You want to know what you’re walking into.
Most therapy profiles are vague on purpose. I find that annoying. Here’s what the process looks like, session by session.
The first few sessions
Session 1
Intake
You start wherever makes sense. What’s bringing you in. I’ll ask questions along the way, get background on your mental health history, family history, and who you are outside of the presenting issue.
By the end, I’ll have a clear sense of whether I’m the right fit for you. And you’ll get a sense of me and whether this is going to click. I’ll share my initial professional impressions and the beginning of what a treatment plan might look like.
It goes both ways. You’re interviewing me too.
Sessions 2–3
Treatment goals
Sometimes session 2 finishes the intake if there’s more ground to cover. Usually it’s where we get into goals — collaboratively, with nuance. I’ll help flesh them out based on what I heard.
By the time you leave session two or three, you’ll have a clear picture of what we’re working on and some sense of what interventions are likely to help. This isn’t a rigid script. It’s a real direction.
Ongoing
Purposeful work
How sessions look from here varies. For OCD work, sometimes they’re structured, planned exposures. For EMDR, planned processing sessions. Most of the time they’re more open, but purposeful: weaving in coping skills, insights, and behavioral strategies toward the goals we set.
Therapy should feel like it’s going somewhere. If it doesn’t, something is wrong and I’ll say so.
What happens between sessions
More than half my clients get between-session work — either specific homework or more general goals. It’s never required. Whether we do it depends on your interest and what you’re working on.
For some presenting issues, it’s more important. ERP for OCD, for instance, is built on practice between sessions. Avoidance between sessions undoes what we do in them.
All homework is mutually agreed. I’m interested in behavior change, but I’m also interested in what might be getting in the way. It’s always collaborative.
How long does this take?
Most of my clients are medium-term. Short-term means under 6 months, usually for a focused issue with a motivated client. Some therapy lasts years, when the work is more complex or when someone wants to use sessions as an ongoing resource.
I monitor goals throughout. When you’ve reached what we set out to do, or you’re making strong progress on your own, we talk about reducing frequency or wrapping up.
Ending therapy doesn’t have to be forever. You can come back for a single tune-up session, a few, or restart when life shifts. I keep my schedule flexible for that.
Common questions
Things people ask before the first session.
Do I have to do homework?
No. Homework is always mutually agreed on and you’re never required to do something you don’t want to do. That said, for some issues, like OCD, between-session practice is where a lot of the real change happens.
What if therapy has never worked for me before?
That’s a really common thing people bring to a first session. Not all therapy is the same, and not every therapist is right for every person. The first session is also about figuring out if I’m the right fit for you.
I know what my problem is. Can therapy still help?
Yes, and this is one of the biggest myths about therapy. Insight isn’t enough. You can think your way to understanding. You can’t think your way to change. The emotional shift, the behavioral changes, the different way of moving through the world — those come from structured work.
Will I be in therapy forever?
Probably not. I don’t let therapy go on indefinitely without goals. When you’ve reached what we set out to do, we wrap up. Ending therapy doesn’t have to be forever. You can always come back.
Do you offer telehealth?
Yes. I see clients in person at my Mission Valley, San Diego office and via telehealth.
Ready to get started?
The first session is intake. Reach out and we’ll go from there.
Request a consultation