What to expect:
The approach I use is a humanistic approach. My job is to ask questions and teach the client to ask themselves questions. I work to help people listen to themselves, ask themselves questions without judgement, and love whatever comes out unconditionally. That is what I ask of myself in our sessions so I will be asking that of you too.
What is an initial assessment:
Our initial assessment is a biopsychosocial assessment meaning we collect information on physical, mental, and social health and functioning. Health and functioning mean different things for different people. We are here to collect your perspective on what that means to you. We will also provide a perspective of what it means to scientific studies or therapist’s experience. That does not mean the provided prospective is the “right” one! It is often not! The client is the expert on themselves and their definition is absolute truth in sessions. The alternative perspective is an attempt to provide all information possible to client to make the most informed and examined decisions for themselves.
A biopsychosocial assessment can be client driven or therapist driven. I can ask structured questions about specific topics or you can share what you feel is most important for me to know. Important things to share in an assessment: what your relationships with others look like, ongoing physical ailments or history on ongoing problems like chronic pain, diarrhea, migraines, etc, previous experiences in therapy, any current or previous substance use or substance use treatment, what your eating and sleeping look like and what is “normal” to you.
Ideally the therapist is able to connect to your perspective in an initial assessment to mutually identify 1. What is the problem? 2. When do I know the problem is gone or better enough to end therapy?
Handling any issues with sessions:
Sometimes technical difficulties or miscommunications will happen. In either case, I’d like you to let me know. If you aren’t able to see my video well or at all, let me know. If our audio connection is choppy, or if you feel at any time in our work together that I respond to you in a way that feels uncomfortable, I want this to feel like a space where that can happen.
Sometimes people don’t have access to a place to practice skills like conflict resolution. The people closest in their life may not have that skill or maybe they don’t have close people in their life to practice with. I like to make this a place where we can practice those things. This is a place where we do hard things, like saying the hard thing.
As a place where we say the hard thing, there may be things we’re scared to say because who is this person going to tell. Things like suicide, violence against others, or illegal activity can feel scary to bring up but they do sometimes come up. And sometimes I do have to tell someone.
The times that I am legally required by my license to tell someone what you say:
Are the following: risk of suicide, risk of harm to someone identifiable, and any implication of harm to children. Let’s talk about what those things are and what they aren’t. Risk of suicide is not thoughts about suicide or death. Thoughts of suicide or thoughts around death are topics that are important to explore and this is where we do that. The fact that you’re experiencing thoughts does not mean you are at risk of suicide. It does mean that we are going to ask more questions. Risk of suicide means currently experiencing a combination of thoughts of suicide, intent to act on thoughts, and access to means to act on thoughts. We will ask questions about the thoughts and if those other pieces come up, we’ll note it and talk about it. If we see all of those pieces add up over the conversation, we’ll talk about next steps.
Next steps can include creating a crisis plan and reaching out to emergency contact, a higher level of care like meeting more often or an Intensive Outpatient Program, or it could mean a temporary in-patient hospitalization.
Things we avoid at all costs for in-patient hospitalization: any police involvement, choices for facility/medical resource used being made by the therapist, being rushed into a step without assistance with creating an actionable plan for how that step will be completed and what to expect afterwards.
Other Disclosures:
There may be other times when information is shared with other professionals for example: your prescriber if experiencing side effects or new symptoms presenting or a fellow therapist or supervisor for your therapist to continually evaluate with outside perspectives their ethical behavior and what is in the best interest of the client. Information shared with prescribers, new referrals, or a workplace will always be discussed with you in advance. You will decide what information specifically is shared and what will not be shared. You are able to decline consent for sharing information at any time in those cases.
Information shared with a colleague or supervisor does not require consent. Information is protected as much as possible by removing any identifying information including: name, age, area in which they live, and sometimes race, gender or sex if not relevant. The most minimal information possible is shared in those cases but it is important for your therapist to be evaluating things like suicide assessment, conflict resolution with clients, approaches or progress with clients to maintain perspective on client’s best interest.
If that is all okay with you, you will provide an emergency contact and the name and location of your medical provider or prescriber in the initial assessment.
Fees for Cancellation or No-Shows:
I value my time and experience so I do charge for late cancellations and no shows. The charge is 50% of the cost of the session. A late cancellation is notice within 24 hours of scheduled appointment time. A no-show is an appointment where the client has not joined the video link within 10 minutes of scheduled appointment time.
If at any time you have questions, concerns, thoughts or feelings you want to share about your therapist, those are always free to discuss at any time in session or you can submit concerns here as well – Contact