Most people, especially if you have not been in therapy before, are nervous or apprehensive about seeking and then beginning treatment. Many have misperceptions about therapy based on things they've seen on TV or in movies. Important to realize that we are aware you may be nervous, apprehensive, guarded and potentially feeling and thinking many other things. We also understand fully that we will be asking you about many things that may feel very personal and uncomfortable and that you may not feel comfortable answering fully, or even completely honestly at first. Why would you? You don't know us, you are likely feeling vulnerable; that is perfectly normal, okay, and we will talk more about that.

Many who seek therapy find that they feel a little bit better after only a few sessions, and a typical course of treatment is anywhere from three months to a year depending on the frequency of the visits, the individual's goals and initial level of symptoms or difficulties. Some people choose longer term treatment because along the way other issues arise, or they want to do more growth-oriented work.

The first session following the initial consultation typically involves completion of what we call a ''Psychosocial Evaluation'' which essentially is gathering information about why you are seeking treatment at this time, your symptoms/difficulties, and on historical factors in your life. This would include information about any past therapy you've had, your medical history, use of substances or addictive behaviors, family and relationship history, childhood and adolescent experiences, and review of any trauma history. This history helps the therapist better understand what past and present environmental (person-in-their-environment) influences to consider when providing your care. 

Therapy today rarely involves a person lying on a couch while the therapist lets you sit in long silences. Silence is sometimes useful in therapy, and there will be some brief silences (for reflection, thought gathering, allowing space for emotional expression), but most therapy involves a fairly interactive dialogue between client and therapist. -In my office you will find a small couch and a chair and clients typically sit facing me, in the seat of their choosing.

Ongoing Psychotherapy does require some work on your part between sessions such as consideration of topics discussed in your last session, practice of recommended skills or behavioral changes and returning prepared  with items to discuss related to the obstacles or progress toward your goals. Sometimes you may find that you are given actual ''homework'' to try to complete or report back on, but this is not necessarily standard from session to session. There will also likely be times when the therapist raises certain issues, concerns or topics they feel are related to your progress.

Another thing to consider is that not every therapist is for everyone. Like other types of relationships, you may have to meet with a few therapists to find the right fit. All therapists have had clients who didn't feel we were the right fit. We understand this can happen, and it is okay. Of course our goal is to do our best to find a way to match our style and approach to your needs. My advice would be to enter treatment with an open mind and if after a handful of sessions you feel that it might not be a good fit, first try to talk to your therapist about your concerns. Sometimes it simply isn't possible for the therapist to adapt or accommodate, but many times it can be- And besides, raising difficult topics and concerns with your therapist is good practice for other relationships in your life.

Lastly, very few people ever require hospitalization, yet so many people come to therapy worried that they will be thought to be ''crazy'' (a word that therapists basically never use) and that somehow they will be whisked away to a hospital. Nothing could be further from the case. There are actually very limited and specific circumstances that would lead a person to be hospitalized. Essentially these are related to safety and risk concerns, such as if you are having active suicidal or homicidal thoughts with a plan and intention to carry out the plan. -Rest assured, we will fully review disclosures related to these concerns in and/or before our first visit.