Getting to Know The Process

Now In Session | Before We Begin Series| Part 1

There is something quietly courageous about showing up for a first therapy session without knowing exactly what is about to happen. Many people show up to their first session and figure it out as they go. Having sat across from that moment more times than I can count, I wanted to offer a chance to know what to expect before you arrive, which is why I developed the Before We Begin series as a way to guide new clients through getting to know the process, from the first few sessions to what to expect me as a therapist.

A Lot of Questions

So what actually happens in that intake? Before we meet, you will complete a brief screening, typically covering anxiety and depression. When we get into the session itself, I will need to gather some specific information, your medical history, mental health history, family history, relationship history, work status, social history, and what brought you in. That sounds like a lot of questions, and it is, but it does not always feel that way. If you are someone who talks, I will let you talk. People who are natural storytellers often answer most of what I need to know just by telling me what is on their mind, and I will weave in questions along the way where they fit naturally. If you are quieter, I will guide us through it more directly. Either way, we get you to where you need to go.

A Clinical Map, Not a Label

There is one part of the intake I want to name directly because it catches some people off guard. In order for insurance to cover therapy, there has to be a clinical reason for treatment. That means part of what I am doing in our intake is gathering enough information to determine whether you meet the criteria for a mental health diagnosis. If you are self-pay, the intake still covers the same ground but without the obligation of a formal diagnosis. Either way, what I am building is a picture of where you are starting from so we have something to work with. And I want to be clear about what a diagnosis means and what it does not mean. In this context it is not a label. It is a clinical map. It tells us where we are starting from and it guides the direction of our work together. Most people who come to therapy meet criteria for something, and that something is usually very human, anxiety, depression, the weight of a life that has been a lot to carry. You are not broken. You are just here.

The Plan

By the time we wrap up the intake, you will leave with a few things. A preliminary diagnosis, a preliminary treatment plan that gives our conversations a direction, a scheduled follow up, and some sense of how often we will meet going forward. You will not leave with answers. That is not what the intake is for. But you will leave with a plan, and sometimes that is exactly what you needed to walk in the door with something to hold onto.

A Boundary to Protect

One more thing worth knowing before we meet. What you share in our sessions is confidential. I will not discuss your information with anyone without your consent, with a few specific exceptions. If you share something that suggests you may be in danger of harming yourself or someone else, or if there is a concern involving the safety of a child, I am legally and ethically required to act on that. I will always be transparent with you about those limits. Confidentiality is not a loophole. It is a boundary designed to protect you, and I take it seriously.

Questions?

And finally, you are allowed to ask questions. About the process, about me, or about anything that comes up. Therapy works better when you feel like a participant rather than a subject. If something I say does not make sense, ask. If you want to know why we are going in a certain direction, ask. This is your time and your work. I am just here to help you do it.

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