The first few sessions tend to be the most difficult because we are meeting for the first time, and if you struggle with anxiety it can feel like an extra dose. This session is about history gathering and exploration, so I'm inclined to ask a bundle of questions and take more notes than usual. If you are comfortable, we will explore all aspects of your life so I can get a well-rounded picture of you.
It's expected that you complete online intake documents which I'll review on my own time. We also review office policies, confidentiality, privileged communication, therapy guidelines, and expectations - questions and honesty are always welcomed.
This is also a time for you to check-in with your gut and ask, "Is this therapist right for me, will she be able to help me, and do I feel comfortable and safe with her?" If your gut says (no), I will be happy to recommend referrals since the goal is to heal and you might struggle if the relationship feels like oil and water. Also note, if your gut generally has issues with commitment and safety then I highly recommend sharing this during our session together.
For many reasons, you might feel emotional during our sessions together; this is quite normal. You might feel relieved during the first session as if you've laid down some bricks, however, there are more bricks to unload and organize! Some studies show it takes 9 sessions before people begin "to work" - you drive the pace so I'll go as fast as you are ready, willing, and able!
I'm afraid to disclose personal information . . .
Your confidentiality is of utmost importance, anything you share stays in the therapy room between you and me unless there is reason to believe you have intentions of hurting yourself, a child, or vulnerable adult. Plenty of individuals have suicidal ideation; a trip to the hospital isn't always warranted, but we will have a thorough discussion to ascertain your safety and establish a safety plan if needed. If a higher level of safety is determined we'll make that happen, together.
If your files are subpoenaed by a court of law, I will notify you immediately and work to provide only a summary statement of your mental health status rather than your entire file, though I can't guarantee this. Sometimes I consult with a professional mentor regarding treatment, however, it's vague and identifying information is not disclosed.
Dependent on the treatment, goals, and symptoms I might ask you, if willing, to sign a release(s) granting me permission to speak with frequented health care providers, such as a medical doctor, nurse practitioner, dietitian, diabetes specialist, coach, psychiatrist, a sponsor, basically anyone on your support team. Release authorizations expire one year from signing, or you can rescind the authorization anytime with written notice. You will receive advance notice if I contact a provider to coordinate care.
What happens in my office stays in my office. It's like Vegas but without the gambling, gluttony, and endless buffets.
How does therapy work and how many sessions will I need. . .
For some of us, each day can seem like one big trigger to explode, implode, blame, engage in numbing behaviors, or self-rejecting thoughts and avoidance. In fact, these behaviors probably didn't happen over night and will take time and commitment to be free from them.
You are unique in your circumstances, up-bringing, biology, strengths, skills, motivation, and stage of change. Therapy encompasses, unites, and considers ALL parts of you so the exact number of sessions is unknown because of our complexity. It's hard to give an exact time-line
I can't afford therapy . . .
Not everyone can truly afford therapy, therefore limited sliding scale and pro-bono sessions are available though not permanent, this way others can receive the gift of therapy too.
There were times when I thought I couldn't afford therapy, and I had to take a hard look at my expenditures and weigh whether my mental health was more important than my daily dose of soy lattes at fancy coffee shops. I choose mental health and cut down on superfluous debt like eating-out, extra buys from target (stuck to the list), and decided on DIY pedicures - you get the picture.
I'd rather not take medication . . .
I believe self-care in general is good medicine: nutritional food, supplements, proper sleep, and frequent movement is a solid start, however, sometimes it's not always enough. I'm a fan of whole person wellness and may suggest blood work or other testing, and even adjunct modalities such as acupuncture, TMS therapy, ketamine therapy, massage, functional nutrition, yoga, meditation, among others.
Research suggests that use of medication and psychotherapy together may be the best approach, especially for more severe conditions. Generally, medication is often prescribed for conditions known to have strong biological components such as major depression, schizophrenia, bipolar disorder, or panic disorder. Medication offers some relief from symptoms and psychotherapy enables the individual to gain knowledge about their condition and how to better cope or strategize for their particular biology. This combined approach offers the fastest, longest-lasting treatment.