How does therapy work?

In the first session, I will gather a lot of information. I will ask about what brings you in, how long it’s been going on, and how it affects your life. I may ask questions about your childhood, family history, medical history, education, career, and hobbies. I will then synthesize this information and use it to build goals with your input. What do you want to change? What would you like to see happen in your life? Once we’ve decided on goals, we will meet at a frequency we decide (usually weekly or bi-weekly) to work on those goals through talk therapy. This involves introspection, conversation, role-playing, and even challenges from me to your thinking and behavior (though I will never challenge your emotions or lived experiences). I may teach you techniques for managing certain symptoms, explore past experiences with you, and utilize media (art, music, stories) to discuss topics. If there is a safety concern, we will collaborate to create a plan. I rarely give “homework” unless you identify that assignments work for you! As therapy continues, we will continue to evaluate how you feel and your progress towards your goals.

If you’re coming in as a couple or non-monogamous relationship structure, the process is pretty much the same! I will collect information on presenting problem, background, and relationship history from all parties in the relationship and goals will be created all together. I may ask for individual sessions with everyone in the relationship for ease of information gathering, though I will not keep secrets from anyone in the relationship.

How long does therapy last?

It really depends! Some people find their issues are resolved with just a few sessions and learned techniques. Some people find they need longer-term ongoing sessions to explore tough experiences and feelings. You and I will continually discuss how things are going and we can discuss termination of services at any time.

Do you give diagnoses?

As an LPCC and LCMHCA, I am qualified to diagnose mental health conditions according to the DSM-TR-5. This resource is published by the American Psychiatric Association and has criteria for recognized mental health conditions. There are pros and cons to diagnosis. Diagnosis can lead to increased self-understanding, strategies for growth, and qualification for services like Americans with Disabilities Act accommodations. On the other hand, diagnosis can be stigmatizing, cause denial of services from insurance, and remains on your insurance record. There is also significant discussion around the cultural sensitivity of these diagnoses, which are created using a Western lens. We will discuss if a diagnosis is necessary and you get to decide if I diagnose or not when using self-pay. If you are using insurance for therapy, a diagnosis is required. I will never make a diagnosis without informing you.

Additionally, there are some diagnoses that require additional evaluation that I am not able to do in private practice (such as autism). I will refer you for additional evaluation while we continue work together in these cases.

Can you prescribe medication?

Nope! For that, you need someone with a medical license such as a medical doctor, nurse practitioner, or psychiatrist. I can help you find a provider if you do not currently have one. Medication, supplements, and treatments like acupuncture and massage can be great additions to psychotherapy. There are a lot of options for wellness!

I’m gender expansive and need a therapist letter for a gender transition service (such as hormone replacement therapy or surgery). Can you provide this?

I absolutely can! I have experience writing these letters and do so at no extra charge beyond the fees for sessions. Current standards indicate that we need an “ongoing counseling relationship” for me to write these letters, so we need to complete a full initial session and at least one subsequent session. Insurance requires a diagnosis of Gender Dysphoria for most transition services. You and I will discuss the pros and cons of this diagnosis before I send off the letter (and you’ll need to sign a form saying I can talk to your doctor). If your transition service requires an additional therapist letter (some surgeries require this), I can refer you to a colleague.

You’re not a good fit for me. Can you refer me to someone else?

Absolutely! I am always happy to provide referrals to other clinicians. Please feel free to contact me using the methods at the footer of this page or the Contact Me page and we can talk referrals at no charge.

I also recommend using directories like Open Path Collective, Inclusive Therapists, and Psychology Today to find therapists. Licenses, specialties, and styles of therapy can be confusing, so feel free to reach out with questions!