What to expect when you begin therapy.
Starting therapy, especially for the first time, or after a long break, can feel like a big unknown. This page walks you through exactly what happens before, during, and after your first session with me, so there are no surprises. And remember: before any of this, we start by scheduling a free 15 minute consultation, a no-pressure conversation to see if we’re a good fit.
Does therapy help?
Therapy works! In my experience working with many people over the years I’ve had the privilege of witnessing the power of therapy. I’ve felt the benefits from these tools in my personal life as well. To see improvement in therapy you need two things:
Evidence-based approaches: In my work, I rely heavily on tools from research-based strategies such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Exposure and Response Prevention (ERP), Gottman Method, and Thomas Gordon’s Effectiveness Training. Research has shown that these approaches work for improving or alleviating symptoms in many people.
Effort by the client to implement the strategies outside of the therapy session: I use evidence-based approaches with all of my clients, but some feel better quickly and for others it takes much longer. Why? The clients who consistently apply the tools outside of our therapy sessions see much quicker progress, and it is more likely to persist beyond their graduation from therapy. Better yet, they have a toolbox of strategies to help themselves through other life challenges in the future.
Some specific skills we can work on
- Caring for yourself: prioritizing yourself and making time in your schedule for your own care; improving self-love, self-confidence, and body image; understanding your strengths and learning to quiet your inner critic.
- Managing emotions and stress: emotion regulation for anger, jealousy, grief, anxiety, and depression; nervous system regulation to calm your body under stress; stress-management techniques for everyday life, work, and family.
- Facing what you’ve been avoiding: coping strategies for situations that typically trigger anxiety, fear, grief, or avoidance; problem-solving skills for the moments you’d usually back down like social situations, asking for help, speaking up; resolving the specific issues that brought you to therapy, like panic attacks or sleepless nights.
- Relationships and boundaries: communication and listening skills; building secure attachment; learning to set and maintain boundaries; reducing codependent and people-pleasing patterns.
Curious whether we’re a good fit? Schedule a free 15 minute consultation today.
What to expect in your first online session
The practical part first: all of my sessions are held by secure, HIPAA-compliant video. Before your first appointment you’ll receive a link. All you need is a private space, a device with a camera, and a decent internet connection. Headphones help with privacy if others are home. If technology hiccups, we troubleshoot together or switch to phone. Clients tell me that being in their own space actually made opening up easier.
Our first meeting is all about getting to know each other. I’ll ask you a lot of questions to get a better understanding of the symptoms and issues you’re currently experiencing, your background, and previous experiences that could be influencing the issues you are facing today. This includes information about your lifestyle, your relationships, your childhood, and your career. I will also review some of the important information from the intake paperwork so you are clear on all of the legal and ethical aspects of therapy. There is a lot to cover, and sometimes we will need to continue the discussion in our second meeting to make sure we don’t miss anything important.
This first session is also a time for you to get to know me. If you have any questions about my approach or background, please feel free to ask. For therapy to be successful, it is important that we establish a supportive and honest relationship. You’ll be more likely to meet your goals and see results if you feel good about working with me. While the specific goals may differ from person to person, in general you can expect the following:
- To be treated with compassion, respect, and understanding.
- Someone who listens to you, and to your interpretation of what you’re experiencing.
- Knowledgeable, scientifically backed techniques and information to help you overcome your struggles.
- A safe, supportive, and confidential space.
- Real strategies and techniques you can use to make positive changes in your life.
In the second or third sessions we will work together to set goals for therapy. I have a very collaborative and open approach to treatment planning, because I find it’s helpful for both of us to be clear about what we are setting out to accomplish. We’ll discuss the specific things you want to work on, and put numbers to those goals so that we can track your progress over time. Every few months we will revisit the goals to track your progress and adjust course if needed.
Whatever brings you here, the first visit works the same way: you bring your story, and I bring my full attention. That’s true for pregnancy or postpartum struggles, infertility, pregnancy loss, PMDD, perimenopause, OCD, chronic illness, or something you don’t have a name for yet.
I look forward to getting to know you and helping you reach your therapy goals.
Is therapy confidential?
As a general rule, all therapy sessions are confidential and anything you discuss with your therapist will remain between the two of you, unless you request otherwise. This confidentiality is protected by law, and no information from the session can be disclosed without prior written consent from the client.
There are exceptions to this law, however, and the therapist can disclose information from the session to legal authorities or appointed persons if any of the following are true:
- The therapist suspects abuse to a child, dependent adult, or an elder. These situations all require the therapist to notify protective services or law authorities immediately. Please note that “sexting” images of minors counts as child abuse and must also be reported to authorities.
- If the therapist suspects an individual has caused, or is threatening to cause, severe bodily harm to another person, therapists are required to report it to the police.
- If an individual intends to harm himself or herself, expressing to the therapist, for example, plans for suicide. While the therapist will attempt to work through this in the therapy session, if it appears to be unresolved or the client does not cooperate, additional action may need to be taken to ensure the safety of the client. This could include calling the client’s emergency contact on file and/or mental health emergency services.
A note on online sessions: confidentiality extends to the technology, too. I use a HIPAA-compliant video platform for all sessions, and I meet with you from a private space. On your end, you control your environment. Many clients use headphones, a parked car, or a closed door to keep their side of the conversation private. Public places like cafes or your living room with family members in the background are not good places for therapy. Also, it is not safe to take therapy while driving your car because you can’t give your full attention to the road when you are thinking about potentially heavy therapy topics.
Ready for your first visit?
The hardest step is usually the first message. Everything after that, we figure out together.
Schedule a free 15 minute consultation today.
“The future depends entirely on what each of us does every day. After all, a movement is only people moving.”
– Gloria Steinem