has a clear objective, it makes it much easier to measure success. It is normal for goals to evolve during the course of working together, and it is also perfectly okay and normal to introduce new goals as we go through the process. As long as we stay clear on what we’re working on, reaching the end will usually be obvious. I love my work, and I do miss clients after our time together is done, but my goal is to help you move forward, not to be your therapist forever.