What actually happens
Not knowing is its own barrier, so here is the whole thing, in order, with nothing left vague.
Before the appointment
- The consultation
- Fifteen minutes, free, by video. You say what is going on in whatever words you have. We ask a few questions. At the end we tell you honestly whether we are a good fit. If we are not, we will give you names of practices that might be.
- Booking
- If you decide to go ahead, we book the first session. Most people are seen within two weeks.
- Paperwork
- Three forms, by email, roughly ten minutes: a short intake questionnaire, a consent form, and
payment details. The intake asks about your history, current symptoms, any medication, and
whether you have had therapy before.
There is a question about thoughts of suicide or self-harm. It is on the form because it matters, and answering it honestly does not automatically trigger anything. It gives your clinician information they need.
The first session, minute by minute
- The first few minutes
- Introductions, and a short explanation of confidentiality and its limits. We do this out loud rather than pointing at a form.
- Most of the hour
- You talking. What brought you here, what has been going on, how long, and what you have already tried. There is no format you are supposed to follow and there is no wrong place to start. If you cry, that is a normal thing that happens in a first session and there is no need to apologize for it.
- Some questions
- History, health, sleep, alcohol and other substances, support around you, and what you want to be different. Not a checklist read aloud, but we do need the picture.
- The last ten minutes
- Your clinician tells you what they are noticing, what they would suggest, and how often they think you should meet. You get to disagree with that.
- At the end
- We book the next one, or we do not. There is no commitment and no package.
A first session often stirs things up for a day or two.
That is common and it is not a sign that something went wrong.
Afterward
If it feels like more than that, email us and say so.
You are also allowed to decide, after one session, that this person is not right for you. Tell us and we will switch you to the other clinician or refer you out. Nobody will be offended. Fit is most of the work.
What is private, and what is not
What you say in session stays in session. There are four exceptions and they are set by law rather than by us:
- If we believe you are at imminent risk of seriously harming yourself.
- If we believe you are at imminent risk of seriously harming someone else.
- If we have reason to suspect abuse or neglect of a child, an older adult, or a dependent adult.
- If a court orders records released.
If you submit superbills, your insurance carrier will see a diagnosis code and the dates of your sessions. It does not see your notes.
We will talk about all of this in the first few minutes of the first session, and you can ask about any of it at any point.