Going to your first counseling session can be intimidating, especially if you have never been to counseling before. Here are a few general ideas of what you might expect if you’re heading to therapy for the first time: ​ You don’t have to lay on a couch (unless you want to get extra comfy!). Like childbirth, therapy is yet another thing TV and movies get wrong. The ball is completely in your court when it comes to how you make yourself most comfortable while in session. You can sit, stand, lie down, dance a jig—whatever makes you comfortable and more willing to open up. Because the session is held over video, you can wear what you like (as long as its appropriate) and sit where ever you like as long as you are able to focus and be uninterrupted. Bring whatever you need to feel comfortable. Always cold? Bring a sweater. Have a tickle in your throat? Pack some cough drops. The more comfortable you are, the more willing you will be to open up. ​ You’ll fill out some paperwork. To eliminate the time spent on paperwork, I will ask you to fill out your paperwork online via your Client Portal prior to your first session. This also allows me time to become familiar with your situation before your appointment. Consents for tele therapy will be sent prior to your session to ensure that we can engage in our first session. So it is super important that you get these completed prior to your session! ​ You’ll talk over administrative details. HIPAA compliance, payment, scheduling, cancellations, confidentiality—all that good stuff will be covered in your first session. Expect lots of questions in your first session. In the first session you’ll probably do a lot of talking. I like to be engaged and aim to formulate a specific therapeutic plan for you—and that means asking a lot of questions. The session will be a mix of free-flowing conversation and some general questions/history gathering to get started. You will most certainly get the chance to talk about your issues and why you decided to start counseling. ​ You will set some goals/directions for your counseling relationship. Expect to be asked about what goals you have for therapy and why you are there. Together, we will work together to set a path to reach those goals (or maybe adjust the goals if they aren’t realistic or fitting). ​ Your provider will take notes. I may type or hand write notes during a session. This helps me to reflect on the details you voice out loud that may be easy to pass by as conversation flows. However, as your therapist I will still be paying attention to you and am trained to multitask in this arena. ​ Don’t be surprised if you open up more than you expected to. There is something really freeing about being in a room alone with a complete stranger who is encouraging you to speak your mind with the promise of confidentiality. You might be shocked by how freely words start flowing out of your mouth (or tears out of your eyes). Go with it. Crying is good and healing in and of itself; there is research to prove it! Or, you might be tempted to shut down like a clam. That’s okay, too. My job is to figure out what key unlocks you. As long as you are showing up and willing to work, you will eventually get to a place where talking about yourself is easier. Don’t give up! ​ You might leave your session with unfinished business. Therapy isn’t a quick fix. And as noted earlier, a 45-60-minute session can only cover so much. Think of each therapy session as a chapter in a book, not a book in a series. There are countless times where clients will hit a major revelation in the last few minutes of a session. At first, this can feel really frustrating—you just had a breakthrough, and you want to keep talking! But, it’s actually nice to take some time and simmer on the breakthrough. Then, you can come back in the next session ready to really dive deeply into it. You might be exhausted afterward. Therapy can be draining. Of course, the sessions where you are able to get all the bottled up tears/emotions out are more draining than the others, but talking through emotional topics for nearly 60 straight minutes is hard work. Plan accordingly. We wouldn’t recommend scheduling a big presentation for work right after your session. ​ You might get homework. Since your time is limited, I may not be able to get to all the work you might need. You could see the therapy session as “in class” time and followed up with some powerful, self-growth homework activity afterwards. Sometimes this homework can be very academic (“read these two chapters on anxiety management techniques“) and sometimes it can be uncomfortable therapeutic work (“spend 5 minutes a day saying something kind to yourself in a mirror”). Don’t skip this part! ​ It might get worse before it gets better. This is maybe the scariest, but most important, thing to know about starting therapy: it might get worse before it gets better. You have to knock a hole in the wall so light can stream in, and those first few sessions of demolition can be rough. It’s just a fact of therapy. You are going to build something better than you could have ever dreamed, but before you do that, the dirty work has to happen. As therapy goes on, there will be fewer tears, less questioning, and more confidence, we promise. Just hold on.

Your initial intake session will be approximately 60 minutes long. Your following sessions will be 45-60 minutes long, unless requested otherwise. These time increments are standard practice, often referred to as the “therapeutic hour”. (Please note that insurance policies may impact whether you are able to shorten or extend the length of an individual session outside of the standard therapeutic hour.) For children, sessions will last between 30 and 60 minutes depending upon their ability to maintain attention.

As a therapist I am ethically bound to take confidentiality and privacy very seriously. Likewise, the law protects the relationship between client and psychotherapist. Therefore, information cannot be disclosed without a client’s specific written permission. However, there are a few exceptions by law, that you will need to be aware of: Suspected child abuse or dependent adult or elder abuse, for which I am required by law to report immediately to the appropriate authorities. If a client is threatening serious bodily harm to another person or persons, I may notify the police and/or inform the intended victim(s). If a client intends to harm themselves, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures that are provided to me by law in order to ensure their safety. If records are subpoenaed by a court of law, I will first work to obtain a signed authorization/release form from the client. I will release only the minimum relevant and necessary information. If a client objects to the release of records, Myself or the client's attorney may file a motion to quash the subpoena on the basis of protection of client-therapist privilege and the client's privacy. My number one code of ethics is to “do no harm”, and we make every effort possible to protect client information and content of sessions. ​ ​**I also store client data and notes in a HIPAA compliant database.

Length of therapy can vary depending on your specific needs and circumstances. Some people come to therapy with a specific issue or concern, and brief solution-focused therapy may be the right fit. This can last anywhere from six to eight sessions. Some people come to therapy to explore issues that seem to run a little deeper. They might engage in therapy for several months or even years. However, at any time that you feel the therapeutic relationship is no longer benefiting you, please speak with me and I will refer you to someone you may feel is better suited for you! Please know that I do not take this personally and am here to help you find the perfect person suited to help you on your journey!

I am able to offer HIPAA compliant and secure teletherapy sessions. These can be conducted from the comfort of your own home. However, FaceTime, Skype, Google Duo, phone, and email for therapy use is not HIPAA compliant and therefore not an ethical way to conduct your sessions. My clients' privacy and confidentiality is a top priority.

No way! Therapy is not just “talking about your problems”; it is also working toward solutions. Some therapy can involve homework, such as tracking your moods, writing about your thoughts, or participating in social activities that have caused anxiety in the past. You will be encouraged to look at things in a different way or learn new ways to react to events or people. I aim to help you cope with feelings, problem solve, and change behavioral or thinking patterns that may contribute to your symptoms. We may engage in mindfulness activities, guided visualizations, art activties, and for children, play therapy activties.

As a trained mental health professional, I assume there will always be SOMETHING my client doesn’t want to tell me. I get it. Sharing the inner most workings of your life is hard. However, I offer a judgment-free and safe therapeutic space. So, the answer is YES. Please tell your provider everything, as you feel comfortable. That is when the best work happens.

Psychotherapists are not licensed to prescribe medication. However, I often can detect the need for medicinal intervention and will refer clients to providers able to assist them in that process of their treatment.

Even the best therapist in the world gets only a snapshot of a teen’s behavior and mood in 30-60 minutes a week. To round out the picture, I aim to set time aside for regular check-ins with the teen's caretaker. How are anxiety management skills translating from therapy to home and school? How is your child responding to their medication? Do you see signs of your teenager's depression worsening? Was there a major meltdown your child may not have mentioned in therapy? Parent feedback provides a richer and more accurate picture of their child’s needs. Whether or not parents sit in on sessions depends on the age of the child and the nature of the treatment. However, I do expect that parents/guardians are still the coaches, the ones who drive treatment at home. The takeaway: For your child to get the most out of treatment, you’ll need to monitor your child closely, know which skills are being worked on and how to reinforce them outside the office in everyday life. I may provide background reading material, online resources, education, and/or offer parent support groups. You can also ask to meet for a full session without the child present. These collaborative sessions may also be covered by insurance, allowing you to discuss issues and care in greater depth.

I understand that parents can be desperately in need of support but sometimes lack adequate childcare. While I encourage you to attend your sessions alone, I know that this may not always be feasible. Therefore, I do make exceptions. I believe it is better in some cases to have a session with your child there, than have no session at all. As for age limits, if the child is at full capacity for understanding language, then it would not be wise for them to be privy to their parents’ therapy session, particularly if emotions are high. Children can absorb negative energy and emotion if they sense their parent(s) are distressed. However, tone over topic can sometimes protect against this and I insist on being very mindful around young children in a session. If you are desiring couples therapy, I can provide referrals in this case. Once you are my client, it becomes difficulty to maintain neutrality when a spouse/partner joins sessions for couples therapy. However, I will allow a spouse, or partner to join a session if it it for psychoeducational purposes. I will assist this person during the session to understand your mental health/life stressors and discuss ways in which this person can support you while at home. The same is true with bringing a friend to sessions. Otherwise, I prefer that you are located in a secure location during sessions where you are able to speak freely. That means driving in your car with your entire family present would be a no go and we would need to reschedule your session. Attempt to schedule sessions when you know you are able to be in a quiet place with no interruptions. This also helps to protect confidentialty. When others are around to hear what you are speaking about, confidentialty becomes compromised.

If therapy was only about paying someone to let you vent or chat with them, it would be a waste of money. But conversation is only the surface layer of therapy, and the conversations you have with a therapist will be a far cry from anything you’ll experience with a friend. Here are some aspects of therapy that provide long-term value and go beyond the kind of chatting you could do with a friend: Learning how to better manage emotions Challenging negative beliefs that negatively affect your life Learning new perspectives on situations and people Learning how to improve good relationships and avoid toxic ones Identifying negative and positive behaviors, decisions and patterns Understanding how your past is affecting the present Reducing symptoms of mental illness Preventing the development of mental illnesses Learning therapeutic techniques such as breathing techniques and/or progressive muscle relaxation Learning to be more authentic and understand who you are Therapists are professionally trained through accredited schools of psychology and counseling and complete a required number of supervised hours in a clinical environment. Additionally, professional counselors pass one or more examinations required by the state in which they practice providing competent and effective therapy. Therapists are not your friend and that can be a good thing! Some of the reasoning behind this is that unlike what you would typically find with friends, with therapists, you as the client can be more open with therapists there is no need to fear being judged. Therapists have no emotional stake in the situation, so they can provide unbiased guidance. Our therapists will also keep the relationship professional rather than becoming attached in a way that could negatively affect the quality of treatment. ​Friends don’t want to judge, but it’s hard for them to resist. They haven’t spent years training to refrain from judgment. If you share something intense, even a sensitive friend might react in a way that hurts your feelings. It is also common to find that friends become attached to you. They sometimes want to be on your side, even if that means missing the opportunity to help. Friends are supposed to listen and provide emotional support, but you might feel guilty if you vent to them for an hour or more every week. They’re not being compensated for that time, and they might need to shift their schedule so they can chat for so long. Then there’s the guilt you might feel about laying complex problems and emotions on someone who doesn’t have the training to handle it. Because friends don’t have the skills therapists do, listening to intense issues and trying to help might be stressful for them. With a therapist, you are paying him or her to listen and help you. The hour belongs to you!

The reality is that most therapists are not able to see 40 clients per week. That would mean 40 hours of face time every week, plus paperwork, creating treatment plans, returning phone calls, preparing for sessions, and all the other things your provider is required to do by law. Consider where your money actually goes when you make an investment in self-improvement. There are rent and utilities for the office space, which are a market all to themselves. Use of Hippa Compliant databases, email, and health record systems are also an additional cost due to use of teletherapy. As a therapist I also stay abreast on the latest research and information you may need. Aside from the minimum required continuing education hours (as required by my licensure), there are seminars, workshops, webinars, books, and journals that provide the ongoing knowledge and practice needed to stay sharp and effective in helping others make positive changes in their life. When working with children I may also provide materials for our sessions. Think back to how you found your therapist. Perhaps you heard from a friend or family member how amazing their therapist had been for them and decided to make that call for yourself. Maybe you searched the Internet to find a website or Psychology Today listing. These also come at a cost. Let’s talk education. Unless you are meeting with Lucy from the Peanuts cartoon,therapists have to be trained somewhere — ideally, an accredited graduate school. Post-secondary education is an expensive endeavor. It is also one of the most necessary endeavors in a growing, competitive job market. Approximately 70 percent of Americans borrow money via student loans to pay for college or graduate school (US News.com, 2014), and spend up to 10 or more years paying them off. In summary, the hourly rate for your therapist has to cover quite a bit. What’s left over from the above-mentioned necessities goes toward paying personal and family expenses and the occasional leisure activity. The helping profession can be quite exhausting. Like you, therapsists also need amenities for unwinding, recharging, and coping with life’s difficulties. I encourage you to do some of your own research to feel confident about your financial investment in therapy, if you'd like. What makes Me, as a therapist, so special? Years and years of refining my skills and expertise, with a lot of unconditional compassion. Trust Me, your sessions will be worth every penny.