Initial Consultation
The first few sessions are initial consultation sessions. I will provide you with a New Patient Form to record your personal history, and I will also review your Psychotherapy Contract with you, outlining your informed consent to treatment. You and I will discuss the reasons you are seeking psychotherapy at this time and the details of your personal history. Along these lines, I will be interested in hearing about the nature and quality of your relationships, both presently and during your childhood, and I will want to learn about your prior experiences in psychotherapy and/or with other kinds of mental health services. We will also discuss any traumatic experiences you may have had, and I will also ask you some questions about your risk for harming yourself or others. Other important things we will talk about include your educational and occupational history, your current and previous substance use, your medical history, legal history, goals for therapy, and anything else you feel is relevant to consider. This information helps me to begin to understand the life circumstances and experiences that have impacted you, and they put your presenting issues for psychotherapy into a very personal and unique context.
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These initial sessions are also used to determine if we would be a good match for one another. Given that the therapeutic relationship between the patient and the therapist is one of the most important tools in psychotherapy work, it is essential that we both feel that we could work together collaboratively and productively. If you or I develop concerns or reservations about this, it is best to voice them during these initial sessions so that we can discuss possible alternatives, which if necessary, may include a referral to another therapist who could better meet your needs.
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Ongoing Sessions
Psychotherapy sessions are generally close to sixty minutes in duration. We will arrange to meet in my office on the same day and at the same time every week. Telehealth sessions are also available via a HIPAA-compliant video chat platform. Sessions may not be scheduled randomly from week to week. New clients will always be seen weekly. Established clients who have seen me for years may wish to downshift to biweekly or monthly sessions as they see fit.
It is natural to feel ambivalent about being in psychotherapy. Part of you may very much want to engage in the process, and another part of you, at the same time, may have urges to withdraw or escape from it. As with any conflict, it is important to give voice to both sides of the felt experience, so I encourage you to talk about any reluctance you may feel along the way.
Furthermore, as you gain access to deeper levels of psychological awareness over the course of our work together, be aware that the psychotherapy process can unleash strong feelings in you, and some of them may be surprising or unpredictable. Because it is human nature to push painful or anxiety-provoking material out of awareness, it is likely that some of your feelings may correspondingly be unpleasant or uncomfortable to experience. Sadness, guilt, shame, anger, resentment, frustration, envy, contempt, loneliness, and helplessness are just as basic to the human condition as more pleasurable feelings are.
For many people, the intense and challenging process of psychotherapy is a worthwhile experience, and you may find at the end of your journey that you have grown in more ways than you had initially imagined. In addition to the relief or reduction of your presenting complaints, some potential areas of growth that you may experience include the development or enhancement of the following psychological capacities*:
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the accurate perception of yourself and your world
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the recognition and healthy management of feelings
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the ability to cope with life difficulties in realistic and constructive ways
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an internal sense of freedom and personal autonomy
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a solid and cohesive identity or sense of who you are
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a reliable and reality-based self-esteem that does not require denigration or inflation
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mature dependency in love and work relationships
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the ability to experience life with an overall quiet serenity and peace of mind, despite its hardships
* McWilliams, N. (1999). Psychoanalytic case formation. New York, NY: Guilford Press.
Attendance Policy
A secure treatment frame is established when sessions are scheduled and attended the same day and time from week to week. When appointments are missed, canceled, or rescheduled, it undermines the security of the treatment frame and detracts from the safety and consistency of regular appointments, a crucial ingredient in the creation of a therapeutic holding environment. It is therefore very important that we both try to keep our regular appointments from week to week as scheduled.
However, I am well aware that situations may arise that may make it impossible for you to keep an appointment as originally planned. For this reason, if you see me weekly, you are permitted to cancel four appointments per year free of charge. If you see me biweekly, you are permitted to cancel two appointments per year free of charge. And if you see me monthly, you are permitted to cancel one appointment per year free of charge. All other appointments that you cancel must be rescheduled at the time of cancellation in order to avoid being personally charged a $50 cancellation fee, as insurance companies do not cover missed sessions. If no such rescheduling is possible, either due to your scheduling limitations or my own, a $50 cancellation charge will nonetheless apply.
Appointments that you miss without prior cancellation (no shows) will always be billed your full session fee because I am prevented from making alternate plans with your time slot. Cancellations must therefore occur prior to the start of the appointment.
Like you, I am also not immune to the life events that require occasional cancellation of sessions. You will, of course, not be billed for any appointments that I may have to cancel, and I will make every effort to reschedule these appointments, if my schedule permits doing so.
Because psychotherapy involves non-verbal communication as well as verbal discussion, it is preferable that our rescheduled sessions be conducted in-person or via video chat. However, phone sessions may sometimes be available for rescheduled sessions in the event that neither in-person nor video chat appointments are possible. Please be aware that phone sessions are typically not covered by healthcare plans, so the cost of a phone session may be yours entirely.
My office is closed on New Year’s Day, Easter, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas. You are free to plan for your holidays and vacations as you wish, bearing in mind that the attendance policy still applies for your vacation time and any holidays that you may observe other than the days mentioned above. Exceptions are made for New Year's Eve and Christmas Eve. You will, of course, not be billed for any vacation days that I may take, and appointments that would have occurred on those days will not be rescheduled.